§ 21.284. Prescribing and dispensing parameters.

 (a)  The Board adopts the American Hospital Formulary Service Pharmacologic-Therapeutic Classification to identify drugs which the CRNP may prescribe and dispense subject to the parameters identified in this section.

 (b)  A CRNP may prescribe and dispense a drug relevant to the area of practice of the CRNP from the following categories if that authorization is documented in the collaborative agreement (unless the drug is limited or excluded under this or another subsection):

   (1)  Antihistamines.

   (2)  Anti-infective agents.

   (3)  Antineoplastic agents, unclassified therapeutic agents, devices and pharmaceutical aids if originally prescribed by the collaborating physician and approved by the collaborating physician for ongoing therapy.

   (4)  Autonomic drugs.

   (5)  Blood formation, coagulation and anticoagulation drugs, and thrombolytic and antithrombolytic agents.

   (6)  Cardiovascular drugs.

   (7)  Central nervous system agents, except that the following drugs are excluded from this category:

     (i)   General anesthetics.

     (ii)   Monoamine oxidase inhibitors.

   (8)  Contraceptives including foams and devices.

   (9)  Diagnostic agents.

   (10)  Disinfectants for agents used on objects other than skin.

   (11)  Electrolytic, caloric and water balance.

   (12)  Enzymes.

   (13)  Antitussive, expectorants and mucolytic agents.

   (14)  Gastrointestinal drugs.

   (15)  Local anesthetics.

   (16)  Eye, ear, nose and throat preparations.

   (17)  Serums, toxoids and vaccines.

   (18)  Skin and mucous membrane agents.

   (19)  Smooth muscle relaxants.

   (20)  Vitamins.

   (21)  Hormones and synthetic substitutes.

 (c)  A CRNP may not prescribe or dispense a drug from the following categories:

   (1)  Gold compounds.

   (2)  Heavy metal antagonists.

   (3)  Radioactive agents.

   (4)  Oxytocics.

 (d)  If a collaborating physician determines that the CRNP is prescribing or dispensing a drug inappropriately, the collaborating physician shall immediately take corrective action on behalf of the patient and notify the patient of the reason for the action and advise the CRNP as soon as possible. This action shall be noted by the CRNP or the collaborating physician, or both, in the patient’s medical record.

 (e)  Restrictions on CRNP prescribing and dispensing practices are as follows:

   (1)  A CRNP may write a prescription for a Schedule II controlled substance for up to a 72 hour dose. The CRNP shall notify the collaborating physician as soon as possible but in no event longer than 24 hours.

   (2)  A CRNP may prescribe a Schedule III or IV controlled substance for up to 30 days. The prescription is not subject to refills unless the collaborating physician authorizes refills for that prescription.

 (f)  A CRNP may not:

   (1)  Prescribe or dispense a Schedule I controlled substance as defined in section 4 of the Controlled Substance, Drug, Device and Cosmetic Act (35 P. S. §  780-14).

   (2)  Prescribe or dispense a drug for a use not approved by the United States Food and Drug Administration without approval of the collaborating physician.

   (3)  Delegate prescriptive authority specifically assigned to the CRNP by the collaborating physician to another health care provider.

 (g)  A prescription blank shall bear the certification number of the CRNP, name of the CRNP in printed format at the top of the blank and a space for the entry of the DEA registration number, if appropriate. The collaborating physician shall also be identified as required in §  16.91 (relating to identifying information on prescriptions and orders for equipment and service).

 (h)  The CRNP shall document in the patient’s medical record the name, amount and dose of the drug prescribed, the number of refills, the date of the prescription and the CRNP’s name.

   The provisions of this §  21.284 issued under section 15(b) of the Medical Practice Act of 1985 (63 P. S. §  422.15(b)).

   The provisions of this §  21.284 adopted November 17, 2000, effective November 18, 2000, 30 Pa.B. 5943.

   This section cited in 49 Pa. Code §  21.285 (relating to collaborative agreement); and 49 Pa. Code §  21.369 (relating to general curriculum requirements).