Controlled drugs

Question 1

MDA3A

Answer 1

Classification of drugs

Question 2

MDA8

Answer 2

Exemptions from sections 6 & 7

Question 3

MDR12A

Answer 3

Authority of designated prescriber nurses, designated prescriber pharmacists, midwives, and nurse practitioners to prescriber certain controlled drugs in certain circumstances

Question 4

MDR12B

Answer 4

Permissions relating to controlled drugs prescribed or supplied by designated prescriber nurses

Question 5

MDR21

Answer 5

Restrictions on application of MDA8

Question 6

MDR24

Answer 6

Supply on prescription

Question 7

MDR25

Answer 7

Labelling of containers

Question 8

MDR28

Answer 8

Custody of controlled drugs

Question 9

MDR29

Answer 9

General requirements in relation to prescriptions

Question 10

MDR31

Answer 10

Restrictions on supply on prescription

Question 11

MDR31A

Answer 11

Exceptions to restriction in MDR31

Question 12

MDR32

Answer 12

Verification of prescriptions

Question 13

MDR33

Answer 13

Retention of prescriptions

Question 14

MDR34

Answer 14

Emergencies

Question 15

MDA3A - Classification of drugs

Answer 15

Drugs are classified by how much risk they pose

Question 16

MDA8 - Exemptions from sections 6 & 7

5 groups who can do CDs?

Answer 16

Medical practitioner, dentist, veterinarian, pharmacist, under pharmacist supervision can prepare & supply CDs

Question 17

MDR12A - Authority for designated prescriber nurses, designated prescriber pharmacists, midwives, and nurse practitioners to prescribe certain controlled drugs in certain circumstances

Answer 17

These professions can prescribe only from determined lists

Midwives: fentanyl, morphine, pethidine

Nurse practitioners (with more training) can prescribe any CD

Question 18

MDR12B - Permissions relating to controlled drugs prescribed or supplied by designated prescriber nurses

Answer 18

CDs are administered by patient themselves or by proxy

Question 19

MDR21 - Restrictions on application of MDA8 etc

length of supply for 5 groups

Answer 19

CDs are only prescribed for patients under their care

Dentists, prescriber nurses can only prescribe 7 day supply [dentists subsidised 5 days]
Prescriber pharmacist 3 day supply

Medical practitioner, nurse practitioner:

• Class A & B: 1 month supply
• Class C: 3 month supply

Question 20

MDR24 - Supply on prescription

when is delivery not done directly?

Answer 20

Delivery done directly to patient/their premises by person or post, UNLESS:

• Written permission from patient otherwise
• Person supplying is satisfied that proxy will deliver to patient

Question 21

MDR25 - Labelling of containers

3 points

Answer 21

1) “CONTROLLED DRUG” in caps followed by category in (2); medicine name; instructions; manufacturer/seller name & address
2) A, B1-3, C1-5 must be stated on label
4) Must have patient name

Question 22

MDR28 - Custody of controlled drugs

2 points

Answer 22

Kept in locked compartment installed/securely fixed in premises

Key to compartment kept in safe place, otherwise combination lock

Question 23

MDR29 - General requirements in relation to prescription [linked to MR41 - Form of prescription]

general, prescriber, patient, medicine

Answer 23

Handwritten on triplicate form
Legible, indelible

Prescriber:

• Physically signed
• Address

Patient:

• Surname & first initial
• Address
• Under 12yo: age in years & months in words

Medicine:

• Unusual dose: underlined, prescriber initials
• “For dental treatment/midwifery use only”
• No abbreviations unless universally recognised

Question 24

MDR31 - Restrictions on supply on prescription

3 points when CDs cannot be supplied, then what records does dispensing site need to keep?

Answer 24

1) CDs cannot be supplied if:
- More than once on same prescription
- Class A & B: 7 days after prescription date
- Class C: 6 months after prescription date

Each dispensing: written/stamped name of dispenser, pharmacy address, date of dispensing

Question 25

MDR31A - Exceptions to restrictions in MDR31 *repeats?*

Answer 25

Class A & B drugs may be supplied twice on same prescription; within 7 days of prescription being written & first dispensing respectively Class C drugs may be supplied thrice on same prescription in monthly intervals [normal repeat dispensing]

Question 26

MDR32 - Verification of prescriptions *2 points*

Answer 26

Do not supply unless sure signature is genuine Only prescriber can edit their prescription, with signature next to change

Question 27

MDR33 - Retention of prescriptions

Answer 27

Prescription must be kept on premises for 4 years (from last supply)

Question 28

MDR34 - Emergencies *3 points*

Answer 28

Emergency supply cannot be dispensed without oral prescription Dentists cannot give emergency supply for CDs [but they can for Rx only medicines] Oral prescription: orally/telephone to personally-known pharmacist - Prescriber must then prepare written prescription (with date of oral prescription) & endorse stating it is a confirmation of oral prescription - Must be sent to pharmacy within 2 business days