PA: Prescriptive Authority

Question 1

Who has Prescriptive Authority (in PA)?

Answer 1

-Doctor or medicine: MD
-Doctor of Podiatric medicine: DPM
-Doctor of dental surgery: DDS
-Doctor of dental medicine: DMD
-Doctor of Osteopathy: DO
-Certified Registered Nurse Practitioner: CRNP
-Physician assistant: PA or PA-C
-Optometrist: OD
-Midwife: CNM

Question 2

Drug categories that cannot be prescribed

Answer 2

-gold compounds
-heavy metal antagonists
-radioactive agents
-oxytocics

Question 3

What is on a prescription blank for CRNP?

Answer 3

-name, title, and certification number
-NPI
-space for entry of DEA reg #

Question 4

CRNP Controlled substance prescribing limitations

Answer 4

-Schedule II: for up to 30 ds
-Schedule III-V: up to 90 ds

Question 5

Physician Assistant prescription blank reqs

Answer 5

-license # for the PA and the name of the PA
-license number and name of supervising physician
-sig of PA, followed by PA-C
-DEA #

Question 6

Physician assistant CS prescribing limits

Answer 6

-Schedule II:
–> initial therapy: up to a 72 hr dose (must state clearly for initial therapy)
–> regular: up to 30 ds if approved by supervising physician for ongoing therapy (must state on rx “ongoing therapy”)

-Schedule III-V: substance permissible and up to 5 refills within a 6 mon period

Question 7

Optometrist prescribing, may NOT prescribe

Answer 7

*tx may not continue beyond 6 weeks

May not prescribe:
-any parenteral drugs
-beta-blockers
-drugs for systemic conditions except for limited to the anterior of the eye structure
-drugs for glaucoma

Question 8

Optometrist prescription blank requirements

Answer 8

-name, addy, phone #, fax # and license number
-name of pt
-date of prescription issued
-name of drug, quantity, potency, expiration date, number of refills, directions for use and any precautions

*L in license means that they CANNOT prescribe

Question 9

Optometrist controlled substance prescribing

Answer 9

-required to have a therapeutic license in order to prescribe (T in license #)
-can prescribe schedule III-V analgesics, but for no more than 6 week therapy

*can prescribe hydrocodone in combo w/ APA or ibuprofen (not to exceed a 72 hr supply)

Question 10

What can Therapeutically Certified Optometrists prescribe?

Answer 10

*have a T in their license #

-topical anesthetics,
-topical ocular lubricants
-topical ophthalmic dyes and stains
-topical hyper-osmotic agents
-topical autonomic drugs
-topical non-steroidal anti-inflammatory drugs
-topical and oral antimicrobial agents
-topical and oral analgesics
-topical anti-allergy
-topical steroids and oral steroids (prednisone and methylprednisolone)
-topical immunomodulators

Question 11

What can Glaucoma Certified Optometrists prescribe?

Answer 11

-in addition to what therapeutically certified optometrists:
-adrenergic receptor agonists
-beta adrenergic receptor blockers
-prostaglandin analogs
-topical carbonic anhydrase inhibitors

*will have a G in their license #

Question 12

Midwife Prescribing

Answer 12

based on a collaborative agreement with a physician
-psychotropic drugs can only be prescribed based upon prior consultation with the physician

Question 13

Midwife prescribing blank reqs

Answer 13

-license number, name and contact info (phone #) & CNM
-signature of the midwife must be followed by CNM
-name of the collaborating physician is NOT required

Question 14

Mid wife controlled substance prescribing

Answer 14

based on the collaborative agreement with the physician:
-C II: limited to 72 hrs supply
-C III-V: limited to 30 ds
-CS can only be prescribed for a women’s acute pain