<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".05" citation="COMAR 10.34.29.05" title_num="10" subtitle_num="34" chapter_num="29" heading="Guidelines for Use of Protocols.">
  <paragraph num="A.">
    <text>On receipt of specific instructions from the authorized prescriber regarding a specific patient, the pharmacist may execute the authorized prescriber’s specific instructions even if the instructions deviate from the protocol.</text>
  </paragraph>
  <paragraph num="B.">
    <text>The protocol may not prohibit the pharmacist from providing other pharmaceutical services that are within the pharmacist's scope of practice.</text>
  </paragraph>
  <paragraph num="C.">
    <text>Documentation of activities performed under a protocol or the authorized prescriber’s specific instructions shall be maintained in such a manner that it is accessible to the:</text>
    <paragraph num="(1)">
      <text>Authorized prescriber; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Pharmacist.</text>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>Documentation may be maintained in written or electronic form.</text>
  </paragraph>
  <paragraph num="E.">
    <text>Oral communications between the authorized prescriber and pharmacist shall be summarized in the documentation maintained by the pharmacist and forwarded to the authorized prescriber.</text>
  </paragraph>
  <paragraph num="F.">
    <text>Unless an alternative time period is stated in the prescriber-pharmacist agreement, the pharmacist shall inform the authorized prescriber within 48 hours if the pharmacist:</text>
    <paragraph num="(1)">
      <text>Modifies the dose or agent under the therapy management contract;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Detects an abnormal result from an assessment activity; or</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Initiates drug therapy under a written, disease-state specific protocol, for protocols by a licensed physician and pharmacist.</text>
    </paragraph>
  </paragraph>
</regulation>