Controlled drugs 2 AT Flashcards
CD register must be used to record details of any schedule ___ + ___ CDs received or supplied by a pharmacy.
1 + 2
What should. be at the head of each CD reg?
class
strength
calsses of CD must be
kept in seperate part
within each class
separate page should be used for different strengths and formulations
CD kept for how long?
2 years from date of last entry
can be kept in original form, copied / approved computerised form
Copy of the register, and other details of stock, receipts and supplies, must be made available to authorised persons e.g _____
(e.g. a GPhC inspector or CD liaison officer) upon request.
For Controlled Drugs received, the following must be recorded
Date supply received
Name and address from whom received
Quantity received.
For Controlled Drugs supplied, the following must be recorded:
Date supplied
Name and address of recipient
Details of authority to possess – prescriber or licence holder’s details
Quantity supplied
Details of person collecting Schedule 2 CD – patient, patient’s representative or healthcare representative (if the latter, also record their name and address)
Whether proof of identity was requested of the person collecting
Whether proof of identity was provided.
These are the minimum fields of information that must be recorded; additional relevant information can be added.
All entries made in CD registers should be:
Entered chronologically
Entered promptly – entries must be made on the day of the transaction or on the following day
In ink or indelible – entries and corrections must be in ink or indelible (or computerised)
Unaltered – entries must not be cancelled, obliterated or altered.
Corrections must be made by dated marginal notes or footnotes. The register should be marked to show who the amendments made are attributable to (e.g. name, initials/signature, GPhC number if applicable).
Electronic CD registers must be:
Attributable
Capable of being audited
Compliant with best practice.
accessible from premises and capable of being printed
Safeguards must be incorporated into the software to ensure all of the following:
The author of each entry is identifiable
Entries cannot be altered at a later date
A log of all data entered is kept and can be recalled for audit purposes.
stocks checks
checked at least once a week
liquids CDs can be affected by overage, residue and spillage
recorded/ signed and dated
An instalment direction combines two pieces of information:
- Amount of medicine to be supplied per instalment
- Interval between each time the medicine can be supplied
Dose and instalment amount must be specified separately
The first instalment must be dispensed within ___ days of the appropriate date.
28
The appropriate date is either the signature date or any other date indicated on the prescription as a treatment start date
The prescription must be:
marked w date of each supply
Home Office wording:
Please dispense instalments due on pharmacy closed days on a prior suitable day.
If an instalment’s collection day has been missed, please still dispense the amount due for any remaining day(s) of that instalment.
Consult the prescriber if three or more consecutive days of a prescription have been missed.
Supervise consumption on collection days.
Dispense daily doses in separate containers.
Supply the balance of an instalment if the interval date is missed
e.g. if three days’ supply was directed to be supplied on day one but it was missed, it allows two days’ supply to be issued on day two)
Supply treatment prior to the start date on the prescription, if this is on a day the pharmacy is closed for example during bank holiday periods
e.g. if the start date is a bank holiday Monday and the pharmacy is closed, a supply can be made if the signature date is before the start date)
Missed Doses
Missed three days’ prescribed treatment
risk that they will have lost tolerance to the drug and the usual dose may cause overdose.
contact the prescriber
Pharmacists, doctors and dentists may supply and procure Sch :
2
3
4
5
Possession also possible by:
Home Office licence (e.g. the RPS museum holds a licence to possess CDs)
Home Office group authority (e.g. paramedics may possess and supply certain CDs)
Class of person (e.g. a postal operator or a midwife)
Class of drug (e.g. Sch 4 Part II drugs when contained in medicinal products and Sch 5 drugs)
Patients
Schedule __ CDs require a Home Office licence
1
A pharmacist can take possession for the purpose of destruction or to handover to a_____ .
.
police officer
patient’s ________should normally be maintained, and the police should be informed on the understanding that the source will not be identified.
confidentiality
Schedule 2, 3 or 4 CDs can be administered to a patient by:
Doctor, dentist, pharmacist independent prescriber or nurse independent prescriber
A supplementary prescriber acting in accordance with a clinical management plan
A person acting in accordance with the directions of a prescriber entitled to prescribe CDs
A special licence from the Home Secretary is required to prescribe cocaine, diamorphine or dipipanone for treating ______.
addiction
license is needed to import or export sched;
1,2,3,4 CDs
A licence is needed for Schedule 4 (Part II) CDs, unless the substance is imported or exported by a person for self-administration.
There are no restrictions : Schedule 5 CDs
person can travle carrying LESS than __ months supply of CDs
3
A covering letter signed by the prescriber may be obtained
Query embassies or high commissions
Query travel operator/ airline company
Requisitions for Sch 2 and 3 CDs must use a standardised form
________ form obtained from LHB
Different forms in England and Scotland
(This applies to both requisitions for human and for veterinary use.
Hospices and prisons are exempt from the requirement to use the approved form. )
WP10CDF
Requestion requirements: obtaining CDs
Signature of the recipient
Name of the recipient
Address of the recipient
Profession or occupation
Total quantity of drug
Purpose of the requisition
Requisition form is a legal requirement for most supplies
Pharmacy to pharmacy supply is exempt, however, the Home Office advises that a written requisition should be on an approved requisition form
In an emergency, a doctor or dentist can be supplied with a Sch 2 or 3 CDs
:
Requisition will be supplied within the next 24 hours, failure to do so would be an offence
Stock collected by a messenger on behalf of a purchaser
Written authorisation where the supplying pharmacist is satisfied that the authorisation is genuine (retain it for two years)
Pharmacists are not able to requisition Sch __ CDs
1
When a requisition for a Sch 1, 2 or 3 CD is received, it is a legal requirement to:
Mark the requisition indelibly with the supplier’s name and address
Send the original requisition to the relevant NHS agency.
Good practice to retain a copy of the requisition for two years from the date of supply.
For a hospital, care home, hospice, prison or organisation providing ambulance services
Must mark and retain the original requisition for two years
A registered midwife may use a midwife supply order to obtain the following CDs:
Diamorphine
Morphine
Pethidine.
The order must contain the following:
Name of the midwife
Occupation of the midwife
Name of the person to whom the CD is to be administered or supplied
Purpose for which the CD is required
Total quantity of the drug to be obtained
Signature of an appropriate medical officer (with supervision over midwives within the area)
Invoices - CDs
Invoices to be retained for two years for Sch 2 and Sch 5CDs.
Remember Sch 5 is CD Inv
NICE advises that organisations should consider retaining all CDs invoices for six years for the purpose of HM Revenue and Customs
Destruction of Controlled Drugs
- prior to disposal
- home office - allow pharmacies to sort and dispose CDs by denaturing them to prior dispsal
- advised all CDs in sch 2,3 and 4 should be denatured and irretriveable b efore disposal
sched 2 - destruction
must be witnessed
(AUTGORISED PERSON)
patient - returned CD; require witness????
NO
All CDs in Sch 2, 3 and 4 (Part 1) should be denatured before being placed into pharmaceutical _______ containers and sent for incineration
WASTE
Prevention of misuse of drugs, harm to the __________ or ______ and prevent the supply of easily retrievable CDs to waste carriers.
enviroment or people
what to use to denature?
Work in a well-ventilated area and wear suitable protective gloves, a face mask and goggles
CD denaturing kits are widely available
denature tablets:
- Grind or crush the solid dose formulation before adding to the CD denaturing kit to ensure that whole tablets or capsules are not retrievable.
- The use of a small amount of water whilst grinding or crushing may assist in minimising particles of dust being released into the air.
