Self-Assessment Quiz Question #2 When an out-of-state prescriber writes a prescription for a Schedule II controlled substance, how many days after it is writ- ten is the prescription valid for?
a. 30 days. b. 60 days. c. 14 days. d. 7 days. Drug disposal
● The waste disposal service abides by all rules of the Texas Commission on Environmental Quality and the U.S. Environ- mental Protection Agency. ● The pharmacist seals the container of disposal-ready medica- tions in the presence of an approved witness (administrator, director, etc.) and seals the container with tamper- resistant tape. ● Records of the container’s transfer to the waste disposal ser- vice, as well as subsequent proof of destruction, must be maintained for two years and include: ○ Date of transfer. ○ Name and address of the waste disposal service. ○ Signature of the individual transferring the container to the service. a timeline for continued education in nonsterile compounding methods and safety. The Board also updated requirements for the nonsterile com- pounding environment within the pharmacy. To this end, TAC §291.131. Pharmacies participating in compounding must have a specific, designated area for non- sterile compounding. This area must be adequately-sized and possess the correct equipment for safe and orderly compounding. Only personnel authorized by a phar- macist-in-charge or responsible pharmacist should be in the area during non-sterile compounding. Non-sterile compounding environments must include a clean, well-maintained sink with hot and cold running water, and must be exclusive from facilities in a rest room. Supplies necessary for adequate washing must be in the immediate area of the sink and include: ● Soap or detergent. ● Air-driers or single-use towels. If any drug product requires special attention to prevent con- tamination, such as penicillin, appropriate measures must be taken to avoid cross-contamination. This could include establish- ing drug-specific equipment for certain substances or diligently cleaning equipment following use of a potential contaminant drug. Cleaning and sanitizing of surfaces within the non-sterile compounding environment must occur on a regular basis, and should be specified in each pharmacy’s standard operating prac - tices. Further changes regarding automated pharmacy dispensing sys- tems were adopted in August 2021, as well. TAC §291.76 pro- vides guidelines for the management of institutional pharmacies (Class C) located in a freestanding ambulatory surgical center. TAC §291.151 refers to pharmacies located in a freestanding emergency medical care facility (Class F). Each of these subchap- ters were revised to include licensed nurses in the management and use of automated pharmacy dispensing systems. Following these updates, licensed nurses with pharmacist authorization may load medications into automated dispensing systems. In conjunction with automated pharmacy dispensing system changes, the Board provided direction regarding pharmacist ver- ification of automatically dispensed medication.
TAC §303.1 outlines the requirements that must be followed when disposing of dangerous drugs or controlled substances. In hospi- tals and other healthcare facilities, there are strict steps involving an inventory, a witness, and which medications may be destroyed. In a February 2023 update to TAC §303.1, the Texas State Board of Pharmacy adopted a new policy for healthcare facilities utiliz- ing an independent, third-party medical waste disposal service. This update removes inventory-keeping requirements and allows for disposal of both dangerous and controlled substances in the same container as permitted by the Drug Enforcement Agency as long as: Nonsterile compounding TAC §291.131 provides guidance for pharmacies participating in compounding nonsterile products. This rule includes important definitions, operational standards, and approved compounding situations. In August 2022, the Texas State Board of Pharmacy adopted a number of revisions focusing on training and the compounding environment. Regarding training, TAC §291.131 outlines: ● All training must be documented and covered by standard operating practices. ● All personnel involved in nonsterile compounding should be well trained and must undergo continued training, as is rele- vant. ● Training must include demonstration and education of the fol- lowing: ○ Hand hygiene. ○ Garbing. ○ Cleaning and sanitizing. ○ Handling and transporting components of and com- pounded nonsterile preparations. ○ Measuring and mixing. ○ Properly using equipment used in nonsterile compound- ing. ○ Completely documenting the compounding process. Each nonsterile compounding pharmacy location must have a pharmacist in charge, who is responsible for confirming the com - pleteness and adequacy of the training on an individual basis. This pharmacist should also determine appropriate content and Remote pharmacy practice Driven by technological advances and the coronavirus pandem- ic, the remote, or off-site, role of the pharmacist has greatly in- creased within the past five years. As a result, the Texas State Board of Pharmacy has adopted a number of revisions related to the remote practice of pharmacy. TAC §291.121 regulates various remote pharmacy services. Re- mote pharmacy services are defined as any aspect of pharmacy practice provided by a community pharmacy (Class A) or institu- tional pharmacy (Class C) that occurs in a facility separate from the actual pharmacy. In an August 2021 update, the Board approved pharmacy services that are provided via an automated pharmacy dispensing system, which is a mechanical system that dispenses drugs remotely and records all dispensing transactions.
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