Oregon State Archives

Oregon Bulletin

January 1, 2011

Oregon Board of Naturopathic Medicine
Chapter 850

Rule Caption: Clarifying the education for injections.

Adm. Order No.: OBNM 6-2010

Filed with Sec. of State: 12-13-2010

Certified to be Effective: 12-13-10

Notice Publication Date: 11-1-2010

Rules Amended: 850-060-0212

Subject: Amend the following sections of OAR 850-060-0212 (bold/underlined text is new; strike-through is deleted.)

      OAR 850-060-0212

      Education Requirements for Injections/ IV Chelation Therapy

      (1) Before using therapeutic injections [of vitamins and minerals], or preventive injections of any substance, whether intramuscular (IM) or subcutaneous (SC) or intravenous (IV), licensee must provide proof of Board approved qualifying continuing education prior to using these applications as set forth in this rule, or proof of Board approved qualifying education received at an approved medical institution equivalent to the prescribed continuing education.

      (2) [Non-IV] Subcutaneous and intramuscular therapeutic injections [of vitamins or minerals] require a one-time two hour qualifying education on this subject.

      (3) IV therapeutic injections of vitamins or minerals require a one-time 12 hour qualifying education on this subject.

      (4) Preventive injections (IM, SC, IV) require an additional one-time four hours of qualifying education in addition to the CE hours noted in OAR 850-060-0212(2) and (3).

Rules Coordinator: Anne Walsh—(971) 673-0193

850-060-0212

Education Requirements for Injections/ IV Chelation Therapy

(1) Before using therapeutic injections or preventive injections of any substance, whether intramuscular (IM) or subcutaneous (SC) or intravenous (IV), licensee must provide proof of Board approved qualifying continuing education prior to using these applications as set forth in this rule, or proof of Board approved qualifying education received at an approved medical institution equivalent to the prescribed continuing education.

(2) Subcutaneous and intramuscular therapeutic injections require a one-time two hour qualifying education on this subject.

(3) IV therapeutic injections of vitamins or minerals require a one-time 12 hour qualifying education on this subject.

(4) Preventive injections (IM, SC, IV) require an additional one-time four hours of qualifying education in addition to the CE hours noted in OAR 850-060-0212(2) and (3).

(5) The use of any IV chelation therapy requires 12 hours of Board approved qualifying education in addition to the education required in (2), (3) and (4) of this rule.

(6) Licensee must stay current in IV chelation training. Current means licensee has completed the education and obtained a certificate of competence within the last five years.

(7) Qualifying chelation therapy education must be provided by faculty with at least five years of experience in IV chelation therapy and current training approved by the Board. The qualifying education must contain all of the following:

(a) Current/ historical research on IV chelation therapy,

(b) Indications/contraindications of IV chelation therapy,

(c) IV Chelation therapy side effects and toxicity,

(d) IV Chelation therapy and practical application,

(e) IV solutions,

(f) Initial evaluation and treatment monitoring requirements,

(g) Frequency of IV treatment and remineralization,

(h) Charting requirements, standards of care, office procedures, consent to treat, nutrition and lifestyle recommendations during treatment,

(i) Heavy metal toxicity and disease,

(j) Practical on mixing and administering IV Chelation solutions,

(k) Examination for certification (exam subject to Board approval).

Stat Auth.: ORS 685.125

Stats. Implemented: ORS 685

Hist: BNE 6-2004, f. & cert. ef. 6-10-04; BNE 6-2005, f. & cert. ef. 8-15-05; Renumbered from 850-010-0212, BNE 8-2005, f. & cert. ef. 10-27-05; OBNM 6-2010, f. & cert. ef. 12-13-10

Rule Caption: Clarifying the formulary classifications.

Adm. Order No.: OBNM 7-2010

Filed with Sec. of State: 12-13-2010

Certified to be Effective: 12-13-10

Notice Publication Date: 11-1-2010

Rules Amended: 850-060-0226

Subject: To OAR 850-060-0226 add the following classification: (bold/underlined is new text.)

      (8) Central Nervous System Agents

      (d) Psychotherapeutic Agents

      (A) Antidepressants

      (i) Monoamine Oxidase Inhibitors

      (ii) Selective Serotonin- and Norepinephrine-reuptake Inhibitors

      (iii) Selective Serotonin- Reuptake Inhibitors

      (iv) Serotonin Modulators

      (v) Tricyclics and Other Norepinephrine-reuptake Inhibitors

      (vi) Antidepressants, Miscellaneous

      (B) Antipsychotics, to include only the following:

      (i) Atypical antipsychotics

      (e) Anorexigenic Agents and Respiratory and Cerebral Stimulants

      (A)Amphetamines

      (B) Anorexigenic Agents and Respiratory and Cerebral Stimulants, Miscellaneous

Rules Coordinator: Anne Walsh—(971) 673-0193

850-060-0226

Formulary Compendium Classifications

The Formulary Council has approved the following pharmacologic-therapeutic classifications based on the 2009 American Hospital Formulary Service (AHFS), in addition to drugs previously approved by the Formulary Council and listed in 850-060-0225. This listing does not supersede the education and training requirement established in 850-060-0212 for administration of IV agents. The Formulary Council may consider new agents, substances and pharmacologic-therapeutic classifications for addition to this list.

(1) Antihistamine Drugs:

(a) First Generation Antihistamine Drugs;

(A) Ethanolamine Derivatives;

(B) Ethylenediamine Derivatives;

(C) Phenothiazine Derivatives;

(D) Piperazine Derivatives;

(E) Propylamine Derivatives;

(F) Miscellaneous Derivatives.

(b) Second Generation Antihistamines.

(2) Anti-Infective Agents:

(a) Antihelmintics;

(b) Antibacterials;

(A) Aminoglycosides;

(B) Cephalosporins;

(i) First Generation Cephalosporins;

(ii) Second Generation Cephalosporins;

(iii) Third Generation Cephalosporins;

(iv) Fourth Generation Cephalosporins.

(C) Miscellaneous β-Lactams;

(i) Carbacephems;

(ii) Carbapenems;

(iii) Cephamycins;

(iv) Monobactams.

(D) Chloramphenicol;

(E) Macrolides;

(i) Erythromycins;

(ii) Ketolides;

(iii) Other Macrolides.

(F) Penicillins;

(i) Natural Penicillins;

(ii) Aminopenicillins;

(iii) Penicillinase-resistant Penicillins;

(iv) Extended-spectrum Penicillins.

(G) Quinolones;

(H) Sulfonamides;

(I) Tetracyclines: Glycylcyclines.

(J) Antibacterials, Miscellaneous;

(i) Aminocyclitols;

(ii) Bacitracins;

(iii) Cyclic Lipopeptides;

(iv) Glycopeptides;

(v) Lincomycins;

(vi) Oxazolidinones;

(vii) Polymyxins;

(viii) Rifamycins;

(ix) Streptogramins.

(c) Antifungals;

(A) Allylamines;

(B) Azoles;

(C) Echinocandins;

(D) Polyenes;

(E) Pyrimidines;

(F) Antifungals, Miscellaneous.

(d) Antimycobacterials;

(A) Antituberculosis Agents;

(B) Antimycobacterials, Miscellaneous.

(e) Antivirals;

(A) Adamantanes;

(B) Antiretrovirals;

(i) HIV Fusion Inhibitors;

(ii) HIV Protease Inhibitors;

(iii) Integrase Inhibitors;

(iv) Nonnucleoside Reverse Transcriptase Inhibitors;

(v) Nucleoside and Nucleotide Reverse Transcriptase Inhibitors.

(C) Interferons;

(D) Monoclonal Antibodies;

(E) Neuraminidase Inhibitors;

(F) Nucleosides and Nucleotides;

(G) Antivirals, Miscellaneous.

(f) Antiprotozoals;

(A) Amebicides;

(B) Antimalarials;

(C) Antiprotozoals, Miscellaneous.

(3) Antineoplastic Agents (oral and topical only) limited to the following:

(a) 5FU;

(b) Anastrozole;

(c) Letrozole;

(d) Megestrol;

(e) Mercaptopunne;

(f) Methotrexate;

(g) Tamoxifen;

(h) Tretinoin.

(4) Autonomic Drugs:

(a) Parasympathomimetic (Cholinergic) Agents;

(b) Anticholinergic Agents;

(A) Antimuscarinics/Antispasmodics;

(c) Sympathomimetic (Adrenergic) Agents;

(A) α-Adrenergic Agonists;

(B) β- Adrenergic Agonists;

(i) Non-selective β — Adrenergic Agonists;

(ii) Selective β1 — Adrenergic Agonists;

(iii) Selective β2 — Adrenergic Agonists;

(C) α-And β-Adrenergic Agonists;

(d) Sympatholytic (Adrenergic Blocking) Agents;

(e) Skeletal Muscle Relaxants;

(A) Centrally Acting Skeletal Muscle Relaxants;

(B) Direct-acting Skeletal Muscle Relaxants;

(C) GABA-derivative Skeletal Muscle Relaxants;

(D) Neuromuscular Blocking Agents;

(E) Skeletal Muscle Relaxants, Miscellaneous.

(f) Autonomic Drugs, Miscellaneous.

(5) Blood Derivatives.

(6) Blood Formation, Coagulation, and Thrombosis:

(a) Antianemia Drugs: Iron Preparations.

(b)(A) Antithrombotic Agents;

(B) Anticoagulants;

(i) Coumarin Derivatives;

(ii) Direct Thrombin Inhibitors;

(iii) Heparins;

(iv) Anticoagulants, Miscellaneous;

(c) Platelet-reducing Agents;

(d) Platelet-aggregation Inhibitors;

(e) Thrombolytic Agents;

(f) Hematopoietic Agents;

(g) Hemorrheologic Agents;

(h) Antihemorrhagic Agents.

(A) Antiheparin Agents;

(B) Hemostatics.

(7) Cardiovascular Drugs:

(a) Cardiac Drugs;

(A) Antiarrhythmic Agents;

(i) Class Ia Antiarrhythmics;

(ii) Class Ib Antiarrhythmics;

(iii) Class Ic Antiarrhythmics;

(iv) Class III Antiarrhythmics;

(v) Class IV Antiarrhythmics.

(B) Cardiotonic Agents;

(C) Cardiac Drugs, Miscellaneous.

(b) Antilipemic Agents;

(A) Bile Acid Sequestrants;

(B) Cholesterol Absorption Inhibitors;

(C) Fibric Acid Derivatives;

(D) HMG-CoA Reductase Inhibitors;

(E) Antilipemic Agents, Miscellaneous.

(c) Hypotensive Agents;

(A) Calcium-Channel Blocking Agents;

(B) Central a-Agonists;

(C) Direct Vasodilators;

(D) Peripheral Adrenergic Inhibitors.

(d) Vasodilating Agents;

(A) Nitrates and Nitrites;

(B) Phosphodiesterase Inhibitors;

(C) Vasodilating Agents, Miscellaneous.

(e) Sclerosing Agents;

(f) α-Adrenergic Blocking Agents;

(g) β-Adrenergic Blocking Agents;

(h) Calcium-Channel Blocking Agents;

(A) Dihydropyridines;

(B) Calcium-Channel Blocking Agents, Miscellaneous;

(i) Renin-Angiotensin-Aldosterone System Inhibitors;

(A) Angiotensin-Converting Enzyme Inhibitors;

(B) Angiotensin II Receptor Antagonists;

(C) Mineralocorticoid (Aldosterone) Receptor Antagonists;

(D) Renin Inhibitors.

(8) Central Nervous System Agents;

(a) Analgesics and Antipyretics;

(A) Nonsteroidal Anti-inflammatory Agents;

(i) Cyclooxygenase-2 (COX-2) Inhibitors;

(ii) Salicylates;

(iii) Other Nonsteroidal Anti-inflammatory Agents.

(B) Opiate Agonists;

(C) Opiate Partial Agonists;

(D) Analgesics and Antipyretics, Miscellaneous.

(b) Opiate Antagonists;

(c) Anticonvulsants, does not include Barbiturates;

(A) Benzodiazepines;

(B) Hydantoins;

(C) Succinimides;

(D) Anticonvulsants, Miscellaneous.

(d) Psychotherapeutic Agents;

(A) Antidepressants;

(i) Monoamine Oxidase Inhibitors;

(ii) Selective Serotonin- and Norepinephrine-reuptake Inhibitors;

(iii) Selective Serotonin- Reuptake Inhibitors;

(iv) Serotonin Modulators;

(v) Tricyclics and Other Norepinephrine-reuptake Inhibitors;

(vi) Antidepressants, Miscellaneous.

(B) Antipsychotics, to include only the following:

(i) Atypical antipsychotics;

(e) Anorexigenic Agents and Respiratory and Cerebral Stimulants;

(A)Amphetamines;

(B) Anorexigenic Agents and Respiratory and Cerebral Stimulants, Miscellaneous.

(f) Anxiolytics, Sedatives, and Hypnotics, does not include Barbiturates;

(A) Benzodiazepines;

(B) Anxiolytics, Seditives, and Hypnotics; Miscellaneous.

(g) Antimanic Agents;

(h) Antimigraine Agents;

(A) Selective Serotonin Agonists: Antiparkinsonian Agents

(A) Adamantanes;

(B) Anticholinergic Agents;

(C) Catechol-O-Methyltransferase (COMT) Inhibitors;

(D) Dopamine Precursors;

(E) Dopamine Receptor Agonists;

(i) Ergot-derivative Dopamine Receptor Agonists;

(ii) Non-ergot-derivative Dopamine Receptor Agonists;

(F) Monoamine Oxidase B Inhibitors.

(j) Central Nervous System Agents, Miscellaneous.

(9) Contraceptives (foams, devices).

(10) Diagnostic Agents.

(11) Disinfectants (for Agents used on objects other than skin).

(12) Electrolytic, Caloric, and Water Balance.

(a) Acidifying Agents;

(b) Alkalinizing Agents;

(c) Ammonia Detoxicants;

(d) Replacements Preparations;

(e) Ion-Removing Agents;

(A) Calcium-removing Agents;

(B) Potassium-removing Agents;

(C) Phosphate-removing Agents;

(D) Other Ion-removing Agents.

(f) Caloric Agents;

(g) Diuretics;

(A) Loop Diuretics;

(B) Osmotic Diuretics;

(C) Potassium-sparing Diuretics;

(D) Thiazide Diuretics;

(E) Thiazide-like Diuretics;

(F) Diuretics, Miscellaneous.

(h) Irrigation Solutions;

(i) Uricosuric Agents.

(13) Enzymes.

(14) Respiratory Tract Agents;

(a) Antihistamines;

(b) Antitussives;

(c) Anti-inflammatory Agents;

(A) Leukotriene Modifiers;

(B) Mast-cell Stabilizers;

(d) Expectorants;

(e) Pulmonary Surfactants;

(f) Respiratory Agents, Miscellaneous.

(15) Eye, Ear, Nose, and Throat (EENT) Preparations;

(a) Antiallergic Agents;

(b) Anti-infectives;

(A) Antibacterials;

(B) Antifungals;

(C) Antivirals;

(D) Anti-infectives, Miscellaneous.

(c) Anti-inflammatory Agents;

(A) Corticosteroids;

(B) Nonsteroidal Anti-inflammatory Agents;

(C) Anti-inflammatory Agents, Miscellaneous.

(d) Local Anesthetics;

(e) Mydriatics;

(f) Mouthwashes and Gargles;

(g) Vasoconstrictors;

(h) Antiglaucoma Agents;

(A) α-Adrenergic Agonists;

(B) β-Adrenergic Agents;

(C) Carbonic Anhydrase Inhibitors;

(D) Miotics;

(E) Prostaglandin Analogs: EENT Drugs, Miscellaneous.

(16) Gastrointestinal Drugs:

(a) Antacids and Adsorbents;

(b) Antidiarrhea Agents;

(c) Antiflatulents;

(d) Cathartics and Laxatives;

(e) Cholelitholytic Agents;

(f) Emetics;

(g) Antiemetics;

(A) Antihistamines;

(B) 5-HT3 Receptor Antagonists;

(C) Antiemetics, Miscellaneous.

(h) Antiulcer Agents and Acid Suppressants;

(A) Histamine H2-Antogonists;

(B) Prostaglandins;

(C) Protectants;

(D) Proton-pump Inhibitors.

(i) Prokinetic Agents;

(j) Anti-inflammatory Agents;

(k) GI Drugs, Miscellaneous.

(17) Gold Compounds.

(18) Heavy Metal Antagonists.

NOTE: IV administration requires education and training compliance with 850-060-0212.

(19) Hormones and Synthetic Substitutes;

(a) Adrenals;

(b) Androgens;

(c) Contraceptives;

(d) Estrogens and Antiestrogens;

(A) Estrogens;

(B) Estrogen Agonists-Antiagonists;

(e) Gonadotropins;

(f) Antidiabetic Agents.

(A) α-Glucosidase Inhibitors;

(B) Amylinomimetics;

(C) Biguanides;

(D) Dipeptidyl Peptidase (DDP-4) Inhibitors;

(E) Incretin Mimetics;

(F) Insulins;

(G) Meglitinides;

(H) Sulfonylureas;

(I) Thiazolidinediones.

(g) Antihypoglycemic Agents: Glycogenolytic Agents;

(h) Parathyroid;

(i) Pituitary;

(j) Somatotropin Agonists and Antagonists;

(A) Somatotropin Agonists;

(B) Somatotropin Antagonists;

(k) Progestins;

(l) Thyroid and Antithyroid Agents;

(A) Thyroid Agents;

(B) Antithyroid Agents.

(20) Local Anesthetics.

(21) Oxytocics.

(22) Serums, Toxoids, and Vaccines;

(a) Serums;

(b) Toxoids;

(c) Vaccines.

(23) Skin and Mucous Membrane Agents;

(a) Anti-infectives;

(A) Antibacterials;

(B) Antivirals;

(C) Antifungals;

(i) Allylamines;

(ii) Azoles;

(iii) Benzylamines;

(iv) Hydroxypyridones;

(v) Polyenes;

(vi) Thiocarbamates;

(vii) Antifungals, Miscellaneous;

(D) Scabicides and Pediculicides;

(E) Local Anti-infectives, Miscellaneous;

(b) Anti-inflammatory Agents;

(c) Antipruritics and Local Anesthetics;

(d) Astringents;

(e) Cell Stimulants and Proliferants;

(f) Detergents;

(g) Emollients, Demulcents, and Protectants;

(h) Keratolytic Agents;

(i) Keratoplastic Agents;

(j) Depigmenting and Pigmenting Agents;

(A) Depigmenting Agents;

(B) Pigmenting Agents.

(k) Sunscreen Agents;

(l) Skin and Mucous Membrane Agents, Miscellaneous.

(24) Smooth Muscle Relaxants:

(a) Gastrointestinal Smooth Muscle Relaxants;

(b) Genitourinary Smooth Muscle Relaxants;

(c) Respiratory Smooth Muscle Relaxants.

(25) Vitamins:

(26) Miscellaneous Therapeutic Agents;

(a) Alcohol Deterrents limited to the following:

(A) Acamprosate;

(B) Disulfiram;

(C) Naltrexone

(b) 5-α Reductase Inhibitors;

(c) Antidotes;

(d) Antigout Agents;

(e) Biologic Response Modifiers, limited to Interferons;

(f) Bone Resorption Inhibitors;

(g) Cariostatic Agents;

(h) Complement Inhibitors;

(i) Disease-Modifying Antirheumatic Agents;

(j) Gonadotropin-releasing Hormone Antagonists;

(k) Immunosuppressive Agents;

(l) Other Miscellaneous Therapeutic Agents limited to the following:

(A) Alfuzosin Hydrochloride;

(B) Drotrecogin Alfa (Activated);

(C) Lanreoytide Acetate;

(D) Rilonacept;

(E) Sapropterin Dihydrochloride;

(F) Tamsulosin Hydrochloride.

Stat. Auth.: ORS 685.125

Stats. Implemented: ORS 685.145

Hist.: BNE 1-2002, f. & cert. ef. 2-19-02; BNE 4-2002, f. & cert. ef. 8-8-02; BNE 3-2003, f. & cert. ef. 6-9-03; BNE 5-2003, f. & cert. ef. 12-5-03; BNE 5-2004, f. & cert. ef. 6-10-04; Renumbered from 850-010-0226, BNE 8-2005, f. & cert. ef. 10-27-05; BNE 9-2005, f. & cert. ef 12-12-05; BNE 4-2006, f. & cert. ef. 12-11-06; BNE 3-2007, f. & cert. ef. 6-12-07; BNE 1-2008, f. & cert. ef. 2-19-08; BNE 2-2008, f. & cert. ef. 3-21-08; BNE 6-2008, f. & cert. ef. 6-11-08; BNE 7-2008, f. & cert. ef. 12-8-08; BNE 2-2009, f. & cert. ef. 6-17-09; BNE 7-2009, f. 12-14-09, cert. ef. 1-1-10; OBNM 5-2010, f. & cert. ef. 6-30-10; OBNM 7-2010, f. & cert. ef. 12-13-10

Notes
1.) This online version of the OREGON BULLETIN is provided for convenience of reference and enhanced access. The official, record copy of this publication is contained in the original Administrative Orders and Rulemaking Notices filed with the Secretary of State, Archives Division. Discrepancies, if any, are satisfied in favor of the original versions. Use the OAR Revision Cumulative Index found in the Oregon Bulletin to access a numerical list of rulemaking actions after November 15, 2010.

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