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California OT Topical Medications

Types of Medications

"Topical medications" means medications applied locally to the skin or underlying tissue where such medications require a prescription or order under federal or state law. 

The following medications are applicable to the practice of occupational therapy and may be used by an occupational therapist:

    • Bacteriocidal agents;
    • Debriding agents;
    • Topical anesthetic agents;
    • Anti-inflammatory agents;
    • Antispasmodic agents; and
    • Adrenocortico-steroids.

Standards of Practice

Any topical medication applied or administered shall have been ordered on a specific or standing basis by a practitioner legally authorized to order or prescribe such medication pursuant to Business and Professions Code section 2571(a).

An occupational therapist may administer a topical medication by the use of a physical agent modality, only if the occupational therapist is approved by the Board in the advanced practice area of physical agent modalities.

An occupational therapist shall follow written protocols in applying or administering topical medications the protocols shall:

    • Be prepared by the facility within which the topical medications are being applied or administered;
    • Be approved by the medical director or equivalent of the facility;
    • Include a description of each medication, its actions, its indications and contraindications, and the proper procedure and technique for application;
    • Require that the administration be consistent with the manufacturer's guidelines for any equipment to be used in the administration of the topical medication; and
    • Be based on research and evidence-based practice, pharmaceutical standards of practice and known desired outcomes.

Supervision of the application or administration of topical medications by an occupational therapy assistant under this section shall be in accordance with Article 9.

Under no circumstance does this section authorize an occupational therapist or occupational therapist assistant to administer a medication via injection.


16 CCR ยง 4152.1

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