Controlled Drug Flashcards

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1
Q

What legislation are CDS covered by

A

Human medicines regulation 2012

The misuse of drugs act 1971

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2
Q

What does the misuse of drugs act cover?

A

Primary purpose is to prevent the misuse of CDs
It is concerned with unlawful use of certain drugs, and penalties

It does this by imposing a total prohibition on the possession, supply, manufacture, import or export of CDs except as allowed by regulation or by licence from the Secretary of State

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3
Q

How do we classify CDs

A

Misuse of drugs regulation have 5 schedules

Schedule 1 is subject to the strictest controls and schedule 5 is subject to the least strict

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4
Q

What are schedule 1 drugs and state some examples

A

These are drugs which have virtually no therapeutic use
Such drugs may only be produced, possessed or supplied for research or other special purposes
A licence from the home office is needed for any of these purposes
Pharmacist need a license to possess and supply
Examples:LSD, ecstasy, methampetamine

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5
Q

What are schedule 2 CDs and state some examples

A

Used in medicine
May only be supplied to a patient in a prescription which is subject to stringent requirements
Must be kept under safe custody
Registers if transactions must be kept: CD reg

Examples:cocaine, diamorphine, methadone, amphetamine

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6
Q

What are the prescription requirements for schedule 2 CDs

A
Patient N&A
Product name 
Strength 
Form- even if one form 
Dose 
Total quantity in words and figures 
Signed and 
Dated 

NO EEA prescribers
Must have for dental treatment only if dentist

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7
Q

Additional CD prescription requirements

A

If there is only 1 strength available then the strength is not needed but is good practise
Dose instruction as direct is not acceptable but one as direct is (NO PRN OR MDU)
Prescriptions are only valid for 28 days (CD5 is 6months)
Private prescription must be written in a special form FP10CD

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8
Q

What are schedule 3 CDs and state some examples

A

Not thought to be so liable to misuse as S2 CDs
Almost the same controls as S2 BUT: not all drugs are under safe custody (only temazapam, buprenorphine, diethylproprion, flunitrazepam)

REGISTERS DONT NEED TK BE MADE
examples: midazolam, tramadol

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9
Q

What are the 2 parts of S4

A
CD benz(odiazapines) 
CD anab(olic steroids) 

Treated more like POM (except only valid for 28 days)
No safe custody
No CD prescription requirements

Examples: zopiclone, diazepam, zaleplon

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10
Q

S5 drugs

A

Some S2 drugs at different form or concentration
Some are P and POM
This is the only one in which anyone can be in possession

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11
Q

What is a 30 day clinical need

A

This is a strong recommendation from the DoH but not a legal requirement
The quantity of schedule 2,3,4 CDs prescribed shouldn’t exceed 30 day supply
Prescribers will need to be able to justify on the basis of clinical need, a supply of more than 30 days

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12
Q

How can we as pharmacists change a CD prescription

A

1) minor typos or spelling mistakes
2) where the total quantity is specified in either words or figures
(Can’t add both)

Pharmacist must sign, date and add there reg number on prescription

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13
Q

What is safe custody

A

This is locking away in a safe certain drugs
All of S2 and 4 S3 drugs
These require continual supervision
Only the pharmacist can access this
When CD is out of the safe it must be under direct supervision of the pharmacist

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14
Q

CD register

A

Seperate register for each preparation
Receipts and supplies on one page
Running balances- they must balance
Must make entry on the date of supple or within 24 hours, the next day
Entries must be in ink or indelible
Keep reg for 2 Years form date of the last entry

NEVER CROSS OUT IN CD REGISTER

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15
Q

classification of CDs

A

Misuse of drugs regulations for schedules

Schedule one being strictest and schedule five being the least strict

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16
Q

What can pharmacist arrange for drug misusers

A

Supply of drugs

Paraphernalia

17
Q

What drugs can be supplied via arrangement

A

Methadone- oral solution

Buprenorphine- subutex not temgesic

Diamorphine

18
Q

What does the misuse of drugs regulation state about prescribing for drug addicts

A

It states that doctors are prohibited from prescribing, administering or supplying the following drugs for the treatment of addiction
Diamorphine, cocaine, dipipanone

Except under a Home office licence

No other types of prescribers can off these drugs for the treatment of addiction

19
Q

What 2 forms can CDs come on for treatment of addiction

A

FP10CD

FP10MDA- blue form A

20
Q

FP10MDA

A

Blue form
Issued by drug treatment centres or by GPs
Max of 14 day supply-NHS rules
Instalments permitted often daily- patient comes into pharmacy daily

21
Q

What modes of therapy are there for addiction

A

Detoxification-stopping few people go through this

Maintenance

22
Q

What is supervised self administration

A

This is when we have to check they are taking it, usually for 1st 3 months- usually oral not inject

1) place in consolation room
2) watch them take it
3) give them water
4) check there mouth
5) never let them bring own drink

23
Q

Who can give out paraphernalia and what can they give

A
Doc 
Dentist 
Pharmacist 
Nurse 
People engaged in the provision of drug treatment 

Needles, swabs, citric acid, spoon, WFI (POM but can get via PGD), aluminium foil

24
Q

Emergency supply with CDs

A

Not permitted for any S2 or S3 CDs
Except: phenobaribtone in treatment of epilepsy

For phenobarbitone, S4 and S5 CDs we can only give 5 days supply NOT 30

25
Q

What is a requisition

A

When a practitioner requires a CD for some other purpose (keep in stock or research)

CD requisitions must be of a FP10CDF form this is a legal requirement

26
Q

Why would someone require a CD

FP10CDF

A

Doctor- supply in practise
Scientist- research
Nurse in charge of ward- emergency or use in practise
Manager if an offshore installation or master of a ship- far away form medical help therefore will need to keep it on the ship

27
Q

When will we need to destroy CDs

A

Patient return- no longer needs or out of date

Doc return- no longer needs or out of date

Our own stock- out of date

We have to destroy o

28
Q

What are the rules for waste management treatment in England

A

Individuals (including pharmacist) require an environment permit in order to lawfully manage or treat waste medicine

There are some exemptions from this requirement
An exemption is not a permit

29
Q

What is the non waste frame work directive (NWFD)

A

Permits pharmacists to receive waste medicines from households and individuals, not treat waste
Pharmacist are automatically granted this exemption so don’t need to apply for
We are obliged to accept unwanted medicines

30
Q

What waste management can we do

A

Remove confidential information- dispensing labels
Remove blister from box to be recycled
We’re are allowed to decanter and deblister CDs and denature them in pharmacy-T28 exemption

31
Q

Destruction of our own cd stock

A

This is already in register
Part of own stock so need you I account for will he destruction
Need an authorised witness for destruction

Enter in the CD register

32
Q

Who is the authorised witness

A

People authorised by am accountable officer (they oversee CDs in the area)

AO may not witness the destruction
Enter in CD register, sign by authorised person
Authorised person may take sample of the drug