Pharmacy Practice

Question 1

Does a collaborative practice agreement need to be submitted to the board?

Answer 1

Yes

Question 2

How often does a collaborative practice agreement need to be renewed?

Answer 2

Annually

Question 3

What actions are pharmacists allowed to perform under a collaborative practice agreement (e.g., initiate, modify, monitor medications)?

Answer 3

1) Monitoring and modifying a disease-specific drug therapy

2) Collecting and reviewing patient history

3) Obtaining and reviewing vital signs, including pulse, temperature, blood pressure, and respiration;

4) Ordering, evaluating, and applying the results of laboratory tests directly related to the disease-specific drug therapy being managed under an order set, provided such tests do not require the pharmacist to interpret such testing or formulate a diagnosis

5) Providing disease or condition-specific patient education and counseling

Question 4

Are there any restrictions on what diseases a pharmacist can manage under a collaborative practice agreement?

Answer 4

No

Question 5

Is every pharmacy required to have a pharmacist-in-charge?

Answer 5

Yes

Question 6

How many pharmacies can a pharmacist serve as the pharmacist-in-charge (PIC) for at one time?

Answer 6

One, unless approved by the Board

Question 7

What is the minimum number of hours the pharmacist-in-charge (PIC) must be present at the pharmacy?

Answer 7

No less than 20 hours per week during the pharmacy’s ordinary course of business.

In the event the pharmacy’s normal hours of business are less than 20 hours per week the PIC shall be present and practicing at least 50 percent of the normal business hours.

Question 8

What activities are interns permitted to perform (e.g., counseling, compounding, final verification, taking verbal prescriptions)?

Answer 8

A pharmacy intern may perform any duty of a pharmacist provided he is under the supervision of a pharmacist.

A pharmacy intern may not:
Present or identify himself as a pharmacist
Sign or initial any document which is required to be signed or initialed by a pharmacist unless a preceptor cosigns the document
Independently supervise pharmacy technicians
Administer immunizations unless properly credentialed as required by the Board
Transfer prescriptions for controlled substances

Question 9

Can technicians accept new prescriptions over the phone?

Answer 9

Yes, but it must be reduced to writing and initialed by the supervising pharmacist prior to releasing.

Question 10

Is tech-check-tech permitted?

Answer 10

Not addressed in the state law

Question 11

What activities can a clerk perform (e.g., cashier functions, receive refills, put a bottle of medication on the shelf)?

Answer 11

The LA Board of Pharmacy does not specify what tasks a pharmacy clerk/cashier can perform

Question 12

Are there limits on prescribing controlled or non-controlled drugs to oneself or family members?

Answer 12

Yes, for controlled substances

Question 13

What are the limits on prescribing controlled or non-controlled drugs to oneself or family members?

Answer 13

Except in cases of emergency, physicians shall not prescribe controlled substances for themselves or their immediate family members.

Question 14

Can new prescriptions or refills be filled if the prescriber is known to be deceased or retired?

Answer 14

The Board does not specify if it is acceptable to fill or refill a prescription if the prescriber is known to be retired or deceased.

Question 15

Can pharmacists fill prescriptions written by prescribers in other countries?

Answer 15

The board does not specify if it is acceptable to fill prescriptions written by prescribers of another country

Question 16

How many years must prescription records be kept?

Answer 16

2 years

Question 17

Within what time frame from the issue date are non-controlled prescriptions permitted to be refilled?

Answer 17

1 year

Question 18

Is there a maximum number of refills permitted for non-controlled drugs?

Answer 18

No, but the prescription is only refillable for up to 1 year after the date it is written.

Question 19

Is emergency refilling of non-controlled drugs permitted without prescriber authorization?

Answer 19

Yes

Question 20

What is the maximum hour supply that can be dispensed for an emergency refill of non-controlled drugs without prescriber authorization?

Answer 20

72 hours

Question 21

What information is required to be on a prescription container label?

Answer 21

In addition to federal law, the label must contain the pharmacy telephone number, the drug name and strength, and the pharmacist’s name or initials.

Federal Requirements:
1) Patient’s name
2) Directions for use
3) Prescriber’s name
4) Name and address of dispenser
5) Serial or prescription number
6) Date of filling
7) Cautionary statements (e.g., the required statement for controlled drugs prohibiting transfer to any person other than the patient)

Question 22

Is it required to provide a larger type size on the container label for patients with visual impairment?

Answer 22

No (not addressed in LA law)

Question 23

Are patient profiles required to be kept in the pharmacy for all patients (e.g., a traveling patient on vacation getting a one-time fill)?

Answer 23

Yes

Question 24

How long must patient profiles be kept after the last fill?

Answer 24

2 years

Question 25

What is required to be in a patient profile?

Answer 25

1) The original prescription number

2) Date of issuance of the original prescription drug order or chart order by the prescriber

3) Date of dispensing by the pharmacist

4) Full name and address of the patient

5) Full name and address of the prescriber

6) Directions for use

7) The name, strength, dosage form, and quantity of the drug prescribed

8) The quantity dispensed if different from the quantity prescribed

9) The pharmacist responsible for prescription information entered into the computer system, the pharmacist responsible for prospective drug utilization review, and the pharmacist responsible for dispensing

10) The total number of refills authorized by the prescriber

11) The refill history of the prescription

Question 26

Is patient identification required to dispense non-controlled drugs in the community pharmacy setting?

Answer 26

No

Question 27

Is the offer to counsel required for all prescriptions?

Answer 27

Yes

Question 28

When must the offer to counsel a patient be made (e.g., all new prescriptions)?

Answer 28

New prescriptions and refills for all patients

Question 29

Who can provide the offer to counsel (e.g., pharmacist, intern or technician)?

Answer 29

The pharmacist or Pharmacy Intern under the supervision of a licensed pharmacist

Question 30

What are the counseling requirements for medications delivered to the patient or sent by mail?

Answer 30

If it is not possible or appropriate to counsel the patient or caregiver “face-to- face”, then a pharmacist should counsel the patient or caregiver by using alternative methods.

Question 31

Are pharmacies required to provide translation services to limited-English proficient (LEP) patients?

Answer 31

No

Question 32

What are the requirements for generic substitution also known as equivalent drug product interchange (e.g., must notify the patient)?

Answer 32

The patient must be informed of the proposed cost savings and provide consent.

The drug dispensed must be less expensive than the drug supplied.

A pharmacist may not interchange a drug if the prescriber has indicated “dispense as written,” the abbreviation “DAW” or “Brand medically necessary” on the prescription. In such cases, non-licensed, non-certified, or non-registered agents of the pharmacy shall not inquire as to the patient’s desire for an equivalent drug product interchange.

Question 33

What resource/s can be used to select a suitable substitution (e.g., Orange Book, state formulary)?

Answer 33

1) If the drug has been rated as pharmaceutically equivalent by the FDA

2) The Orange Book

3) The Purple Book (for Biological Products)

Question 34

What actions can be taken by the prescriber or patient to prevent generic interchange?

Answer 34

The patient can refuse the substitution, or the prescriber can handwrite “Brand Necessary,” “Brand Medically Necessary,” “dispense as written,” or the abbreviation “DAW” on the face of the prescription.

Question 35

What documentation is required when a generic substitution occurs?

Answer 35

None

However, for biological products that are interchanged, the pharmacist must notify the prescriber within 5 business days following the date that the product was dispensed to the patient, including the name of the product and the manufacturer.

Question 36

Are there any drugs (e.g., narrow therapeutic index) that cannot be substituted?

Answer 36

No

Question 37

Does the state have a conscience clause (if so, what are the stipulations of the clause, or what drugs does it specifically apply to)?

Answer 37

No

Question 38

Does the state have death with dignity laws?

Answer 38

No