Pharmacist Roles and Responsibilities
What this domain tests
This domain asks what a New Hampshire pharmacist may do beyond routine dispensing - collaborative practice, immunization, emergency authority, naloxone and harm reduction, and prescription monitoring - and where those authorities end.
Expanded authority
- Collaborative practice: pharmacists may enter written agreements with prescribers to manage defined drug therapy, with protocols for initiation, adjustment, monitoring, and referral back.
- Immunization: pharmacists with current certification and training may administer vaccines under protocol; document the dose, lot, site, and route, and report to the state immunization registry as required.
- Naloxone: New Hampshire pharmacists may dispense naloxone under the state's standing order framework, and can counsel patients and family members on use.
- Harm reduction: syringe sales and safe-use supplies are handled under state law without requiring a prescription.
- Emergency authority: during declared public health emergencies the Governor and Board may waive or modify rules and issue emergency licenses; authority granted this way ends with the emergency.
Prescription monitoring
The New Hampshire prescription monitoring program is administered in connection with the Board of Pharmacy. Pharmacists query it to support corresponding responsibility and review patient history when red flags arise; dispensers must report controlled substance dispensing completely and on time.
Worked example
A patient asks for naloxone for a family member and mentions the relative uses oxycodone from two prescribers. Reasoning: dispense naloxone under the standing order and counsel on recognition of overdose and rescue breathing; separately, the two-prescriber information is a red flag relevant to the controlled substance dispensing and warrants a PMP review and prescriber contact. Two distinct duties flow from one conversation, and the harm-reduction service should not be withheld because of the red flag.
Traps that cost marks
Practicing under a collaborative agreement that lacks a written protocol or a named prescriber. Immunizing without current certification or without documentation. Treating emergency waivers as permanent. Assuming PMP queries are optional when suspicious circumstances are present.