§ 43-15-31.6 — Prescriptive authority

North Dakota § 43-15-31.6

• Jurisdiction: North Dakota
• Title 43: Occupations and Professions
• Ch. 43-15: Pharmacists

Text

1. A pharmacist whose practice is physically located within this state, acting in good faith
and exercising reasonable care, may independently prescribe drugs, drug categories,
and devices as provided in this section if each of the following requirements are met:
a. A pharmacist may prescribe drugs or devices only for conditions for which the
pharmacist is educationally prepared and competence has been achieved and
maintained.
b. A pharmacist may issue a prescription only for a legitimate medical purpose
arising from a patient-pharmacist relationship.
c. A pharmacist shall obtain adequate information about the patient's health status
to make appropriate decisions based on the applicable standard of care.
d. For each drug or drug category a pharmacist intends to prescribe, the pharmacist
shall maintain a patient assessment protocol based on current clinical guidelines,
when available, or evidence-based research findings that specify the following:
(1) Patient inclusion and exclusion criteria; and
(2) Explicit medical referral criteria.
e. A pharmacist shall revise the patient assessment protocol when necessary to
ensure continued compliance with clinical guidelines or evidence-based research
findings. The pharmacist's patient assessment protocol, and any related forms,
must be made available to the board upon request.
f. A pharmacist shall consult with and refer to other health care professionals as
appropriate, including in situations where the pharmacist's knowledge or
experience is limited.
g. A pharmacist shall develop and implement an appropriate followup care plan,
including any monitoring parameters, in accordance with clinical guidelines. The
plan may include followup care with the patient and communication with the
patient's primary care provider.

h. A pharmacist shall inquire about the identity of the patient's primary care provider
or provider of record. If a primary care provider or provider of record is identified,
the pharmacist shall provide notification to the primary care provider or provider
of record within three business days following the prescription of a drug. The
notification must include the results of any test that required the prescription and,
upon the provider's request, any relevant documentation required under
subdivision i.
i. A pharmacist shall maintain documentation adequate to justify the care provided,
including information collected as part of the patient assessment, the prescription
record, any notification provided under this section, and the followup care plan.
2. A pharmacist may prescribe any drug approved by the federal food and drug
administration which is indicated for the following conditions:
a. Lice;
b. Cold sores;
c. Motion sickness, including the prevention of motion sickness; and
d. Hypoglycemia.
3. A pharmacist may prescribe any of the following devices approved by the federal food
and drug administration:
a. Inhalation spacer;
b. Nebulizer;
c. Disposable diabetes blood sugar testing supplies;
d. Pen needles; and
e. Auto-injectors containing drugs for patients with a documented history of allergies
or anaphylaxis.
4. A pharmacist may prescribe any drug approved by the federal food and drug
administration which is indicated for the following conditions, provided the symptomatic
patient first tests positive to a test that is waived under the Federal Clinical Laboratory
Improvement Act of 1988 [Pub. L. 100-578, section 2; 102 Stat. 2903; 42 U.S.C. 263a
et seq.], as amended:
a. Influenza;
b. Group A streptococcal pharyngitis; and
c. Severe acute respiratory syndrome coronavirus 2 identified as SARS-CoV-2.
5. If a patient tested positive for influenza, a pharmacist may prescribe an antiviral drug
to an individual who has been exposed to the infected patient and for whom the clinical
guidelines recommend chemoprophylaxis.
6. A pharmacist may prescribe any drug approved by the federal food and drug
administration for the purpose of closing a gap in clinical guidelines as follows:
a. Postexposure prophylaxis for nonoccupational exposure to human
immunodeficiency virus infection; and
b. Short-acting beta agonists for a patient with asthma who has had a prior
prescription for a short-acting beta agonist and who has a current prescription for
a long-term asthma control drug.
7. A pharmacist who successfully completes an accredited continuing pharmacy
education or continuing medical education course on travel medicine may prescribe
any noncontrolled drug recommended for individuals traveling outside the United
States which is specifically listed in the federal centers for disease control and
prevention health information for international travel publication. The pharmacist only
may prescribe drugs that are indicated for the patient's intended destination for travel.
8. If an emergency situation exists which in the professional judgment of the pharmacist
threatens the health or safety of the patient, a pharmacist may prescribe the following
drugs approved by the federal food and drug administration in the minimum quantity
necessary until the patient is able to be seen by a provider:
a. Diphenhydramine;
b. Epinephrine; and
c. Short-acting beta agonists.

9. A pharmacist may prescribe antimicrobial prophylaxis for the prevention of lyme
disease in accordance with the federal centers for disease control and prevention
guidelines.