Destruction of CDs Flashcards
What is the T28 exemption?
an exemption is issued by the Environment Agency
- allows pharmacies to sort and dispose of CDs and to comply with the 2001 Regulations by denaturing them prior to disposal.
How are CDs destroyed?
must be denatured prior to disposal
- this process usually requires an appropriate licence but pharmacies can register an exemption (T28) without needing to obtain a licence
Home Office recommends:
Schedule 2, 3, 4.1 be denatured prior to disposal
What are the advantages and disadvantages of denaturing CDs?
advantages
- prevents misuse of drugs
- reduces harm to environment
- minimises patient safety issues
- prevents the supply of easily retrievable drugs to waste carriers
disadvantages - can cause harm to health if fumes inhaled = require a ventilated area - can cause allergic reactions = require protective clothing
are not expected to render the detection of active ingredients with specialist equipment impossible, or to modify the chemical composition or properties of CDs.
Which CDs need their denaturing witnessed? Why does the denaturing of CDs need to be witnessed?
out of date/obsolete CDs must have a witness (another member of staff) to their denaturing
denaturing of pharmacy stock of Schedule 2 CDs need to be witnessed
patient returned CDs do not need a witness
Which CDs need a record in the CD register after being denatured?
records of patient-returned Schedule 2 CDs and their subsequent destruction should be recorded in a separate record for this purpose
records of expired/obsolete/unwanted stock Schedule 2 CDs and their subsequent destruction should be recorded in a separate record for this purpose
How should solid dosage forms be destroyed?
Method 1
grind or crush and add to the CD denaturing kit
- use of a small amount of water during crushing may assist in preventing the inhalation of particles
Alternative Method (no CD denaturing kit is available)
- crush or grind the solid dosage form
- place it into a small amount of warm, soapy water stirring sufficiently to ensure the drug has been dissolved or dispersed
- resulting mixture is poured onto an appropriate amount of suitable product (cat litter) and added to an appropriate waste disposal bin supplied by the waste contractor.
How should liquid dosage forms be destroyed?
Method 1
- pour into an appropriately-sized CD denaturing kit
Alternative Method (no CD denaturing kit is available) - pour the liquid onto an appropriate amount of suitable product and add this to an appropriate waste disposal bin
What is the issue with denaturing liquid dosage forms when there is no CD denaturing kit?
When a bottle containing a liquid CD has been emptied, small amounts of the pharmaceutical can remain
bottles can be rinsed and the liquid disposed using the denaturing kit and then as the correct category of pharmaceutical waste
clean empty bottles are disposed of into the recycling or general waste
- must remember to remove or obliterate any labels
How should patches be destroyed?
Method 1
- remove the backing and fold the patch over on itself
- place into a waste disposal bin or a CD denaturing kit.
How should aerosol formulations be destroyed?
Method 1
- expel into water
- pour into an appropriately-sized CD denaturing kit
Method 2
- expel into an absorbent material
- dispose of this as pharmaceutical waste
Method 3
- consider if it would be safe to open or to otherwise compromise the container to release the CD safely
= the resulting liquid mixture should then be disposed of in a CD denaturing kit and disposed of as pharmaceutical waste.
How should ampoules and vials be destroyed?
liquid containing ampoules
- open the ampoule and empty the contents into a CD denaturing kit
- dispose of the ampoule as sharps pharmaceutical waste
powder containing ampoules
- open the ampoule and add water to dissolve the powder inside
- the resulting mixture can be poured into the CD denaturing kit
- dispose of the ampoule as sharps pharmaceutical waste
Alternative method
- ampoules are crushed with a pestle inside an empty plastic container
- mall quantity of warm soapy water (for powder ampoules) or suitable product (for liquid ampoules) is added
- resulting liquid mixture should then be disposed of in a CD denaturing kit or in the bin that is used for disposal of liquid medicines
What is recorded in the CD register? How long should it be kept for?
date of destruction
quantity and details of CD destroyed
- name, strength, formulation, quantity
authorised witness and pharmacist signature
records should be kept for 2 years
What is an accountable officer?
accountable of cers are responsible for supervising and managing the use of CDs in their organisation or setting
- cannot be an authorised witness
are usually senior members of staff
What is the procedure for CD destruction in prisons?
must all be denatured
in order to maintain a robust audit trail
- Schedule 2 and 3 CDs must be recorded in the Cd register
- recommended for Schedule 4 CDs
What are the properties of Sativex?
indications
- treatment of Multiple Sclerosis (MS) symptoms
= chronic spasticity, neuropathic pain and overactive bladder.
dosing
- titration period over two weeks to reach optimal dose
licensing
- Schedule 4.1 (CD Benz POM)
prescription Validity:
- up to 28 days
storage
- keep in Fridge (2-8)
- store upright
- use within 42 days once open
destruction
- requires denaturing
- no Authorised Witness required
record keeping
- home office strongly advises making records
- retain records for 2 years from date of last entry
