A protocol developed under this chapter must include the following:

1. (1) The identification of:

   1. (A) the individual whose drug regimen may be adjusted;
   2. (B) the attending physician who is delegating the authority to adjust an individual's drug regimen; and
   3. (C) the pharmacist who is authorized to adjust the individual's drug regimen.

2. (2) The attending physician's diagnosis of the individual's:

   1. (A) condition; or

   2. (B) disease state;

      whose drug regimen may be adjusted.

3. (3) A statement regarding:

   1. (A) the types and:

      1. (i) categories; or

      2. (ii) therapeutic classifications;

         of medication, including the specific therapeutic alternatives that may be substituted for a drug prescribed by a physician;

   2. (B) the minimum and maximum dosage levels within the types and:

      1. (i) categories; or

      2. (ii) therapeutic classifications;

         of medications described in clause (A);

   3. (C) the dosage forms;
   4. (D) the frequency of administration;
   5. (E) the route of administration;
   6. (F) the duration of the administration of the drug regimen and any adjustment to the drug regimen; and

   7. (G) exceptions to the application of the drug regimen or the adjustment to the drug regimen;

      for which the pharmacist may adjust the individual's drug regimen.

4. (4) A requirement that:

   1. (A) the individual's medical records be available to both the individual's attending physician and the pharmacist; and
   2. (B) the procedures performed by the pharmacist relate to a disease or condition for which the patient has been under the attending physician's medical care.

As added by P.L.75-2004, SEC.3.