Must Read: Two Important APRN Practice Issues

 

                                                   30-DAY CDS PRESCRIPTION LIMITATION

 

Earlier this year, the Oklahoma Board of Nursing sought direction from the Attorney General’s office on whether an Advanced Practice Registered Nurse (APRN) with prescriptive authority, has authority to prescribe and/or administer Controlled Dangerous Substance (CDS) Schedule III-V medications that are one-time medications that provide time released CDS medication for greater than 30 days.   The request to the Attorney General was made as a result of the Board receiving several reports of APRN’s practicing outside their legal parameters by prescribing testosterone pellets, a Schedule III CDS medication that is implanted under a patient’s skin and may deliver the Schedule III medication for greater than 30 days, and often delivers testosterone for 90-180 days.

 

The Board Rules provide:

  The Advanced Practice Registered Nurse with prescriptive authority who prescribes Schedule III-V drugs will comply with state and Federal Drug Enforcement Administration (DEA) requirements prior to prescribing controlled substances. No more than a 30-day supply for Schedule III-V drugs shall be prescribed by the Advanced Practice Registered Nurse with prescriptive authority.

OAC 485:10-16-5.(c) (Emphasis added).

 

APRN’s, with prescriptive authority, have the right to prescribe and/or administer CDS Schedule III-V medication(s) that are one-time dose medications that provide time released medication for up to 30 days. Pursuant to the laws in Oklahoma, an APRN cannot prescribe a Schedule III-V CDS medication(s) for greater than 30 days. Some applicable laws are more restrictive. A prescription for a testosterone pellet(s) that delivers medication for 31 days or greater requires a licensed physician prescription that must be documented in writing.    

 

Following the entry of a written Order an APRN may lawfully administer testosterone pellet medications if the APRN is appropriately trained in the administration of the testosterone pellets and whose scope of practice recognizes the practice of testosterone pellet(s) insertion.

 

In sum, the Deputy General Counsel with Attorney General’s office concurred with the Board that an APRN may prescribe Schedule III-V CDS medications, so long as the prescription does not exceed a 30-day supply. See, OAC 485:10-16-5(c).   A single dose of time-release Schedule III CDS medication that releases into the body over a period exceeding 30 days is more than a 30-day supply.   Therefore, an APRN may not lawfully prescribe and then administer a single dose of a Schedule III CDS medication that is time released for greater than 30 days.

 

If questions please call Gina Stafford, Associate Director for Nursing Practice at (405) 962-1840.