Controlled Drug

Question 1

What are the classification of controlled drugs under Misuse of Drugs Act 1971

Answer 1

3 classes

Class A:
Heroin, diamorphine, morphine, LSD, ecstasy, cocaine

Class B:
Barbiturates, cannabis, ketamine

Class C:
Benzodiazepines, tramadol, zopiclone, testosterone

Question 2

What are the classification under Misuse of Drugs Regulation 2001

Answer 2

Schedule 1 (CD Lic POM) - don’t have therapeutic effects
Schedule 2 (CD POM) - tight regulations e.g. morphine
Schedule 3 (CD no register POM) - don’t need to enter register
Schedule 4 (CD Benz and CD Anab POM)
Schedule 5 (CD INV P or CD INV POM) - INV: reminder to keep the invoice

Question 3

Which schedules are stored in the cupboard and what the exception

Answer 3

Schedule 1: yes
Schedule 2: yes. Exception: secobarbital
Schedule 2: some - temazepam, buprenorphine
Exception: phenobarbitone, midazolam, tramadol, pentazocine, gabapentin, pregabalin

Question 4

controlled drug - patient returning vs expired

Answer 4

• if patient brings back CD drugs then record in the CD destruction book
• out of data shock in cupboard: recorded in CD balance, authorised witness need to be present and they have to update the balance

Question 5

What are the prescription requirement for CD schedule 2 + 3

Answer 5

• signature of prescriber - have to be in UK
• date: 28 days after appropriate day, owing needs to be given within 28 days
• DOB: if under 12 yrs
• address: don’t have address NFA
• name of patient
• quantity in words and figures {30 days supply not legally required}
• dose needs to be specific [NOT as directed/when required]
• formulation and strength of the medicine

Question 6

Additional requirement for CD dental prescription

Answer 6

Must have ‘For dental treatment only’ written on them

Question 7

Additional requirement for CD veterinary prescription

Answer 7

Name + address of person who will receive CD
Needs declaration that it is prescribed for mainland or herd under their care.
RCVS number for schedule 2 + 3 prescriptions

Question 8

Additional requirement for instalment prescriptions

Answer 8

Total amount to be supplied AND the intervals in which to supply.
First instalments must be within 28 days validity others can run beyond

Question 9

What would the colour of the prescription be for treatment of addiction

Answer 9

Blue FP10MDA

Question 10

Additional requirement for private prescription

Answer 10

Separate registration number and FP10CD
Submission of prescription
Only can write schedule 2 and 3

Question 11

What happens if the legal requirements are not met

Answer 11

• contact the prescriber
• pharmacist can amend quantity if either the quantity is written in words or figures, one needs to be present. Amend minor spelling mistakes

Question 12

Pharmacy amending the prescription is called

Answer 12

Technical amendment
Need to write their names, sign, date + GPHC number

Question 13

Requisitions for schedule 2 and 3

Answer 13

• can be handwritten or computer generated
• name, form and strength of drug
• requires identifying code for prescriber or account code of pharmacy raising the requisition

Request between different pharmacy/ other healthcare professional.
Requisition form needs; signature, name, address, their profession and the purpose and how much they want

Question 14

Formulation conversion

Answer 14

Changing to other opioids - strength needs to be reduced by 25-50% - check the opioid conversation table

Patient factors such as age, pain servitude, frailty, tolerability and current opioid dose has to be taken into account

Question 15

Breakthrough pain

Answer 15

Sharp, intense bits of pain with the background pain relief

Question 16

Some counselling points on patches

Answer 16

• apply to the upper part of body - not on irritated/hairy skin
• can’t cut patches
• don’t be exposed to high temp of water for a period of time
• opioid side effects: avoid alcohol, dizziness, drowsy, increase risk of respiratory depression