Prescribing in the Digital Era

Provide an example of a drug that may be prescribed from each of the Schedule II-V drug levels by a Psychiatric Mental Health Nurse Practitioner in Texas.

Controlled Medications that May Be Prescribed by the Psychiatric-Mental Health Nurse Practitioner (PMHNP) from Each of the Schedule II-V Drug Categories

The state of Texas is one of those that have a restricted scope of practice for the nurse practitioner (NP). That means that the PMHNP does not have full prescriptive authority and therefore must always be supervised and authorised by the physician with whom they have a career-long collaborative agreement (AANP, 2020). With this background, there are few occasions that the PMHNP practicing in Texas will be required to prescribe scheduled medications on their own. If that were to happen, however, they are required to obtain a DEA number for that (Androus, 2019; RegisteredNursing.org, n.d.). The Drug enforcement Administration or DEA in the United States is the body concerned with making sure drugs of abuse and controlled substances are not misused. They therefore track all prescriptions made by clinicians including PMHNPs by giving them unique DEA numbers that they must enter into the system when prescribing scheduled drugs (FederalLawEnforcement.org, 2019). With the DEA number, the PMHNP is expected to stick to the provisions of the Controlled Substances Act. Prescribing in the Digital Era

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            Legislation in the state of Texas requires that all pharmacies in the state that issue prescribed controlled drugs (schedule II-V) must report to the Prescription Monitoring Program (PMP) not later than the following business day (TSPB, 2014). All the prescribing information regarding these prescriptions will be forwarded to the PMP and the prescriber’s DEA number will be quoted every time. This ensures that the prescriber can be traced and questioned and accountability can be enforced. Schedule I drugs have the highest likelihood of misuse while schedule V have the least likelihood of misuse (DEA, n.d.). In Texas, the PMHNP can prescribe morphine from schedule II, naloxone from schedule III, diazepam from schedule IV, and promethazine (phenergan) from schedule V. In these examples, morphine has the highest potential for abuse while phenergan has the least potential for abuse.

References

American Association of Nurse Practitioners [AANP] (October 20, 2020). State practice environment. https://www.aanp.org/advocacy/state/state-practice-environment

Androus, A.B. (2019). What is a DEA number and how can a nurse practitioner obtain one? https://www.registerednursing.org/answers/dea-number-how-nurse-practitioner-obtain-one/

Drug Enforcement Administration [DEA] (n.d.). Drug scheduling. https://www.dea.gov/druginfo/ds.shtml

FederalLawEnforcement.org (2019). What is the Drug Enforcement Agency’s primary responsibilities? https://www.federallawenforcement.org/dea/

RegisteredNursing.org (n.d.). What Is a DEA Number and How Can a Nurse Practitioner Obtain One? https://www.registerednursing.org/answers/dea-number-how-nurse-practitioner-obtain-one/

Texas State Board of Pharmacy [TSBP] (2014). Texas Prescription Monitoring Program. https://www.pharmacy.texas.gov/files_pdf/3Texas_Prescription_Monitoring_Program_info.pdf

Prescribing in the Digital Era