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Advanced Pharm-2024 > Mod 10: Principles Of Controlled Substancea > Flashcards

Mod 10: Principles Of Controlled Substancea Flashcards

CH: 44, 25, and 37

1
Q

What is a controlled substance?

A

Any drug whose use is controlled by the federal government based on risk potential for addiction, diversion, and harm.

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2
Q

How are controlled substances categorized?

A

They are divided into schedules one through five depending on the potential for abuse.

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3
Q

What does REMS stand for?

A

Risk Evaluation and Mitigation Strategies.

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4
Q

What is the purpose of REMS?

A

To decrease adverse outcomes associated with high-risk drugs.

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5
Q

Define physical dependence.

A

The presence of an abstinence syndrome if the drug is discontinued, requiring the drug for normal functioning.

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6
Q

What is bridging in the context of substance use?

A

Using other prescription opiates to minimize withdrawal symptoms until the drug of choice is available.

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7
Q

What are examples of Schedule I drugs?

A
  • Heroin
  • LSD
  • Bath salts
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8
Q

What are the prescribing requirements for Schedule II substances?

A

Prescribers must be registered with the DEA, prescriptions must be in ink, signed, and cannot be refilled.

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9
Q

What is required for electronic prescriptions of controlled substances?

A

A two-factor authentication system and a certification for e-prescribing.

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10
Q

Can Schedule II prescriptions be called in during emergencies?

A

Yes, but a paper prescription must follow within 72 hours.

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11
Q

List some uses for controlled substances beyond pain management.

A
  • ADD
  • Sedation
  • Anxiety
  • Sleep disorders
  • Seizure disorders
  • Diet and weight loss
  • Anabolic steroids
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12
Q

What is one risk factor for opioid abuse?

A

A patient’s social or environmental history.

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13
Q

What are the legal principles regarding prescribing controlled substances?

A

State and federal laws regulate authority to prescribe, including prescription content and refill rules.

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14
Q

What must all Schedule II prescriptions include?

A

The provider’s DEA number.

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15
Q

What is the maximum period for filling prescriptions from Schedule 3 to 5?

A

They may not be filled after 6 months from issuance.

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16
Q

What is the primary goal of the DEA regarding controlled substances?

A

To prevent diversion from legitimate use.

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17
Q

What is an integral part of preventing abuse in prescribing?

A

Assessment and maintenance of healthcare records.

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18
Q

True or False: States can place a substance in a lower schedule than federal regulations.

A

False.

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19
Q

Fill in the blank: Controlled substances are regulated by the ______.

A

DEA.

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20
Q

What is the main purpose of the DEA in relation to controlled substances?

A

To ensure legitimate prescribing and regulate the issuance and filling of prescriptions for controlled substances

The DEA monitors prescribing practices to prevent abuse and ensure patient safety.

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21
Q

Can a practitioner prescribe controlled substances for themselves?

A

No

It is mandated by law that practitioners cannot prescribe controlled substances for themselves or for family members.

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22
Q

What does PDMP stand for?

A

Prescription Drug Monitoring Program

PDMPs are state-run databases that track prescribing and dispensing of controlled substances.

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23
Q

How many states currently participate in PDMPs?

A

30 states

49 states have PDMPs in place, but participation varies.

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24
Q

What is the significance of the morphine equivalence in opioid prescriptions?

A

It helps prescribers estimate the total opioid dosage a patient is taking

Understanding equivalency is crucial for safe prescribing practices.

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25
Q

True or False: Prescribers can sign blank prescription forms in advance.

A

False

It is illegal and unsafe to sign blank prescriptions.

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26
Q

What must be documented when using alternative therapies in patient care?

A

All non-pharmacological therapies must be documented

This ensures comprehensive patient care and adherence to regulations.

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27
Q

What are the two components of a DEA number?

A

Two letters and six numbers

The first letter identifies the type of provider, and the second letter is the first letter of the provider’s last name.

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28
Q

Fill in the blank: Orders for controlled substances must be issued for _______ medical purposes.

A

legitimate

This is a key requirement set by the Controlled Substances Act.

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29
Q

What is one consequence of prescribing controlled substances inappropriately?

A

Loss of NP license

Practitioners can face severe disciplinary actions for improper prescribing.

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30
Q

What should prescribers always report?

A

Suspicious prescription activities

This is essential for preventing abuse and ensuring patient safety.

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31
Q

What does the Controlled Substances Act (CSA) require regarding transaction records?

A

A written record must be kept of all transactions involving controlled substances

This is to maintain compliance and accountability.

32
Q

What is the cost associated with obtaining a DEA number?

A

$731 for three years

This fee can often be covered by employers.

33
Q

True or False: Drug reporting systems can be used as evidence in court.

A

False

Most drug reporting systems contain disclaimers that prevent them from being admissible in court.

34
Q

What is a key ethical concern when prescribing controlled substances?

A

Ensuring patient safety

Practitioners must prioritize the well-being of their patients while adhering to regulations.

35
Q

What must be included in the PDMP entry for a patient?

A

Patient identifiers and prescriber DEA number

This includes the patient’s name, date of birth, and address.

36
Q

What should practitioners do to stay compliant with PDMP requirements?

A

Keep up to date with state regulations and participate in reporting

Understanding state-specific laws is crucial for safe prescribing.

37
Q

What is the role of the state board of nursing in relation to controlled substances?

A

They regulate and discipline nurses for improper prescribing practices

This includes monitoring for abuse and ensuring compliance with standards.

38
Q

What is the importance of timeliness in reporting for PDMPs?

A

Ensures accurate tracking of prescriptions

Timely data entry helps prevent issues like doctor shopping.

39
Q

What do FDA REMs apply to?

A

All opioids

REMs (Risk Evaluation and Mitigation Strategies) are required by the FDA to ensure that the benefits of a drug outweigh its risks.

40
Q

What is the role of state-based PDMPs?

A

To help monitor prescription drug use and prevent abuse

PDMPs (Prescription Drug Monitoring Programs) track prescriptions of controlled substances.

41
Q

What is the responsibility of medical staff regarding pain intervention?

A

Evaluation and documentation of response to pain intervention

It’s crucial for providers to track patient progress towards pain management goals.

42
Q

What percentage of opioid naive patients prescribed opioids for acute pain post-surgery become chronic users?

A

3 to 10%

This statistic emphasizes the risk of long-term opioid dependency following short-term use.

43
Q

What is the significance of providing patient education about opioids?

A

To ensure safe use and understanding of pain management

Education includes information on side effects, disposal, and appropriate use of medications.

44
Q

Fill in the blank: The hospital monitors patients identified as being high risk for _______.

A

Adverse outcomes related to opioid treatment

Monitoring helps prevent complications associated with opioid use.

45
Q

What are the six principles of CDC chronic pain management?

A

Guidelines for safe prescribing and patient evaluation

These principles help healthcare providers manage chronic pain effectively while minimizing risks.

46
Q

What should be done with leftover opioid medications?

A

Return to pharmacy or police station, or dispose of safely

Safe disposal methods include mixing with kitty litter and throwing in the trash.

47
Q

True or False: More than 90% of patients received opioids on discharge for surgical procedures.

A

True

This indicates a high reliance on opioids for post-surgical pain management.

48
Q

What is a significant risk when combining opioids with sedatives?

A

Increased likelihood of overdose

The combination can lead to severe respiratory depression and increased mortality.

49
Q

What are prescription stimulants used to enhance?

A

Brain activity, including attention span and goal-oriented activity

Historically used for various medical conditions before their abuse potential was recognized.

50
Q

What is the percentage of patients who felt they were prescribed too many opioids after surgery?

A

More than 25%

This highlights the issue of overprescribing in surgical pain management.

51
Q

Fill in the blank: Opioids are prescribed for ______ pain only.

A

Surgical

It’s crucial to communicate that opioids should not be used for other types of pain.

52
Q

What role do nurses play in pain management in hospitals?

A

Documenting pain assessments and educating patients

Nurses are integral to monitoring pain and ensuring patient understanding of pain management strategies.

53
Q

What is the risk associated with long-term use of sedatives?

A

High association with mortality

Sedatives have significant risks, especially when used in combination with other drugs.

54
Q

What is the importance of setting realistic pain management goals?

A

To ensure patient understanding and adherence to treatment

Goals should be measurable and achievable to foster effective communication between patient and provider.

55
Q

What feelings are often produced by the abuse of stimulants?

A

Euphoria, weight loss, increased energy

56
Q

What is the diversion risk for stimulants?

A

Very high

57
Q

What is one of the most prescribed drugs in the United States that has a high abuse potential?

A

Dexamphetamine

58
Q

What is required to refill scheduled drugs?

A

Written prescription

59
Q

What is a class A felony in relation to scheduled drugs?

A

Illicit trading

60
Q

What are the potential effects of excessive doses of GI drugs?

A

Morphine-like effects

61
Q

Which substance is an exception and not a controlled substance despite being a stimulant?

A

Methamphetamine

62
Q

What type of drugs are included in the category of GI drugs?

A

Anti-emetics and others

63
Q

What is a common combination drug that includes topiramate and phentermine?

A

Qsymia

64
Q

What schedule are anabolic hormones classified under?

A

Schedule 3

65
Q

What conditions are anabolic hormones typically used to treat?

A

Catabolic states, male hypogonadism, delayed puberty, female breast cancer

66
Q

What cardiovascular effects need to be monitored when using anabolic hormones?

A

Chest pain and myocardial effects

67
Q

What do the top 10 most abused drugs have in common?

A

All are controlled substances

68
Q

What resource is recommended for learning about opioid prescribing guidelines?

A

CDC website

69
Q

What should practitioners know about controlled substances regulation?

A

State-specific regulations

70
Q

What is the importance of accessing state-specific nursing regulations?

A

To understand what is allowed and not allowed in practice

71
Q

Fill in the blank: GI drugs are at high risk for _______.

A

Diversion

72
Q

True or False: All scheduled drugs require a written prescription to be refilled.

A

True

73
Q

What potential side effects should be monitored with GI drugs?

A

Increased alertness, anxiety, insomnia

74
Q

What does the term ‘abuse potential’ refer to?

A

Likelihood of a drug being misused

75
Q

What is the recommended action for students to take regarding resources during their education?

A

Save and know how to access them

Advanced Pharm-2024 (19 decks)

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