NMBOP: 16.19.04 PHARMACIST

Question 1

Define

A year

Answer 1

“A year” begins with the pharmacist’s birth month and ends the last day of the pharmacist’s birth month the following year

Question 2

Define

“Accredited Provider”

Answer 2

An institution, organization or agency that has been recognized by the Accreditation Council for Pharmacy Education, in accord with its policy and procedures, as having demonstrated compliance with the standards which are indicative of the Provider’s capability to develop and deliver quality continuing pharmacy education.

Question 3

Define

“Activity”

Answer 3

as used in the ACPE criteria for quality and these regulations, the term refers to an individual educational experience or program such as a lecture, home study course, workshop, seminar, symposium, etc.

Question 4

Define

“Alternate supervising physician”

Answer 4

means a physician who holds a current unrestricted license, is a cosignatory on the notification of supervision, agrees to act as the supervising physician in the supervising physician’s absence, or expand the “scope of practice or sites of practice” of the pharmacist clinician and is approved by the board.

Question 5

Define

“Consultation”

Answer 5

means communication in person, telephonically, by two-way radio, by e-mail or by other electronic means.

Question 6

Define

“Contact hour”

Answer 6

means a unit of measure equivalent to 60 minutes of participation in an approved organized learning experience or activity

Question 7

Define

“Continuing professional development (CPD)”

Answer 7

means the responsibility of individual pharmacists for systematic maintenance, development and broadening of knowledge, skills and attitudes, to ensure continuing competence as a professional, throughout their careers.

Question 8

Define

“Criteria for quality”

Answer 8

means continuing education provider shall show evidence of adherence to the criteria adopted by the American council on pharmaceutical education as indicative of the ability to provide continuing pharmaceutical education activities; areas include: administrative and organization; budget and resources; teaching staff; educational content management of activity; method of delivery; facilities; evaluation mechanism.

Question 9

Define

“Dangerous drug”

Answer 9

means a drug that, because of any potentiality for harmful effect or the methods of its use or the collateral measures necessary to its use, is not safe except under the supervision of a provider licensed by law to direct the use of such drug and the drug prior to dispensing is required by federal law and state law to bear the manufacturer’s legend “Caution: Federal law prohibits dispensing without a prescription;” or “Caution: federal law restricts this drug to use by or on the order of a licensed veterinarian.”; or “Rx only.”

Question 10

Define

“Guidelines or protocol”

Answer 10

means a written agreement between a pharmacist clinician or group of pharmacist clinicians and a physician or group of physicians that delegates prescriptive authority.

Question 11

Define

“Initial pharmacist licensure”

Answer 11

means the license issued shall be valid for no less than 24 months. The license will expire the last date of his/her birth month that immediately follows the minimum 24 month time period.

Question 12

Define

“Live programs”

Answer 12

means CPE activities that provide for direct interaction between faculty and participants and may include lectures, symposia, live teleconferences, workshops, etc.

Question 13

Define

“Oversight committee”

Answer 13

means a joint committee made up of four members to hear issues regarding pharmacist clinicians’ prescriptive authority activities and supervising physicians’ direction of these activities.

Question 14

Define

“Monitor dangerous drug therapy”

Answer 14

“Monitor dangerous drug therapy” means to review the dangerous drug therapy regimen of patients by a pharmacist clinician for the purpose of evaluating and rendering advice regarding adjustment of the regimen. “Monitor dangerous drug therapy” includes:

(1) collecting and reviewing patient dangerous drug histories;
(2) measuring and reviewing routine patient vital signs including pulse, temperature, blood pressure and respiration;
(3) ordering and evaluating the results of laboratory tests relating to dangerous drug therapy, including blood chemistries and cell counts, controlled substance therapy levels, blood, urine, tissue or other body fluids, culture and sensitivity tests when performed in accordance with guidelines or protocols applicable to the practice setting and;
(4) evaluating situations that require the immediate attention of the physician and instituting or modifying treatment procedures when necessary.

Question 15

Define

“Pharmaceutical care”

Answer 15

means the provision of drug therapy and other patient care services related to drug therapy intended to achieve definite outcomes that improve a patient’s quality of life, including identifying potential and actual drug-related problems, resolving actual drug-related problems and preventing potential drug-related problems.

Question 16

Define

“Pharmacist clinician”

Answer 16

means a pharmacist with additional training required by regulations adopted by the board in consultation with the New Mexico medical board and the New Mexico academy of physician assistants, who exercises prescriptive authority in accordance with guidelines or protocol.

Question 17

Define

“Patient safety”

Answer 17

means the prevention of healthcare errors and the elimination or mitigation of patient injury caused by healthcare errors.

Question 18

Define

“Pharmacist in charge”

Answer 18

means a pharmacist who accepts responsibility for the operation of a pharmacy in conformance with all laws and rules pertinent to the practice of pharmacy and the distribution of drugs and who is personally in full and actual charge of the pharmacy and its personnel.

Question 19

“Practice of pharmacy” means continually optimizing medication safety, patient wellness, and quality of services through the effective use of pharmaceutical care and emerging technologies and competency-based and performance-based training. The practice of pharmacy may include:

Answer 19

(1) Pharmaceutical dispensing including product selection.

(2) specialty pharmacy practice including pharmacists working for licensed pharmaceutical manufacturers or wholesalers;

(3) practice of telepharmacy within and across state lines;

(4) engaging in health care educational activities;

(5) pharmacy-specific academia;

(6) provision of those acts or services necessary to provide pharmaceutical care in all areas of patient care including patient counseling, prescriptive authority, drug administration, primary care, medication therapy management, collaborative practice, and monitoring dangerous drug therapy;

(7) inspecting on a full time basis to ensure compliance with the practice of pharmacy;

(8) provision of pharmaceutical and drug information services, as well as consultant pharmacy services;

(9) engaging in other phases of the pharmaceutical profession including those with research or investigational or dangerous drugs;

(10) engaging in functions that relate directly to the administrative, advisory, or executive responsibilities pursuant to the practice of pharmacy in this state;

(11) the responsibility for compounding and labeling of drugs and devices;

(12) the proper and safe storage of drugs and devices; and

(13) the maintenance of proper records.

Question 20

Define

“Practitioner”

Answer 20

means a health care provider duly authorized by law in New Mexico to prescribe dangerous drugs including controlled substances in schedules II through V.

Question 21

“Prescriptive authority”

Answer 21

means the authority to prescribe, administer, monitor or modify dangerous drug therapy.

Question 22

“Professional judgment”

Answer 22

means a cognitive process, by alicensed pharmacist, that takes education, experience and current standards of practice into consideration when drawing conclusions and reaching decisions.

Question 23

“Renewal period”

Answer 23

means continuing education programs or activities must be completed during the 24 month time period occurring between the last day of the pharmacist’s birth month and the last day of his/her birth month 2 years later.

Question 24

“Scope of practice”

Answer 24

means those duties and limitations of duties placed upon a pharmacist clinician and includes the limitations implied by the field of practice of the supervising physician and/or the alternate supervising physician(s) and the board.

Question 25

“Supervising physician”

Answer 25

means a doctor, or group of doctors, of medicine or osteopathy approved by the respective board to supervise a pharmacist clinician; and includes a physician approved by the medical board as an alternate supervising physician.

Question 26

Question: What constitutes “gross immorality” and how does it affect licensure?

Answer 26

Answer:
- Gross Immorality: Defined as a felony conviction involving disqualifying criminal offenses, including:
- Murder
- Criminal sexual offenses (including against minors)
- Sexually oriented material harmful to minors
- Sexual exploitation of children
- Robbery, fraud, embezzlement, extortion, forgery, receiving stolen property
- Identity theft, dealing in credit cards, fraudulent use of credit cards
- Criminal solicitation, racketeering, Medicaid fraud, abuse or neglect of care facility residents
- Money laundering, human trafficking, tampering with monitoring devices
- False statements in claims for payment
- Fourth or subsequent DUI conviction

• Considerations:
  
  • The board will not consider other criminal convictions unless they are specifically listed.
  • The board may still deny or discipline based on conduct violating pharmacy laws or related acts, even if not convicted of a listed crime.
  • The board will not use records of arrests without valid convictions, sealed/expunged/pardoned convictions, juvenile adjudications, or convictions not listed as disqualifying.

Decisions are made in accordance with the Uniform Licensing Act.

Question 27

Question: What constitutes “unprofessional or dishonorable conduct” for a pharmacist?

Answer 27

Unprofessional or dishonorable conduct by a pharmacist includes, but is not limited to:

1. Violations:
   
   • Pharmacy Act provisions
   • Board regulations
   • Drug and Cosmetic Act
   • Controlled Substances Act
2. Professional Conduct Failures:
   
   • Failure to adhere to federal, state, and local laws and regulations
   • Poor maintenance and security of the pharmacy or practice area
   • Acquiring prescription stock from unlicensed sources
   • Breaching confidentiality regarding patrons and prescriptions
3. Compromising Professional Services:
   
   • Participating in plans that reduce the quality of professional services or public health
   • Soliciting prescription business by providing prescribers with pre-printed blanks or pre-selected medications (except in specific cases like inpatient settings or therapeutic interchange)
   • Soliciting prescriptions not initiated by the patient or practitioner (except for therapeutic interchange)
4. Reporting Failures:
   
   • Not reporting theft or loss of controlled substances
   • Not reporting an impaired licensee
5. Inadequate Supervision:
   
   • Failing to properly train or supervise supportive personnel
6. Legal and Disciplinary Issues:
   
   • Conviction or legal agreements for violations of related acts
   • Disciplinary actions by other licensing agencies
7. Prescription Handling:
   
   • Dispensing dangerous drugs without an established practitioner-patient relationship (with exceptions for specific situations such as partner therapy, on-call practitioners, public health emergencies, naloxone dispensing, and immunization programs)
   • Dispensing dangerous drugs with knowledge or reasonable suspicion that the prescription was issued based on an internet-based consultation without a valid practitioner-patient relationship
8. Drug Review Failures:
   
   • Not performing or documenting a prospective drug review as required

Each of these actions may lead to disciplinary measures or other consequences as determined by the board.

Question 28

Notecard 1: General Continuing Pharmacy Education Requirements

Question: What are the general requirements for continuing pharmacy education (CPE) in New Mexico?

Answer 28

• CPE must cover areas like socioeconomic and legal aspects of health care, properties and actions of drugs, disease state therapeutics, and other board-approved subjects.
• Approved CPE must be from ACPE, accredited providers, board-approved programs, or pharmacy law programs offered by the board.

Question 29

Notecard 2: CPE Requirements for Renewal

Question: What are the CPE requirements for renewing a pharmacist license in New Mexico?

Answer 29

• Every two years: 3.0 CEU (30 contact hours)
• Live Programs: Minimum of 1.0 CEU (10 contact hours) excluding law requirement, through ACPE or ACCME-approved programs. Other providers may be acceptable with board approval.
• Patient Safety: Minimum of 0.2 CEU (2 contact hours) per renewal period.
• Pharmacy Law: Minimum of 0.2 CEU (2 contact hours) per renewal period from the New Mexico board of pharmacy.
• Opioid Use: Minimum of 0.2 CEU (2 contact hours) on safe opioid use effective January 1, 2015. Programs addressing both patient safety and opioid use can satisfy both requirements.

Question 30

Notecard 3: CEU Award and Out-of-State CPE

Question: How are CEUs awarded and what about out-of-state CPE?

Answer 30

Answer:

• CEU Awarding: The accredited provider determines the CEUs in advance of the activity.
• Out-of-State CPE: Accepted if the provider was approved by ACPE at the time of the program.

Question 31

Notecard 4: CPE for Inactive Status and New Licenses

Question: What are the CPE requirements for inactive licensees and new licensees in New Mexico?

Answer 31

• New Licensees: Exempt from CPE requirements.
• Inactive Licensees: Must provide 1.5 CEU for each year of inactivity to reinstate to active status.

Question 32

Question: What happens if a pharmacist fails to meet CPE requirements?

Answer 32

• Audit: At least 10% of registrants are randomly audited annually.
• Penalties:
  Fine of at least $1000.
  Required to complete deficient CPE within a time frame set by the board

Question 33

Notecard 6: CPE Documentation and Board Hearing

Question: What if a pharmacist cannot provide proof of CPE compliance upon renewal?

Answer 33

The board will offer an opportunity for a hearing pursuant to the Uniform Licensing Act

Question 34

Notecard 7: Pharmacy Law CPE Requirements

Question: What are the specific CPE requirements for pharmacy law?

Answer 34

Answer:

• Active Status: Minimum of 0.2 CEU (2 contact hours) of the 3.0 CEU required for renewal must be in pharmacy law offered by the board. Alternatively, an - - ACPE accredited course in pharmacy law is acceptable for non-residents or non-practitioners in New Mexico.
• Board Meetings: Licensees can earn 0.1 CEU (1 contact hour) per year by attending a full day of a New Mexico board meeting or serving on a board-approved committee.

Question 35

Notecard 8: Board of Pharmacy Law Programs

Question: What are the details of board pharmacy law programs?

Answer 35

Answer:

Program Details: Board law programs offer 0.2 CEU and are two contact hours in length.

Question 36

CONSULTANT PHARMACIST:

A. Duties and responsibilities:

Answer 36

(1) To abide by the code of ethics of the American Society of Consultant Pharmacists. Must be qualified to practice as a consultant pharmacist and is to be aware of all federal and state drug laws, rules and regulations related to pharmacy services, and to provide the facility with current information pertaining to drug service.

(2) Ensure that drugs are handled in the facility in which he/she is the consultant pharmacist, in a manner that protects the safety and welfare of the patient.

(3) Set the policies and procedures in the facility as related to all facets of drug handling and distribution; these policies and procedures to be reviewed and updated on an annual basis.

(4) To visit the facility, commensurate with their duties, as specified by board regulations relative to the facility or by written contract with the administration of the facility not inconsistent with board regulations.

(5) His/her primary goal and objective shall be the health and safety of the patient, and he/she shall make every effort to assure the maximum level of safety and efficacy in the provision of pharmaceutical services.

(6) The consultant pharmacist shall not condone or participate in any transaction with any practitioner of another health profession, or any other persons whosoever under which fees are divided, or rebates or kickbacks paid or caused to be paid, or which may result in financial exploitation of patients or their families in connection with the provision of drugs and medication or supplies or pharmaceutical services.

Question 37

Consultant pharmacist serving skilled nursing facilities and intermediate care facilities - upper level care - long term care facilities by any other title
.
Question: What are the key duties of a consultant pharmacist serving skilled nursing or intermediate care facilities?

Answer 37

• Committees: Serve on and attend appropriate committees.
• Drug Control Manual: Develop drug control procedures manual.
• Drug Distribution Monitoring: Routinely monitor all aspects of the drug distribution system.
• Pharmacist Status: Maintain active pharmacist status registration.
• Destruction of Drugs: Handle the destruction or removal of unwanted dangerous drugs and controlled substances.
• Log Maintenance: Keep logs of visits and activities available for inspection.
• Emergency Drug Supply: Provide and maintain an emergency drug supply, with logs of use and replacement.
• Routine Inspections: Inspect drug storage areas and patient health records monthly; report irregularities to medical staff.
• 24/7 Pharmacy Services: Ensure pharmacy services are available 24/7, including stat orders.
• In-Service Training: Provide or arrange for staff training as outlined in the procedures manual.
• Additional Responsibilities: Meet all other consultant pharmacist responsibilities as set by board regulations and laws.

Question 38

Consultant pharmacist serving skilled nursing facilities and intermediate care facilities - upper level care - long term care facilities by any other title
.
Notecard 4: Repackaging and Return of Medications

Question: How should repackaging and returning of patient medication packages be handled?

Answer 38

• Repackaging: When drugs are added or discontinued, repackaging is allowed. Drugs returned must be reused or properly disposed of.
  Return to Stock:
  ——Multi-Drug Containers: May not be returned to stock.
  ——Single-Drug Containers:
  ———–Non-Institutional: Cannot be returned.
  ———–Institutional: May be returned if conditions are met (sealed, properly labeled, expiration adjusted, no Schedule II drugs).

Question 39

Consultant pharmacist serving skilled nursing facilities and intermediate care facilities - upper level care - long term care facilities by any other title
.
Notecard 3: Customized Medication Packages

Question: What are the guidelines for customized patient medication packages?

Answer 39

• Creation: Pharmacists can create customized medication packages with consent from the patient, caregiver, prescriber, or institution.
• Guidelines: Follow guidelines for labeling, packaging, and record-keeping from the United States Pharmacopoeia.

Question 40

Consultant pharmacist serving skilled nursing facilities and intermediate care facilities - upper level care - long term care facilities by any other title
.
Question: What are the requirements for agreements when a consultant pharmacist provides services to a facility?

Answer 40

• Local Pharmacist: If the consultant is not nearby, they must have a local “co-consultant” pharmacist available for emergencies.
• Agreement Documentation: File agreements with the facility and maintain a copy. Report terminations within 10 days.
• Alternative Procedures: If no local pharmacist is available, provide an alternative procedure approved by the board for drug and pharmacy services.

Question 41

Consultant pharmacists serving custodial care facilities:
.
Question: What are the duties of a consultant pharmacist in custodial care facilities?

Answer 41

• Facility Definition: Serves any facility providing ongoing care to two or more residents not related to the operator, and which maintains custody of residents’ drugs.
• Licensing: Facilities must be licensed by the board and engage a consultant pharmacist as outlined in regulations.
• Drug Procurement: Medications must be procured based on a licensed practitioner’s prescription. Refills can be requested by the facility’s administrator or designee.
• Receipt of Drugs: The administrator or a designated employee must sign for prescription drugs upon delivery.
• Storage: Prescription drugs must be stored in a locked cabinet or room with the key assigned to a designated employee or administrator.

Question 42

Consultant pharmacists serving custodial care facilities:
Question: What are the storage and record-keeping requirements for custodial care facilities?

Answer 42

• Storage Requirements:
  Prescription drugs must be stored in a locked cabinet or room.
  Stock dangerous drugs allowed: tuberculin testing solution, CDC-recommended vaccines, and naloxone.
• Records Maintained by Consultant Pharmacist:
  Incoming medications (including refills)
  Record of administration
  Waste or loss records (patient log meeting board requirements)

Question 43

Consultant pharmacists serving custodial care facilities:
.
Question: What are the requirements for medication labeling and the procedures manual in custodial care facilities?

Answer 43

Labeling: Prescription containers must be properly labeled according to regulations.
Bulk Containers: Bulk containers of legend drugs are not allowed, except in facilities with 24-hour licensed nursing.
Procedures Manual: Must include:
Name of individuals responsible for medication assistance.
Procedures for receipt, storage, record-keeping, maintenance of patient profiles, administration, and accountability of legend drugs.
Procedures for removal and destruction of unwanted, outdated, or recalled drugs (controlled substances handled per regulations).

Question 44

Consultant pharmacists serving custodial care facilities:
.
Question: What are the training, visit, and emergency procedures requirements for consultant pharmacists in custodial care facilities?

Answer 44

Training: Consultant pharmacist must train facility staff responsible for medication administration, including handling adverse reactions and special dietary needs.
Patient Profiles: Maintain a patient profile on each individual if applicable.
Facility Visits: Visit the facility at least once a quarter or more frequently as needed. Maintain a log of visits, activities, and irregularities available for state drug inspectors.
Emergency Availability: Be available in emergencies as needed.

Question 45

No drug that has been dispensed pursuant to a prescription and has left the physical premises of the facility licensed by the board shall be dispensed or reused again except the re-labeling and reuse of pharmaceuticals may be permitted in the following situations: in a correctional facility, licensed by the board, under the following circumstances dangerous drugs, excluding controlled substances, may be re-used:

Answer 45

(1) the patients must reside in the same facility;

(2) the reused medication must have been discontinued from the original patient’s drug regimen;

(3) the drug was never out of the possession of the licensee “keep on person” pharmaceuticals may never be reused;

(4) the drugs were originally dispensed in packaging that is unopened, single-dose or tamper-evident containers;

(5) the patient receiving the re-labeled medication must have a valid prescription/order for the medication that is to be reused;

(6) repackaging and re-labeling may only be completed on site by the consultant pharmacist designated for that facility.

Question 46

The consultant pharmacist must maintain records at the facility for three years containing the following information:

Answer 46

(1) date when the re-labeling occurred;

(2) the name and ID of the patient for whom the medication was originally intended for and the date in which it was discontinued from his or her drug regimen;

(3) the name and ID of the patient who will receive the reused medication;

(4) the name, strength and amount of the medication being reused;

(5) the name of pharmacist re-labeling the medication;

(6) pursuant to 16.19.10.11 NMAC the pharmacist must label the reused pharmaceutical and maintain a dispensing log for all such re-issued pharmaceuticals and the expiration date for such re-issued drugs shall be no greater than fifty percent of the time remaining from the date of repackaging until the expiration date indicated on the original dispensing label or container.

Question 47

Notecard 1: Applicability of Impaired Licensee or Registrant Regulations

Question: To whom does the section on impaired licensee or registrant apply?

Answer 47

Answer:
- Applicability: This section applies to:
- All licensed/registered externs
- Interns
- Pharmacists
- Any other board licensee/registrant
- Applicants for licensure or registration
- Definition: For this section, the term “licensee” includes:
- All individuals licensed/registered by the board of pharmacy
- Applicants for license or registration

Question 48

Impaired Licensee or Registrant Regulations

Procedures:
(1) Impaired licensee reporting:

Answer 48

(a) If any person knows that a licensee is impaired, that person shall report any relevant information either to the board-contracted treatment program or to the board.

(b) When the board receives an initial report relating to an alleged impaired board licensee, the board may:

(i) refer the licensee to the examining committee who may require evaluation by the board-contracted program and require enrollment if recommended; or
(ii) refer the licensee to the board-contracted program with required enrollment if recommended; or
(iii) file a complaint to initiate disciplinary action.

Question 49

Impaired Licensee or Registrant Regulations

Notecard: Disciplinary Sanctions and Board Referral

Question: What is the process for a licensee whose license or registration has been suspended or revoked to be considered for reinstatement after completing a board-approved treatment program?

Answer 49

Answer:
- Requirement: After successfully completing a board-approved treatment program, the licensee must appear before the board as a condition for consideration of reinstatement.
- Documentation: The licensee must provide:
- Documentary evidence from the contracted treatment program
- Proof that the licensee has reached recovery and may be allowed to practice without endangering the public

Question 50

Impaired Licensee or Registrant Regulations

Confidentiality: The names of voluntary participants in the program and records relating to their referral and treatment are confidential provided, however, that this information may be disclosed:

Answer 50

(a) in a disciplinary hearing before the board and in court proceedings arising therefrom;

(b) to the board and to the pharmacist’s licensing/disciplinary authorities of other jurisdictions in accordance with law;
(c) pursuant to an order of a court of competent jurisdiction;

(d) in injunctive proceedings brought by the board; and
(e) as otherwise provided by law.

Question 51

CHANGE OF ADDRESS: Any registrant or licensee shall report in writing any change of address or employment to the board within _______________

Answer 51

10 days

Question 52

Notecard: Active Status for Pharmacists

Question: What are the requirements for a pharmacist to obtain and maintain an active status license?

Answer 52

Answer:
- Competency: The pharmacist must maintain and demonstrate competency through ongoing development of knowledge, skills, and aptitude.
- Documentation: Records of continuing education or continuous professional development must be kept and available for inspection by the board or its agents.
- Application: An active status license is issued upon proper application and payment of fees.

Question 53

Notecard: Inactive Status for Pharmacists

Question: What are the conditions and requirements for a pharmacist with inactive status?

Answer 53

Answer:
- Issuance: A pharmacist who has not practiced pharmacy for two or more years can obtain an inactive status license by applying properly and paying the required fees.
- Reactivation: To return to active status after two or more years of inactivity, the pharmacist may need to:
- Complete an internship training program.
- Provide evidence of continuing education related to pharmacy practice.
- Follow the requirements outlined in Sections 61-11-6 and 61-11-13, and board regulations.

Question 54

RESPONSIBILITIES OF PHARMACIST AND PHARMACIST INTERN:

A. The following responsibilities require the use of professional judgment and therefore shall be performed only by a pharmacist or pharmacist intern:

Answer 54

(1) receipt of all new verbal prescription orders and reduction to writing;

(2) initial identification, evaluation and interpretation of the prescription order and any necessary clinical clarification prior to dispensing;
(3) professional consultation with a patient or his agent regarding a prescription;

(4) evaluation of available clinical data in patient medication record system;

(5) oral communication with the patient or patient’s agent of information, as defined in this section under patient counseling, in order to improve therapy by ensuring proper use of drugs and devices;

(6) professional consultation with the prescriber, the prescriber’s agent, or any other health care professional or authorized agent regarding a patient and any medical information pertaining to the prescription;

(7) drug regimen review,

(8) professional consultation, without dispensing, will require that the patient be provided with the identification of the pharmacist or pharmacy intern providing the service.

Question 55

RESPONSIBILITIES OF PHARMACIST
Only a pharmacist shall perform the following duties:

Answer 55

(1) final check on all aspects of the completed prescription including sterile products and cytotoxic preparations, and assumption of the responsibility for the filled prescription, including, but not limited to, appropriateness of dose, accuracy of drug, strength, labeling, verification of ingredients and proper container;

(2) evaluation of pharmaceuticals for formulary selection within the facility;

(3) supervision of all supportive personnel activities including preparation, mixing, assembling, packaging, labeling and storage of medications;

(4) ensure that supportive personnel have been properly trained for the duties they may perform;

(5) any verbal communication with a patient or patient’s representative regarding a change in drug therapy or performing therapeutic interchanges (i.e. drugs with similar effects in specific therapeutic categories); this does not apply to substitution of generic equivalents;

(6) any other duty required of a pharmacist by any federal or state law.

Question 56

Patient records.

(1) A reasonable effort must be made to obtain, record and maintain at least the following information:

Answer 56

(1) A reasonable effort must be made to obtain, record and maintain at least the following information:
(a) name, address, telephone number, date of birth (or age) and gender of the patient;
(b) individual medical history, if significant, including disease state or states, known allergies and drug reactions and a comprehensive list of medications and relevant devices; and
(c) pharmacist’s comments relevant to the individuals drug therapy.
.
(2) Such information contained in the patient record should be considered by the pharmacist or pharmacist intern in the exercise of their professional judgment concerning both the offer to counsel and the content of counseling.

Question 57

Prospective drug regimen review.

(1) Prior to dispensing any prescription, a pharmacist shall review the patient profile for the purpose of identifying:

Answer 57

(a) clinical abuse/misuse;
(b) therapeutic duplication;
(c) drug-disease contraindications;
(d) drug-drug interactions;
(e) incorrect drug dosage;
(f) incorrect duration of drug treatment;
(g) drug-allergy interactions;
(h) appropriate medication indication.
.
(2) Upon recognizing any of the above, a pharmacist, using professional judgment, shall take appropriate steps to avoid or resolve the potential problem. These steps may include requesting and reviewing a controlled substance prescription monitoring report or another states’ reports if applicable and available, and consulting with the prescriber and counseling the patient. The pharmacist shall document steps taken to resolve the potential problem.

Question 58

PMP

Question: Why is it important for a pharmacist to obtain and review a PMP report when presented with an opioid prescription?

Answer 58

Answer: Obtaining and reviewing a PMP report can help the pharmacist identify issues or problems that put the patient at risk of prescription drug abuse, overdose, or diversion. The pharmacist should use professional judgment based on prevailing standards of practice to determine whether to obtain and review a PMP report before dispensing an opioid prescription and must document their actions regarding such reports.

Question 59

PMP

Question: Under what circumstances must a pharmacist request and review a PMP report covering at least a one-year time period?

Answer 59

Answer: A pharmacist must request and review a PMP report if:

(a) The patient exhibits potential abuse or misuse of opioids (e.g., over-utilization, early refills, multiple prescribers, appears sedated or intoxicated, or pays cash when they have insurance).
(b) The opioid prescription is from an unfamiliar prescriber (e.g., out-of-state or outside the usual pharmacy geographic area).
(c) The opioid prescription is for an unfamiliar patient residing outside the usual geographic patient area.
(d) The prescription is for an initial long-acting opioid formulation (e.g., fentanyl or methadone).
(e) The patient is receiving an opioid concurrently with a benzodiazepine or carisoprodol.

Question 60

PMP

Question: What is required regarding documentation after reviewing a PMP report?

Answer 60

Answer: The pharmacist shall document the review of the PMP report, including actions taken to address any issues identified.

Question 61

PMP

Question: How frequently must a pharmacist review PMP reports for an established patient using opioids?

Answer 61

Answer: PMP reports must be reviewed a minimum of once every three months during continuous opioid use for each established patient. The pharmacist shall document the review of these reports.

Question 62

PMP

Question: What should a pharmacist do if a PMP report is not immediately available?

Answer 62

Answer: The pharmacist should use professional judgment to determine whether it is appropriate and in the patient’s best interest to dispense the prescription prior to receiving the report.

Question 63

PMP

Question: Are there any exemptions from the PMP report requirements for opioid prescriptions?

Answer 63

Answer: Yes, prescriptions for opioids written for patients in a long-term care facility (LTCF) or for patients with a medical diagnosis documenting a terminal illness are exempt. If there is any question about whether a patient qualifies as having a terminal illness, the pharmacist should contact the practitioner and document whether the patient is “terminally ill” or an “LTCF patient.”

Question 64

Counseling.

(1) Upon receipt of a new prescription drug order and following a review of the patient’s record, a pharmacist or pharmacist intern shall personally offer to counsel on matters which will enhance or optimize drug therapy with each patient or the patient’s agent. Upon receipt of a refill prescription drug order a pharmacy technician may query the patient or patient’s agent regarding counseling by the pharmacist or pharmacist intern concerning drug therapy. Such counseling shall be in person, whenever practicable, or by telephone, and shall include appropriate elements of patient counseling which may include, in their professional judgment, one or more of the following:

Answer 64

a) the name and description of the drug;

(b) the dosage form, dosage, route of administration, and duration of drug therapy;

(c) intended use of the drug and expected action;

(d) special directions and precautions for preparation, administration and use by the patient;

(e) common severe side or adverse effects or interactions and therapeutic contraindications that may be encountered, including their avoidance and the action required if they occur;

(f) techniques for self-monitoring drug therapy;

(g) proper storage;

(h) prescription’s refill information;

(i) action to be taken in the event of a missed dose;

(j) the need to check with the pharmacist or practitioner before taking other medication; and

(k) pharmacist comments relevant to the individual’s drug therapy, including any other information peculiar to the specific patient or drug.

Question 65

Counseling

Question: What alternative forms of patient information may be used to supplement patient counseling?

Answer 65

Answer: Alternative forms of patient information that may supplement counseling include, but are not limited to, written information leaflets, pictogram labels, and video programs.

Question 66

Counseling

Question: What should a pharmacist do if a patient or patient’s agent refuses counseling?

Answer 66

Answer: A pharmacist is not required to counsel a patient or patient’s agent if they refuse such consultation. However, the pharmacist must not attempt to circumvent or willfully discourage the patient or patient’s agent from receiving counseling.

Question 67

Counseling

Question: What are the requirements for pharmacies delivering prescriptions by mail or common carrier?

Answer 67

Answer: For pharmacies delivering more than fifty percent of their prescriptions by mail or other common carrier, the hours of availability for counseling must be a minimum of 60 hours per week and not less than six days per week. The facility must have sufficient toll-free phone lines and personnel to provide counseling within 15 minutes.

Question 68

Counseling

Question: What is required regarding the posting of counseling notices in pharmacies?

Answer 68

Answer: Every pharmacy must prominently post a notice concerning available counseling in a place conspicuous to and readable by prescription drug consumers

Question 69

Regulatory assessment. Profiles, either electronic or hard copy, shall be available for inspection, and shall provide the capability of storing the described historical information. The profiles must demonstrate that an effort is being made to fulfill the requirements by the completion of the detail required. A patient record shall be maintained for a period of not less than ________________ from the date of the last entry in the profile record.

Answer 69

3 years

Question 70

Pharmacist Clinician

Question: What are the requirements for initial certification and registration as a pharmacist clinician?

Answer 70

Answer: To obtain initial certification and registration as a pharmacist clinician, the following must be submitted:
- Proof of completion of a 60-hour board-approved physical assessment course, followed by a 150-hour, 300 patient contact preceptorship supervised by a physician or other practitioner with prescriptive authority, with hours counted only during direct patient interactions.
- A log of patient encounters as part of the application.
- Patient encounters must be initiated and completed within two years of the application.
- Training in responsible opioid prescribing practices for those requesting a controlled substance registration to prescribe controlled substances in schedule II or III.

Question 71

Pharmacist Clinician

Question: What must be included in a renewal application for pharmacist clinician registration?

Answer 71

Answer: Renewal applications must include:
- Documentation of continuing education hours, including proof of completion of 2.0 CEU (20 contact hours), with at least 10 hours of live CPE or CME approved by ACPE or ACCME.
- For those with controlled substance registration, a minimum of 0.2 CEU (two contact hours) in responsible opioid prescribing practices.
- A current protocol of collaborative practice signed by the supervising physician (if prescriptive authority is sought).
- A copy of the pharmacist clinician’s registration with the supervising physician’s board (if prescriptive authority is sought).
- Any additional information requested by the board.

Question 72

Pharmacist Clinician

Question: What are the requirements for a pharmacist clinician to exercise prescriptive authority?

Answer 72

Answer: Only a registered pharmacist clinician with current protocols, registered with the New Mexico medical board, may exercise prescriptive authority. The pharmacist clinician must submit an application to the board including the supervising physician’s name, current medical license, protocol of collaborative practice, and other requested information. The protocol must be established and approved by the supervising physician and kept on file at each practice site and with the board.

Question 73

Pharmacist Clinician

Question 74

Pharmacist Clinician

Question: What must the prescriptive authority protocol include?

Answer 74

Answer: The protocol must include:
- The name of the physician(s) authorized to prescribe dangerous drugs and the pharmacist clinician.
- A statement of the types of prescriptive authority decisions the pharmacist clinician is authorized to make, including diseases, dangerous drugs, ordering lab tests, and procedures.
- Activities to be followed by the pharmacist clinician while exercising prescriptive authority, including documentation of feedback to the authorizing physician.
- Description of mechanisms for consulting with the supervising physician and a quality assurance program for review of medical services.
- Description of the scope of practice of the pharmacist clinician

Question 75

Pharmacist Clinician

Question: Are there any restrictions on a pharmacist clinician prescribing dangerous drugs?
.

Answer 75

Answer: Pharmacist clinicians shall not prescribe dangerous drugs, including controlled substances, for self-treatment or treatment of immediate family members, except in emergency situations. This does not apply to medications that may be prescribed under 16.19.26 NMAC

Question 76

Pharmacist Clinician

Question: What is the scope of practice for a pharmacist clinician?

Answer 76

Answer: A pharmacist clinician shall perform only those services delineated in the protocol and within the scope of practice of the supervising physician. They may practice in a health care institution within the policies of that institution and prescribe controlled substances with the required registrations and within the guidelines or protocols established.

Question 77

Pharmacist Clinician

Question: What are the PMP requirements for a pharmacist clinician?

Answer 77

Answer: A pharmacist clinician must:
- Register with the board to participate in PMP inquiry and reporting.
- Review a PMP report before prescribing a controlled substance in schedule II, III, or IV for the first time or after a gap of 30 days or more.
- Review a PMP report at least once every three months during continuous use of opioids, benzodiazepines, or carisoprodol, and once every six months for other controlled substances.
- Document the review of PMP reports in the patient’s medical record.

Question 78

Pharmacist Clinician

Question: When is a PMP report not required before prescribing controlled substances?

Answer 78

Answer: A PMP report is not required before prescribing controlled substances in schedule II, III, or IV to:
- A patient in a nursing facility.
- A patient in hospice care.

Question 79

Pharmacist Clinician

Question: What are the PMP review requirements for pharmacist clinicians in opioid treatment programs?

Answer 79

Answer: Pharmacist clinicians in opioid treatment programs must review a PMP report upon a patient’s initial enrollment and every three months thereafter while prescribing, ordering, administering, or dispensing opioid treatment medications in schedule II or III for treating opioid use disorder. The review must be documented in the patient’s medical record.

Question 80

Pharmacist Clinician

Question: What is the process for handling complaints against pharmacist clinicians?

Answer 80

Answer: The chair of the board will appoint two board members, and the chair of the supervising physician board will appoint two board members to an oversight committee. This committee will review complaints concerning pharmacist clinician practice and make a report with non-binding recommendations for disciplinary action. The board may accept or reject these recommendations. Applicants for certification or pharmacist clinicians may appeal board decisions according to the Uniform Licensing Act.