§ 6.1. Approved drugs.
(a) Administration and prescription of pharmaceutical agents. Optometrists who are certified to prescribe and administer pharmaceutical agents for therapeutic purposes under section 4.1 of the Optometric Practice and Licensure Act (35 P. S. § 244.4a), may prescribe and administer the drugs listed in subsection (b) in their practice of optometry under the following conditions:
(1) The drugs shall be approved by the Food and Drug Administration (FDA).
(2) Over-the-counter medications (per FDA listing) are fully authorized.
(3) An optometrist may not administer any drug parenterally.
(4) The treatment undertaken by an optometrist under this section:
(i) May not continue beyond 6 weeks from the initiation of treatment unless the prescribing optometrist documents consultation with a licensed physician.
(ii) May not include beta-blockers or steroids.
(iii) May not be prescribed for systemic conditions except as an adjunctive therapy and shall be limited to the anterior eye structures (and adnexa).
(5) An optometrist may not treat glaucoma.
(6) An optometrist may not prescribe or administer a Schedule I or II controlled substance.
(b) Allowable pharmaceutical products. Optometrists may prescribe and administer the following pharmaceutical products or the A-rated generic therapeutically equivalent drug:
(1) Topical anesthetics.
(i) Proparacaine.
(ii) Benoxinate.
(iii) Tetracaine.
(2) Topical ocular lubricants.
(3) Topical opthalmic dyes and stains.
(i) Fluorescein.
(ii) Rose Bengal.
(iii) Fluorexen.
(4) Topical hyperosmotic agents.
(5) Autonomic drugs—topical only.
(i) Cholinergic agonists.
(A) Pilocarpine nitrate and pilocarpine hydrochloride—diagnostic use only.
(B) Physostigmine.
(C) DFP (diisopropylfluorophosphate).
(D) Echothiopate.
(ii) Cholinergic antagonists.
(A) Homatropine hydrobromide.
(B) Tropicamide.
(C) Atropine sulfate.
(D) Cyclopentolate hydrochloride.
(E) Scopolamine hydrobromide.
(iii) Adrenergic agonists.
(A) Hydroxyamphetamine hydrobromide.
(B) Phenylephrine hydrochloride.
(C) Tetrahydrazoline.
(D) Nefazoline.
(E) Oxymetazoline.
(iv) Adrenergic antagonists—diagnostic use only.
(A) Dapiprazole.
(B) Thymoxamine.
(6) Nonsteroidal antiinflammatory drugs—topical only.
(i) Diclofenac.
(ii) Ketorolac.
(iii) Flurbiprofen.
(iv) Suprofin.
(7) Antimicrobial agents.
(i) Antibacterial—topical use only.
(A) Cell wall inhibitors.
(I) Bacitracin.
(II) Cephalosporins.
(III) Penicillins.
(IV) Vancomycin.
(B) Protein synthesis inhibitors.
(I) Aminoglycosides.
(II) Tetracycline.
(III) Erythromycin.
(IV) Chloramphenicol.
(C) Intermediary metabolism inhibitors.
(I) Sodium sulfacetamide and sulfisoxazole.
(II) Trimethoprim.
(D) DNA synthesis inhibitors.
(I) Ciprofloxacin.
(II) Norfloxacin.
(III) Ofloxacin.
(IV) Levofloxacin.
(E) Cell membrane permeability.
(I) Polymyxin B.
(II) Gramicidin.
(ii) Antibacterial—oral.
(A) Cell wall inhibitors.
(I) Penicillins—including in combination with clavulanic acid.
(II) Cephalosporins.
(-1-) First generation—cephalexin and cefadroxil.
(-2-) Second generation—cefaclor and cefuroxime.
(B) Protein synthesis inhibitors.
(I) Tetracycline.
(II) Doxycycline.
(III) Erythromycin.
(IV) Azithromycin.
(iii) Antivirals—topical only.
(A) Idoxurine.
(B) Vidarabine.
(C) Trifluridine.
(iv) Antivirals—oral.
(A) Acyclovir.
(B) Valacyclovir.
(C) Famciclovir.
(v) Antifungal and antiparasitic—topical only.
(A) Amphotericin B, nystatin, natamycin.
(B) Miconazole, ketoconazole, clotrimazole.
(C) Thiabendazole.
(D) Neomycin and polymyxin B.
(E) Paromycin.
(8) Analgesic drugs—oral and topical.
(i) Analgesic drugs—oral.
(A) Codeine in combination with acetaminophen or aspirin.
(B) Hydrocodone.
(C) Pentazocine.
(D) Propoxyphene.
(E) Tramadol.
(ii) Antihistamines and mast cell stabilizers—topical only.
(A) Pheniramine.
(B) Pyrilamine.
(C) Antazoline.
(D) Levocarbastine.
(E) Cromolyn.
(F) Nedocromil.
(G) Lodoxamide.
(H) Olopatadine.
(I) Pemirolast potassium.
(J) Emedastine difumarate.
(K) Azelastine hydrochloride.
(L) Ketotifen fumerate.
(Editor’s Note: The act of December 16, 2002 (P. L. 1950, No. 225) that amended the Optometric Practice and Licensure Act (63 P. S. § § 244.1—244.12) allows the Secretary of the Department of Health to approve drugs which may be prescribed by optometrists. The list of drugs is now being published as a notice in the Pennsylvania Bulletin).)
Authority The provisions of this § 6.1 amended under section 2 of the Optometric Practice and Licensure Act (63 P. S. § 244.2); and section 2102(g) of The Administrative Code of 1929 (71 P. S. § 532(g)).
Source The provisions of this § 6.1 amended November 21, 1997, effective November 22, 1997, 27 Pa.B. 6088; amended October 9, 1998, effective October 10, 1998, 28 Pa.B. 5094; amended July 19, 2002, effective July 20, 2002, 32 Pa.B. 3484. Immediately preceding text appears at serial pages (251627) to (251628) and (248717) to (248718).
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