Module 8 - Advanced Pharmacy Practice/Misc

What is Expedited Partner Therapy?

To prescribe, dispense, or furnish to a patient an antimicrobial drug to be used by a sexual partner of the patient to treat a chlamydial infection, gonorrhea, or trichomoniasis without physical examination of the sexual partner.

What must the prescriber write on the Rx if the name of the partner is unknown for EPT?

Expedited partner therapy, or EPT

For what 3 infections is EPT permitted?

Chlamydia, gonorrhea, or trichomoniasis

What counseling points must be mentioned to the person picking up an EPT drug?

The pharmacist shall ask whether the person for whom the antimicrobial drug has been prescribed is allergic to the antimicrobial drug and advise that the person for whom the antimicrobial drug has been prescribed must discontinue use of the antimicrobial drug if the person is allergic to or develops signs of an allergic reaction to the antimicrobial drug.

What “authorized entities” may be prescribed and maintain a supply of epinephrine auto-injectors?

Schools, a recreational and educational camp, college, university, day care facility, youth sports league, amusement park, restaurant, place of employment, and sports arena

How may an employee, agent, or authorized individual use an epinephrine auto-injector?

To provide or administer epinephrine to any individual who the authorized person believes in good faith is experiencing an anaphylactic reaction, regardless of whether the individual has a prescription for epinephrine.

What may a school nurse or designated school personnel do with an epinephrine auto-injector, and what is required for students without a prescription?

1. They may provide epinephrine to a student to self-administer if they have a prescription on file specific to them. 2. They may also administer epinephrine even if the student doesn’t have a prescription, if they in good faith believe the person is experiencing anaphylaxis.

What training is required for an “authorized individual” to administer epinephrine?

1. How to recognize signs and symptoms of severe allergic reactions, including anaphylaxis. 2. Standards and procedures for the storage and administration of an epinephrine delivery system. 3. Emergency follow-up procedures after an epinephrine delivery system is administered, including the necessity of calling the telephone number “911” or another telephone number for an emergency medical service provider.

Whose name is on the prescription for epinephrine auto-injectors under these provisions?

It would be under the name of the school or location that has adopted the plan.

Whose name should be on the label for a dispensed prescription for epinephrine auto-injectors under these provisions?

Under the name of the school.

Prescriptions for what other two drug classes may be written in the name of a school by a physician, PA, or APNP?

• A short acting bronchodilator
• Glucagon

What training is required for a pharmacist, student pharmacist, or graduate intern to administer a vaccine?

12 hours in a course of study and training approved by the Accreditation Council for Pharmacy Education, in vaccination storage protocols, administration technique, emergency procedures, and record keeping.

What training is required for a pharmacy technician to administer a vaccine?

1. At least 2 hours in a course of study and training, approved by the Accreditation Council for Pharmacy Education or the board, in hands-on injection technique and the recognition and treatment of emergency reactions to vaccines. 2. The pharmacy technician holds a current certification in basic life support or cardiopulmonary resuscitation. 3. The pharmacy technician holds a certified pharmacy technician certification from either the Pharmacy Technician Certification Board, or its successor organization, or the National Healthcareer Association, or its successor organization.

Who may supervise a student pharmacist or graduate intern administering vaccines, and what level of supervision is required?

• A pharmacist or any other licensed health-care provider legally permitted to administer vaccines in Wisconsin.
• Physically present at the location where the vaccination occurs and are readily and immediately available.

Who may supervise a technician administering vaccines, and what level of supervision is required?

A pharmacist – and needs to be physically present and readily available on-site.

Under what two conditions may a pharmacist administer a vaccine to a person under the age of 6?

1. The vaccine administered has a prescription ordered within 29 days. 2. The pharmacist has completed a course to administer vaccines to children under the age of 6.

Under what conditions may a pharmacy professional administer a vaccine without a prescription order?

They may if the vaccine is listed in the current immunization schedules recommended by the federal advisory committee on immunization practices and published by the federal centers for disease control and prevention.

What documentation (and time frame) must be completed after vaccine administration?

They need to update the Wisconsin Immunization Registry (WIR) established by the department of health services within 7 days.

What insurance must a pharmacist have to administer (or supervise students/techs administering) vaccines?

Liability insurance that covers the pharmacist and a person who administers a vaccine against loss, expense and liability resulting from errors, omissions or neglect in the administration of vaccines in an amount that is not less than 1,000,000 for each occurrence and 2,000,000 for all occurrences in any one policy year.

Immunizers must maintain proof of what two items?

1. Liability insurance. 2. Proof of completion of training and certification.

How long are physician-pharmacist immunization protocols valid?

2 years.

What education is required for a pharmacist or student to administer a non-vaccine injection to a patient?

1. Pharmacists must:
   • Complete a Board-approved or ACPE-approved injection training course.
   • Follow Pharmacy Examining Board procedures.
   • Notify the prescriber or document the injection in a shared medical record.
2. Interns and students must also be under direct supervision of a pharmacist.

What are the requirements for a student pharmacist/graduate intern to administer injectable drugs, and at what point in their education may a student give a vaccine?

1. They need to take a course about injectable drug administration; must administer under direct supervision of a pharmacist; and comply with board rules and notify the prescribing practitioner.
2. The student must have completed his or her second year at their school of pharmacy.

What must a pharmacist or student (or their agent) do after administering an injection to a patient?

They must notify the prescribing practitioner or enter the information in a patient record system shared by the prescribing practitioner.

What topics must a course of study for pharmacist injections include?

1. Techniques of injection administration.
2. Storage and handling of injectable drugs and devices.
3. Recognition and treatment of adverse reactions.
4. Patient assessment and screening.
5. Legal and ethical considerations.
6. Documentation and record keeping.
7. Emergency procedures.

What type of supervision is required for students administering vaccines and other injectables?

Direct supervision.

Within what time frame must a pharmacy dispense a lawfully prescribed contraceptive drug or device?

“Usual and customary” time frame expected for dispensing non-contraceptives.

Under what circumstances may a pharmacist NOT dispense a contraceptive drug or device?

1. Rx has error or inadequate instructions.
2. Drug is contraindicated or has drug interactions.
3. Rx is potentially fraudulent.