PHARMACOLOGY - Legislation Flashcards
Who do veterinary practices have to be registered with in order to dispense veterinary medicines and be termed a Veterinary Practice Premises (VPP)?
Veterinary practices must be registered with the RCVS
Who carry out the inspections of veterinary practices to ensure the practice is complying with the veterinary medicines regulations?
RCVS inspect premises registered with the Practice Standards Scheme (PSS)
VMD (Veterinary Medicines Directorate) inspect non PSS practices
What is the Practice Standards Scheme (PSS)?
The Practice Standards Scheme is a voluntary accreditation run by the RCVS which is in place to promote and maintain the highest standards of veterinary care
What are COSHH risk assessments?
A COSHH risk assessment is a health and safety document which concentrates on the hazards and risks from hazardous substances in the workplace
What are Standard Operating Procedures (SOPs)?
Standard Operating Procedures (SOPs) are written documents describing routine proceudres carried out in veterinary practice
What are the four main problems with keeping drugs in vehicles?
Temperature fluctuations the drugs are exposed to
Public access
Lack of stock rotation
Drug wastage
What can you do to manage the temperature fluctuations that drugs are exposed to in your vehicle?
Install a min-max thermometer
Install a data logger (records temperature changes over time)
Install a portable refrigeration unit
(T/F) A lockable bag, box, or a glove compartment are an acceptable compartment for transporting controlled drugs or firearms, however are not acceptable for long term storge in your vehicle
TRUE.
Which drug category cannot generally be sent via the mail?
Controlled drugs
How can controlled drugs be sent via the mail in exceptional circumstances?
In exceptional circumstances, controlled drugs can be sent using recorded delivery or via a ‘signed for’ courier service
What can you do if you witness an adverse reaction to a drug?
You can report adverse reactions to drugs on the veterinary medicines directorate (VMD) website (however this is not a legal requirement)
Why is it beneficial to report any adverse reactions to drugs on the VMD website?
Reporting any adverse reactions to a drug on the VMD website provides a really valuable insight regarding the safety of the drug
How do the Misuse of Drugs regulations classify controlled drugs?
Controlled drugs are classified from schudule 1 to 5 which classifies drugs based on their therapeutic use versus risk of harm
What are schedule 1 drugs?
Schedule 1 drugs have the greatest risk of harm and are not considered to have any significant therapeutic value. We are not allowed to prescribe schedule 1 drugs
Which six rules do you have to comply with to store, perscribe and administer schedule 2 drugs?
- Store in a fixed locked recepticle (to ensure safe custody)
- Additional information is required on the prescription
- Prescriptions are only valid for 28 days
- Use must be recorded in a controlled drugs register, signed by the vet
- Destruction of the drug must be authorised and witnessed
- Invoices must be retained for a minimum of two years
Give six examples of schedule 2 drugs
Morphine
Methodone
Pethidine
Fentanyl
Ketamine
Quinalbarbitone
Which schedule 2 drug is legally excempt from safe custody requirements?
Quinalbarbitone
However the RCVS states that you will not meet practice standards if you do not practice safe custody requirements for this drug
Which three rules do you have to comply with to store, prescribe and administer schedule 3 drugs?
- Additional information is required on the prescription
- Prescriptions are only valid for 28 days
- Invoices must be retained for a minimum of two years
Give six examples of schedule 3 drugs
Buprenorphine
Tramadol
Gabapentin
Phenobarbitone
Midazolam
Pentobarbitone
Which schedule 3 drug legally has to meet the safe custody requirements?
Buprenorphine
However the RCVS professional conduct guidlines state that ALL schedule 3 CDs should meet safe custody requirements
Which two rules do you have to comply with to store, prescribe and administer schedule 4 drugs?
- Prescriptions only valid for 28 days
- Invoices must be retained for a minimum of two years
Give three examples of schedule 4 drugs?
Benzodiazepines (except midazolam)
Anabolic steroids
Androgenic steroids
What is a schedule 5 drug?
A schedule 5 drugs are preparations containing low concentrations of controlled drugs
Which rule do you have to comply with to store, perscribe and administer schedule 5 drugs?
Invoices must be retained for a minimum of two years
What are the five main requirements for a controlled drugs cabinet?
Must be bolted to the wall or floor
Preferably double locked
Must be locked when not in use
Keys must only be available to authorised members of staff
The lock should be different to other locks on the premises
Cabinet should be reserved purely for the storage of controlled drugs
Who can be the keyholder for the controlled drugs cabinet?
Any responsible member of staff within the practice
Which controlled drug schedules require the vet’s signature to be hand written in ink on the prescription?
Schedule 2
Schedule 3
How many days worth of medication can you prescribe for schedule 2 and 3 controlled drugs?
28 days (unless the drug is being used long-term)
In addition to general prescription requirements, what should prescriptions for schedule 2 and schedule 3 drugs also state?
- Decleration that the controlled drug is prescribed for an animal under the prescribing veterinarians care
- State the total amount of product supplied in both numbers and words e.g. twenty (20) capsules
- Strength of preparation
- Dose to be administered and the route
- State the prescribing veterinarians MRCVS number
- The issue date
- Can only be prescribed for 28 days with no repeats
(T/F) You can supply a controlled drug via a faxed or emailed prescription
FALSE. It is an offence to supply a controlled drug via a faxed or emailed prescription
How often should you check the balance of the controlled drug cabinet (i.e. how much of each drug is left over) and compare this to the controlled drug register?
Preferably you should check the balance of the controlled drugs cabinet daily
What information should you record in the controlled drugs register for schedule 2 drugs?
- Record receipt of the controlled drugs (date received, name and address of supplier and amount of drug received, signed by vet surgeon or vet nurse)
- Record suppy of the controlled drugs (date, name and address of the patient, or case number, and amount of drug supplied, amount of drug left over i.e. the running balance, signed by vet surgeon with MRCVS number)
How should you correct any controlled drugs register errors?
Any incorrect entries must still be readable (i.e should not be obliterated with tippex). Instead bracket the error and asterix* and use a footnote in the register to record the reason for error
How should you address any controlled drug register discrepancies?
Consult the Standard Operating Procedure (SOP) in the event of a register discrepency. Once resolved, include a footnote in the register correcting this discrepancy. If the source of the discrepency cannot be identified, a formal internal investigation must be undertaken
What are the steps involved in the destruction of out-of-date schedule 2 drugs?
- Destruction of the drug must be witnessed
- Drug must be denatured
- Drug must be disposed of in pharmaceutical waste
- Destruction of the out-of date drug must be recorded in the controlled drug register
Who can witness the destruction of out-of-date schedule 2 drugs?
A veterinarian independent of the practice
Controlled drugs liason police officer
VMD inspector or Practice Standards Scheme (PSS) assesor
What are the steps involved in the destruction of residual schedule 2 drugs?
- Drug must be denatured
- Drug must be disposed of in pharmaceutical waste
- Destruction of the residual drug must be recorded in the controlled drug register
What are the steps involved in the destruction of returned schedule 2 drugs?
- Drug must be denatured
- Drug must be disposed of in pharmaceutical waste
Which two methods can be used to denature schedule two drugs?
Commercial denaturing kit
Pouring the drug into cat litter
(T/F) If you break an ampoule containing a schedule 2 drug, you have to record this in the controlled drug register
TRUE.
Is it acceptable to split tablets?
This was in dispensing quiz
Yes it is generally acceptable to split tablets that have been scored during manufacture. However, if an acceptable dose can be delivered without splitting tablets then this is generally the preferred option
