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TITLE 22EXAMINING BOARDS
PART 15TEXAS STATE BOARD OF PHARMACY
CHAPTER 291PHARMACIES
SUBCHAPTER DINSTITUTIONAL PHARMACY (CLASS C)
RULE §291.72Definitions

The following words and terms, when used in this subchapter, shall have the following meanings, unless the context clearly indicates otherwise.

  (1) Accurately as prescribed--Distributing and/or delivering a medication drug order:

    (A) to the correct patient (or agent of the patient) for whom the drug or device was prescribed;

    (B) with the correct drug in the correct strength, quantity, and dosage form ordered by the practitioner; and

    (C) with correct labeling as ordered by the practitioner and required by rule.

  (2) Act--The Texas Pharmacy Act, Chapters 551 - 566 and 568 - 569, Occupations Code, as amended.

  (3) Administer--The direct application of a prescription drug by injection, inhalation, ingestion, or any other means to the body of a patient by:

    (A) a practitioner, an authorized agent under his supervision, or other person authorized by law; or

    (B) the patient at the direction of a practitioner.

  (4) Automated compounding or counting device--An automated device that compounds, measures, counts and/or packages a specified quantity of dosage units of a designated drug product.

  (5) Automated medication supply system--A mechanical system that performs operations or activities relative to the storage and distribution of medications for administration and which collects, controls, and maintains all transaction information.

  (6) Board--The State Board of Pharmacy.

  (7) Clinical Pharmacy Program--An ongoing program in which pharmacists are on duty during the time the pharmacy is open for pharmacy services and pharmacists provide direct focused, medication-related care for the purpose of optimizing patients' medication therapy and achieving definite outcomes, which includes the following activities:

    (A) prospective medication therapy consultation, selection, and adjustment;

    (B) monitoring laboratory values and therapeutic drug monitoring;

    (C) identifying and resolving medication-related problems; and

    (D) disease state management.

  (8) Confidential record--Any health-related record that contains information that identifies an individual and that is maintained by a pharmacy or pharmacist, such as a patient medication record, prescription drug order, or medication drug order.

  (9) Consultant pharmacist--A pharmacist retained by a facility on a routine basis to consult with the facility in areas that pertain to the practice of pharmacy.

  (10) Controlled substance--A drug, immediate precursor, or other substance listed in Schedules I - V or Penalty Groups 1 - 4 of the Texas Controlled Substances Act, as amended, or a drug, immediate precursor, or other substance included in Schedules I - V of the Federal Comprehensive Drug Abuse Prevention and Control Act of 1970, as amended (Public Law 91-513).

  (11) Dangerous drug--A drug or device that:

    (A) is not included in Penalty Group 1, 2, 3, or 4, Chapter 481, Health and Safety Code, and is unsafe for self-medication; or

    (B) bears or is required to bear the legend:

      (i) "Caution: federal law prohibits dispensing without prescription" or "Rx only" or another legend that complies with federal law; or

      (ii) "Caution: federal law restricts this drug to use by or on the order of a licensed veterinarian."

  (12) Device--An instrument, apparatus, implement, machine, contrivance, implant, in vitro reagent, or other similar or related article, including any component part or accessory, that is required under federal or state law to be ordered or prescribed by a practitioner.

  (13) Direct copy--Electronic copy or carbonized copy of a medication order, including a facsimile (FAX) or digital image.

  (14) Dispense--Preparing, packaging, compounding, or labeling for delivery a prescription drug or device in the course of professional practice to an ultimate user or his agent by or pursuant to the lawful order of a practitioner.

  (15) Distribute--The delivery of a prescription drug or device other than by administering or dispensing.

  (16) Distributing pharmacist--The pharmacist who checks the medication order prior to distribution.

  (17) Downtime--Period of time during which a data processing system is not operable.

  (18) Drug regimen review--

    (A) An evaluation of medication orders and patient medication records for:

      (i) known allergies;

      (ii) rational therapy--contraindications;

      (iii) reasonable dose and route of administration;

      (iv) reasonable directions for use;

      (v) duplication of therapy;

      (vi) drug-drug interactions;

      (vii) drug-food interactions;

      (viii) drug-disease interactions;

      (ix) adverse drug reactions; and

      (x) proper utilization, including overutilization or underutilization.

    (B) The drug regimen review may be conducted prior to administration of the first dose (prospective) or after administration of the first dose (retrospective).

  (19) Electronic signature--A unique security code or other identifier which specifically identifies the person entering information into a data processing system. A facility which utilizes electronic signatures must:

    (A) maintain a permanent list of the unique security codes assigned to persons authorized to use the data processing system; and

    (B) have an ongoing security program which is capable of identifying misuse and/or unauthorized use of electronic signatures.

  (20) Expiration date--The date (and time, when applicable) beyond which a product should not be used.

  (21) Facility--

    (A) a hospital or other patient facility that is licensed under Chapter 241 or 577, Health and Safety Code;

    (B) a hospice patient facility that is licensed under Chapter 142, Health and Safety Code;

    (C) an ambulatory surgical center licensed under Chapter 243, Health and Safety Code; or

    (D) a hospital maintained or operated by the state.

  (22) Floor stock--Prescription drugs or devices not labeled for a specific patient and maintained at a nursing station or other hospital department (excluding the pharmacy) for the purpose of administration to a patient of the facility.

  (23) Formulary--List of drugs approved for use in the facility by the committee which performs the pharmacy and therapeutics function for the facility.

  (24) Full-time pharmacist--A pharmacist who works in a pharmacy from 30 to 40 hours per week or if the pharmacy is open less than 60 hours per week, one-half of the time the pharmacy is open.

  (25) Hard copy--A physical document that is readable without the use of a special device (i.e., data processing system, computer, etc).

  (26) Hot water--The temperature of water from the pharmacy's sink maintained at a minimum of 105 degrees F (41 degrees C).

  (27) Institutional pharmacy--Area or areas in a facility where drugs are stored, bulk compounded, delivered, compounded, dispensed, and distributed to other areas or departments of the facility, or dispensed to an ultimate user or his or her agent.

  (28) Investigational new drug--New drug intended for investigational use by experts qualified to evaluate the safety and effectiveness of the drug as authorized by the Food and Drug Administration.

  (29) Medical Practice Act--The Texas Medical Practice Act, Subtitle B, Occupations Code, as amended.

  (30) Medication order--A written order from a practitioner or a verbal order from a practitioner or his authorized agent for administration of a drug or device.

  (31) Number of beds--The total number of beds is determined by the:

    (A) number of beds for which the hospital is licensed by the Texas Department of State Health Services; or

    (B) average daily census as calculated by dividing the total number of inpatients admitted during the previous calendar year by 365 (or 366 if the previous calendar year is a leap year).

  (32) Part-time pharmacist--A pharmacist either employed or under contract, who routinely works less than full-time.

Cont'd...

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