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PDFWAC 246-851-590

Guidelines for the use of oral Schedule II hydrocodone combination products and Schedule III through V controlled substances and legend drugs.

Nothing in these guidelines should be construed to restrict the recommendation of over-the-counter medications, vitamins, or supplements, nor restrict the ordering of any radiologic or laboratory testing necessary to the diagnosis of any eye related disease that is within the scope of practice of optometry.
(1) All oral forms and dosages of antibiotic agents will be available for use excluding: Vancomycin.
(2) Antifungal agents used in eye care shall fall into the following categories:
(a) All oral forms and dosages of polyene antifungals.
(b) All oral forms and dosages of imidazole antifungals.
(c) All oral forms and dosages of triazole antifungals.
(3) Anti-emetic agents used in eye care shall be the following medications:
(a) All oral forms and dosages of prochlorperazine.
(b) All oral forms and dosages of metoclopramide.
(c) All oral forms and dosages of promethazine.
(4) Diuretic agents used in eye care shall fall into the following categories:
(a) All oral forms and dosages of carbonic anhydrase inhibitors.
(b) All oral forms and dosages of osmotic diuretics. Osmotic diuretics shall be used only in the case of acute angle closure glaucoma administered in-office, outpatient, and/or ambulatory procedures only.
(5) All oral forms and dosages of nonsteroidal anti-inflammatory agents will be available for use excluding: Ketorolac tromethamine.
(6) Benzodiazepines prescribed, as anti-anxiety agents, shall be used for in-office, outpatient, and/or ambulatory procedures. This family of medications will be utilized as one dosage unit per prescription.
(7) Schedule II controlled substance will only include hydrocodone combination products.
(8) Schedules III and IV controlled substances will have a maximum quantity count of thirty dosage units per prescription.
(9) Specific dosage for use and appropriate duration of treatment of oral medications listed in WAC 246-851-580(1) will be consistent with Food and Drug Administration on- and off-label indications.
(10) Notation of purpose shall be included on all prescriptions.
(11) An optometrist may not:
(a) Use, prescribe, dispense, or administer oral corticosteroids; or
(b) Prescribe, dispense, or administer a controlled substance for more than seven days in treating a particular patient for a single trauma, episode, or condition or for pain associated with or related to the trauma, episode, or condition; or
(c) Prescribe an oral drug within ninety days following ophthalmic surgery unless the optometrist consults with the treating ophthalmologist. If treatment exceeding the limitation is indicated, the patient must be referred to a physician licensed under chapter 18.71 RCW.
(12) The prescription or administration of drugs as authorized in this section is specifically limited to those drugs appropriate to treatment of diseases or conditions of the human eye and the adnexa that are within the scope of practice of optometry. The prescription or administration of drugs for any other purpose is not authorized.
(13) Nothing in this chapter may be construed to authorize the use, prescription, dispensing, purchase, possession, or administration of any Schedule I or II controlled substance with the exception of Schedule II hydrocodone combination products.
[Statutory Authority: RCW 18.54.070(2) and 18.53.010(4). WSR 19-04-071, § 246-851-590, filed 2/1/19, effective 3/4/19. Statutory Authority: RCW 18.54.070(2) and 18.53.010. WSR 16-16-017, § 246-851-590, filed 7/21/16, effective 8/21/16. Statutory Authority: 2003 c 142 and RCW 18.54.070(2). WSR 04-12-127, § 246-851-590, filed 6/2/04, effective 7/3/04.]
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