Controlled Drugs & Infectious Wastes Flashcards
Controlled Substance?
Drug or other substance under the jurisdiction of the Federal Controlled Substance Act of 1970
-Narcotics
-Depressants
-Stimulants
-Hallucinogens
-Anabolic steriods
State of MO
Comprehensive Drug Control Act of 1989
Bureau of Narcotics and Dangerous Drugs
More stringent in some cases
Takes precedence over federal law
* Narcotic containing cough syrups and certain products containing ephedrine are
Schedule IV and cannot be purchased without script
* Drugs containing solid dosage forms of pseudoephedrine are Schedule V; must be
signed for
Controlled Substance Registrations
To conduct activities with controlled substances must register with:
* Missouri Bureau of Narcotics and Dangerous Drugs (BNDD)
* Drug Enforcement Administration (DEA)
* Physicians, dentists, optometrists, podiatrists, veterinarians, and advance practice
nurses
Permanent Registration
- Obtained every three years
- Principal practice location
- Patient records are kept
- Location is open for inspection
- The BNDD registration terminates if a practitioner discontinues practice without proper notification
- If notified within 30 days of change, registration can be amended
Temporary Registration
- Locum tenen
- Issued for one year
- For travelling practitioners who fill in on temp basis
- Must provide a MO practice location where they spend majority of time
- Not allowed to accept or stock controlled substances for dispensing
- Must maintain log with places and dates worked
- Maintained for 2 years; available upon request
Veterinarian - May work under the authority of their employer’s DEA registration
- May not issue controlled substance prescription; must have valid DEA number
- Each vet must have their own MO state registration
Multiple Registrations?
- Need if:
- Stocking and storing substances in more than one location
- Perform other activities such as manufacturing, distributing, research, analytical lab,
importer or exporter
Purchasing Controlled Substances
Can Do
* Purchase and obtain from pharmacy, wholesaler, distributor, or have drugs transferred to
you by another DEA registrant
* Drug transfer documented
* Name, address, DEA numbers of supplier/receiver
* Transfer form template
Cannot Do
* Issue a prescription to obtain office stock
* Accept any portion of a patient’s controlled substance script unless you were the
originator
* Never store patient’s drugs in practice
* Never store unused meds and use them for dispensing to patients
Record Keeping
- Documented and tracked from the day they are made until they are dispensed
- Manufacturer
- Distributor
- Pharmacy/practitioner
Receipt Records
- Name, address, DEA number of supplier
- Name, address, DEA number of recipient
- Drug name, strength, form, quantities received
- Date drugs were received
**Maintain on file, available for inspection/copying
Receiving Schedule II
- Requires a DEA Form 222 Official Order Form
- Purchaser fills our form (contains name, address, DEA #)
- List drugs, strength, form, and quantities desired
- Name, address, DEA number of distributor is documented
- Form is sent to supplier
- Supplier fills order, ships to purchaser
- Purchaser must document 3rd copy of the form to document what received and date
rec’d - Maintain for 2 years
Receiving Schedule III-V
- Maintain record receipt with all information
- Invoices/packing slips
- Record in controlled drug log when rec’d
Controlled Drug Storage
- Securely locked cabinet or safe
- Access restricted
- Locked at all times
- Do not mix drugs of multiple practitioners in one single safe or cabinet
- If safe is small or portable, it should be bolted to floor or wall or placed in locked closet
Initial Inventory - First day you receive controlled substances for first time
- Registrant’s name and DEA #
- Date
- Drug names, strengths, dosage forms and quantities
- Must take inventory at opening or closing of business and document
- If business open 24 hours, document time
- File away, do not write on again
- Schedule II inventoried and documented separately
Annual Inventory
- Once a year, inventory must be performed
- Same info as initial inventory
- Document and file away
- Schedule II drugs done separately
Administering/Dispensing
Logs
* Maintained separate from medical records
* Rec’d, administered, dispensed and disposed
* Date
* Pt. name
* Pt. address
* Drug name, strength, dosage form, quantity dispensed, name and initials of person
performing
Required Labeling When Dispensing
* Name/address of dispenser
* Pt. name
* Name of prescribing practitioner
* Drug name, strength, dosage form and quant.
* Directions
* Date
* Vet
* Animal species and owner’s name
Packaging/Labeling
- Should be done under direct supervision
- Child-proof container
- Affix a label that warns and cautions the pt. that it is illegal to transfer these controlled drugs
to another person
Disposing of Unwanted
Why do I want to dispose of these medications?
* Contaminated by patient contact.
* Destroy drug beyond reclamation
* Done by 2 employees
* Drugs are out-dated, expired, or no longer wanted.
* Transferred to another registrant
* Send back to supplier or reverse distributor
* May not be destroyed
Documenting Destruction
- Wastage and destruction documented in log to maintain accurate balance
- Date
- Drug name, strength, form, quantity destroyed
- Reason for destruction
- Name of person performing and person witnessing signs the log
Reporting Losses/Thefts
Insignificant Loss
* i.e. Tablet dropped on floor, stepped on and crushed
* Document
* Staple to annual inventory
Lost or Stolen
* Stolen, diverted, or lost
* Report to BNDD immediately upon discovery
* Lost report form within 7 days
* Written loss report to the DEA
