When a controlled substance is dispensed from an automated dis- pensing system, the pharmacist will verify this withdrawal as soon as reasonably possible, but no more than 72 hours following dis- pensing. When a dangerous drug is dispensed from an automat- ed dispensing system, the pharmacist will verify this withdrawal as soon as reasonably possible, but no more than one calendar week following dispensing. Pharmacists must verify all withdrawals at the soonest reasonable time, but no less than once every calendar week that the pharmacy is open. In some Class C pharmacies located in a freestanding ambulato- ry surgical center, a stock of controlled substances is maintained to provide quick and easily accessible medication when needed for emergent situations. TAC §291.76 overviews the requirements associated with maintaining this stock of controlled substances. While freestanding ambulatory surgical centers have always been required to maintain a log of controlled substance use, as of Feb- ruary 2023, pharmacists are now responsible for ensuring this per- petual inventory of controlled substances is both complete and accurately reconciled. Another remote service provided by pharmacies is emergency medication kits. These kits include specific medications required for life-saving measures and may reside in facilities without an es- tablished pharmacy. TAC §291.121 lists requirements for main- taining an emergency medication kit, including how to apply to provide an emergency kit, the process for stocking, and reporting use of the kit. Beginning in May 2022, the Texas State Board of Pharmacy removed restrictions on duplicating drugs within emer- gency medication kits, which allows pharmacies to place dupli- cate medications in the kit in the case of multiple crises or wasted doses of crucial medication. Conclusion Remaining competent and up to date with all Texas state phar- macy laws is an important part of providing safe and effective pharmacy care. The rules and regulations, while often revised and fine-tuned, are designed to encourage patient safety outcomes and protect the interests of pharmacists, pharmacy interns, and
Self-Assessment Quiz Question #3 When a controlled substance is dispensed from an automated pharmacy dispensing system, how long does a pharmacist have to verify the order? a. 7 days. b. 72 hours. c. 5 days. d. 24 hours. Self-Assessment Quiz Question #4 The Texas State Board of Pharmacy recently removed limitations on placing duplicates of medications in emergency medication kits located at remote sites. What was the reasoning behind this change? a. Save the pharmacist time by limiting the number of times medications need to be replaced. b. Allow for an adequate supply of medication in case of multiple crises or wasted drugs. c. Extend beyond-use dating of the kit by allowing remote staff to remove expired drugs and replace with duplicates. d. Expand the practice capabilities of the remote site and remove the need for pharmacist verification of drugs in nonemergent situations.
pharmacy technicians within the healthcare field. As such, fre - quently referring to both the Texas Administrative Code and Tex - as Pharmacy Act will further cement concepts of lawful pharmacy practice.
References •
Accreditation Council for Pharmacy Education (ACPE). (2016). Accreditation standards and key elements for the professional program in pharmacy leading to the Doctor of Pharmacy degree . https://www.acpe-accredit.org/pdf/Standards2016FINAL.pdf • State of Texas. (2019). Constitution and Statutes . 3 Tex. Occup. Code . §551-569. Texas State Government. https://statutes.capitol.texas.gov/?link=OC • State of Texas. (2019). Constitution and Statutes . 6 Tex. Health. Code. §431, 442. https:// statutes.capitol.texas.gov/Docs/HS/htm/HS.431.htm •
State of Texas. (2023). Constitution and Statutes. 22 Tex. Admin . Code. §281-315. https:// texreg.sos.state.tx.us/public/readtac$ext.ViewTAC?tac_view=3&ti=22&pt=15 • Texas Prescription Monitoring Program. (2020). Data submission guide for dispensers. Appriss Health . https://www.pharmacy.texas.gov/files_pdf/TX_PMP_AWARxE_ DispenserGuide.pdf • Texas State Board of Pharmacy. (February 2018). “ Red flags” checklist for pharmacists . https://www.pharmacy.texas.gov/files_pdf/You_might_be_a_pill_mill_if.pdf
OVERVIEW OF TEXAS PHARMACY LAW, 2ND EDITION Self-Assessment Answers and Rationales
1. The correct answer is C. Rationale: Pharmacists are allowed to dispense a 72-hour sup- ply in emergency refill situations for noninsulin medications. Tex - as Administrative Code §291.34 outlines that to protect patients from unnecessary refills, pharmacist emergency fills are capped at 3-day supplies. 2. The correct answer is A. Rationale: When the Texas State Board of Pharmacy updated Schedule II controlled substance prescription validity windows, they initially left out-of-state prescribers out of the 30-day window extension. However, in a February 2022 update to TAC §291.34, out-of-state prescribers were included in this provision to match federal Drug Enforcement Agency standards.
3. The correct answer is B. Rationale: In both institutional (Class C) pharmacies and free- standing emergency center (Class F) satellite pharmacies, phar - macists must verify controlled substance dispense orders from automated dispensing cabinets within 72 hours of the controlled substance being pulled. This information is found in TAC §291.76 and §291.151. 4. The correct answer is B. Rationale: Emergency medication kits are intended to provide healthcare professionals who are proficiently trained in life-saving measures with resources to perform emergency medicine without pharmacist oversight. In this case, earlier limitations prevented staff from effectively handling all potential emergency situations, and removing this limitation allows for best patient care outcomes.
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Book Code: RPTX3024
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