O. Reg. 112/11: DESIGNATED DRUGS AND STANDARDS OF PRACTICE, Filed April 5, 2011 under Optometry Act, 1991, S.O. 1991, c. 35
ONTARIO REGULATION 112/11
made under the
OPTOMETRY ACT, 1991
Made: December 8, 2010
Approved: March 23, 2011
Filed: April 5, 2011
Published on e-Laws: April 6, 2011
Printed in The Ontario Gazette: April 23, 2011
DESIGNATED DRUGS AND STANDARDS OF PRACTICE
PART I
PRESCRIPTIONS
Drugs that may be prescribed
1. For the purposes of paragraph 2.1 of section 4 of the Act, and subject to sections 2, 3 and 4 and Part II of this Regulation, a member may prescribe a drug set out under a category and sub-category heading in Schedule 1.
Limitation
2. Where a limitation or a route of administration is indicated in the sub-category heading set out in Schedule 1, a member shall only prescribe a drug listed under that sub-category in compliance with the limitation and in accordance with the route of administration specified.
Training required
3. No member may prescribe any drug unless he or she has successfully completed the relevant training in pharmacology that has been approved by the Council.
Recording
4. Every time a member prescribes a drug the member shall record the following in the patient’s health record as that record is required to be kept under section 10 of Ontario Regulation 119/94 (General) made under the Act:
1. Details of the prescription, including the drug prescribed, dosage and route of administration.
2. Details of the counselling provided by the member to or on behalf of the patient respecting the use of the drug prescribed.
Non-prescription drugs
5. In the course of engaging in the practice of optometry a member may prescribe any drug that may lawfully be purchased or acquired without a prescription.
PART II
STANDARDS OF PRACTICE — GLAUCOMA
Prescribing of antiglaucoma agents
6. It is a standard of practice of the profession that in treating glaucoma a member may only prescribe a drug set out under the category of “Antiglaucoma Agents” in Schedule 1.
Open-angle glaucoma
7. (1) Subject to subsection (2) and to section 8, it is a standard of practice of the profession that a member may only treat a patient with glaucoma where the patient has primary open-angle glaucoma the treatment of which is not complicated by either a concurrent medical condition or a potentially interacting pharmacological treatment.
(2) It is a standard of practice of the profession that a member may only treat a patient having open-angle glaucoma, the treatment of which is complicated by either a concurrent medical condition or a potentially interacting pharmacological treatment, in collaboration with a physician with whom the member has established a co-management model of care for that patient and who is,
(a) certified by the Royal College of Physicians and Surgeons of Canada as a specialist in ophthalmology; or
(b) formally recognized in writing by the College of Physicians and Surgeons of Ontario as a specialist in ophthalmology.
Referral to physician or hospital
8. (1) Subject to subsections (2) and (3), it is a standard of practice of the profession that a member shall immediately refer a patient having a form of glaucoma other than primary open-angle glaucoma to a physician or to a hospital.
(2) It is a standard of practice of the profession that a member may initiate treatment for a patient having angle-closure glaucoma only in an emergency and where no physician is available to treat the patient.
(3) It is a standard of practice of the profession that a member shall immediately refer any patient being treated in accordance with subsection (2) to a physician or hospital once the emergency no longer exists or once a physician becomes available, whichever comes first.
(4) In this section,
“hospital” means a hospital within the meaning of the Public Hospitals Act.
Commencement
9. This Regulation comes into force on the day it is filed.
SCHEDULE 1
ANTI-INFECTIVE AGENTS
Antibacterials (topical)
azithromycin
besifloxacin
ciprofloxacin
erythromycin
framycetin
fusidic acid
gatifloxacin
gentamicin
moxifloxacin
ofloxacin
polymyxin B/gramicidin/neomycin
polymyxin B/neomycin/ bacitracin
polymyxin B/trimethoprim
sulfacetamide
tetracycline
tobramycin
Antifungals (topical)
natamycin
Antivirals (topical)
trifluridine
Acyclovir
Antibacterials (oral) – for corneal or eyelid infections only and for a duration not exceeding 14 days
amoxicillin
amoxicillin/clavulanic acid
azithromycin
cephalexin
ciprofloxacin
clarithromycin
clindamycin
cloxacillin
doxycycline
erythromycin
levofloxacin
minocycline
moxifloxacin
tetracycline
Antivirals (oral) – for corneal or eyelid infections only
acyclovir
famciclovir
valacyclovir
ANTI-INFLAMMATORY AGENTS
Corticosteroids (topical)
dexamethasone
fluorometholone
loteprednol
prednisolone
rimexolone
Nonsteroidal anti-inflammatory agents (topical)
diclofenac
ketorolac
nepafenac
ANTI-INFECTIVE/ANTI-INFLAMMATORY AGENTS
Antibacterials /corticosteroids (topical)
framycetin/gramicidin/dexamethasone
gentamicin/betamethasone
neomycin/fluorometholone
neomycin/polymyxin B/dexamethasone
neomycin/bacitracin/polymyxin B/hydrocortisone
sulfacetamide/prednisolone
tobramycin/dexamethasone
MYDRIATICS
Mydriatics (topical)
atropine
cyclopentolate
homatropine
ANTI-ALLERGIC AGENTS
Antiallergic agents (topical)
emedastine
ketotifen
levocabastine
lodoxamide
nedocromil
olopatadine
ANTIGLAUCOMA AGENTS
β-Adrenergic blocking agents (topical)
betaxolol
levobunolol
timolol
Carbonic anhydrase inhibitors (topical)
brinzolamide
dorzolamide
Miotics (topical)
carbachol
pilocarpine
Prostaglandin analogs (topical)
bimatoprost
latanoprost
travoprost
α-Adrenergic agonists (topical)
apraclonidine
brimonidine
α-Adrenergic agonists/β-adrenergic blocking agents (topical)
brimonidine/timolol
Carbonic anhydrase inhibitors/β-adrenergic blocking agents (topical)
dorzolamide/timolol
Prostaglandin analogs/β-adrenergic blocking agents (topical)
latanoprost/timolol
travoprost/timolol
Made by:
Council of the College of Optometrists of Ontario:
Richard Kniaziew
President
Christopher Nicol
Registrar
Date made: December 8, 2010.
