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TITLE 22EXAMINING BOARDS
PART 14TEXAS OPTOMETRY BOARD
CHAPTER 280THERAPEUTIC OPTOMETRY
RULE §280.10Optometric Glaucoma Specialist: Administration and Prescribing of Oral Medications and Anti-Glaucoma Drugs

(a) An optometric glaucoma specialist may administer and prescribe any drug authorized by the Texas Optometry Act, §351.358 and §351.3581, in addition to those drugs that may be administered and prescribed by a therapeutic optometrist.

(b) The requirements of §280.5 and the statutes cited in the rule apply to the optometric glaucoma specialist's prescription orders, the administration of drugs in the optometric office and the labeling of drugs supplied to patients. The requirements for a prescription order for a Controlled Substance are listed in subsection (f) of this section.

(c) At least annually, the Texas Optometry Board shall provide to the Texas State Board of Pharmacy a list of the oral pharmaceutical agents and anti-glaucoma drugs which may be administered and prescribed by an optometric glaucoma specialist.

(d) An optometric glaucoma specialist may administer and prescribe, in addition to those drugs authorized by §280.5:

  (1) appropriate oral pharmaceutical agents used for diagnosing and treating visual defects, abnormal conditions, and diseases of the human vision system, including the eye and adnexa, which are included in the following classifications or are combinations of agents in the classifications:

    (A) one 10-day supply of oral antibiotics;

    (B) one 72-hour supply of oral antihistamines;

    (C) one seven-day supply of oral nonsteroidal anti-inflammatories;

    (D) one three-day supply of any analgesic identified in Schedules III, IV, and V of 21 U.S.C. §812; and

  (2) antiglaucoma drugs.

(e) An optometric glaucoma specialist may administer appropriate medications to treat a patient who has an anaphylactic reaction in order to counteract the anaphylaxis. The optometric glaucoma specialist shall immediately refer the patient to a physician.

(f) Controlled Substances

  (1) The following paragraphs apply to an optometric glaucoma specialist possessing, administering or prescribing a Schedule III, IV or V analgesic Controlled Substance. The paragraphs also apply to an optometric glaucoma specialist who has obtained the registrations necessary to possess, administer, or prescribe a Schedule III, IV or V Controlled Substance.

  (2) An optometric glaucoma specialist must possess a current Controlled Substances Registration from the United States Drug Enforcement Administration (DEA) and the Texas Department of Public Safety (DPS) in order to procure, possess, administer or prescribe a Schedule III, IV or V analgesic Controlled Substance. A licensee applying for or possessing a Controlled Substances Registration must observe all requirements of the Texas Controlled Substances Act, the Health and Safety Code, Chapter 481, applicable federal law, and all requirements of the Texas Department of Public Safety (DPS) Drug Rules, 37 TAC Chapter 13.

  (3) An optometric glaucoma specialist must obtain a registration number from the DPS for the principal office of practice. Application may be made for a separate registration for the possession, administration, and prescribing of controlled substances at a satellite office but all requirements of this rule shall apply in all locations.

  (4) All prescriptions for a Schedule III, IV or V Controlled Substance shall contain the following information (Licensees telephoning or communicating the prescription orally to a pharmacist shall supply the information in this subsection to the pharmacist, except for the signature of the optometric glaucoma specialist.):

    (A) date of issuance;

    (B) name, address and date of birth of the patient for whom the controlled substance is prescribed;

    (C) name, strength, and quantity (written as both a number and as a word) of the controlled substance prescribed;

    (D) direction for use of the controlled substance;

    (E) intended use of the controlled substance prescribed unless the optometric glaucoma specialist determines the furnishing of this information is not in the best interest of the patient;

    (F) printed or stamped name, address and business telephone number of the optometric glaucoma specialist;

    (G) written signature of the prescribing optometric glaucoma specialist;

    (H) complete license number of the prescribing optometric glaucoma specialist; and

    (I) DEA and DPS registration number.

  (5) An optometric glaucoma specialist shall maintain a complete and accurate record of purchases (to include samples received from pharmaceutical manufacturer representatives) and administrations of Schedule III, IV or V analgesic Controlled Substances.

  (6) The record keeping listed in this section shall be subject to inspection at all times by the Texas Department of Public Safety, the U.S. Drug Enforcement Administration, and the Texas Optometry Board and any officer or employee of the governmental agencies shall have the right to inspect and copy records, reports, and other documents, and inspect security controls, inventory and premises where Schedule III, IV, and V analgesic controlled substances are possessed or administered.

  (7) Minimum security controls shall be established to include but not limited to:

    (A) establishing adequate security to prevent unauthorized access and diversion of the controlled substance,

    (B) during the course of business activities, not allowing any individual access to the storage area for controlled substances except those authorized by the optometric glaucoma specialist,

    (C) storing the controlled substance in a securely locked, substantially constructed cabinet or security cabinet which shall meet the requirements under the DPS Drug Rules, and

    (D) not employ in any manner an individual that would have access to controlled substances who has had a federal or state application for controlled substances denied or revoked, or have been convicted of a felony offense under any state or federal law relating to controlled substances or been convicted of any other felony, or have been a licensee of a health regulatory agency whose license has been revoked, canceled, or suspended.

  (8) Failure of the optometric glaucoma specialist to maintain strict security and proper accountability of controlled substance shall be deemed to be a violation of the Texas Optometry Act, §351.501 and §351.551.


Source Note: The provisions of this §280.10 adopted to be effective August 3, 2000, 25 TexReg 7176; amended to be effective March 9, 2009, 34 TexReg 1591

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