Controlled drugs: FP10MDA Flashcards
What are the 3 components to addiction?
- Physical dependence
- Psychological dependence
- Tolerance
What is harm reduction?
To help to reduce adverse effects of drug misuse until the misuser is able to stop misusing the drug.
What are 2 of the most common drugs used to help in patients with addiction?
- Methadone
- Buprenorphine
How is a patient usually started on medication for addiction?
Put on psychosocial support programme. They are then put on an equal dose to what they would usually be taking.
True or False: The programmes for addiction patient are used to helped reduce there addiction to zero.
False. They can be maintenance or reduction to zero.
What prescription is used for the treatment of addiction?
FP10MDA
Which schedule drugs can be prescribed on an FP10MDA prescription?
Schedule 2 CDs. Buprenorphine and diazepam.
What is the maximum days of supply on an FP10MDA?
14 days.
What are the legal requirements on an FP10MDA?
- Legal requirements for a CD prescription
- Installment direction
-> amount of medicine per installment
-> Interval between each installment
HAS TO BE SEPARATE FROM THE DOSE - Marked with each date of dispensing
True or False: An FP10MDA must contain a start date.
False. If there is no start date it must start from within 28 days of the appropriate date.
Why is methadone a good option for patients with addiction?
It is a long acting opiate, so it can be taken once a day.
What colour is a 1mg/ml methadone solution?
Green
What colour is a 2mg/5ml methadone solution?
Orange
What colour is a 10mg/ml methadone solution?
Blue
What colour is a 20mg/ml methadone solution?
Brown
What are 2 branded examples of buprenorphine and what are they usually taken for?
- Temgesic (low dose e.g 200mcg) - for a minor pain relief.
- Subutex (high dose e.g. 2mg) - for opioid dependence
True or False: You have to supervise a patient when administering methadone or subutex.
False. You would only supervise a patient if the prescriber says to do so.
How long do Subutex tablets take to dissolve? Is there anything that can be done about this?
10 minutes.
The tablets can be crushed so they dissolve quicker. However, authorization by the prescriber and the patient is required as this would be an unlicensed use.
Should benefit the patient rather than for the convenience of the pharmacist.
Can a representative of a patient collect their methadone if it is for unsupervised doses?
Yes as long as the have a letter of authorization which is signed and dated. It should be kept at the pharmacy.
-> It is good practice.
How often should a patient see there pharmacist if they usually have a representative collecting their medication?
It is good practice to see them at least once a week unless it is unpractical.
True or False: For supervised doses, the pharmacist must watch the patient take the dose.
False. It is not a legal requirement, it is just an agreement.
What should be done if a patient cannot come in for their supervised dose and a representative comes instead? (e.g. they don’t feel well)
Contact their prescriber and ask if the supply can be given to the representative. Document this on their medication record or prescription. (On prescription, must be signed with date, name and GPhC number)
What happens if on an FP10MDA it says to dispense 350ml on the 8.11.24 and 350ml on 15.11.24 and the patient comes in on the 9th instead and explains that he wasn’t able to come on the 8th?
The medication cannot be dispensed as that would be deviating from what was written on the prescription. If the patient misses one dose, they have missed the full installment. The patient would have to go back to the prescriber for a new prescription for the remainder of the days. The 350ml on 15.11.24 would still be fine to dispense on the 15th.
Is home office wording a legal requirement or good practice? Why is it good to have?
Good practice.
It protects the pharmacist against the consequences of an unlawful prescription.
