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TITLE 22 - EXAMINING BOARDS
PART 9 - TEXAS MEDICAL BOARD
CHAPTER 169 - DELEGATION
SUBCHAPTER D - PHARMACISTS
SECTION/RULE §169.20 - General Standards
Chapter Review Date 07/22/2008

(a) In accordance with §157.001 and §157.101 of the Act, a physician licensed to practice medicine in Texas may delegate to a properly qualified and trained pharmacist acting under adequate supervision the performance of specific acts of drug therapy management, immunizations and vaccinations authorized by the physician through the physician's order, standing medical order, standing delegation order, other order, or protocol.(b) A written protocol or order for drug therapy management must contain at a minimum:(1) the identity of the physician and the pharmacist engaging in drug therapy management;(2) the condition requiring drug therapy;(3) the drugs to be used for the drug therapy management authorized, including allowing generically equivalent drug selection unless otherwise indicated; and(4) the procedures, decision criteria, or plan the pharmacist shall follow when exercising drug therapy management authority, including maintaining a record for each patient.(c) A written protocol or order for immunizations and vaccination must contain at a minimum:(1) the location(s) at which the pharmacist may administer immunizations or vaccinations;(2) the immunizations or vaccinations that may be administered;(3) procedures to follow when administering immunizations or vaccinations including:(A) a requirement that if the patient is under 14 years of age, they have a physician referral;(B) procedures if adverse reactions occur; and(C) a requirement to report to the delegating physician the administration of the immunization or vaccination within 24 hours after administration.(D) A periodic review and update, if necessary, of a written protocol for drug therapy management, immunizations, and vaccinations are required.(E) A physician who provides care to persons over 65 years of age must comply with Chapter 161.0052 of the Texas Health and Safety Code regarding pneumococcal and influenza vaccines.

Source Note: The provisions of this §169.20 adopted to be effective January 9, 2025, 50 TexReg 342.

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