§340.1610. Unnecessary, Psychotropic, and Antipsychotic Drugs

a)         A resident shall not be given unnecessary drugs in accordance with Section 340.Table B. In addition, an unnecessary drug is any drug used:

 

1)         in an excessive dose, including in duplicative therapy;

 

2)         for excessive duration;

 

3)         without adequate monitoring;

 

4)         without adequate indications for its use; or

 

5)         in the presence of adverse consequences that indicate the drugs should be reduced or discontinued.  (Section 2-106.1(a) of the Act, see P.A. 88-413, effective August 20, 1993)

 

b)         Psychotropic medication shall not be prescribed without the informed consent of the resident, the resident's guardian, or other authorized representative.  (Section 2-106.1(b) of the Act, see P.A. 88-413, effective August 20, 1993) Informed consent includes information about potential negative outcomes of psychotropic medication use. Additional informed consent is not required for reduction in dosage level or deletion of a specific medication.

 

c)         Residents shall not be given antipsychotic drugs unless antipsychotic drug therapy is necessary, as documented in the resident's comprehensive assessment, to treat a specific or suspected condition as diagnosed and documented in the clinical record or to rule out the possibility of one of the conditions in accordance with Section 340.Table B, Guidelines for the Use of Various Drugs.

 

d)         Residents who use antipsychotic drugs shall receive gradual dose reductions and behavior interventions, unless clinically contraindicated, in an effort to discontinue these drugs in accordance with Section 340.Table B, Guidelines for the Use of Various Drugs.

 

e)         For the purposes of this Section:

 

1)         "Duplicative drug therapy" means any drug therapy that duplicates a particular drug effect on the resident without any demonstrative therapeutic benefit.  For example, any two or more drugs, whether from the same drug category or not, that have a sedative effect.

 

2)         "Psychotropic medication" means medication that is used for or listed as used for antipsychotic, antidepressant, antimanic or antianxiety behavior modification or behavior management purposes in the latest edition of the AMA Drug Evaluations or the Physician's Desk Reference or Drug Evaluation Subscription, American Medical Association, Vols. I-III, Summer 1993.  (Section 2-106.1(b) of the Act, see P.A. 88-413, effective August 20, 1993)

 

3)         "Antipsychotic Drug" means a neuroleptic drug that is helpful in the treatment of psychosis and has a capacity to ameliorate thought disorders.