As used in this chapter: (1) "Biological product" means a biological product as defined by 42 U.S.C. § 262(i)(1) , as it existed on January 1, 2019; (2) "Credentialing" means the issuance of or approval by the Arkansas State Board of Pharmacy of a credential issued to a pharmacist by an agency approved by the Arkansas State Board of Pharmacy certifying that the pharmacist has met the standards of competency established by the Arkansas State Board of Pharmacy for pharmacy services necessitating a credential; (3) "Dentist" means a practitioner of dentistry duly licensed under the laws of this or some other state; (4) (A) "Disease state management" means a strategy that utilizes a team-oriented, multidisciplinary approach to improve healthcare outcomes and quality of care, and when possible, to control healthcare cost through management of targeted chronic disease states. (B) Disease state management focuses on improving health care from prevention to diagnosis and treatment to ongoing follow-up. (C) Disease state management will involve, but not be limited to, patient education, self-care techniques, and outpatient drug therapy management pursuant to a patient care plan; (5) "Drug" shall include all medicines and preparations recognized in the United States Pharmacopeia - National Formulary as substances intended to be used for the care, mitigation, or prevention of disease of either man or other animals; (6) "Generically equivalent" means a drug that is pharmaceutically and therapeutically equivalent to the drug prescribed; (7) "HIV" means the human immunodeficiency virus or any other identified causative agent of acquired immunodeficiency syndrome (AIDS); (8) "Interchangeable biological product" means a biological product that is interchangeable as defined by 42 U.S.C. § 262(i)(3) , as it existed on January 1, 2019; (9) (A) "Licensed pharmacist" means a person holding a license under the provisions of this chapter. (B) A "licensed pharmacist" shall be considered an individual healthcare provider; (10) "Medicine" means a drug or preparation of drugs in suitable form for use as a curative or remedial substance; (11) "Optometrist" means a practitioner of optometry duly licensed under the laws of this state; (12) "Patient care plan" means a written course of action that is patient- or physician- or pharmacist-specific and disease-specific for helping a patient to achieve outcomes that improve a patient's quality of life; (13) "Pharmaceutically equivalent" means drug products that have identical amounts of the same active chemical ingredients in the same dosage form and that meet the identical, compendious, or other applicable standards of strength, quality, and purity according to the United States Pharmacopeia - National Formulary or another nationally recognized compendium; (14) "Pharmacy" means the place licensed by the Arkansas State Board of Pharmacy in which drugs, chemicals, medicines, prescriptions, and poisons are compounded, dispensed, or sold at retail; (15) "Pharmacy care" means the process by which a pharmacist in consultation with the prescribing practitioner identifies, resolves, and prevents potential and actual drug-related problems and optimizes patient therapy outcomes through the responsible provision of drug therapy or disease state management for the purpose of achieving any of the following definite outcomes that improve a patient's quality of life: (A) Cure of disease; (B) Elimination or reduction of a patient's symptomology; (C) Arresting or slowing a disease process; or (D) Preventing a disease or symptomology; (16) "Physician" means a practitioner of medicine duly licensed under the laws of this or some other state; (17) "Poisons" means any drug, chemical, medicine, or preparation liable to be destructive to adult human life in quantities of sixty (60) grains or less; (18) (A) "Practice of pharmacy" means the healthcare provider profession of: (i) (a) Dispensing, selling, distributing, transferring possession of, vending, bartering, or, in accordance with rules adopted by the Arkansas State Board of Pharmacy, administering drugs, medicines, poisons, or chemicals that under the laws of the United States or the State of Arkansas may be sold or dispensed only on the prescription and order of a practitioner authorized by law to prescribe drugs, medicines, poisons, or chemicals. (b) Except as limited by rules adopted by the Arkansas State Board of Pharmacy, a pharmacist has the ability to administer medications. (c) A pharmacist may prescribe, administer, deliver, distribute, or dispense medications that treat adverse reactions associated with the administration of vaccines and immunizations, vaccines, and immunizations to or for a person three (3) years of age or older. (d) A pharmacist who prescribes and administers vaccines and immunizations other than for influenza or coronavirus 2019 (COVID-19) to a person who is three (3) years of age to six (6) years of age shall: (1) Participate in the federal Vaccines for Children Program; and (2) Inform the person who is three (3) years of age to six (6) years of age and adult caregivers accompanying the person who is three (3) years of age to six (6) years of age of the importance of a well-child visit with a pediatrician or other licensed primary care provider and recommend a well-child visit at least yearly. (e) (1) A pharmacist may administer medications other than medications that treat adverse reactions associated with the administration of vaccines and immunizations, vaccines, and immunizations under a patient-specific order or prescription or general written protocol. (2) The administration of the medication under subdivision (18)(A)(i) (e)(1) of this section is subject to reporting to the prescribing physician, if applicable. (f) A general written protocol and patient-specific orders or prescriptions under subdivision (18)(A)(i) (e) of this section shall be from a physician licensed by the Arkansas State Medical Board and practicing in Arkansas or within fifty (50) miles of the Arkansas border. (g) Under a statewide protocol, a pharmacist may initiate therapy and administer or dispense, or both, drugs that include Naloxone, nicotine replacement therapy products, oral contraceptives, HIV pre-exposure prophylaxis, and HIV post-exposure prophylaxis; (ii) Placing, packing, pouring, or putting into a container for dispensing, sale, distribution, transfer of, possession of, vending, or bartering any drug, medicine, poison, or chemical that under the laws of the United States or the State of Arkansas may be sold or dispensed only on the prescription of a practitioner authorized by law to prescribe drugs, medicines, poisons, or chemicals; (iii) Placing in or affixing upon any container described in subdivision (18)(A)(ii) of this section a label required to be placed upon drugs, medicines, poisons, or chemicals sold or dispensed upon prescription of a practitioner authorized by law to prescribe those drugs, medicines, poisons, or chemicals; (iv) Preparing, typing, or writing labels to be placed in or affixed on any container described in subdivision (18)(A)(ii) of this section, which label is required to be placed upon drugs, medicines, poisons, or chemicals sold or dispensed upon prescription of a practitioner authorized by law to prescribe those drugs, medicines, poisons, or chemicals; (v) Interpreting prescriptions for drugs, medicines, poisons, or chemicals issued by practitioners authorized by law to prescribe drugs, medicines, poisons, or chemicals that may be sold or dispensed only on prescription; (vi) Selecting, taking from, and replacing upon shelves in the prescription department of a pharmacy or apothecary drugs, medicines, chemicals, or poisons that are required by the laws of the United States or the State of Arkansas to be sold or dispensed only on prescription of a practitioner authorized by law to prescribe them; (vii) Compounding, mixing, preparing, or combining drugs, medicines, chemicals, or poisons that under the laws of the United States or the State of Arkansas may be sold or dispensed only on the prescription of a practitioner authorized by law to prescribe them; (viii) Advising and providing information concerning utilization of drugs and devices and participation in drug utilization reviews; (ix) (a) Performing a specific act of drug therapy management or disease state management delegated to a pharmacist for an individual patient based upon a written protocol or a patient care plan approved by a physician, who shall be licensed in this state under the Arkansas Medical Practices Act, § 17-95-201 et seq., § 17-95-301 et seq., and § 17-95-401 et seq. (b) Drug therapy management shall not include the selection of drug products not prescribed by the physician unless the drug products are either named in the physician-initiated protocol or the physician-approved patient care plan; (x) (a) Providing pharmacy care. (b) A pharmacist may treat the following conditions within the framework of a statewide written protocol: (1) Influenza; (2) Pharyngitis caused by streptococcus A; or (3) Other health conditions that can be screened utilizing the waived test under the Clinical Laboratory Improvement Amendments of 1988, that may be adopted by rule of the Arkansas State Board of Pharmacy, in consultation with and upon approval of the Arkansas State Medical Board. (c) A pharmacist shall only treat conditions for which the pharmacist has tested and that are approved under subdivision (18)(A)(x) (b) of this section. (d) (1) The Arkansas State Board of Pharmacy, with consultation and upon approval of the Arkansas State Medical Board, shall adopt by rule: (A) A formulary of medicinal drugs that a pharmacist may prescribe for treatment of conditions listed in subdivision (18)(A)(x) (b) of this section; and (B) A written statewide protocol for conditions listed in subdivision (18)(A)(x) (b) of this section, which shall include without limitation the age of people that can be treated and medications to be used to treat people under this subdivision. (2) The formulary shall include medicinal drugs approved by the United States Food and Drug Administration which are indicated for treatment of these conditions, including without limitation any over-the-counter medication. (3) The formulary shall not include any controlled substance in Schedules I - IV or 21 U.S.C. § 812 , as existing on January 1, 2021. (e) A pharmacist may write a prescription for over-the-counter medications, supplies, and devices; and (xi) Providing pharmacokinetic services. (B) The provisions of subdivisions (18)(A) and (18)(C) of this section shall not apply to employees of wholesale drug companies or other drug distributors who do not fill prescriptions or sell or dispense drugs to the consumer. (C) (i) The Arkansas State Board of Pharmacy may permit pharmacy technicians other than pharmacists or interns to perform some or all of those functions described in Arkansas State Board of Pharmacy rules under the direct, personal supervision of a licensed pharmacist under rules defining the minimum qualifications of such employees, the ratio of pharmacy technicians to supervising pharmacists, and the scope of the duties, practices, and procedures that the Arkansas State Board of Pharmacy determines will promote the delivery of competent, professional pharmaceutical services and promote the public health and welfare. (ii) A pharmacy technician may administer vaccines and immunizations to a person three (3) years of age or older if delegated to do so by a supervising pharmacist, but may not administer other medications. (iii) The conduct of a pharmacy technician is the responsibility of the pharmacist-in-charge and supervising pharmacist of the pharmacy who shall not permit the employee to perform any act, task, or function that involves the exercise of independent judgment by the employee. (iv) Pharmacy products prepared by pharmacy technicians shall be verified for accuracy by the supervising pharmacist before release for patient use, and the verification shall be documented. (v) The use of pharmacy technicians in a manner not authorized by this chapter or rules promulgated hereunder shall be unprofessional conduct by the pharmacist-in-charge and the supervising pharmacist. (vi) It is recognized that hospital pharmacy technicians as defined in § 17-92-602(4) are governed by the Hospital Pharmacies Act, § 17-92-601 et seq., and related Arkansas State Board of Pharmacy rules developed under the Hospital Pharmacies Act, § 17-92-601 et seq.; (19) (A) (i) "Prescription" means an order for medicine or medicines usually written as a formula by a physician, optometrist, dentist, veterinarian, or other licensed medicinal practitioner. (ii) A prescription contains the names and quantities of the desired substance, with instructions to the pharmacist for its preparation and to the patient for the use of the medicine at a particular time and may authorize the pharmacist to substitute a therapeutically equivalent drug that is at an equal or lower cost to the patient and communicate that authorization by any generally accepted means of communication of a prescription from a prescriber to a pharmacist. (B) (i) A pharmacist whose practice is located within this state may substitute one (1) medication for a therapeutically equivalent medication. (ii) However, a pharmacist shall not substitute one (1) medication for a therapeutically equivalent medication if: (a) A prescription is in writing and the prescriber indicates in his or her own handwriting by name or initial that no substitution is to be made; (b) A prescription is not in writing and the prescriber expressly indicates that the prescription is to be dispensed as communicated; or (c) The Arkansas State Board of Pharmacy has determined that a therapeutically equivalent medication should not be substituted and has notified all pharmacists of that determination. (C) (i) Before dispensing, the pharmacist shall discuss verbally any suggested substitution with the patient and inform the patient that the patient has a right to refuse the substitution. (ii) The discussion under subdivision (19)(C)(i) of this section shall include without limitation: (a) Notification to the patient that the therapeutically equivalent drug does not contain the identical active ingredient present in the prescribed drug; and (b) All differences in dosage and frequency between the prescribed drug and the therapeutically equivalent drug. (D) The pharmacist shall send notice of the substitution to the prescriber in writing or by electronic communication within twenty-four (24) hours after the drug is dispensed to the patient. (E) Subdivision (19)(B) of this section does not apply to specific acts of drug therapy management or disease state management delegated to a pharmacist based upon a written protocol or patient care plan approved by a physician under subdivision (18)(A)(ix) of this section; (20) "Proprietary medicines", when not otherwise limited, means remedies that a certain individual or individuals have the exclusive right to manufacture or sell; (21) "Statewide protocol" means a standardized procedure or protocol approved by the Arkansas State Board of Pharmacy and the Arkansas State Medical Board authorizing a pharmacist to initiate therapy and administer or dispense, or both, a drug or device; (22) "Supervision" means under the direct charge or direction of and does not contemplate any continued absence of such supervision; (23) "Therapeutic class" means a group of similar drug products that have the same or similar mechanisms of action and are used to treat a specific condition; (24) "Therapeutically equivalent" means drug products from the same therapeutic class that if administered in appropriate amounts will provide the same therapeutic effect, identical in duration and intensity; (25) "Veterinarian" means a practitioner of veterinary medicine duly licensed under the laws of this or some other state; and (26) "Written protocol" means a physician's order, standing medical order, standing delegation order, or other order or protocol as defined by rule of the Arkansas State Medical Board under the Arkansas Medical Practices Act, § 17-95-201 et seq., § 17-95-301 et seq., and § 17-95-401 et seq.
Amended by Act 2023, No. 314,§ 2, eff. 8/1/2023. Amended by Act 2023, No. 314,§ 1, eff. 8/1/2023. Amended by Act 2021, No. 503,§ 3, eff. 1/1/2022. Amended by Act 2021, No. 503,§ 2, eff. 1/1/2022. Amended by Act 2021, No. 408,§ 1, eff. 7/28/2021. Amended by Act 2021, No. 407,§ 1, eff. 7/28/2021. Amended by Act 2021, No. 406,§ 1, eff. 7/28/2021. Amended by Act 2021, No. 63,§ 1, eff. 7/28/2021. Amended by Act 2019, No. 315,§ 1570, eff. 7/24/2019. Amended by Act 2019, No. 315,§ 1569, eff. 7/24/2019. Amended by Act 2019, No. 315,§ 1568, eff. 7/24/2019. Amended by Act 2019, No. 315,§ 1567, eff. 7/24/2019. Amended by Act 2019, No. 652,§ 1, eff. 7/24/2019. Amended by Act 2019, No. 651,§ 1, eff. 7/24/2019. Amended by Act 2019, No. 637,§ 1, eff. 7/24/2019. Amended by Act 2019, No. 386,§ 43, eff. 7/24/2019. Amended by Act 2017, No. 284,§ 3, eff. 8/1/2017. Amended by Act 2017, No. 284,§ 2, eff. 8/1/2017. Amended by Act 2017, No. 284,§ 1, eff. 8/1/2017. Amended by Act 2013, No. 536,§ 1, eff. 8/16/2013. Amended by Act 2013, No. 274,§ 3, eff. 8/16/2013. Amended by Act 2013, No. 274,§ 2, eff. 8/16/2013. Amended by Act 2013, No. 274,§ 1, eff. 8/16/2013. Acts 1929, No. 72, § 1; Pope's Dig., § 4624; Acts 1955, No. 57, preliminary section; 1971, No. 26, §§ 1, 3; 1983, No. 511, §§ 2, 13; 1985, No. 616, § 2; A.S.A. 1947, §§ 72-1001, 72-1001.1, 72-1044, 72-1046; Acts 1987, No. 101, § 3; 1991, No. 740, § 1; 1997, No. 437, §§ 1, 2; 1997, No. 1204, §§ 1, 2; 1999, No. 105, §§ 1-5; 2001, No. 801, § 1; 2001, No. 910, § 1; 2003, No. 1473, § 34; 2009, No. 355, § 1; 2011, No. 147, § 1.