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O. Reg. 188/24: DESIGNATED DRUGS AND SUBSTANCES

filed May 3, 2024 under Midwifery Act, 1991, S.O. 1991, c. 31

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ontario regulation 188/24

made under the

Midwifery Act, 1991

Made: March 8, 2024
Approved: April 25, 2024
Filed: May 3, 2024
Published on e-Laws: May 6, 2024
Published in The Ontario Gazette: May 18, 2024

Designated Drugs and Substances

CONTENTS

1.

Prescribing drugs

2.

Administration by inhalation

3.

Administration by injection, general

4.

Administration by injection, controlled substances

5.

Use, etc. on order

6.

Non-prescription drugs and substances

7.

Revocation

8.

Commencement

Schedule 1

Drugs that may be prescribed

Schedule 2

Substances that may be administered by inhalation

Schedule 3

Substances that may be administered by injection

Schedule 4

Controlled drugs and substances

 

 

 

Prescribing drugs

1. (1) For the purposes of paragraph 6 of section 4 of the Act, a member may, on the member’s own responsibility, prescribe a drug set out in Schedule 1 to this Regulation, subject to any conditions noted in that Schedule.

(2) For the purposes of paragraph 6 of section 4 of the Act, a member may prescribe a drug set out in Schedule 4 to this Regulation for the purpose of being administered in a public hospital, if the member complies with the standards of practice set out in subsection (3) of this section.

(3) It is a standard of practice of the profession that a member who prescribes a drug set out in Schedule 4 shall first have either,

(a) satisfied the Registrar or the Registration Committee that the member has sufficient knowledge, skill and judgment, based on the member’s formal education and training, to safely and competently prescribe drugs set out in Schedule 4; or

(b) successfully completed a course approved by the Council on prescribing drugs set out in Schedule 4.

Administration by inhalation

2. For the purposes of paragraph 5 of section 4 of the Act, a member may, on the member’s own responsibility, administer by inhalation a substance set out in Schedule 2 to this Regulation.

Administration by injection, general

3. For the purposes of paragraph 5 of section 4 of the Act, a member may, on the member’s own responsibility, administer by injection a substance set out in Schedule 3 to this Regulation.

Administration by injection, controlled substances

4. (1) For the purposes of paragraph 5 of section 4 of the Act, a member may, in a public hospital, on the member’s own responsibility, administer by injection a substance set out in Schedule 4 to this Regulation, if the member complies with the standards of practice set out in subsection (2) of this section.

(2) It is a standard of practice of the profession that a member who administers by injection a substance set out in Schedule 4 shall first have either,

(a) satisfied the Registrar or the Registration Committee that the member has sufficient knowledge, skill and judgment, based on the member’s formal education and training, to safely and competently administer by injection substances set out in Schedule 4; or

(b) successfully completed a course approved by the Council on administering by injection substances set out in Schedule 4.

Use, etc. on order

5. (1) In the course of engaging in the practice of midwifery, a member may use any drug on the order of a member of the College of Physicians and Surgeons of Ontario or on the order of a member of the College of Nurses of Ontario who holds an extended certificate of registration as a registered nurse.

(2) In the course of engaging in the practice of midwifery, a member may administer any substance by injection or inhalation on the order of a member of the College of Nurses of Ontario who holds an extended certificate of registration as a registered nurse. 

Non-prescription drugs and substances

6. A member may administer, prescribe or order any drug or substance that may lawfully be purchased or acquired without a prescription.

Revocation

7. Ontario Regulation 884/93 is revoked.

Commencement

8. This Regulation comes into force on the later of March 1, 2024 and the day this Regulation is filed.

SChedule 1
drugs that may be prescribed

Vaccines and Immune Globulins

1. Covid-19 vaccine.

2. DTaP-IPV-Hib.

3. Hepatitis B immune globulin.

4. Hepatitis B vaccine.

5. Influenza vaccine.

6. Measles-mumps-rubella virus vaccine.

7. Pneumococcal conjugate.

8. Respiratory syncytial virus (RSV) vaccine.

9. RhD immune globulin.

10. Rotavirus (Rot-1).

11. Tdap vaccine.

12. Varicella vaccine.

13. Varicella Zoster immune globulin.

Anti-infectives

14. Mupirocin-betamethasone valerate-miconazole.

Antibacterials

15. Amoxicillin.

16. Amoxicillin-clavulanic acid.

17. Azithromycin.

18. Cefixime.

19. Cephalexin.

20. Ciprofloxacin.

21. Clindamycin.

22. Cloxacillin.

23. Doxycycline.

24. Erythromycin.

25. Metronidazole

26. Nitrofurantoin.

27. Penicillin VK.

28. Sulfamethoxazole-trimethoprim.

29. Trimethoprim.

Antifungals

30. Clotrimazole.

31. Fluconazole.

32. Miconazole.

33. Nystatin.

Antivirals

34. Acyclovir.

35. Famciclovir.

36. Valacyclovir.

Hormonal Contraceptives

37. Hormonal contraceptives, all types.

Analgesics and Antipyretics

38. Diclofenac.

Antiemetics

39. Doxylamine succinate-pyridoxine hydrochloride.

40. Ondansetron.

41. Prochlorperazine.

Dopamine Agonists

42. Cabergoline.

Vitamins, Minerals and Fluid Replacements

43. Vitamins, minerals and fluid replacements, all types.

Oxytocics and Prostaglandins

(For the purposes of preventing and treating postpartum haemorrhage, inducing or augmenting labour, cervical ripening and for the management of spontaneous early pregnancy loss or retained placental tissue.)

44. Dinoprostone.

45. Ergonovine.

46. Misoprostol.

47. Misoprostol-Mifepristone.

Galactagogues

48. Domperidone.

Corticosteroids

49. Hydrocortisone anorectal therapy compound.

Proton Pump Inhibitors

50. Omeprazole.

Histamine Blockers

51. Ranitidine.

SCHEDULE 2
SUBSTANCES THAT MAY BE ADMINISTERED BY INHALATION

1. Oxygen (therapeutic).

2. Nitrous oxide.

SCHEDULE 3
SUBSTANCES THAT MAY BE ADMINISTERED BY INJECTION

Vaccines and Immune Globulins

1. Covid-19 vaccine.

2. DTaP-IPV-Hib.

3. Hepatitis B immune globulin.

4. Hepatitis B vaccine.

5. Influenza vaccine.

6. Measles-mumps-rubella virus vaccine.

7. Pneumococcal conjugate.

8. Respiratory syncytial virus (RSV) vaccine.

9. RhD immune globulin.

10. Rotavirus (Rot-1).

11. Tdap vaccine.

12. Varicella vaccine.

13. Varicella Zoster immune globulin.

Antibacterials

14. Ampicillin.

15. Benzathine Penicillin G.

16. Ceftriaxone.

17. Cefazolin.

18. Ciprofloxacin.

19. Clindamycin.

20. Cloxacillin.

21. Erythromycin.

22. Gentamicin.

23. Penicillin G.

Adrenergic Agents

24. Epinephrine hydrochloride.

Hormonal Contraceptives

25. Hormonal contraceptives, all types.

Local Anaesthetics

26. Bupivacaine.

27. Lidocaine hydrochloride with or without epinephrine.

Antiemetics

28. Dimenhydrinate.

29. Ondansetron.

30. Prochlorperazine.

Opiate Antagonists

31. Naloxone hydrochloride.

Vitamins, Minerals and Fluid Replacements

32. Vitamins, minerals and fluid replacements, all types.

Oxytocics and Prostaglandins

33. Carbetocin.

34. Carboprost tromethamine.

35. Ergonovine.

36. Oxytocin.

Haemostatics

37. Tranexamic acid.

Antihistamines

38. Diphenhydramine hydrochloride.

SCHEDULE 4
CONTROLLED drugs and SUBSTANCES

Opioid Analgesics

1. Fentanyl citrate.

2. Meperidine.

3. Morphine sulfate.

4. Nalbuphine.

Made by:
Pris par :

Council of the College of Midwives of Ontario:
Le Conseil de l’Ordre des sages-femmes de l’Ontario :

Claire Ramlogan-Salanga

Chair of Council

Kelly Dobbin

Registrar & CEO

Date made: March 8, 2024
Pris le : 8 mars 2024

 

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