19. Disposal Of Prescription Drugs Flashcards
What is the primary purpose of a syringe-exchange program?
A. To collect used syringes for recycling.
B. To save the users money.
C. To keep used syringes out of the trash where they may prick the garbage collector.
D. To reduce the risk of infectious disease through needle sharing.
E. To encourage users to inject more frequently.
D. Syringe-exchange programs enable injection drug users to exchange used syringes for new ones. Unfortunately budgetary restrictions have limited the availability of these programs. Besides the health of the addict, it costs society much more to care for the addict once infected.
A patient does not have money to purchase a red plastic used syringe container and asks the pharmacist what she could use instead. She has been given a special container to put the used syringes in for trash pick-up, but needs a container to place inside the trash pick-up bin. What is the best option?
A. A used plastic milk jug.
B. Any of the above are acceptable disposal options.
C. A plastic bag, tied shut with a knot.
D. A used glass jar.
E. A used cardboard box.
A. Used syringes cannot be stored in glass, paper or cardboard. Heavy plastic is best. Another option is a metal coffee can with a plastic lid. Seal the top after use and place in the recycled box. If instructed to dispose of in the regular trash, the container should be labeled to indicate that it contains sharps.
Which of the following drugs are permitted by the FDA (and the DEA) to be flushed in order to reduce the risk of accidental exposure or diversion? (Select ALL that apply.)
A. Oxycontin
B. AndroGel
C. Opana
D. Nucynta ER
E. Duragesic
A, C, D, E.
Many patients flush medications down the toilet. Which of the following statements are correct? (Select ALL that apply.)
A. Only the controlled drugs, with the exception of C V cough syrups, can be flushed.
B. Exposure to even low levels of drugs has negative effects on fish and other aquatic species.
C. Dumping medicines in the toilet negatively affects human health.
D. Disposing of medication waste properly is the law.
E. Most streams, rivers and oceans bordering the U.S. have measurable concentrations of prescription and nonprescription drugs, steroids, and reproductive hormones.
B, C, D, E. Try to encourage all patients to practice safe medication disposal. Even if we were able to eliminate flushing drugs, environmental risk would still be present because the majority of drug presence in the waterways comes from human waste.
Choose options that may be present in a given community for patients to return used sharps (syringes and needle tips): (Select ALL that apply.)
A. Pharmacies
B. Police and fire departments
C. Public drop boxes and mail boxes
D. Hazardous waste pick-up days or collection sites
E. Discarding in public waste bins that are present on city streets and at bus stops.
A, B, C, D. Wherever you are working, you will need to know where local residents are supposed to bring sharps. In many communities there exists residential hazardous waste pick-up where home users place the used sharps in a special “sharps” container and, much like a recycling container, it is set outside for pick-up by special waste handlers.
Pharmacies in all 50 states participate in the national days to collect unneeded prescription drugs that are organized under the auspices of the DEA. What is the name of this program?
A. Take-Control
B. Alert
C. Take-Back
D. Take-Away
E. ReUse-and-ReCycle
C. Take Back Days are for non-scheduled drugs and collect a lot of drugs. Scheduled drugs must be returned under DEA supervision, to an authorized disposal company that will destroy the drugs.
A patient asks the pharmacist why she has been instructed to cut up her fentanyl patch and mix it with the used coffee grounds. Choose the correct statements: (Select ALL that apply.)
A. Fentanyl has poor oral absorption, but the amount that is received (sublingually) by chewing a used patch can be fatal to a child or pet.
B. The DEA prohibits the flushing of the fentanyl patch; it must be disposed of in the disposal kit that comes with the drug, or cut up and mixed with an unpalatable substance.
C. Mixing the cut patch with coffee grounds will make it less appealing to children and pets.
D. Mixing the cut patch with coffee grounds should make the patch unrecognizable to people who may intentionally go through your trash.
E. You can purchase a bag of inexpensive cat litter and use that if you don’t drink coffee, or use an unpleasant substance such as Comet.
A, C, D, E. It does not take a lot of fentanyl to kill an opioid-naïve person; a used patch contains a deadly amount. The medication will be less appealing to children and pets, and unrecognizable to people who may intentionally go through your trash, if it is cut up and mixed with an undesirable substance. Alternatively, the fentanyl patch is one of the drugs that the FDA states is acceptable to flush.
Which of the following drugs are permitted by the FDA (and the DEA) to be flushed in order to reduce the risk of accidental exposure or diversion? (Select ALL that apply.)
A. Butrans
B. Diastat
C. Onsolis
D. Avinza
E. Norco
A, B, C, D.
Jan is a chronic pain patient in a community without a drug take-back program. She changes her pain medication occasionally and needs to know how to dispose of the prescription drugs she no longer requires. Jan will not flush anything down the toilet because she believes in trying not to harm plants and animals. In the absence of a take-back program, the pharmacist should recommend the following: (Select ALL that apply.)
A. Return the unused drugs to your local hospital during regular work hours.
B. Put this mixture into a disposable container with a lid, such as an empty margarine tub or into a sealable bag.
C. Conceal/remove any personal information, including the Rx number, on the empty containers by covering it with black permanent marker or duct tape, or by scratching it off.
D. Throw the container in the household trash.
E. Send the medications (with patient identifiers removed) back to the drug manufacturer’s disposal facility.
B, C, D. These are the instructions to provide to patients in the absence of a place to bring the drugs-community “take back” programs, which may include hazardous waste pick-up days, are preferred. If no collection facilities are available, some localities provide postage paid mailers. These can also be purchased.
Jan is a chronic pain patient. She uses the following medications: hydrocodone-acetaminophen, pregabalin, the fentanyl patch, diltiazem and sertraline. According to the FDA, it is permissible to flush the following medication in the toilet:
A. Hydrocodone-acetaminophen
B. Fentanyl
C. Pregabalin
D. Diltiazem
E. Sertraline
B. The FDA produces a list of which unused or expired medicines can be flushed down the sink or toilet to help prevent danger to people and pets in the home. The list includes many of the opioids (not the combo drugs like hydrocodone-acetaminophen, but the full opioids such as morphine, oxycodone, etc) and the fentanyl patch, methylphenidate patch and the buprenorphine patch.
A 75 year-old patient had been using clopidogrel, aspirin, an ACE inhibitor, a beta blocker, a loop diuretic and potassium. The patient recently expired and the family is asking the pharmacist what to do with his medications. Choose the most preferable option for disposing of these drugs:
A. A community “take back” program for unwanted drugs, if available.
B. Removing identifying information and disposing in the trash.
C. Flushing pills down the toilet, and throwing empty containers in the trash.
D. Donating to the Salvation Army.
E. Sending back to the manufacturers.
A. To dispose of prescription drugs not labeled to be flushed, the best option is to take advantage of community drug take-back programs or other programs, such as household hazardous waste collection events, that collect drugs at a central location for proper disposal.
