Prescriber Dispensing - Pharmacy - Business & Professions - CA

Section § 4170

Prescribers, like doctors or nurse practitioners, can only dispense drugs directly to patients in their office or practice if they follow several rules. They must ensure the drugs are for their own patient, necessary for treatment, and not handed out by their staff. They can't run a pharmacy, must label and record drugs correctly, and use childproof packaging. Before dispensing, they must offer the patient a written prescription to fill elsewhere and inform them they can choose where to get it. Certain nurses and assistants can hand out prepackaged prescriptions but must follow specific protocols. Relevant boards and authorities ensure compliance with these rules.

(a) A prescriber shall not dispense drugs or dangerous devices to patients in the prescriber’s office or place of practice unless all of the following conditions are met:

(1) The dangerous drugs or dangerous devices are dispensed to the prescriber’s own patient, and the drugs or dangerous devices are not furnished by a nurse or physician attendant.

(2) The dangerous drugs or dangerous devices are necessary in the treatment of the condition for which the prescriber is attending the patient.

(3) The prescriber does not keep a pharmacy, open shop, or drugstore, advertised or otherwise, for the retailing of dangerous drugs, dangerous devices, or poisons.

(4) The prescriber fulfills all of the labeling requirements imposed upon pharmacists by Section 4076, all of the recordkeeping requirements of this chapter, and all of the packaging requirements of good pharmaceutical practice, including the use of childproof containers.

(5) The prescriber does not use a dispensing device unless the prescriber personally owns the device and the contents of the device, and personally dispenses the dangerous drugs or dangerous devices to the patient packaged, labeled, and recorded in accordance with paragraph (4).

(6) The prescriber, before dispensing, offers to give a written prescription to the patient that the patient may elect to have filled by the prescriber or by any pharmacy.

(7) The prescriber provides the patient with written disclosure that the patient has a choice between obtaining the prescription from the dispensing prescriber or obtaining the prescription at a pharmacy of the patient’s choice.

(b) A certified nurse-midwife who functions pursuant to a mutually agreed-upon policy or protocol described in Section 2746.5, a nurse practitioner who functions pursuant to a standardized procedure described in Section 2836.1, or protocol, a physician assistant who functions pursuant to Section 3502.1, or a naturopathic doctor who functions pursuant to Section 3640.5, may hand to a patient of the supervising physician and surgeon a properly labeled prescription drug prepackaged by a physician and surgeon, a manufacturer as defined in this chapter, or a pharmacist.

(c) The Medical Board of California, the California State Board of Optometry, the California Board of Naturopathic Medicine, the Dental Board of California, the Podiatric Medical Board of California, the Osteopathic Medical Board of California, the Board of Registered Nursing, the Veterinary Medical Board, and the Physician Assistant Board shall have authority with the California State Board of Pharmacy to ensure compliance with this section, and those boards are specifically charged with the enforcement of this chapter with respect to their respective licensees.

(d) “Prescriber,” as used in this section, means a person who holds a physician’s and surgeon’s certificate, a license to practice optometry, a license to practice naturopathic medicine, a license to practice dentistry, a license to practice veterinary medicine, a certificate to practice podiatry, a certificate to practice as a nurse practitioner practicing pursuant to Section 2837.103 or 2837.104, or a certificate to practice as a nurse-midwife, and who is duly registered by the Medical Board of California, the Osteopathic Medical Board of California, the California State Board of Optometry, the California Board of Naturopathic Medicine, the Dental Board of California, the Veterinary Medical Board, the Podiatric Medical Board of California, or the Board of Registered Nursing.

prescriber dispensing dangerous drugs treatment necessity

Section § 4170.5

This law allows veterinarians at accredited veterinary teaching hospitals to use a shared supply of dangerous drugs and controlled substances. A designated pharmacist is responsible for managing this supply, ensuring that everything from ordering to dispensing is done safely and in accordance with public health standards. The pharmacist must establish clear procedures and guidelines, taking into account how they work with veterinarians. Additionally, the state board has the right to inspect these hospitals to ensure compliance with the regulations.

(a) Veterinarians in a veterinary teaching hospital operated by an accredited veterinary medical school may dispense and administer dangerous drugs and devices and controlled substances from a common stock.

(b) The veterinary teaching hospital shall designate a pharmacist to be responsible for ordering the drugs for the common stock and the designated pharmacist-in-charge shall be professionally responsible to insure that inventories, security procedures, training, protocol development, recordkeeping, packaging, labeling, and dispensing occur in a manner that is consistent with the promotion and protection of the health and safety of the public.

(c) The veterinary teaching hospital’s pharmacist-in-charge shall develop policies, procedures, and guidelines that recognize the unique relationship between the institution’s pharmacists and veterinarians in the control, management, dispensation, and administration of drugs.

(d) The board may inspect a veterinary teaching hospital dispensing or administering drugs pursuant to this section.

veterinary teaching hospital accredited veterinary medical school dangerous drugs

Section § 4171

This law explains exceptions to restrictions on the distribution of medication samples by healthcare providers. It allows prescribers to give a limited amount of free samples to patients, provided no money is charged and records are kept. It also exempts certain clinics and cancer treatment providers from these restrictions.

(a) Section 4170 shall not prohibit the furnishing of a limited quantity of samples by a prescriber, if the prescriber dispenses the samples to the patient in the package provided by the manufacturer, no charge is made to the patient therefor, and an appropriate record is entered in the patient’s chart.

(b) Section 4170 shall not apply to clinics, as defined in subdivision (a) of Section 1204 or subdivision (b) or (c) of Section 1206 of the Health and Safety Code, to programs licensed pursuant to Sections 11876, 11877, and 11877.5 of the Health and Safety Code, or to a prescriber dispensing parenteral chemotherapeutic agents, biologicals, or delivery systems used in the treatment of cancer.

medication samples prescriber exceptions patient samples

Section § 4172

This law requires any prescriber who gives out drugs to store them in a safe and secure place. The Medical Board of California will come up with rules to explain what 'secure' means in this context.

A prescriber who dispenses drugs pursuant to Section 4170 shall store all drugs to be dispensed in an area that is secure. The Medical Board of California shall, by regulation, define the term “secure” for purposes of this section.

prescriber dispensing drugs drug storage

Section § 4173

This law allows registered nurses to dispense drugs or medical devices if they are doing so under the guidelines provided in another specific law, Section 2725.1.

This chapter does not prevent the dispensing of drugs or devices by registered nurses functioning pursuant to Section 2725.1.

dispensing drugs registered nurses medical devices

Section § 4174

This law allows pharmacists to give out drugs or devices based on the orders from certain healthcare professionals. This includes nurse practitioners, certified nurse-midwives, physician assistants, naturopathic doctors, and even other pharmacists, as long as they are working under specific guidelines. It basically expands the range of professionals who can write orders that pharmacists can fill.

Notwithstanding any other law, a pharmacist may dispense drugs or devices upon the drug order of a nurse practitioner practicing pursuant to Section 2836.1, 2837.103, or 2837.104, or a certified nurse-midwife functioning pursuant to Section 2746.51, a drug order of a physician assistant functioning pursuant to Section 3502.1 or a naturopathic doctor functioning pursuant to Section 3640.5, or the order of a pharmacist acting under Section 4052.1, 4052.2, 4052.3, or 4052.6.

pharmacist dispensing drug order nurse practitioner

Section § 4175

If there's a complaint about drugs or devices given out by certain medical professionals, like nurse practitioners or physician assistants, the California State Board of Pharmacy must send it to the proper licensing board. If the complaint involves serious injuries, it gets top priority with medical boards.

(a) The California State Board of Pharmacy shall promptly forward to the appropriate licensing entity, including the Medical Board of California, the California Veterinary Medical Board, the Dental Board of California, the California State Board of Optometry, the Podiatric Medical Board of California, the Osteopathic Medical Board of California, the Board of Registered Nursing, the California Board of Naturopathic Medicine, or the Physician Assistant Board, all complaints received related to dangerous drugs or dangerous devices dispensed by a prescriber, certified nurse-midwife, nurse practitioner, naturopathic doctor, or physician assistant pursuant to Section 4170.

(b) All complaints involving serious bodily injury due to dangerous drugs or dangerous devices dispensed by prescribers, certified nurse-midwives, nurse practitioners, naturopathic doctors, or physician assistants pursuant to Section 4170 shall be handled by the Medical Board of California, the Dental Board of California, the California State Board of Optometry, the Podiatric Medical Board of California, the Osteopathic Medical Board of California, the California Board of Naturopathic Medicine, the Board of Registered Nursing, the California Veterinary Medical Board, or the Physician Assistant Board as a case of greatest potential harm to a patient.

California State Board of Pharmacy licensing entity Medical Board of California