<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".11" citation="COMAR 10.34.03.11" title_num="10" subtitle_num="34" chapter_num="03" heading="Drug Dispensing — Emergency Supplies and Procedures.">
  <paragraph num="A.">
    <text>The director of pharmacy shall participate in the development and maintenance of the formulary for emergency drugs and supplies that are maintained throughout the institutional facility.</text>
  </paragraph>
  <paragraph num="B.">
    <text>The director of pharmacy or designee shall, in conjunction with the medical staff of the institutional facility, develop and implement written policies and procedures to ensure compliance with the provisions of this regulation.</text>
  </paragraph>
  <paragraph num="C.">
    <text>The institutional pharmacy shall furnish emergency drugs and supplies only if:</text>
    <paragraph num="(1)">
      <text>The emergency drugs and supplies are stored in an environment which:</text>
      <paragraph num="(a)">
        <text>Maintains the integrity of the drugs; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Provides accessibility only to authorized personnel;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>The institution follows a policy that drugs will be dispensed from the emergency drugs and supplies formulary only upon written or verbal order by an authorized prescriber;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>The emergency drugs and supplies are stocked and maintained in a manner that complies with the standards of applicable State law;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>The emergency drugs and supplies are:</text>
      <paragraph num="(a)">
        <text>Stored and secured:</text>
        <paragraph num="(i)">
          <text>With a tamper evident seal; or</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Via electronic means; and</text>
        </paragraph>
      </paragraph>
      <paragraph num="(b)">
        <text>Kept in a secure area;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(5)">
      <text>The emergency drugs and supplies are labeled as follows:</text>
      <paragraph num="(a)">
        <text>Clearly indicating that the emergency drugs and supplies are for use in emergencies only;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Listing the expiration dates of the emergency drugs and supplies;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Listing the name or initials of the pharmacist who checked the emergency drugs and supplies; and</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Highlighting the expiration date of the medication with the shortest expiration date;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(6)">
      <text>When the emergency drugs and supplies are contained within an emergency cart, the pharmacist checking the emergency cart shall ensure that the exterior of the cart is labeled with the:</text>
      <paragraph num="(a)">
        <text>Contents of the emergency cart; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Name or initials of the pharmacist; and</text>
      </paragraph>
    </paragraph>
    <paragraph num="(7)">
      <text>The director of pharmacy or designee shall ensure that repackaged drugs contained in emergency drugs and supplies are labeled:</text>
      <paragraph num="(a)">
        <text>In accordance with Regulation .10 of this chapter; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>With other information as may be required by the medical staff.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>Upon notification that emergency drugs and supplies have been opened, a pharmacist or registered pharmacy technician shall:</text>
    <paragraph num="(1)">
      <text>Restock the emergency drugs and supplies; or</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Provide a replacement supply.</text>
    </paragraph>
  </paragraph>
  <paragraph num="E.">
    <text>The director of pharmacy or designee shall ensure:</text>
    <paragraph num="(1)">
      <text>That the expiration date of emergency drugs and supplies is the earliest date of expiration of any drug supplied; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Before the expiration date, the pharmacist or designee shall replace the expired drug and relabel the emergency drugs and supplies as provided in §C(5) of this regulation.</text>
    </paragraph>
  </paragraph>
</regulation>