| (II) if transmitted by a designated agent, the name
of the designated agent; and
(xi) if issued by an advanced practice nurse or physician
assistant in accordance with Subtitle B, Chapter 157, Occupations
Code:
(I) the name, address, telephone number, and if the
prescription is for a controlled substance, the DEA number of the
supervising practitioner; and
(II) the address and telephone number of the clinic
where the prescription drug order was carried out or signed; and
(xii) if communicated orally or telephonically:
(I) the initials or identification code of the transcribing
pharmacist; and
(II) the name of the prescriber or prescriber's agent
communicating the prescription information.
(B) At the time of dispensing, a pharmacist is responsible
for documenting the following information on either the original hardcopy
prescription or in the pharmacy's data processing system:
(i) the unique identification number of the prescription
drug order;
(ii) the initials or identification code of the dispensing
pharmacist;
(iii) the initials or identification code of the pharmacy
technician or pharmacy technician trainee performing data entry of
the prescription, if applicable;
(iv) the quantity dispensed, if different from the
quantity prescribed;
(v) the date of dispensing, if different from the date
of issuance; and
(vi) the brand name or manufacturer of the drug or
biological product actually dispensed, if the drug was prescribed
by generic name or interchangeable biological name or if a drug or
interchangeable biological product other than the one prescribed was
dispensed pursuant to the provisions of the Act, Chapters 562 and
563.
(C) Prescription drug orders may be utilized as authorized
in Title 26, Part 1, Chapter 554 of the Texas Administrative Code.
(i) A prescription drug order is not required to bear
the information specified in subparagraph (A) of this paragraph if
the drug is prescribed for administration to an ultimate user who
is institutionalized in a licensed health care institution (e.g.,
nursing home, hospice, hospital). Such prescription drug orders must
contain the following information:
(I) the full name of the patient;
(II) the date of issuance;
(III) the name, strength, and dosage form of the drug
prescribed;
(IV) directions for use; and
(V) the signature(s) required by 26 TAC §554.1506
(relating to Drug Orders).
(ii) Prescription drug orders for dangerous drugs shall
not be dispensed following one year after the date of issuance unless
the authorized prescriber renews the prescription drug order.
(iii) Controlled substances shall not be dispensed
pursuant to a prescription drug order under this subparagraph.
(8) Refills.
(A) General information.
(i) Refills may be dispensed only in accordance with
the prescriber's authorization as indicated on the original prescription
drug order except as authorized in paragraph (10) of this subsection
relating to accelerated refills.
(ii) If there are no refill instructions on the original
prescription drug order (which shall be interpreted as no refills
authorized) or if all refills authorized on the original prescription
drug order have been dispensed, authorization from the prescribing
practitioner shall be obtained prior to dispensing any refills and
documented as specified in subsection (l) of this section.
(B) Refills of prescription drug orders for dangerous
drugs or nonprescription drugs.
(i) Prescription drug orders for dangerous drugs or
nonprescription drugs may not be refilled after one year from the
date of issuance of the original prescription drug order.
(ii) If one year has expired from the date of issuance
of an original prescription drug order for a dangerous drug or nonprescription
drug, authorization shall be obtained from the prescribing practitioner
prior to dispensing any additional quantities of the drug.
(C) Refills of prescription drug orders for Schedules
III-V controlled substances.
(i) Prescription drug orders for Schedules III-V controlled
substances may not be refilled more than five times or after six months
from the date of issuance of the original prescription drug order,
whichever occurs first.
(ii) If a prescription drug order for a Schedule III,
IV, or V controlled substance has been refilled a total of five times
or if six months have expired from the date of issuance of the original
prescription drug order, whichever occurs first, a new and separate
prescription drug order shall be obtained from the prescribing practitioner
prior to dispensing any additional quantities of controlled substances.
(D) Pharmacist unable to contact prescribing practitioner.
If a pharmacist is unable to contact the prescribing practitioner
after a reasonable effort, a pharmacist may exercise his or her professional
judgment in refilling a prescription drug order for a drug, other
than a Schedule II controlled substance, without the authorization
of the prescribing practitioner, provided:
(i) failure to refill the prescription might result
in an interruption of a therapeutic regimen or create patient suffering;
(ii) the quantity of prescription drug dispensed does
not exceed a 72-hour supply;
(iii) the pharmacist informs the patient or the patient's
agent at the time of dispensing that the refill is being provided
without such authorization and that authorization of the practitioner
is required for future refills;
(iv) the pharmacist informs the practitioner of the
emergency refill at the earliest reasonable time;
(v) the pharmacist maintains a record of the emergency
refill containing the information required to be maintained on a prescription
as specified in this subsection;
(vi) the pharmacist affixes a label to the dispensing
container as specified in §291.33(c)(7) of this title (relating
to Operational Standards); and
(vii) if the prescription was initially filled at another
pharmacy, the pharmacist may exercise his or her professional judgment
in refilling the prescription provided:
(I) the patient has the prescription container, label,
receipt or other documentation from the other pharmacy that contains
the essential information;
(II) after a reasonable effort, the pharmacist is unable
to contact the other pharmacy to transfer the remaining prescription
refills or there are no refills remaining on the prescription;
(III) the pharmacist, in his or her professional judgment,
determines that such a request for an emergency refill is appropriate
and meets the requirements of clause (i) of this subparagraph; and
(IV) the pharmacist complies with the requirements
of clauses (ii) - (vi) of this subparagraph.
(E) Natural or man-made disasters. If a natural or
man-made disaster has occurred that prohibits the pharmacist from
being able to contact the practitioner, a pharmacist may exercise
his or her professional judgment in refilling a prescription drug
order for a drug, other than a Schedule II controlled substance, without
the authorization of the prescribing practitioner, provided:
(i) failure to refill the prescription might result
in an interruption of a therapeutic regimen or create patient suffering;
(ii) the quantity of prescription drug dispensed does
not exceed a 30-day supply;
(iii) the governor of Texas has declared a state of
disaster;
(iv) the board, through the executive director, has
notified pharmacies that pharmacists may dispense up to a 30-day supply
of prescription drugs;
(v) the pharmacist informs the patient or the patient's
agent at the time of dispensing that the refill is being provided
without such authorization and that authorization of the practitioner
is required for future refills;
(vi) the pharmacist informs the practitioner of the
emergency refill at the earliest reasonable time;
(vii) the pharmacist maintains a record of the emergency
refill containing the information required to be maintained on a prescription
as specified in this subsection;
(viii) the pharmacist affixes a label to the dispensing
container as specified in §291.33(c)(7) of this title; and
(ix) if the prescription was initially filled at another
pharmacy, the pharmacist may exercise his or her professional judgment
in refilling the prescription provided:
(I) the patient has the prescription container, label,
receipt or other documentation from the other pharmacy that contains
the essential information;
Cont'd... |
