Lecture 18 - controlled drugs Flashcards
what ar drug schedules based on?
an assessment of their medicinal or therapeutic usefulness and the need for legitimate access
the potential harm if/when misused
Scheduling is from 1-5 based on decreasing levels of harm.
The higher the schedule e.g 1, the more robust is the regimen around its availability/supply.
describe schedule 1 CD licensed POM
Substances which have NO therapeutic value
e.g hallucinogens, cannabis and synthetics (MDMA, lysergamide)
Mainly used in ‘research’.
Require a Home Office licence for lawful possession unless transferring to someone authorised for public safety e.g. Police
Describe schedule 2 CD POM
Substances / drugs which have a therapeutic value but are highly addictive e.g. potent opioids, such as diamorphine, morphine, oxycodone, fentanyl and methadone
Subject to ‘prescription requirements’ relating to their prescribing, dispensing, recording and safe custody.
Safe custody regulations apply e.g. must be kept securely in a CD cabinet
Subject to recording in Controlled Drug Register
Describe schedule 3 CD no registration POM
CDs with lower therapeutic value and less propensity for harm e.g. barbiturates, some benzos, gabapentanoids and weak opioids.
‘prescription requirements’ relating to their prescribing and dispensing.
Do not require supplies or acquisitions to be recorded in CD register
Safe custody restrictions apply to some e.g. buprenorphine & temazepam) but many are exempt eg tramadol or gabapentin
describe schedule 4 CD
benzodiazepines or controlled drugs anabolic or androgenic steroids POM
Part 1- benzodiazepines CD (Benz) POM e.g diazepam, lorazepam & Z-drug hypnotics.
Controls on import and export. Possession without authority is illegal.
No ‘prescription requirements’
Part 2 -anabolic and androgenic steroids CD (Anab) POM e.g testosterone, nandrolone),
Subject to lighter regulation with no possession offence.
No ‘prescription requirements’
describe schedule 5 drugs
controlled drug invoice POM or controlled drug invoice P meds
Non injectable preparations of Schedule 2 drugs
CD Inv POM - e.g morphine (in less than 0.2% concentration: Oramorph 10mg in 5mL), or e.g. dihydrocodeine 30mg or co-codamol 30/500
CD Inv P - often sold over the counter- P meds e.g. co-codamol 8/500
Invoice copy or record must kept for two years after the transaction (a business record)
No ‘prescription requirements’
what is the prescription writing for schedule 2 and 3 controlled drugs that is required?
handwritten or computer-generated (Computer-generated dates acceptable)
Must be signed by the prescriber (only signature needs to be handwritten)
Patient name and address required
Prescriber designation and address required
Must be indelible ink
MUST state :
Drug name
Drug form
Drug strength (unless only 1 strength)
State dose – e.g. 1 bd; 2 as required; -
NB ‘Take as required’ or ‘Use as directed’ are not acceptable
State the total quantity in words and figures (can be number dose units or total drug quantity)
what is the criteria for receipts when recording a controlled drug in the register ?
date, name and address from whom received, amount received, form received, strength received.
what is the criteria required to fill out when a controlled drug is supplied ?
date, name and address of whom to supplied to, amount supplied, form of product supplied, strength of product supplied, and authority under which supplied eg GP
how are controlled drug destroyed?
The drug needs to be rendered irretrievable i.e. “denatured” so cannot be used / reconstituted.
Stock destroyed in the presence of an ‘authorised person’ – records must be kept
Patient ‘returns’ destroyed by pharmacist - good professional practice to record an entry for the acquisition and for destruction.
Should be timely
what are the service to substances misusers in place at the pharmacy ?
Methadone Sch 2 & Buprenorphine Sch 3
GP10 - Home Office Approved Wording
Written protocol /SOP / Addiction Services Treatment Agreement
Instalment dispensing- Clear arrangements for weekends or periods when pharmacy is closed
Supervised consumption or Take Home (safe storage at home?)
Security of staff, premises, stock
Contract with client / record card
descried methadone as a cd drug and the script requirements.
CD Sch 2 POM
Signed by prescriber
Date, supply details
SF only if stated on Rx
Safe custody
Containers
Supervision
Records
how are instalments dispensed in the pharmacy?
First instalment must be dispensed within 28 days of the ‘appropriate date’
The instalment quantity & intervals between supplies must be stated on the Rx.
Prescription must be endorsed with the date of dispensing of each supply (PC70)
Missed instalments cannot be issued after the due date
Clients are not required to sign for each instalment
Must be marked by supplying pharmacy with name & address (stamp) – PC70
