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Pharmacists in California may now provide naloxone, the medication that can help to reverse the effects of an opioid overdose, without a prescription after the California State Board of Pharmacy approved new emergency regulations (PDF).

To be eligible to dispense the drug under the new regulations, pharmacists must complete one hour of continuing education (CE) on the use of the drug, notes a press release (PDF) from the Board.

When dispensing the drug, pharmacists must screen for any hypersensitivity, and must provide the recipient with training in opioid overdose prevention, recognition, response, and on the administration of the drug.

The pharmacist must also provide the recipient a naloxone fact sheet (PDF), which has been approved by the Board.

In October 2014, NABP released a statement supporting an active role for pharmacists in increasing access to naloxone.

NABP is also active in educating consumers about prescription drug abuse and prevention through the AWARXE® Prescription Drug Safety Program, and information and educational resources on these topics are available on the program’s website.


Pharmacists in California may now provide naloxone, the medication that can help to reverse the effects of an opioid overdose, without a prescription after the California State Board of Pharmacy approved new emergency regulations (PDF).

To be eligible to dispense the drug under the new regulations, pharmacists must complete one hour of continuing education (CE) on the use of the drug, notes a press release (PDF) from the Board.

When dispensing the drug, pharmacists must screen for any hypersensitivity, and must provide the recipient with training in opioid overdose prevention, recognition, response, and on the administration of the drug.

The pharmacist must also provide the recipient a naloxone fact sheet (PDF), which has been approved by the Board.

In October 2014, NABP released a statement supporting an active role for pharmacists in increasing access to naloxone.

NABP is also active in educating consumers about prescription drug abuse and prevention through the AWARXE® Prescription Drug Safety Program, and information and educational resources on these topics are available on the program’s website.


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A patient comes to your pharmacy and presents the following prescription. The prescription reads:

Metoprolol 50 mg
1 tab po b.i.d. qty: 120
Refill: 3 times
 
Which of the following is TRUE?
 
a. Shall not fill more than 60 tablets.
b. Shall fill 120 tablets as indicated.
c. Shall not fill more than 360 tablets in a single filling.
d. Shall only fill 30 tablets.
Answer: 


A patient comes to your pharmacy and presents the following prescription. The prescription reads:

Metoprolol 50 mg
1 tab po b.i.d. qty: 120
Refill: 3 times
 
Which of the following is TRUE?
 
a. Shall not fill more than 60 tablets.
b. Shall fill 120 tablets as indicated.
c. Shall not fill more than 360 tablets in a single filling.
d. Shall only fill 30 tablets.
Answer: Shall not fill more than 60 tablets, [California Pharmacy Law Chapter 4000 Section 4064.5]. 
A pharmacist may dispense not more than a 90-day supply of a dangerous drug other than a controlled substance pursuant to a valid prescription that specifies an initial quantity of less than a 90-day supply followed by periodic refills of that amount if all of the following requirements are satisfied:
 
(1). The patient has completed an initial 30-day supply of the dangerous drug. 
 
(2). The total quantity of dosage units dispensed does not exceed the total quantity of dosage units authorized by the prescriber on the prescription, including refills. 
 
(3). The prescriber has not specified on the prescription that dispensing the prescription in an initial amount followed by periodic refills is medically necessary.
 
(4). The pharmacist is exercising his or her professional judgment. 
 
(b). For purposes of this section, if the prescription continues the same medication as previously dispensed in a 90-day supply, the initial 30-day supply under paragraph (1) of subdivision (a) is not required.
 
(c). A pharmacist dispensing an increased supply of a dangerous drug pursuant to this section shall notify the prescriber of the increase in the quantity of dosage units dispensed.


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Mr. Smith comes to the pharmacy and asks for the prescription drug Hydrochlorothiazide. Upon reviewing his profile, the pharmacist has found that the patient has no refills left on the current prescription. The pharmacist calls the prescriber but he is out of town for 3 days. The pharmacist gives 3 days worth of medication to Mr. Smith. Is the pharmacist acting in accordance with the standard of care?

Answer: Yes or No


Mr. Smith comes to the pharmacy and asks for the prescription drug Hydrochlorothiazide. Upon reviewing his profile, the pharmacist has found that the patient has no refills left on the current prescription. The pharmacist calls the prescriber but he is out of town for 3 days. The pharmacist gives 3 days worth of medication to Mr. Smith. Is the pharmacist acting in accordance with the standard of care?

Answer: Yes, [California Pharmacy Law Chapter 4000 Section 4064]. 

Hydrochlorothiazide is considered a maintenance drug. It is normally indicated for the treatment of blood pressure. Mr. Smith has been taking this drug to control his blood pressure. 

The pharmacist tried to contact the physician to find the current status of therapy.  The pharmacist made a reasonable effort to prevent any health consequences that may arise due to discontinuation of therapy. The pharmacist was in accordance with the standard of care.

Emergency Refill of Prescription without Prescriber Authorization:

(a). A prescription for a dangerous drug or dangerous device may be refilled without the prescriber's authorization if the prescriber is unavailable to authorize the refill and if, in the pharmacist's professional judgment, failure to refill the prescription might interrupt the patient's ongoing care and have a significant adverse effect on the patient's well-being.

(b). The pharmacist shall inform the patient that the prescription was refilled pursuant to this section.

(c). The pharmacist shall inform the prescriber within a reasonable period of time of any refills dispensed pursuant to this section.

(d). Prior to refilling a prescription pursuant to this section, the pharmacist shall make every reasonable effort to contact the prescriber. The pharmacist shall make an appropriate record, including the basis for proceeding under this section.

(e). The prescriber shall not incur any liability as the result of a refilling of a prescription pursuant to this section.

(f). Notwithstanding Section 4060 or any other law, a person may possess a dangerous drug or dangerous device furnished without prescription pursuant to this section.


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