Prescribing Controlled Drugs Flashcards
2 pieces of legislation define controlled drugs?
Misuse of Drugs Act 1971
Misuse of Drugs Regulations 2001
What is the misure of Drugs act ?
- Prohibits manufacture, supply & possession of certain drugs
- Intended to ensure accountability for the use of certain drugs and prevent misuse
- Drugs subject to this Act are known as ‘controlled’ drugs.
- It divides them into classes A, B and C according to harmfulness (most to least)
- Penalties applicable to offences against the Act reflect their harmfulness
What are some Class A drugs ?
- Methadone
- Morphine
- Oxycodone Hydrochloride
What are some class B drugs ?
- Codeine
- Ketamine
What are Class C drugs ?
- Most benzodiazepines
- Tramadol
- Gabapentin and pregablin
What is the Misure of Drugs regulation ?
- Defines which professionals can supply/ possess CDs & the conditions which must be met
- Divides CDs into 5 schedules according to level of control (most to least)
- Schedule 1 has the highest level of control, virtually never used as medicines
- Schedule 5 has the lowest level of control
Name the difference between the schedule 1 to schedule 5 drugs
Where do you find a drugs schedule ?
BNF
The law for CDs prevent them from what ?
Being misused
Being obtained illegally
Causing harm
The laws govern how controlled medicines canbe
Stored
Produced
Supplied
Prescribed
Standard operating procedures for CD include what ?
Health Act 2006 requires each healthcare organisation to appoint an Accountable Officer responsible for the safe and effective use of CDs in their organisation
A SOP describes the responsibilities and procedures necessary to manage CDs safely and accountably:
Ordering and receipt of CDs
Assigning responsibilities
Where the CDs are stored
Who has access to the CDs
Security in the storage and transportation of CDs
Disposal and destruction of CDs
The person who is to be alerted if complications arise
Record keeping
Responsibilities within the practice team
Validation by clinical commissioning group (CCG) and date
Review period
Lead author and named people contributing to the SOP
How are control drugs stored ?
CDs must be stored in a metal cupboard to which there is restricted access
Secured to a thick wall and fixed with bolts that are not accessible from the outside
Fitted with strong hinges & a robust multiple point lock (or digital code)
GP (nurse in charge of hospital area) is responsible for the CDs and appoints key holders
The keys are kept safe and no unauthorised members of staff should have access
A practice storing CDs must keep a CD register
Must be a bound book or electronic
Separate sections for each class of CD
Separate page for each strength and form of that drug
Record:
Date obtained
Name and address of supplier (e.g. pharmacy)
Quantity running balances of each drug
Prescriber’s registration number
Name and registration number of clinician supplying the CD to the patient.
Explain the GPS bags for control drugs ?
Eg they tale them to home visits sometimes.
Staff member should witness GP stocking bag from practice stock & record in the CD register
Store CD in locked bag, box or case; not be left in car overnight
GP should keep a register of CDs carried in his bag & record when & to which patient given
Expired drugs are recorded in the practice and GPs bag register, usually passed to pharmacy for destruction
Who has responsibility for CDs in a GP practice?
GP has overall responsibility
Police, CQC & CCG accountable officer can & do enter practices and inspect CD registers.
Who can prescribe control drugs?
nurse independent prescribers
doctors
pharmacy independent prescriber
Dentists
Supplementary prescribers if it’s associated with the patient’s clinical management plan.
How would a CD be prescribed to ensure saftey ?
Prescriptions for drugs in Schedules 2 and 3 (including temazepam)
Indelible
Name and address of the patient
Signed by the prescriber (advanced electronic signatures can be accepted via EPS)
Specify the prescriber’s address
Dated
Drug name, form, strength and dose
Total quantity or number of doses in both words and figures*
The words ‘for dental treatment only’ if issued by a dentist.