Appropriate controlled substance prescribing Flashcards
Schedule I:
Drugs with no currently accepted medical use and a high potential for
abuse.
Examples: heroin, lysergic acid diethylamide (LSD), marijuana (cannabis), 3,4 methylenedioxymethamphetamine (ecstasy), and peyote.
Schedule 2:
Drugs with high potential for abuse and potential for severe psychological
or physical dependence. Some medical usages.
Examples: cocaine, methadone, hydromorphone, hydrocodone,
oxycodone, fentanyl, Stimulants (methamphetamine, Adderall, and
Ritalin)
Schedule 3:
Drugs with a moderate to low potential for physical and psychological dependence.
Examples: Tylenol with codeine, ketamine, anabolic steroids, Suboxone, testosterone
Schedule 4:
Drugs with a low potential for abuse and low risk of dependence.
Examples: Benzodiazepines, sedative hypnotics (Ambien), Tramadol,
Soma, Armodafinil (Nuvigil
Schedule 5:
Drugs with lower potential for abuse than Schedule IV.
Examples: cough meds with low amounts of codeine, Lomotil, Motofen,
Lyrica
Licensed PAs may prescribe Schedules _____ if they are within the
physician assistant’s scope of practice
II-V
Typical supply of a controlled substance prescription in Utah?
30 day supply
_____: Use of a prescription medication, outside of the manner and intent for which it was prescribed. This includes overuse, to get high, and diversion.
Prescription Drug Misuse
_____: Sharing or selling a medication prescribed to you
Diversion
_____: Seeing multiple providers at the same time, filling prescriptions at multiple different pharmacies, frequent ER visits, buying pills on the street
Common sources
In a given year, around ____% of adolescents/adult will qualify
for a prescription stimulant use disorder
0.5
Before prescribing a controlled substance (CS) what other things can you do?
● Optimize other Treatments First: behavioral, exercise, and self-mgmt education
● Assess the risk of addiction and harm (Untreated substance use disorder, Poorly controlled psychiatric illness, Inconsistent follow-up). Consider a UDS before start
● Establish a Treatment Plan: Make it clear what your intentions are for dosing, frequency, and duration of the medication. Document it.
● Educate the patient about side effects, risk of addiction, dependence, tolerance, and withdrawals
● Establish protocols/rules the patient needs to abide by while being
prescribed a CS. Have these outlined in a CS contract (Next slide)
Other options outside of controlled substances for Pain management
PT, injections or blocks, CBT, Acetaminophen, NSAIDs, topicals, SNRIs.
Other options outside of controlled substances for anxiety management
Psychotherapy, SSRIs, SNRIs, Hydroxyzine, Buspar
Other options outside of controlled substances for ADHD management
Psychotherapy, Atomoxetine, bupropion
