EXAM 3 Lecture 15 Flashcards
Citing Indiana Code
IC Title-Article-Chapter-Section
Citing Indiana Administrative Code
Title IAC Article-Chapter(rule)-Section
Definition of Sale
(1) Manufacturing, processing, transporting, handling, packing, or other production, preparation, or repackaging
(2) Exposure, offer, or any other proffer
(3) Holding, storing, or any other possession
(4) Dispensing, giving, delivering, or any other supplying
(5) Applying, administering, or any other using
Unconventional Examples of a sale
Placing legend drug outside the pharmacy in a publicly accessible area
Administering a medication to a patient
Transporting a drug from one pharmacy to another
Practitioners according to Indiana Code
Physician
Veterinarian
Dentist
Podiatrist
Optometrist
Advanced practice nurse
Physician Assistant
Practitioners according to Indiana Code that can do Generic Substitution
Physician
Dentist
Podiatrist
Optometrist
Advanced Practice Nurse
Physician Assistant
The big four prescribers
Physicians
Dentists
Podiatrist
Veterinarians
What are advanced practice registered nurses?
Nurse practitioners
Certified Nurse midwives
Clinical nurse specialists
Must work under: physician, podiatrist, or dentist
APRN prescribing
must apply for prescribing authority and have a collaborative practice agreement
APRNS are limited to prescribing within scope and specialty of supervising practitioner
Can prescribe controls, but need DEA and CS registration
Physician Assistants
More limitations than APRNs
Must work with a supervising physician (no other practitioner)
Must be directly supervised by a physician in person
Physician Assistant Prescribing
Can only prescribe things directly delegated by collaborative practice agreement on file with medical licensing board of Indiana
CANNOT prescribe opthalmic devices under any circumstances, and cannot prescribe or admin general anesthesia or deep sedation
Need DEA and CSR for controls
Optometrists
Can prescribe independently without supervising practitioner but may only do so according to a formulary: Three Tiers
Independent prescribing
Dependent prescribing by notification: must notify patients PCP
Dependent prescribing by consult: consult with patients PCP
Optometrists Prescribing Formulary
- Any legend drug for treatment of the eye or associated structures of the eye
- All formulary drugs may be independently prescribed by an optometrist
- Controlled substances as defined in IC 35-48-1 are prohibited use by an optometrist
Indiana code says, “An optometrist who:
1. holds a license under this article
2. meets the requirements of this chapter for certfication to admin, dispense, or prescribe a legend drug
3. maintains a CSR under IC 35-48-3
may prescribe Tramadol
When there is a direct conflict between administrative code and indiana code, which should you follow?
Follow Indiana Code
Optometrist Prescribing
You may NOT fill a prescription written by an optometrist who IS NOT licensed in Indiana
Pharmacists as Independent Prescribers
Pharmacists are not recognized, but they have limited independent prescribing authority in Indiana.
Can prescribe the following:
Inhalation Spacer
Nebulizer
Supplies for Medical Devices
Normal Saline and sterile water for irrigation
Diabetes blood sugar testing supplies
Pen needles
Syringes for medication use
Hormonal Contraceptives
Pharmacists Statewide standing orders
Auto-Injectable Epinephrine
Vaccines
Naloxone
Tobacco Cessation
Pharmacists Protocols
May act as prescribers under a collaborative practice agreement
Outside of a hospital, pharmacists may enter a protocol with:
a physician, an APRN, a PA
as long as the protocol is signed by a physician and applies to a single patient or a group of patients –> specified by the physician
Can you fill a prescription written by a pharmacist who is not licensed in Indiana?
NO
Other midlevel practitioners:
naturopaths, dieticians, chiropractors, etc
are not providers in Indiana
you may not fill a prescription by these midlevel providers
