Iowa Administrative Code › Agency 657 - Pharmacy Board › Chapter 39 - Expanded Practice Standards › Rule 657-39.7 - Opioid Antagonist Dispensing by Pharmacist-standing Order

Current through Register Vol. 47, No. 3, July 24, 2024
An authorized pharmacist may dispense an opioid antagonist
				pursuant to a standing order established by the department, which standing
				order can be found via the board's website, or pursuant to a standing order
				authorized by an individual licensed health care professional in compliance
				with the requirements of this rule. An authorized pharmacist may only delegate
				the dispensing of an opioid antagonist to an authorized pharmacist-intern under
				the direct supervision of an authorized pharmacist. Nothing in this rule
				prohibits a prescriber or facility from establishing and implementing standing
				orders or protocols under the authority granted to the prescriber or
				facility.
(1)
Definitions.
For the purposes of this rule, the following
			 definitions shall apply:
"Authorized pharmacist"
means an Iowa-licensed
				pharmacist who has completed the training requirements of this rule.
				"Authorized pharmacist" also includes an Iowa-registered pharmacist-intern who
				has completed the training requirements of this rule and is working under the
				direct supervision of an authorized Iowa-licensed pharmacist.
"Department"
means the Iowa department of
				public health.
"First responder"
means an emergency medical
				care provider, a registered nurse staffing an authorized service program under
				Iowa Code section 147A.12, a physician assistant
				staffing an authorized service program under Iowa Code section
				147A.13, a firefighter, or a
				peace officer as defined in Iowa Code section
				801.4 who is trained and
				authorized to administer an opioid antagonist.
"Licensed health care professional"
means a
				person licensed under Iowa Code chapter 148 to practice medicine and surgery or
				osteopathic medicine and surgery, an advanced registered nurse practitioner
				licensed under Iowa Code chapter 152 or 152E and registered with the board of
				nursing, or a physician assistant licensed to practice under the supervision of
				a physician as authorized in Iowa Code chapters 147 and 148C.
"Opioid antagonist"
means the same as defined
				in Iowa Code section 147A.1.
"Opioid-related overdose"
means the same as
				defined in Iowa Code section
				147A.1.
"Person in a position to assist"
means a
				family member, friend, caregiver, health care provider, employee of a substance
				abuse treatment facility, school employee, or other person who may be in a
				position to render aid to a person at risk of experiencing an opioid-related
				overdose.
"Recipient"
means an individual at risk of an
				opioid-related overdose or a person in a position to assist an individual at
				risk of an opioid-related overdose.
"Standing order"
means a preauthorized
				medication order with specific instructions from the licensed health care
				professional to dispense a medication under clearly defined
				circumstances.
(2)
Authorized pharmacist training.
An authorized pharmacist shall
			 document successful completion of an ACPE-approved continuing education program
			 of at least one-hour duration related to opioid antagonist utilization prior to
			 dispensing opioid antagonists pursuant to a standing order.
(3)
Additional supply.
Notwithstanding a standing order to the contrary, an authorized pharmacist
			 shall only dispense an opioid antagonist after completing an eligibility
			 assessment and providing training and education to the recipient.
(4)
Assessment.
An
			 authorized pharmacist shall assess an individual for eligibility to receive an
			 opioid antagonist pursuant to a standing order. In addition to the criteria
			 identified in a standing order, an authorized pharmacist shall also take into
			 consideration the following criteria to determine the eligibility of the
			 recipient to receive and possess an opioid antagonist:
a. The person at risk of an opioid-related
			 overdose for which the opioid antagonist is intended to be administered has no
			 known sensitivity or allergy to naloxone, unless the person at risk is not
			 known to the recipient, including but not limited to a first responder or
			 member of law enforcement.
b. The
			 recipient is oriented to person, place, and time and able to understand and
			 learn the essential components of opioid-related overdose, appropriate
			 response, and opioid antagonist administration.