Wyo. Code R. 059-0001-18
Pharmacy, Board of
Chapter 18: Prescribing by Pharmacists
Effective Date: 10/31/2017 to 01/04/2023
Rule Type: Superceded Rules & Regulations
Reference Number: 059.0001.18.10312017
These rules are promulgated as authorized by the Wyoming Pharmacy Act W.S. § 33-24-101 through -301.
To describe procedures for pharmacist prescribing of specific prescription medications.
This rule applies to any person licensed under Wyoming statutes as a pharmacist and who is practicing within the scope of their license.
(a) 'Opiate antagonist' means naloxone hydrochloride, narcan or any other brand name used for naloxone hydrochloride approved by the United States Food and Drug Administration (FDA) for the treatment of an opiate related drug overdose.
(b) 'Opiate-related drug overdose' means a condition, including extreme physical illness, a decreased level of consciousness or respiratory depression resulting from the consumption or use of an opioid, or another substance with which an opioid was combined, that a reasonable person would believe to require medical assistance.
Pharmacists may prescribe and administer immunizations in accordance with Board rules and W.S. § 33-24-157.
(a) A pharmacist acting in good faith and exercising reasonable care may, without a prescriber-patient relationship, prescribe an opiate antagonist to:
(i) A person at risk of experiencing an opiate related drug overdose, such as:
(A) Current use or a history of using illicit or prescription opioids;
(B) A new prescription for an opioid to treat a new condition such as trauma or surgery related pain;
(C) Concurrent prescriptions for an opioid plus other medications that may cause respiratory depression;
(D) Persons with respiratory, hepatic or renal impairment who are prescribed an opioid;
(E) Persons mixing opioids with alcohol;
(F) Persons recently leaving a correctional or rehab facility; or
(G) Persons taking opioids for $\geq 30$ days.
(ii) A person in a position to assist a person at risk of experiencing an opiate related drug overdose; or
(iii) A person who, in the course of the person’s official duties or business, may encounter a person experiencing an opiate related drug overdose.
(b) A pharmacist who prescribes an opiate antagonist shall provide appropriate counseling and written instruction to the person to whom the opiate antagonist is prescribed, including:
(i) How to prevent an opiate related drug overdose;
(ii) How to recognize an opiate related drug overdose;
(iii) How to respond appropriately to an opiate related drug overdose;
(iv) How to administer an opiate antagonist;
(v) Naloxone is an opiate antagonist (blocker) that may reverse the effects of opioids within two (2) to three (3) minutes of administration;
(vi) Naloxone is not abusable, nor is it a controlled substance;
(vii) Effects of naloxone may only last thirty (30) minutes;
(viii) Opioid dependent persons will be sent into withdrawal; and
(ix) Ensuring that the person to whom an opiate antagonist has been administered receives, as soon as possible, additional medical care and a medical evaluation.
(c) If the person to whom the opiate antagonist would be administered has a known hypersensitivity to naloxone, the pharmacist should not prescribe nor dispense naloxone.
(d) Prior to prescribing naloxone, a pharmacist shall successfully complete a minimum of one hour of an approved continuing education program specific to the use of naloxone.
(e) The prescribing pharmacist shall generate a written or electronic prescription for any naloxone dispensed, as follows:
(i) Record themselves as the prescriber;
(ii) Maintain the prescription for two years; and
(iii) Report the dispensing to the Wyoming prescription drug monitoring program (WORx) as required by the Wyoming Controlled Substances Act Rules Chapter 8.