text:
184.108.40.206 ISSUING AGENCY: Regulation
and Licensing Department - Board of Pharmacy, Albuquerque, NM.
126.96.36.199 NMAC - Rn, 16 NMAC 19.4.1, 03-30-02; A, 12-15-02; A, 08-16-10]
184.108.40.206 SCOPE: All
designations of pharmacists subject to licensure and regulation by the Board of
188.8.131.52 NMAC - Rn, 16 NMAC 19.4.2, 03-30-02]
Section 61-11-6.A.(1) authorizes the Board of Pharmacy to adopt,
regularly review and revise rules and regulations necessary to carry out the
provisions of the Pharmacy Act, Sections 61-11-1, 61-11-2, 61-11-4 to 61-11-28
NMSA 1978. Those provisions include the authority to (i) deny or take
disciplinary action with respect to any certificate of registration or license
held or applied for under the Pharmacy Act, Sections 61-11-20 NMSA 1978; (ii)
require and establish criteria for continuing education as a condition of
renewal of a pharmacist license, Sections 61-11-6.A.(4) NMSA 1978; (iii) issue
permits or licenses, as defined and limited by Board regulation, to nursing
homes, industrial and public health clinics and home care services,
Sections 61-11-6.A.(6), 61-11-14 NMSA
1978; (iv) provide for the annual renewal of licenses for pharmacists, Sections
61-11-6.A.(3), 61-11-13 NMSA 1978; (v) provide for the registration of
pharmacist interns, their certification, annual renewal of certification,
training, supervision, and discipline, Sections 61-11-6.A.(5) NMSA 1978; and
(vi) adopt rules and regulations that establish patient counseling
requirements, 61-11-6.A.(18) NMSA 1978.
Under the Pharmacist Prescriptive Authority Act, Sections 61-11B-1 to 61-11B-3
NMSA 1978, the Board is required to establish regulations governing
certification as a pharmacist clinician.
The Impaired Pharmacists Act, Sections 61-11A-1 to 61-11A-8 NMSA 1978,
requires the establishment by the Board of a plan for treatment and rehabilitation
of impaired pharmacists.
184.108.40.206 NMAC - Rn, 16 NMAC 19.4.3, 03-30-02]
184.108.40.206 NMAC - Rn, 16 NMAC 19.4.4, 03-30-02]
18.104.22.168 EFFECTIVE DATE: February
15, 1996, unless a different date is cited at the end of a Section or Paragraph.
This Part reformatted for inclusion into the New Mexico Administrative Code
(NMAC) effective 2-15-96.
22.214.171.124 NMAC - Rn, 16 NMAC 19.4.5, 03-30-02]
126.96.36.199 OBJECTIVE: The
objective of Part 4 of Chapter 19 is to promote the delivery of quality
pharmaceutical services by establishing comprehensive regulations governing
pharmacists, conduct, continuing education and requirements, criteria for
specialized certification, and duties and responsibilities.
22.214.171.124 NMAC - Rn, 16 NMAC 19.4.6, 03-30-02]
A. "A year" begins with the first day of the
pharmacist's birth month and ends the last day of the pharmacist's birth month
the following year.
B. "Activity" as used in the
ACPE criteria for quality and these regulations, the term refers to an
individual educational experience or program such as a lecture, home study
course, workshop, seminar, symposium, etc.
C. "Alternate supervising physician"
means a physician who holds a current unrestricted license, is a cosignatory on
the notification of supervision, agrees to act as the supervising physician in
the supervising physician's absence, or expand the "scope of practice and/or
sites of practice" of the pharmacist clinician and is approved by the board.
D. "Approved provider" means an
institution, organization or agency that has been recognized by the
accreditation council for pharmaceutical education (ACPE) as having met it's
criteria indicative of the ability to provide quality continuing pharmaceutical
education, and is listed in the ACPE annual publication of approved providers.
E. "Board" means the New Mexico
board of pharmacy.
F. "Consultation" means
communication in person, telephonically, by two-way radio, by e-mail or by
other electronic means.
G. "Contract hour" means a unit
of measure equivalent to sixty (60) minutes of participation in an approved
organized learning experience or activity.
H. "Continuing education unit (CEU)"
means ten contact hours of participation or it's equivalent in an organized
continuing education activity sponsored by an approved provider.
I. "Continuing pharmacy education
(CPE)" means a structured education activity offered by an approved
provider, designed or intended to support the continuing development of
pharmacies or pharmacy technicians to maintain and enhance their
competence. Continuing pharmacy
education should promote problem-solving and critical thinking and be
applicable to the practice of pharmacy.
J. "Continuing professional development (CPD)" means the
responsibility of individual pharmacists for systematic maintenance,
development and broadening of knowledge, skills and attitudes, to ensure
continuing competence as a professional, throughout their careers.
K. "Criteria for quality" means
continuing education provider shall show evidence of adherence to the criteria
adopted by the American council on pharmaceutical education as indicative of
the ability to provide continuing pharmaceutical education activities; areas
include: administrative & organization; budget & resources; teaching
staff; educational content management of activity; method of delivery;
facilities; evaluation mechanism.
L. "Dangerous drug" means a drug
that, because of any potentiality for harmful effect or the methods of its use
or the collateral measures necessary to its use, is not safe except under the
supervision of a physician licensed by law to direct the use of such drug and
the drug prior to dispensing is required by federal law and state law to bear
the manufacturer's legend "Caution:
Federal law prohibits dispensing without a prescription".
M. "Guidelines or protocol" means
a written agreement between a pharmacist clinician or group of pharmacist
clinicians and a physician or group of physicians that delegates prescriptive authority.
N. "Initial pharmacist licensure"
means the license issued shall be valid for no less than 24 months. The license will expire the last date of
his/her birth month that immediately follows the minimum 24 month time period.
O. "Live programs" means CPE
activities that provide for direct interaction between faculty and participants
and may include lectures, symposia, live teleconferences, workshops, etc.
P. "Mediated forms" means
learning transmitted via intermediate mechanism such as audio and/visual tape,
telephonic transmission, etc.
Q. "Monitor dangerous drug therapy"
means to review the dangerous drug therapy regimen of patients by a pharmacist
clinician for the purpose of evaluating and rendering advice to the prescribing
physician regarding adjustment of the regimen.
"Monitor dangerous drug therapy" includes:
(1) collecting and reviewing patient
dangerous drug histories;
(2) measuring and reviewing routine
patient vital signs including pulse, temperature, blood pressure and respiration;
(3) ordering and evaluating the results
of laboratory tests relating to dangerous drug therapy, including blood chemistries and cell counts, controlled substance therapy levels, blood, urine,
tissue or other body fluids, culture and sensitivity tests when performed in
accordance with guidelines or protocols applicable to the practice setting and;
(4) evaluating situations that require
the immediate attention of the physician and instituting or modifying treatment
procedures when necessary.
R. "Oversight
committee" means a joint committee made up of (4) members to hear issues
regarding pharmacist clinicians' prescriptive authority activities and
supervising physicians' direction of these activities.
S. "Patient safety" means
the prevention of healthcare errors and the elimination or mitigation of
patient injury caused by healthcare errors.
T. "Pharmaceutical care" means
the provision of drug therapy and other patient care services related to drug
therapy intended to achieve definite outcomes that improve a patient's quality
of like, including identifying potential and actual drug-related problems,
resolving actual drug-related problems and preventing potential drug-related
U. "Pharmacist" means a person
duly licensed by the board to engage in the practice of pharmacy pursuant to
the Pharmacy Act, Sections 61-11-1, 61-11-2, 61-11-4 to 61-11-28 NMSA 1978.
V. "Pharmacist clinician" means
a pharmacist with additional training required by regulations adopted by the
board in consultation with the New Mexico medical board and the New Mexico
academy of physician assistants, who exercises prescriptive authority in
accordance with guidelines or protocol.
W. "Pharmacist in charge" means a
pharmacist who accepts responsibility for the operation of a pharmacy in
conformance with all laws and rules pertinent to the practice of pharmacy and
the distribution of drugs and who is personally in full and actual charge of
the pharmacy and its personnel.
X. "Practice of pharmacy" means continually optimizing medication
safety, patient wellness, and quality of services through the effective use of
pharmaceutical care and emerging technologies and competency-based and
performance-based training.
(1) Pharmaceutical dispensing including
product selection. Practice of
pharmacy may include, but is not limited
(2) specialty pharmacy practice including
pharmacists working for licensed pharmaceutical manufacturers or wholesalers;
(3) practice of telepharmacy within and
across state lines;
(4) engaging in health care educational
(5) pharmacy-specific academia;
(6) provision of those acts or services
necessary to provide pharmaceutical care in all areas of patient care including
patient counseling, prescriptive authority, drug administration, primary care,
medication therapy management, collaborative practice, and monitoring dangerous
drug therapy;
(7) inspecting on a full time basis to
ensure compliance with the practice of pharmacy;
(8) provision of pharmaceutical and drug information
services, as well as consultant pharmacy services;
(9) engaging in other phases of the
pharmaceutical profession including those with research or investigational or
dangerous drugs; or
(10) engaging in functions that relate
directly to the administrative, advisory, or executive responsibilities
pursuant to the practice of pharmacy in this state;
(11) the responsibility for compounding and
labeling of drugs and devices;
(12) the proper and safe storage of drugs
and devices; and
(13) the maintenance of proper records.
Y. "Practitioner" means a
physician duly authorized by law in New Mexico to prescribe dangerous drugs
including controlled substances in schedules II through V.
Z. "Prescriptive authority"
means the authority to prescribe, administer, monitor or modify dangerous drug
AA. "Professional judgment" means a
cognitive process, by alicensed pharmacist, that takes education, experience
and current standards of practice into consideration when drawing conclusions
and reaching decisions.
BB. "Renewal period" means
continuing education programs or activities must be completed during the 24
month time period occurring between the first day of the pharmacist's
birth month and the last day of his/her birth month 2 years later.
CC. "Scope of practice" means those
duties and limitations of duties placed upon a pharmacist clinician and/or the
alternate supervising physician(s) and the board; includes the limitations
implied by the field of practice of the supervising physician and/or the
alternate supervising physician(s) and the board.
DD. "Supervising physician" means a
doctor, or group of doctors, of medicine or osteopathy approved by the
respective board to supervise a pharmacist clinician; "supervising physician
includes a physician approved by the respective board as an alternate
supervising physician.
188.8.131.52 NMAC - Rn, 16 NMAC 19.4.7, 03-30-02; A, 01-31-07; A, 08-16-10; A,
Gross immorality shall constitute a conviction of a crime involving
moral turpitude including, but not limited to, rape, murder, fraud, theft,
embezzlement or bribery. A copy of the record of conviction certified by the
clerk of the court entering the conviction is conclusive evidence.
220.127.116.11 NMAC - Rn, 16 NMAC 19.4.8, 03-30-02]
A. Preamble: In defining "unprofessional conduct"
the definitions of professional conduct and a pharmacist's duty should be
B. Professional conduct may be defined as complying with all
the laws and regulations that apply to a given professional activity.
C. Definition: Unprofessional or dishonorable conduct by a
pharmacist shall mean, among other things, but not be limited to.
(1) Violation of any provision of the
Pharmacy Act as determined by the board.
(2) Violation of the board of pharmacy
regulations as determined by the board.
(3) Violation of the Drug and Cosmetic
Act as determined by the board.
(4) Violation of the Controlled
Substances Act as determined by the board.
(5) Failure of the pharmacist to conduct
himself professionally in conformity with all applicable federal, state and
municipal laws and regulations to his relationship with the public, other
health professions and fellow pharmacists.
(6) Failure to keep his pharmacy and/or
area of professional practice clean, orderly, maintained and secured for the
proper performance of his professional duties.
(7) Acquiring prescription stock from
unlicensed sources.
(8) Failure to hold on the strictest
confidence all knowledge concerning patrons, their prescriptions, and other
confidence entrusted or acquired of by him; divulging in the interest of the
patron only by proper forms, or where required for proper compliance with legal
(9) Participation in a plan or agreement
which compromises the quality or extent of professional services, or facilities
at the expense of public health or welfare.
(10) The solicitation of prescription
business by providing prescribers with prescription blanks with the name of any
licensed pharmacy or pharmacist printed thereon.
(11) Failure to report a theft or loss of
controlled substances in accordance with 22.214.171.124 NMAC.
(12) Failure to report an impaired licensee
in compliance with Subparagraph (a) of Paragraph (1) of Subsection C of 18.104.22.168
(13) Failure to train or supervise
adequately supportive personnel or the use of supportive personnel in
activities outside the scope of their permitted activities.
(14) Conviction, plea of nolo contendere, or
entering into any other legal agreements for any violation of the Pharmacy Act,
Controlled Substances Act, Drug Device and Cosmetic Act or any similar act of
another state or territory of the United States.
(15) Suspension, revocation, denial, or
forfeiture of license to practice or similar disciplinary action by a licensing
agency of another state or territory of the United States.
(16) Dispensing a prescription for a
dangerous drug to a patient without an established practitioner-patient
(a) except for the provision of treatment
of partners of patients with sexually transmitted diseases when this treatment
is conducted in accordance with the expedited partner therapy guidelines and
protocol published by the New Mexico department of health;
(b) except for on-call practitioners
providing services for a patient's established practitioner;
(c) except for delivery of dangerous drug
therapies to patients ordered by a New Mexico department of health physician as
part of a declared public health emergency;
(d) except for dispensing a prescription
for the dangerous drug naloxone to a person for administration to another as
authorized in public health law 24-23 administration of opioid antagonist;
(e) except for the prescribing or
dispensing and administering for immunizations programs.
(17) Dispensing a prescription order for a
dangerous drug to a patient if the pharmacist has knowledge, or reasonably
should know under the circumstances, that the prescription order was issued on
the basis of an internet-based questionnaire or an internet-based consultation
without a valid practitioner-patient relationship.
(18) Failure to perform a prospective drug
review as described in Subsection D of 184.108.40.206 NMAC and document steps taken
to resolve potential problems.
18.104.22.168 NMAC - Rn, 16 NMAC 19.4.9, 03-30-02; A, 07-15-02; A, 01-15-08; A,
A. Continuing pharmacy education (CPE) shall include study
in one or more of the general areas of socioeconomic and legal aspects of
health care; the properties and actions of drugs and dosage forms; etiology;
characteristics and therapeutics of the disease state, or such other subjects
as the board may from time to time approve. Continuing pharmacy education
approved in New Mexico shall be limited to programs and activities offered by
the accredidation council for pharmacy education (ACPE), approved provider,
programs or courses approved by other state baords of pharmacy and pharmacy law
programs offered by the New Mexico board of pharmacy.
B. Continuing pharmacy education, certified as completed by
an approved provider will be required of a registered pharmacist who applies
for renewal of New Mexico registration as follows: 3.0 CEU (30 contact hours) every two years. Effective January 1, 2013, pharmacist and
pharmacist clinician renewal applications shall document.
(1) A minimum of 1.0 CEU (10 contact
hours) excluding the law requirement, per renewal period shall be obtained
through "live programs" that are approved as such by the ACPE or the
accreditation council for continuing medical education (ACCME). Live programs provided by other providers
(such as continuing nursing education) may be acceptable based on review and
approval of the board.
(2) A minimum of 0.2 CEU (2 contact
hours) per renewal period shall be in the area of patient safety as applicable
to the practice of pharmacy.
(3) A minimum of 0.2 CEU (2 contact
hours) per renewal period shall be in the subject area of pharmacy law offered
by the New Mexico board of pharmacy.
(4) Effective January 1, 2015, a minimum
of 0.2 CEU (2 contact hours) per renewal period shall be in the area of safe
and appropriate use of opioids. An
educational program consisting of a minimum of 0.2 CEU (2 contact hours) that
addresses both patient safety as applicable to the practice of pharmacy and the
safe and appropriate use of opioids will satisfy requirements of Paragraphs (2)
and (4) of Subsection B of this section.
C. The number of CEU's to be awarded for successful
completion shall be determined by the approved provider in advance of the
offering of the activity.
D. The board of
pharmacy will accept CPE education units for programs or activities completed
outside the state; provided, the provider has been approved by the ACPE under
its' criteria for quality at the time the program was offered.
E. Continuing pharmacy education will be required of all
registrants holding an in-state status and out-of-state active status license.
(61-11-13D). Pharmacists granted New Mexico initial licensure are exempt from
CPE requirements. Inactive status
licensees will be required to furnish CPE for the current licensing period, 1.5 CEU for each year the licensee was
inactive, only for the purpose of reinstating to active status.
F. Not less than 10% of the registrants will be randomly
selected each year by the board of pharmacy for audit of certificates by the
state drug inspectors. Pharmacists and
pharmacist clinicians without sufficient documentation of completion of CPE
requirements shall.
(1) Be subject to a fine of not less that
(2) Be required to complete the deficient
CPE in a satisfactory time period as determined by the board.
G. In the event a pharmacist makes an application for
renewal and does not furnish necessary proof of compliance upon request, the board will afford
the applicant opportunity for hearing pursuant to the Uniform Licensing Act.
J. Pharmacy law requirement for.
(1) Active status: A minimum of 0.2 CEU (2 contact hours) of the 3.0 CEU (30
contact hours) required for
registration renewal, shall be in the subject area pharmacy law as offered by
the N.M. board of pharmacy. In lieu of a board program, pharmacists not
residing and not practicing pharmacy in New Mexico, may complete an ACPE
accredited course, in the subject area pharmacy law, meeting the CEU
requirements of this paragraph.
(2) Effective
date. Registration renewals due June 1996 and thereafter.
(3) Licensees
may obtain 0.1 CEU (1 contact hour) per year, in the subject area pharmacy law,
by attending one full day of a regularly scheduled New Mexico board of
pharmacy board meeting or serving on a board approved committee.
(4) Licensees who successfully complete
an open book test, administered by the board, shall
receive credit for 0.2 CEU (2 contact hours) in the subject area pharmacy law.
K. Board of pharmacy law programs.
(1) Pharmacy law programs shall be
offered in each of the five pharmacy districts, as defined in NMSA 61-11-4.E, a
minimum of once every calendar year (January through December).
(2) Pharmacy law programs shall offer 0.2
CEU and be two contact hours in length.
[02-26-95; 126.96.36.199
NMAC - Rn, 16 NMAC 19.4.10, 03-30-02; A, 12-15-02; A, 01-31-07; A, 08-16-10; A,
(1) To abide by the code of ethics of the
American Society of Consultant Pharmacists. Must
be qualified to
practice as a consultant pharmacist and is to be aware of all federal and state
drug laws, rules and regulations related to pharmacy services, and to provide
the facility with current information pertaining to drug service.
(2) Ensure that drugs are handled in the
facility in which he/she is the consultant pharmacist,
in a manner that
protect the safety and welfare of the patient.
(3) Set the policy and procedures in the
facility as related to all facits of drug handling and
these policies and procedures to be reviewed and updated on an annual basis.
(4) To visit the facility, commensurate
with his duties, as specified by Board regulations
relative to the
facility or by written contract with the administration of the facility not
inconsistent with Board regulations.
(5) His/her primary goal and objective
shall be the health and safety of the patient, and
he/she shall make
every effort to assure the maximum level of safety and efficacy in the
provision of pharmaceutical services.
(6) The consultant pharmacist shall not
condone or participate in any transaction with any
practitioner of
another health profession, or any other persons whosoever under which fees are
divided, or rebates or kickbacks paid or caused to be paid, or which may result
in financial exploitation of patients or their families in connection with the
provision of drugs and medication or supplies or pharmaceutical services.
(1) The consultant pharmacist's agreement
with the facility shall include but is not limited to
the following
duties and responsibilities.
(a) Serve as a member of appropriate
committees, and attend these meetings.
(b) Development of the Drug Control
Procedures Manual.
(c) Monitor on a routine basis all
aspects of the total drug distribution system - to be accomplished in a manner
designed to monitor and safeguard all areas of the drug distribution system.
(d) Maintain active pharmacist status
registration in the state.
(e) Assume responsibility for the
destruction or removal of unwanted dangerous drugs and any controlled
substances as prescribed by law and regulations.
(f) Maintain a log of all visits and
activities in the facility indicating dates and other pertinent data; such logs
are to be available to inspection by state drug inspectors upon request.
(g) Furnish and replenish emergency drug
supply in acceptable containers. Maintain a log of use and replacement of drugs
in the emergency tray.
(h) Make routine inspections of drug
storage areas, patient health records, and review drug regimen of each patient
at least once a month. Report irregularities, contraindication, drug
interactions, etc., to the medical staff.
(i) Provide or make arrangements for
provision of pharmacy services to the facility on a 24-hour 7 days a week
basis, including stat orders.
(j) Provide in-service training of staff
personnel as outlined in the procedures manual.
(k) Meet all other responsibilities of a
consultant pharmacist as set forth in the Board regulations and federal or
state laws and which are consistent with quality patient care.
(l) The contract consultant pharmacist
to a SNF or ICF facility, that is required to review patients' drug regimen as
set forth in Subparagraph h of Paragraph 1 of Subsection B of 220.127.116.11 NMAC,
who is under contract as sole supplier of unit-doses/state of the art
medications, shall be exempt from charges of Unprofessional Conduct under
Paragraph 10 of Subsection B of 220.127.116.11 NMAC.
(m) The consultant pharmacist to a SNF or
ICF facility who delivers drugs in a unit-dose system, approved by an agent of
the Board, which is a tightly sealed, unopened, individual dose, shall be
exempt from the requirements of 126.96.36.199 NMAC, Prohibition of Resale of
Drugs. The regulation shall not prohibit the return to the pharmacy stock,
where partial credit may be given in accordance with any federal or state law
or regulation, to the patient for such medication, when the physician
discontinues the drug therapy, the patient expires or for any other reason,
other than an outdated drug.
(n) Customized Patient Medication Packages; In lieu of dispensing one, two, or more
prescribed drug products in separate containers or standard vial containers, a
pharmacist may, with the consent of the patient, the patient's care-giver, the
prescriber, or the institution caring for the patient, provide a customized
patient medication package. The pharmacist preparing a patient medication
package must abide by the guidelines as set forth in the current edition of the
U.S. Pharmacopoeia for labeling, packaging and record keeping.
(o) Repackaging of Patient Medication
Packages; In the event a drug is added
to or discontinued from a patient's drug regimen, when a container within the
patient medication package has more than one drug within it, the pharmacist may
repackage the patient's patient medication package and either add to or remove
from the patient medication packaged as ordered by the physician. The same
drugs returned by the patient for repackaging must be reused by the pharmacist
in the design of the new patient medication package for the new regimen, and
any drug removed must either be destroyed, returned to the DEA or returned to
the patient properly labeled. Under no circumstances may a drug within a
container of a patient medication package which contains more than one drug be
returned to the pharmacy stock.
(p) Return of Patient Medication Package
(i) Patient medication package's with
more than one drug within a container: Patient medication packages with more
than one drug within a container may not under any circumstances be returned to
a pharmacy stock.
(ii) Patient Medication Package's with
only one drug within a container: 1
Non-Institutional: A patient medication package stored in a non-institutional
setting where there is no assurance of storage standards may not be returned to
pharmacy stock. 2 Institutional: A
patient medication package stored in an institutional setting where the storage
and handling of the drugs are assured and are consistent with the compendia standards
may be returned to the pharmacy stock provided the following guidelines are
followed: (1) the drug is to be kept within the patient medication package and
it is to remain sealed and labeled until dispensed; (2) the expiration date of
drug shall become 50% of the time left of the expiration for the drug; (3) no
Schedule II drugs may be returned to inventory; and (4) proper record keeping
for the addition of other scheduled drugs into inventory must be done.
(2) When a consultant pharmacist enters
into a written contractual agreement with a facility to which he/she will
provide service.
(a) The consultant pharmacist whose
practice is not in the immediate vicinity of the facility for which he has
entered into a written service agreement, shall have a written agreement with a
local pharmacist to be available on any emergency basis. The consultant
pharmacist shall be responsible for the proper training and instruction of such
local pharmacist. Said local pharmacist shall be known as a
"co-consultant". The vendor shall be responsible for the safety and
efficacy of back-up pharmaceutical services he provides.
(b) A copy of these agreements must be
filed with the Board of Pharmacy and the facility. Any termination of such
agreement shall be reported in writing, within ten (10) days, of termination to
the Board and to the administrator.
(c) Should a local pharmacist
(co-consultant) not be available, the consultant pharmacist must provide an
alternative procedure approved by the Board. If the consultant is also the
vendor, then such alternative procedure must reasonably assure rapid delivery
of drugs; medical supplies and pharmacy service to the facility.
(1) The consultant pharmacist providing
services to a clinic shall.
(a) Assume overall responsibility for
clinic pharmacy services, for clinic pharmacy supportive personnel, and for
procedures as outlined in the procedures manual, including all records of drugs
procured, administered, transferred, distributed, repackaged or dispensed from
the clinic.
(b) Assume responsibility for the
destruction or removal of unwanted or outdated dangerous drugs, including
controlled substances, as required by laws and regulations.
(c) Develop the pharmacy services
procedures manual for the clinic establishing the system for control and
accountability of pharmaceuticals.
(d) Provide in-service education and
training to clinic staff, as applicable.
(e) Report in writing to the Board within
ten (10) days, any termination of services to the clinic. Report in writing to
the Board the names and places of employment of any pharmacy technicians under
the supervision of the consultant pharmacist.
(f) Comply with all other provisions of
Part 10, Limited Drug Clinics, as applicable to the individual clinic facility.
(g) The consultant pharmacist shall
personally visit the clinic on the minimum basis described in subparagraphs (a)
through (c) [(i) through (iv)] to ensure that the clinic is following set
policies and procedures. Visitation schedules are as follows.
(i) Class A clinics shall have the
on-site services of a consultant pharmacist for the dispensing or distribution
of dangerous drugs. The consultant pharmacist shall comply with Paragraphs 4, 5
and 7 of Subsection A of 188.8.131.52 NMAC of this regulation.
(ii) Class B clinics shall have the
services of a consultant pharmacist as listed below: 1. Category 1 clinics shall be visited by the
consultant pharmacist at least bi-monthly.
2. Category 2 clinics shall be visited by the consultant pharmacist at
least monthly. 3. Category 3 clinics
shall be visited by the consultant pharmacist at least bi-weekly.
(iii) Class C clinics shall be visited by
the consultant pharmacist at least every three months.
(iv) Class D clinic shall be reviewed at
least once yearly during school session.
(h) The consultant pharmacist shall
review the medical records of not less than 5% of a Class B clinics patients
who have received dangerous drugs (as determined by the dispensing or
distribution records) since the consultant pharmacist's last visit. Such review
shall be for the purpose of promoting therapeutic appropriateness, eliminating
unnecessary drugs, and establishing the medical necessity of drug therapy, by
identifying over-utilization or under-utilization, therapeutic duplication,
drug-disease contraindications, drug-drug contraindications, incorrect drug
dosage or duration of drug treatment, drug-allergy interactions, appropriate
medication indication, and/or clinical abuse/misuse. Upon recognizing any of
the above, the consultant pharmacist shall take appropriate steps to avoid or
resolve the problem which shall, if necessary, include consultation with the
(i) The consultant pharmacist shall
maintain a log or record of all visits and activities in the clinic. Such
record shall include a log of all medical records reviewed, along with a record
of all consultant pharmacist interventions and/or consultations. This log or
record shall be available for inspection by state drug inspectors upon request.
(j) The consultant pharmacist shall
review Class D clinics annually to ensure the clinic is in compliance with
training and protocols required by the department of health (DOH).
(i) clinic staff designated by the
department of health shall complete a board of pharmacy self-inspection form;
(ii) self-inspection form shall be
approved by the consultant pharmacist; and
(iii) clinic staff shall submit the
self-inspection form to the board upon initial licensure and at each renewal.
clinic may petition the Board for an alternative visitation schedule as set
forth in R of 126.96.36.199 NMAC.
(1) Custodial Care Facility as used in
this regulation includes: Any Facility
which provides care and services on a continuing basis, for two or more
in-house residents, not related to the operator, and which maintains custody of
the residents' drugs.
(2) Any facility which meets the
requirements outlined in Paragraph 1 of Subsection D of 18.104.22.168 NMAC of this
section shall be licensed by the Board of Pharmacy, engage a consultant
pharmacist, whose duties and responsibilities are indicated in Paragraph 3 of
Subsection D of 188.8.131.52.A NMAC.
(3) Procurement of drugs or medications
for residents will be on the prescription order of a licensed physician -
written or by oral communication, which order shall be reduced to writing by
the pharmacist as required by law. Refills shall be as authorized by the
physician. When refill authorization is indicated on the original prescription,
a refill for a resident may be requested by the administrator of the licensed
facility or his designee by telephone to the consultant pharmacist, or the
providing pharmacy.
(4) The administrator or a designated
employee of the facility will sign a receipt for prescription drugs upon
(5) All prescription drugs will be stored
in a locked cabinet or room and the key will be assigned to a designated
employee or the administrator as indicated in the procedures manual.
(6) Proper storage as stipulated in the
official compendium USP/NF will be the responsibility of the licensed facility.
(7) Records - the consultant pharmacist
shall be responsible for the following records:
(a) incoming medications - including
(b) record of administration;
(c) waste or loss; This accountability record shall be
maintained on a patient log, on forms provided to the consultant pharmacist by
the Board of Pharmacy.
(8) All prescription containers shall be
properly labeled as required in 16.19.11 NMAC.
No bulk containers of legend drugs will be kept on the premises.
(9) Consultant pharmacist shall include
in the procedures manual the name of individual(s) responsible for the
assistance with the medication.
(10) It shall be the responsibility of the
pharmacist to give proper training/instruction to the person(s) at the facility
who have day-to-day responsibility for receipt and administration of
medications to resident when adverse reactions, special diet, or any other
information relative to the administration of a drug is needed by the staff.
(11) The consultant pharmacist shall be
required to maintain a patient profile on each individual, if applicable to the
facility and individual.
(12) The consultant pharmacist shall visit
the facility no less than once a quarter or more often, commensurate with
patient drug regimen and shall be available in emergencies, when needed. A log
shall be maintained indicating all visits to the facility and noting any
activities or irregularities to be recorded or reported. This log shall be
available for state drug inspectors' review upon request.
(13) The consultant shall be responsible for
the preparation of a procedures manual outlining procedures for the receipt,
storage, record keeping, maintenance of patient profiles, administration and
accountability of all legend drugs and procedures for the removal and
destruction of unwanted, unused, outdated or recalled drugs - controlled
substances shall be handled pursuant to state and federal regulations.
E. No
drug that has been dispensed pursuant to a prescription and has left the
physical premises of the facility licensed by the board shall be dispensed or
reused again except the re-labeling and reuse of pharmaceuticals may be
permitted in the following situations:
in a correctional facility, licensed by the board, under the following
circumstances dangerous drugs, excluding controlled substances, may be re-used:
(1) the patients must reside in the same
(2) the reused medication must have been
discontinued from the original patient's drug regimen;
(3) the drug was never out of the
possession of the licensee "keep on person pharmaceuticals may never be
(4) the drugs were originally dispensed
in packaging that is unopened, single-dose or tamper-evident containers;
(5) the patient receiving the re-labeled
medication must have a valid prescription/order for the medication that is to
be reused;
(6) repackaging and re-labeling may only
be completed on site by the consultant pharmacist designated for that facility.
F. The consultant
pharmacist must maintain records at the facility for three years containing the
following information:
(1) date when the re-labeling occurred;
(2) the name and ID of the patient for
whom the medication was originally intended for and the date in which it was
discontinued from his or her drug regimen;
(3) the name and ID of the patient who
will receive the reused medication;
(4) the name, strength and amount of the
medication being reused;
(5) the name of pharmacist re-labeling
the medication;
(6) pursuant to 126.96.36.199 NMAC the
pharmacist must label the reused pharmaceutical and maintain a dispensing log
for all such re-issued pharmaceuticals and the expiration date for such
re-issued drugs shall be no greater than 50 percent of the time remaining from
the date of repackaging until the expiration date indicated on the original
dispensing label or container.
220.127.116.11 NMAC - Rn, 16 NMAC 19.4.11, 03-30-02; A, 06-30-06; A, 10-24-14]
A. DEFINITIONS; For
the purpose of this Section:
(1) Chemical Dependence - repeated use of
alcohol or drugs culminating in a pattern of chemical need.
(2) Disciplinary Authority - the Board
which may discipline pharmacists.
(3) Diversion - illicit dispensing,
distribution or administration of a scheduled controlled substance not in the
normal course of professional practice.
(4) Drug - a chemical substance alone or in
combination including alcohol.
(5) Drug Abuse - improper or excessive
use of a drug to the detriment of the individual and/or society.
(6) Impaired Pharmacist - a pharmacist
who is unable to practice pharmacy with reasonable skill, competence or safety
to the public because of drug abuse, and/or mental illness, the aging process
or loss of motor skills, sight or hearing.
(7) Licensing Authority - authority that
licenses/registers pharmacists.
(8) Recovering - a term used to describe
an impaired pharmacist who has successfully completed the approved treatment
program and is being rehabilitated in accordance with a professionally
prescribed aftercare treatment. (Use of "recovering" rather than
"recovered" is intended to indicate that recovery is a continuous
process with no finite end point).
(9) Reinstatement - the process whereby
the recovering impaired pharmacist is permitted to resume the practice of
(10) Treatment - the therapeutic
interruption of the disease process by competent and skilled professional
This regulation is applicable to all licensed/registered externs,
interns, pharmacists, and any other Board licensee/registrant. For the purpose
of this regulation, the word "licensee" shall include all persons
licensed/registered by the Board of Pharmacy.
(a) If any person knows or suspects that
a licensee is impaired, that person shall report any relevant information
either to the Impaired Pharmacist Program or to the Board of Pharmacy
(b) When the Board receives an initial
report relating to an alleged impaired Board licensee, that authority may:
(i) refer the licensee to the Impaired
Pharmacist Program for verification, intervention and subsequent evaluation
and/or treatment; or
(ii) verify the information provided on
the alleged impaired licensee and assume the responsibility for intervention
and referral for evaluation and/or treatment; or
(iii) file a complaint to initiate
disciplinary action.
(2) INTERVENTION: Board approved intervenors shall:
(a) Respond to information from concerned
(b) Ascertain validity of the information
(c) Perform additional necessary
investigations to arrive at an accurate position prior to contacting the
alleged impaired licensee; and, if necessary, to perform intervention.
(d) Contact the alleged impaired
licensee. After intervention, referral may be made to evaluation/treatment
center at licensee's expense. (Contact shall be made as planned intervention).
(e) Reduce all reports in writing and
place in permanent file for preservation of the report until the situation is
(a) Structured Treatment - an approved
treatment plan which shall include inpatient and/or outpatient therapy as
recommended/required. With the consent
of the treatment provider, the plan may include, but is not limited to,
individualized inpatient and/or outpatient care. Following either an intensive
inpatient or outpatient care, after treatment may be prescribed by the provider
with the approval of the Board and/or Impaired Pharmacist Committee.
(b) Supervised Treatment - treatment
which is prescribed by the treatment provider and approved by the Board and/or
Impaired Pharmacist Program.
(4) DISCIPLINARY SANCTIONS: Board Authority Referral to the Impaired
Pharmacist Program - when an impaired licensee who has been reported to the
Board successfully completes a Board/Committee approved treatment program, that
licensee must appear before the Board. The licensee must provide documentary
evidence from the approved treatment program, stating that the licensee has
reached recovery and may be allowed to practice without endangering the public.
The Board may suspend the registration/license, stay the execution of the
suspension and impose a period of probation during which the following
conditions shall be met:
(a) the licensee shall strictly adhere to
the aftercare program; and
(b) during the probationary period, the
licensee shall comply with the general and special conditions of probation
imposed by the Board, including but not limited to, monitoring and drug screens
where applicable.
(5) CONFIDENTIALITY; The names of voluntary participants in the program
and records relating to their referral and treatment are confidential pursuant
to Section 61-11A-3 and Section 61-11A-7, provided, however, that this
information may be disclosed:
(a) in a disciplinary hearing before the
Board and in court proceedings arising therefrom;
(b) to the Board and to the pharmacist's
licensing/disciplinary authorities of other jurisdictions in accordance with
(c) pursuant to an order of a court of
competent jurisdiction;
(d) injunctive proceedings brought by the
Board; and
(e) as otherwise provided by law.
(6) CIVIL IMMUNITY; No member of the Board or the committee or
any Board-approved intervenor shall be liable for any civil damages because of
acts or omissions which may occur while acting in good faith pursuant to the
Impaired Pharmacists Act (61-11A-1 to 61-11A-8, NMSA, 1978).
220.127.116.11 NMAC - Rn, 16 NMAC 19.4.12, 03-30-02]
220.127.116.11 CHANGE OF ADDRESS: Any
registrant or licensee shall report in writing any change of address or
employment to the Board within ten (10) days.
18.104.22.168 NMAC - Rn, 16 NMAC 19.4.13, 03-30-02]
18.104.22.168 ACTIVE STATUS: Any pharmacist who maintains competency through the development and
maintenance of knowledge, skill and aptitude, to ensure continuing competence
as a pharmacy professional, and is able to demonstrate to the board said
competence in the practice of pharmacy shall be issued an active license. Records
of continuing education or continuous professional development shall be
maintained and available for inspection by the board or the board's agent. A
pharmacist shall be issued an active status license upon proper application and
payment of fees.
126.96.36.199 NMAC - Rn, 16 NMAC 19.4.14, 03-30-02; A, 12-15-02; A, 10-25-12]
A. A pharmacist not engaged or ceasing to be engaged in the
practice of pharmacy for more than one year shall be issued an inactive status
license upon proper application and payment of fees.
B. Pursuant to Section 61-11-13.B, an inactive status
pharmacist applying for an active status license, who has not been actively
engaged in pharmacy for over one year, may be required to serve an internship
training program and submit evidence of continuing education relating to the
practice of pharmacy, as required by Section 61-11-6 and Section 61-11-13 and
the Board regulations.
220.127.116.11 NMAC - Rn, 16 NMAC 19.4.15, 03-30-02; Repealed, 12-15-02; 18.104.22.168
NMAC - Rn, 126.96.36.199 NMAC, 12-15-02]
A. The following responsibilities require the use of
professional judgement and therefore shall
be performed only by a
pharmacist or pharmacist intern:
(1) receipt of all new verbal
prescription orders and reduction to writing;
(2) initial identification, evaluation
and interpretation of the prescription order and any necessary clinical clarification prior to
(3) professional consultation with a
patient or his agent regarding a prescription;
(4) evaluation of available clinical data
in patient medication record system;
(5) oral communication with the patient or patient's agent of
information, as defined in this section under patient counseling, in order to
improve therapy by ensuring proper use of drugs and devices;
(6) professional consultation with the
prescriber, the prescriber's agent, or any other health care professional or
authorized agent regarding a patient and any medical information pertaining to
the prescription;
(7) drug regimen review, as defined in
(8) professional consultation, without
dispensing, will require that the patient be provided with the identification
of the pharmacist or pharmacy intern providing the service.
B. Only a pharmacist shall perform the following duties:
(1) final check on all aspects of the
completed prescription including sterile products and cytotoxic preparations,
and assumption of the responsibility for the filled prescription, including,
but not limited to, appropriateness of dose, accuracy of drug, strength,
labeling, verification of ingredients and proper container;
(2) evaluation of pharmaceuticals for
formulary selection within the facility;
(3) supervision of all supportive
personnel activities including preparation, mixing, assembling, packaging,
labeling and storage of medications;
(4) ensure that supportive personnel have
been properly trained for the duties they may perform;
(5) any verbal communication with a
patient or patient's representative regarding a change in drug therapy or
performing therapeutic interchanges (i.e. drugs with similar effects in
specific therapeutic categories); this does not apply to substitution of
generic equivalents;
(6) any other duty required of a
pharmacist by any federal or state law.
C. Patient records.
(1) A reasonable effort must be made to
obtain, record and maintain at least the following information:
(a) name, address, telephone number, date
of birth (or age) and gender of the patient;
(b) individual medical history, if
significant, including disease state or states, known allergies and drug
reactions and a comprehensive list of medications and relevant devices; and
(c) pharmacists comments relevant to the
individuals drug therapy.
(2) Such information contained in the
patient record should be considered by the pharmacist or pharmacist intern in
the exercise of their professional judgement concerning both the offer to
counsel and the content of counseling.
D. Prospective drug review.
(1) Prior to dispensing any prescription,
a pharmacist shall review the patient profile for the purpose of identifying:
(a) clinical abuse/misuse;
(b) therapeutic duplication;
(c) drug-disease contraindications;
(d) drug-drug interactions;
(e) incorrect drug dosage;
(f) incorrect duration of drug
(g) drug-allergy interactions;
(h) appropriate medication indication.
(2) Upon recognizing any of the above, a
pharmacist, using professional judgment, shall take appropriate steps to avoid
or resolve the potential problem. These
steps may include requesting and reviewing a controlled substance prescription
monitoring report or another states' reports if applicable and available, and
consulting with the prescriber and counseling the patient. The pharmacist shall document steps taken to
resolve the potential problem.
E. Prescription
monitoring report for opiate prescriptions.
When presented with an opiate prescription for a patient, obtaining and
reviewing a prescription monitoring report for that patient can be an important
tool that assists the pharmacist in identifying issues or problems that put his
or her patient at risk of prescription drug abuse or diversion. A pharmacist shall use professional judgment
based on prevailing standards of practice in determining whether to obtain and
review a prescription monitoring report before dispensing an opiate
prescription to that patient, and shall document his or her action regarding
such reports.
(1) A pharmacist shall request and review
a prescription monitoring report covering at least a one year time period and
another states' report, where applicable and available if;
(a) a pharmacist becomes aware of a
person currently exhibiting potential abuse or misuse of opiates (i.e.
over-utilization, early refills, mulitple prescribers, appears overly sedated
or intoxicated upon presenting a precription for an opiate or an unfamiliar
patient requesting an opiate by specific name, street name, color, or
identifying marks, or paying cash when the patient has prescription insurance);
(b) a pharmacist receives an opiat
prescription requesting the dispensing of opiates from a prescription issued by
a prescriber with whom the pharmacist is unfamiliar (e.i. prescriber is located
out-of-state or prescriber is outside the usual pharmacy geographic prescriber
care area);
(c) providing opiates for a patient that
is receiving chronic pain management prescriptions.
(2) After obtaining an initial
prescription monitoring report on a patient, a pharmacist shall use
professional judgment base on prevailing standards of practice, in deciding the
frequency of requesting and reviewing further prescription monitoring reports
and other states' reports for that patient.
The pharmacist shall document the review of these reports.
(3) In the event a report is not
immediately available, the pharmacist shall use professional judgment in
determining whether it is appropriate and in the patient's best interest to
dispense the prescription prior to receiving a report.
(4) A prescription for an opiate written for a
patient in a long term care facility (LTCF) or for a patient with a medical
diagnosis documenting a terminal illness is exempt from Subsection D of
22.214.171.124 NMAC. If there is any
question whether a patient may be classified as having a terminal illness, the
pharmacist shall contact the practitioner.
The pharmacist shall document whether the patient is "terminally ill" or
an "LTCF patient".
F. Counseling.
(1) Upon receipt of a new prescription
drug order and following a review of the patient's record, a pharmacist or
pharmacist intern shall personally offer to counsel on matters which will
enhance or optimize drug therapy with each patient or the patient's agent. Upon
receipt of a refill prescription drug order a pharmacy technician may query the
patient or patient's agent regarding counseling by the pharmacist or pharmacist
intern concerning drug therapy. Such counseling shall be in person, whenever
practicable, or by telephone, and shall include appropriate elements of patient
counseling which may include, in their professional judgement, one or more of
the following:
(a) the name and description of the drug;
(b) the dosage form, dosage, route of
administration, and duration of drug therapy;
(c) intended use of the drug and expected
(d) special directions and precautions
for preparation, administration and use by the patient;
(e) common severe side or adverse effects
or interactions and therapeutic contraindications that may be encountered,
including their avoidance and the action required if they occur;
(f) techniques for self-monitoring drug
(g) proper storage;
(h) prescriptions refill information;
(i) action to be taken in the event of a
missed dose;
(j) the need to check with the
pharmacist or practitioner before taking other medication; and
(k) pharmacist comments relevant to the
individual's drug therapy, including any other information peculiar to the
specific patient or drug.
(3) Alternative forms of patient
information may be used to supplement patient counseling when appropriate.
Examples include, but not limited to, written information leaflets, pictogram labels
and video programs.
(4) Patient counseling, as described
above and defined in this regulation shall not be required for in-patients of a
hospital or institution where other licensed health care professionals are
authorized to administer the drug(s).
(5) A pharmacist shall in no way attempt
to circumvent or willfully discourage a patient or patient's agent from
receiving counseling. However, a pharmacist shall not be required to counsel a
patient or patients's agent when the patient or patients's agent refuses such
(6) When the patient or agent is not
present when the prescription is dispensed, including but not limited to a
prescription that was shipped by the mail, the pharmacist shall ensure that the
patient receives written notice of available counseling. Such notice shall
include days and hours of availability, and: (1) of his or her right to request
counseling; and (2) a toll-free telephone number in which the patient or
patient's agent may obtain oral counseling from a pharmacist who has ready
access to the patient's record. For pharmacies delivering more than 50% of
their prescriptions by mail or other common carrier, the hours of availability
shall be a minimum of 60 hours per week and not less than 6 days per week. The
facility must have sufficient toll-free phone lines and personnel to provide
counseling within 15 minutes.
(7) In every pharmacy there shall be
prominently posted in a place conspicuous to and readable by prescription drug
consumers a notice concerning available counseling.
H. Regulatory assessment. Profiles, either electronic or hard copy,
shall be available for inspection, and shall provide the capability of storing
the described historical information. The profiles must demonstrate that an effort
is being made to fulfill the requirements by the completion of the detail
required. A patient record shall be maintained for a period of not less than
three (3) years from the date of the last entry in the profile record.
22.214.171.124 NMAC - Rn, 16 NMAC 19.4.16, 03-30-02; 188.8.131.52 NMAC - Rn,
A. Purpose: The
purpose of these regulations is to implement the Pharmacist Prescriptive
Authority Act, Sections 61-11B-1 through 61-11B-3 NMSA 1978 by providing
minimum standards, terms and conditions for the certification, registration, practice, and
supervision of pharmacist clinicians. These regulations are adopted pursuant to
Section 61-11B-3 of the Pharmacist Prescriptive Authority Act.
B. Initial certification and registrants.
(1) The board may certify and register a pharmacist as a
pharmacist clinician upon completion of an application for certification and
satisfaction of the requirements set forth in these regulations.
(2) A pharmacist who applies for
certification and registration
as a pharmacist clinician shall complete application forms as required by the
board and shall pay a fee. The fee shall be set by the board to defray the cost
of processing the application, which fee is not returnable.
(3) To obtain initial certification and registration as a pharmacist
clinician, she/he must submit the following:
(a) proof of completion of sixty (60) hour board approved physical assessment
course, followed by a 150 hour, 300 patient contact preceptorship supervised by
a physician or other practitioner with prescriptive authority, with hours
counted only during direct patient interactions;
(b) the applicant will submit a log of patient encounters as part of the
(c) patient encounters must be initiated and completed within 2 years of the
(d) a pharmacist clinician requesting a
controlled substance registration to prescribe controlled substance in Schedule
II or Schedule III shall be trained in responsible opioid prescribing
practices. Educational programs shall
include an understanding of the pharmacology and risks of controlled
substances, a basic awareness of the problems of abuse, addiction, and
diversion, and awareness of the state and federal regulations of the
prescribing of controlled substances.
(4) The board shall register each pharmacist certified as
a pharmacist clinician.
(5) Upon certification and registration by the board, the
name and address of the pharmacist clinician, (name of the supervising physician
if applicable), and other
pertinent information shall be enrolled by the board on a roster of pharmacist
C. Biennial
renewal of registration.
(1) Renewal applications shall be submitted prior to the license expiration.
(2) Applications for renewal must
(a) after January 1, 2013, documentation of continuing education hours,
including proof of completion of 2.0 CEU twenty (20) contact hours of
live CPE or continuing medical education (CME) approved by (ACPE) or AACME
(live programs provided by other continuing education providers may be
submitted for review and approval to the board), beyond the required hours in
188.8.131.52 NMAC (as amended), as required by the board; and;
(b) effective January 1, 2015, a
pharmacist clinician with a controlled substance registration to prescribe
controlled substances listed in Schedule II or Schedule III shall complete a
minimum of 0.2 CEU (2 contact hours) per renewal period in the subject area of
responsible opioid prescribing practices, and;
(c) a current protocol of collaborative practice signed by the supervising
physician (if prescriptive authority is sought); and
(d) a copy of the pharmacist clinicians registration with the supervising
physicians board (if prescriptive authority is sought); and
(e) other additional information as
requested by the board.
D. Prescriptive
authority, guidelines or protocol.
(1) Only a registered pharmacist clinician with current protocols, registered
with the New Mexico medical board or the New Mexico board of osteopathic
medical examiners, may exercise
prescriptive authority.
(2) A pharmacist clinician seeking to
exercise prescriptive authority shall submit an application to the board. The
application must include the supervising physicians' name and current medical license, protocol of collaborative practice and other
information requested by the board. A pharmacist may submit the application
with the initial application for certification or as a separate application
after becoming certified and registered
as a pharmacist clinician.
(3) The protocol will be established and
approved by the supervising physician
as set forth in these regulations and will be kept on file at each practice
site of the pharmacist clinician and with the board.
(4) The protocol must include:
(a) name of the physician(s) authorized to prescribe dangerous drugs and name of
the pharmacist clinician;
(b) statement of the types of
prescriptive authority decisions the pharmacist clinician is authorized to
make, including, but not limited to:
(i) types of diseases, dangerous drugs
or dangerous drug categories involved and the type of prescriptive authority
authorized in each case;
(ii) ordering lab tests and other tests
appropriate for monitoring of drug therapy;
(iii) procedures, decision criteria or plan
the pharmacist clinician is to follow when exercising prescriptive authority;
(c) activities to be followed by the
pharmacist clinician while exercising prescriptive authority, including
documentation of feedback to the authorizing physician concerning specific decisions made; documentation may be
made on the prescriptive record, patient profile, patient medical chart or in a
separate log book;
(d) description of appropriate mechanisms
for consulting with the
supervising physician, including a
quality assurance program for review of medical services provided by the
pharmacist clinician, (this quality assurance program will be available for
board review); and
(e) description of the scope of practice
of the pharmacist clinician.
(5) Pharmacist clinicians shall not
prescribe dangerous drugs including controlled substances for self-treatment or
treatment of immediate family members, except under emergency situations. This will not apply to pharmacist
administered vaccinations. Pharmacist
clinicians shall not write a recommendation for the use of medical cannabis.
E. Scope of practice.
(1) A pharmacist clinician shall perform
only those services that are delineated in the protocol and are within the
scope of practice of the supervising physician
and/or alternate supervising physician(s).
(2) A pharmacist clinician may practice
in a health care institution within the policies of that institution.
(3) A pharmacist clinician may prescribe
controlled substances provided that the pharmacist clinician:
(a) has obtained a New Mexico controlled
substances registration and a drug enforcement agency registration, and
(b) prescribes controlled substances
within the parameters of written guidelines or protocols established under
these regulations and Section 3, A. of the Pharmacist Prescriptive Authority
(4) The board may, in its discretion
after investigation and evaluation, place limitations on the tasks a pharmacist
clinician may perform under the authority and direction of a supervising physician and/or alternate supervising
F. Collaborative
professional relationship between pharmacist clinicians and supervising
(1) The direction and supervision of
pharmacist clinicians may be rendered by approved supervising physician/designated alternate supervising
(2) This direction may be done by written protocol or by oral consultation. It is the responsibility
of the supervising physician to
assure that the appropriate directions are given and understood.
(3) The pharmacist clinician must have prompt access to consultation with the
physician for advice and direction.
(4) Upon any change in supervising physician between registration renewals, a
pharmacist clinician shall submit to the board, within ten (10) working days,
the new supervising physician's name, current medical license, and protocol;
notification to and completion of requirements for the supervising physicians'
board shall be completed per that boards requirements. This notice requirement does not apply to an
alternate supervising physician who is designated to cover during the absence
of the supervising physician.
G. Complaints and appeals.
(1) The
chair of the board will appoint two (2) members of the board, and the president
of the supervising physician respective board will appoint (2) members of the
respective board to the oversight committee; the oversight committee will
review complaints concerning the pharmacist clinician practice; the oversight
committee will make a report that may include non-binding recommendations to
both the board and respective board(s) regarding disciplinary action. Each board can accept or reject the
(2) Any
applicant for certification or any pharmacist clinician may appeal a decision
of the board in accordance with the provisions of the Uniform Licensing Act,
Sections 61-1-1 to 61-1-33 NMSA 1978.
220.127.116.11 NMAC - Rn, 16 NMAC 19.4.17, 03-30-02; 18.104.22.168 NMAC - Rn,
184.108.40.206 [Reserved]
184.108.40.206 NMAC - Rn, 16 NMAC 19.4.18, 03-30-02; Reserved, 12-15-02]
History: The material in this part was derived from
that previously filed with the State Records Center and Archives:
BOP 69-2, Rules
and Regulations of the State Board of Pharmacy, 6-13-69.
BOP 69-3, New
Mexico Laws and Regulations, Pharmacy Act, Drug and Cosmetic Act, Narcotic Drug
Act, Poisons Act, Board of Pharmacy Rules and Regulations, 8-15-69.
BOP 72-1, New
Mexico Board of Pharmacy Rules and Regulations Promulgated Pursuant to New
Mexico Drug and Cosmetic Act, Pharmacy Act, Controlled Substances Act, 7-31-72.
Regulation No. 4,
Pharmacist, 2-7-80.
Regulation No. 4,
Pharmacist, 10-23-85.
Regulation No. 4,
Pharmacist, 2-2-87.
Regulation No. 4,
Pharmacist, 7-27-90.
History of
Repealed Material:
BOP 72-1, New
Mexico Board of Pharmacy Rules and Regulations Promulgated Pursuant to New
Mexico Drug and Cosmetic Act, Pharmacy Act, Controlled Substances Act -
Repealed, 10-29-85.
Other History:
Pharmacists - Pharmacist, filed 02-02-96; 16 NMAC 19.4, Pharmacists -
Pharmacist, filed 05-02-96; 16 NMAC 19.4, Pharmacists - Pharmacist, filed
02-25-98, reformatted and renumbered to 16.19.4 NMAC, Pharmacist, effective


text:
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Motortopia > Muscle Car Power > TECH > Hotchkis Suspension Makes the A-Body Hang Hairpins > MCP-1010-Dust-11
The Hotchkis adjustable tie rods link up easily and should tighten up the steering when we throw this A-body into the corners.
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Power Rangers Time Force (2001)
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Lists10 votes
Power Rangers: From Best to Worst
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ReviewsOMG MATURE PR~!6 years, 5 months ago at Oct 30 1:34
This seems to be everyone's go-to season for comparing Power Rangers to a prime time drama, like Smallville. Yes, it does have mature elements like death; but so did just about every other season in it's own way. In fact, one of my favorite episodes is "Movie Madness," which is one of the silliest episodes in the history of the franchise.If anything, what this season does best is... read more The Wesley Collins Show8 months, 4 weeks ago at Jul 23 4:33
While I love this season, and have watched it numerous times, my most recent re-watch has changed my outlook on the overall product.[img id=7542881 width=300full] While most fans have no problem saying that Lucas, Katie and Trip are shafted in terms of character development, they are not alone. While the main story arc is good, it's still Wesley's story. He is the one that d... read more |
Release date: 3 February 2001
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DIY Open Baffle Full Range Speakers from Wal-Mart . . .
2 Attachment(s)
Have to share a photo of my very first DIY Speaker Project.
Visaton B200's arrived today (Thank you Solen!). I just could not wait until the weekend to buy a sheet of plywood & get to someone's shop (we live in an apartment) to build some nice baffles. So this evening I ran down to Wal-Mart, searching all over the store for anything that might work, at least temporarily anyway. Lo and behold, I ended up bring home a pair of 22x34 cork bulletin boards with some nice oak trim (I know, not the best for diffraction) for all of $13 each! I did some "Golden Mean" calculations for speaker hole placement. Whipped out the jigsaw and cut out the holes in the kitchen - No problem!. The holes for the bolts were a little more tricky as the drill bit would break off some cork as it exitted the backside. No worrys. The speakers bolted in fine. Hooked them up and WOW! Open Baffle sure is what everyone says it is! Very open, clean & natural. Sure notice the lack of that "Box Sound" The B200's are very quick and smooth - and they have some breaking in to do yet. Bass is a bit shy of course, but still is more than I expected. Treble extends nicely. This is going to be a late one! Thanks everyone here for the inspiration & motivation and also for letting me live vicariously (up until now anyway) through your experiences. Don't worry, I'll get those B200's in a nice set of baffles soon enough, probably with a sub of some type in the bottom of each. I'm calling these the "Corky's". Incredible sound for less than $350! Now I'm thinking about a decent SET amplifier. And maybe the Fertin voice coils one day as well. Fun stuff. PS: Yep, that's a towel over the TV (to avoid the camera flash issue) |
Original thinking
Plus you can keep your diy thoughts/sketches pinned conveniently close to hand.
hi loudandclear
nice job i have been big fan of open baffle for a long time, but you can never expect adequate bass from one full range on open baffle here is the option how to continue the project http://www.blackdahlia.com/html/tip_45.html enjoy ed |
As is, do you find the bass warm and satisfying...though not too deep?
With my recent mounting of the CSS FR125S on open baffles, I'm convinced, without a doubt that this is the best way to mount a driver. And the Visaton B200, being designed for an open baffle certainly has aroused my curiosity. |
For future use, I'd go with two of them, dipolar, mouted either on a flat baffle or an H frame with EQ, preferably active unless you've got 200W available from your amp to pump into them, in which case passive is possible (though not as good). Should give you decent lows, but maintain the dipolar benefits, which are at their most pronounced in my experience in the bass and lower-mid regions (ironic, as this is the most difficult thing to do with dipoles) in preventing or reducing the influence of the room.
I like the idea of the cork boards -novel, and attractive too. Wish I could find somewhere in the UK that makes decent ones for a reasonable price. Looks great to me! Best |
Thanks Guys!
@Ropie: Yep, my partner suggested taking the picture with a bunch of paper & notes pinned to the boards but I thought that would be a bit too "tacky". @adason: I have always been intrigued by the Basszilla. I think I may go a little different route though. I'm hoping to have a seperate amp/Eq for the Bass and try to do it with 10" or 12" drivers. I think the B200's go lower than the Lowthers and Fostex do in OB, so hopefully I can get away with a fast sub of sorts (probably in a sealed enclosure) like the Rythmik or maybe using a TCSounds driver. I'd be happy with response down to somewhere around 30hz. @TomekZ "Satisfying" is fairly relative. I listened to these guys for a few hours last night no problem. It is warm & natural bass and is not "one-note" resonant which i hear in so many systems. I have to admit though, it could use a boost (for my tastes) in the lower registers. I need to play with some wings and come up with a good plan to integrate a pair of subs. One other note I'll have to add is that these are my first full-range drivers so I am getting the double benefit of both no-crossover and open-baffle. I think what else has bothered me with a lot of speakers (we listened to 50 or so pairs when buying our last set) is suboptimal driver integration. Having no crossover in the "presence" range is so alluring (preaching to the choir here!). |
I'd love to keep the added bass drivers dipolar! I come up to two issues. I want to get the baffle width down to 16" so large "pro" drivers are out. Then, I have been modelling a bunch of drivers (subs and woofers) in Thorsten's xbaffle.xls and have not found anything that is going to give me a significant boost in bass using one driver in an OB. I see why a lot of dipolar bass implementations use multiple woofers. The B200 actually gives better OB bass response than most 10" and 12" drivers I have modelled so your idea of using another one may not be so bad! H or U baffles are a definite consideration as well. I wonder how a couple of EQed 6.8extremis's in an H baffle on each side would work? Lot's of planning left to do on this one . . . PS: the cork boards I used are not actually cork all the way through. There is a thin layer of cork on the surfaces and the middle is some sort of tightly packed fibre. I double stacked a small and large washer on the speaker bolts to make sure I had enough surface area against the baffle, otherwise the smaller washers would sink right into the material. |
2 Attachment(s)
I did some more experimenting with the Corkys tonight. I flipped the speakers over and changed sides. More weight now and a better balance overall, even with the drivers down that low.
This also gets the drivers away from radiating directly back into the blinds (which are made of metal). Very educational. Another idea I had today was that if I were to use cork board again, I would put a block of wood behind them when I was drilling the speaker bolt holes. This would probably prevent the cork layer at the back from breaking off when the drill punched through. Also, Sixmoons just posted a review of the Omega A8's which use the Visaton B200 where Louis of Omega explained: "I chose to modify the back wave of the B200. It's basically damping of the cast frame of the driver. I heard a need for this in listening. The damping reduces peakiness in the critical midrange. I try to response-shape by mechanical methods only. I have tried electronic components in the past but they always took the life out of the sound." Hmmmm, I'm wondering exactly what he did there. Anyone have any ideas? |
Aha you put the drivers closer to the floor.
If you haven't read JEL's open baffle page, check it out: http://members.myactv.net/~je2a3/open.htm There are two basket mods with which I am aware. The first is putting "rope caulk" or similar on frame to damp any vibrations. Popular with stamped frame speakers. The second is wool or felt on inside of basket, to dampen reflections off of the frame. |
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The Grove at North Regional
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Course Details
Course Reviews
Course is challenging and brings a variety of holes and obstacles. Course could use basic maintenance. There are several places with thick brush, thorn bushes and many ravines that you can lose your disc in. There are also a couple streams/water hazards in which I believe that I lost one of my discs in the first time I played the course. With some work this could be a good and challenging course.
The Course is fun and addicting. A big variety of shots. Plenty of OB! Concrete pads are a bit short at times, but easily remedied in the future. No signs yet but seems like good progress is being made on the course. Course weaves in a clover like pattern, so you can always join up with your friends and play a few holes conveniently. Woods holes are tough, but well designed. Future looks good for this course. Close proximity to fast food and stores makes it an easy choice for a last minute day of golf.
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Alan - Unregistered May 05, 2013 2:46 PM Thats what happens when you allow a corner to be named after you 38 agree 9 disagree
Markg - Unregistered May 05, 2013 2:47 PM Mm had the chance, or was given the chance and took it. Very glad Lorenzo didn't wipe out but I'd say racing incident. 50 agree 21 disagree
Jed - Unregistered May 05, 2013 2:48 PM Don't need to see the pictures again to see what happened. Lorenzo should've closed the door earlier. That said Marquez was heading for the gravel, he wouldn't have made the corner without Lorenzo but its a racing incident. Tough luck that Jorge is on the receiving end this time, he's done worse to others in the past. 18 agree 10 disagree
moominpapa yam - Unregistered May 05, 2013 2:48 PM Marquez did nothing wrong in my opinion 31 agree 27 disagree
Dean - Unregistered May 05, 2013 2:52 PM Only a true racer tries that kind of overtake. That is the reason why Stoner Pedrosa and Lorenzo will never be in the same league as Rossi and Marquez to me, they would have just settled for 3rd in that situation 46 agree 31 disagree
Alan - Unregistered May 05, 2013 2:53 PM How many times have we seen passing moves being made in that corner and still theres professional riders leaving the door wide open on the last lapM M will get a small clip around the ear but it will be put down as a racing incident 2 agree 3 disagree
west coast Oz - Unregistered May 05, 2013 2:54 PM That's racing, thy all want to win and he took the opportunity ....there not playing beachball ....Marquez need to keep his nerve and not be put off by the post race unpleasentness 4 agree 2 disagree
rod99 - Unregistered May 05, 2013 2:54 PM Finally the days of "racing" are returning, gone is the time trail, F1 style, era .Bet CS is glad he's gone, there wouldn't be enough hours in the day for him to finish complaining.Lets just hope JL doesn't start publicly banging on about MM being dangerous and end up making him hesitant, like he did with the last guy willing to "race" RIP.I hope Rossi can up the pace a touch and get involved in this, set for a mega season! 35 agree 9 disagree
636stunter - Unregistered May 05, 2013 2:55 PM The late great Ayrton Senna once said :-"And if you no longer go for a gap that exists, you're no longer a racing driver, because we are competing. We are competing to win, and the main motivation to all of us is to compete for victory, it's not to come 3rd, 4th, 5th or 6th" 36 agree 5 disagree
drake - Unregistered May 05, 2013 2:55 PM and the new rivialry begins.. media will have a field day with this.it was a hard overtake move but "dis is racing casey"yer this is racing we'll see... hahaah 4 agree 3 disagree


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Pontoon Beach, IL (May 1st, 2015) Rusty Griffaw took the victory in a wild and crazy UMP DIRTcar Modified feature event. It appeared to be a two car battle for the win for most of the race as Matt Mevert and Michael Long had checked out on the field and were battling for the lead when an encounter with lapped traffic left both of the spun in turn one on lap twenty-one of the twenty-five lap feature event. On the restart, Rick Stevenson would be out front with Dave Wietholder
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Focusing on USAC's wingless Sprint Car ranks over the past few years, the 25-year-old Schuerenberg is delving back into the winged wars and came away with a victory in just his third night out by topping Friday night's Neal Tire MOWA Sprint Series feature event at Tri-City
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Dennis Rodman and his old-timer team catch an "L" in North Korea, plus he admits to drinking before CNN outburst, Spike Lee gets new nickname #mamaspike, plus more. — Dominique Zonyéé (@DominiqueZonyee)
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Tell her, regardless of race :)

Race doesn't matter.
You're welcome :D
Do it guy!I fell in love with a biracial lady back in 1976,and i will always rue that i didnthave the courage to ask her out.Dont be an idiot and spend the rest of your life regretting,son. Beauty is in tghe eye of the beholder,and to love someone of a different color,means thatvyou are game to expanding your horizons!!!!Good luck,and if she loves you back,u are one luckyb.....d
Go for it, and see where it takes you. Could be someplace wonderful. Best of luck. ;)
Ask her out.
Why would race be a problem? Unless she's Armenian and you're Turkish.
You should realize that there's the chance she's waiting on you. Maybe she wants you too. Asking her wouldn't hurt and even if she says no, she doesn't represent every black girl. I would personally date a white guy.

In fact, there's this guy that I met here on EP and I think I really like him. Guess what? He's white and I'm black. What do you think I'm waiting for? I won't sacrifice being a lady for a minute and ask a guy out. Most black girls won't, at least. See what I mean?
I am completely in support of you and her having many babies!!

My greatest dream would be for "race" to no longer exist.

We are taking over people... prepare yourselves.... Muahahaha
Race shouldn't matter, its the person you like for who they are. Nit for there race. If your OK with dating out of your race, I say do it. I did and married him. So of my family didn't like it but he completes me and I have been so Happy that I took that chance. And wouldn't change him for the world.
Go for it.I have an open mind and I would not mind dating a woman of a different race.Black or spanish especially.
ask the lady out you FOOL.and get the race nonsence out of your head
opposite race? what is oppiste of human race. if you mean she aint white so what i have dated black and asain girls. my son is engaged to a mixed race girl. just go for it the worst thing she is gonna do is telll ya to get lost
Races are not opposite. History can create resentments and fears, but then, all human beings will harbour such feelings anyway.
dont let her daddy find out....
Ask her out.
say hi
Go for it, if there aren't to many differences between you two other than race.
What's an "opposite race"?
What is the opposite race?
Oh. So what? I thought you were going to say something sick like she was a Martian or a kangaroo or something. Take that girl out.
Opposite race is not a real term.
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Samyuktha Varma
Colin Chartres (Colombo, Sri Lanka) is a world authority on water issues and Director General of the International Water Management Institute (IWMI). He has 35 years' experience in R+D and policy areas related to water and natural resources, and served as Chief Science Advisor to the Australian National Water Commission. Samyuktha Varma works at IWMI. She focuses on issues of water, equity and poverty in developing countries, and with ensuring that women's voices are heard in the development of water management solutions. A social scientist, her background has led to her work on issues ranging from human rights to urban governance.
- Climate Change and Water Supply
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text: HAPPY ROVIN' COWBOY Recorded by: Sons Of The Pioneers [Theme song of Hank Williams, Sr.] Writer: Bob Nolan CHORUS [G] Hear my song as I [C] ride along I'm a [G] Happy Rovin' [D] Cowboy [G] Herdin' the dark clouds [C] out of the sky [G] Keepin' the [D] heavens [G] blue. [G] I aint got a wife to [C] bother my life I'm a [G] Happy Rovin' [D] Cowboy Let me [G] make my bed where the [C] varmints prowl [G] Beneath the [D] sky of [G] blue. CHORUS I aint got a dime; I'm just spendin' my time I'm a Happy Rovin' Cowboy Let me ride that long trail down to the end Where the skies are always blue. CHORUS SOURCE: THE SONS OF THE PIONEERS FAVORITE COWBOY SONGS 1956 RCA LPM-1130 ----------------------------------------- Theme song of Hank Williams, Sr. [HEALTH & HAPPINESS SHOWS] CHORUS Hear my song as I ride along I'm a Happy Rovin' Cowboy Herdin' the dark clouds out of the sky Keepin' the heavens blue. I aint got a dime; I'm just spendin' my time I'm a Happy Rovin' Cowboy Let me sing my song till they call me home To that land beyond the blue.


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2009 Acura TL SH-AWD Review
Description:Acura might be considered "the geek" among Sport Sedans with more emphasis on technology than performance. Bumper2Bumpertv got a chance to see what bells and whistles the company is putting in to the new TL with all wheel drive. (2:14)
Source: Bumper2Bumpertv
Tags: 2009 Acura TL SH-AWD Model Review , 2009 acura tl sh-awd , Acura 289 Horsepower Engine , Acura 3.5 Liter V6 Engine


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Towns & Villages
Craignure & South Mull
Situated close to Mull's easternmost point, Craignure is a small village and the main ferry port from the mainland.
Towns & Villages
Craignure & South Mull
Craignure is a village and the main ferry terminal on the Isle of Mull.
Towns & Villages
The largest of the islands of Argyll & The Isles and the third largest in Scotland. Rich in culture, heritage, stunning landscapes and wildlife.
Oban, Mull and Lorn
Home to Lismore Lighthouse, this island is 10 miles long and 1 mile wide, and found at the southern end of the Great Glen.
Oban, Mull and Lorn
Mull is the largest of the islands of Argyll and the third largest in Scotland, with 300 miles of coastline.
Ganavan Sands is located north of Oban in Argyll & The Isles.
Towns & Villages
The largest town in Argyll & The Isles, Oban is known as the 'Gateway to the Isles' and the 'Seafood Capital of Scotland'.
Forests & Woodlands
Mull Eagle Watch - Join our eagle experts to get the low down on these high fliers.
Towns & Villages
Tobermory & North Mull
Tobermory is the main town on the island of Mull, in the Inner Hebrides. The picture-postcard port with its brightly coloured harbour-front buildings was the setting of children's TV show Balamory.
Towns & Villages
Salen is a small village situated at the narrowest point on the east coast of Isle of Mull in the Inner Hebrides.