S8 Poison Laws Flashcards
What information does a schedule 8 prescription have to include?
- name, address and telephone number of the prescriber
- patient full name, address, and date of birth
- date of prescription (less than 6 months)
- medicine, strength, and form
- quantity for supply
- precise dosing directions
- number of times the prescription may be supplied
- a repeat interval, if the prescription is to be supplied more than once
What action is required by a pharmacist if presented with a suspected fraudulent prescription?
Take possession of the prescription ASAP and forward the prescription to the CEO of the health department
What does the term drug-dependent person mean?
Means a person who has acquired, as a result of repeated administration of drugs of addiction or Schedule 9 poisons, an overpowering desire for the continued administration of a drug of addiction or a Schedule 9 poison
What are the emergency situations for someone who self-prescribes?
- the immediate administration of the drug of addiction was necessary for therapeutic purposes
- it was not reasonably practicable to arrange for another person to prescribe the drug of addiction without there being a delay that would pose an unreasonable threat to the health, safety and welfare of the person
When does the practitioner need to inform the CEO of the health department about the drug-dependent status of a patient?
Within 48 hours of forming the belief
What are the conditions required for a prescriber to give direction to a pharmacist to supply a medicine that is an S4 or S8 poison?
Prescriber must provide confirmation of directions by sending a prescription within 24 hours to the patient
- If pharmacist does not receive the prescription within 5 working days –> notify CEO of the health department
What details does a pharmacist need to confirm when presented with a prescription for a schedule 8 drug? What happens if a pharmacist is unable to confirm these details?
- Authenticity of prescription
- Identity of person who issuesd the prescription
- The bona fides authenticity of the person presenting the prescription
If unable to confirm details: pharmacist may supply a quantity of medicine required to provide treatment for 2 days
Note: this process is not required for prescription issued by electronic prescribing systems
In what situations does a pharmacist not dispense medication that is schedule 8. Provide 3 reasons
- More than 6 months old
- Illegible or appears to have been altered by a person other than the prescriber who issued it
- Or is cancelled
Does a pharmacist keep the repeat prescription of a S8 drug? Can the repeats be transferred to another pharmacist?
Repeat prescriptions for S8 medicines must be retained by the pharmacy that dispenses the original prescription
- Repeats may not be transferred unless approved by the DOT
What is the process of requesting a transfer of a repeat prescription for an S8 medicine?
- Requests should be made in writing using a form, the form should be faxed or emailed to the medicines and poisons regulation branch of the health department. A copy of the prescription should be attached
- Reason for transfer must be provided and a pharmacy must be nominated to receive the repeats
Transferring the prescription
- Repeat prescriptions may not be returned to the patient. The repeats should be posted to the new pharmacy and the pharmacy alerted to expect the transfer
In what situations does a pharmacist cancel a prescription for a schedule 8 drug?
- the supply is the last repeat or only supply ordered,
- the prescription appears to be fraudulent or false in any manner
Prescription is cancelled by marking the words “cancelled” across the prescription
Where are S8 poisons stored at relevant premises for the following amount of doses?
A) < 250 doses
B) Between 250 and 500 doses
C) > 500 doses
A) Small Safe
B) Small Safe with a monitored alarm
C) Large Safe with a monitored alarm
How to store s8 poison in a pharmacy/pharmacy department of a hospital?
- in secure cabinet access to which is supervised at all times by a pharmacist
- in a large safe with a detection device
- in accordance with an approved alternative storage arrangement
What are the requirements for transporting S8 medicines for commercial purposes? Provide three requirements
- that does not contain goods other than medicines that are Schedule 8 poisons (therefore they are separated)
- that is secure and sturdy without any exterior writing that might indicate the contents of the package
- that is clearly addressed to a person who is authorized to be in possession of the medicine
When can S8 medicines be advertised?
Must be in a publication that is normally sold or intended for a sale only to health professionals or persons licensed to manufacture/supply medicines
Can an authorized health professional administer/prescribe/supply an S8 medicine for a drug-dependent person/ oversupplied person?
Yes, an authorised health professional may administer/prescribe/supply S8 poison for the treatment of a patient who is drug dependent or oversupplied
CEO of the Health Department may authorize prescribing of specified medicine that is Schedule 8 poison to specified patient. The authorization —must be in writing, and may be subject to conditions; and may, at any time, be amended, suspended or revoked by the CEO
A prescription for the supply of opioid pharmacotherapy must not cover a period of more than?
Must not cover a period of more than 3 months
What information is required to be kept for an authorised health professional who administers or supplies a medicine that is an S4 or S8?
- the name, quantity, strength, and form of the medicine supplied or administered
- the address of the person treated or the name and address of the owner of the animal treated
- the date on which the medicine is supplied or administered
- if the medicine is supplied in accordance with a prescription
> the prescription reference number
> the date of issue of the prescription
- if the medicine is a Schedule 8 poison administered or supplied for the treatment of a person — the date of birth of the person
- if the medicine is a Schedule 8 poison — the name and address of the prescriber
How long must the record of supply of medicine of S4 and S8 poisons be kept for? Who do these records have to be provided to?
S4 poison: be kept for at least 2 years from the date on which the medicine is administered or supplied
S8 poison: be kept for at least 5 years from the date on which the medicine is administered or supplied
> Record must be provided to the CEO of the Health Department in the manner and form and at the times specified by the CEO –> be produced for inspection on the request of the CEO or an investigator
What information must be recorded in the register for S8s NOT dispensed on prescription?
- name, quantity, strength and form of the medicine supplied
- name address of the person ordering and receiving the medicines
- date of supply
- identifying number of any request document
When can schedule 8/ schedule 9 medicines be destroyed?
No longer suitable for patient use, such as being expired, contaminated, damaged or otherwise unfit for human or animal use
- They must be destroyed and disposed of under the personal supervision of an authorized person
Who are the persons authorised to destroy schedule 8/schedule 9 medicines?
Health practitioners ordinarily permitted to obtain, possess or supply an S8, such as medical practitioners, pharmacists, registered nurses, etc.
Who witnesses the destruction of schedule 8/schedule 9 medicines?
Destruction of a Schedule 8 must also be independently witnessed by another approved person
- Each time a Schedule 8 is destroyed this action must be recorded in the approved transaction Register, including the date, item and quantity destroyed and reason for destruction
What are the THREE main methods of destruction of S8/S9 medicines? Describe the processes.
FINAL DISPOSAL
- To physically dispose of a Schedule 8 medicine they should be first be made unidentifiable by removing all labelling and packaging, and then made physically or chemically unusable by breaking ampoules, emptying liquid contents, crushing tablets and using a disposal kit
Disposal kit
- Purpose made controlled drug disposal kits suspend the Schedule 8 medicine in a gel preventing retrieval. They are strongly recommended to maintain security and those with a chemical neutralising agent included are preferred
Secure Transfer
- While awaiting final disposal Schedule 8 medicines must continue to be held securely to prevent theft or diversion.
- Storage in an approved drug safe should continue, until immediately before final transfer to the place of incineration
When do pharmacies have to provide information on supply of schedule 8 medicines?
At the end of each month
> includes dispensed items, doctors bag items and CPOP summaries
Send via:
- email to poisons@health.wa.gov.au
- post to Medicines and Poisons Regulation Branch, PO Box 8172 Perth Business Centre 6849
What is the official way of correcting a schedule 8 register imbalance as stated by the chief pharmacist?
Identify the incorrect entry by means of an asterisk and then writing a marginal or footnote of the correct entry. If the mistake is discovered at the time of writing the correct entry may be placed on the next line in the S8 register, if the mistake is discovered at a later date then the correct entry would be placed at the foot of the page.
Can prescriptions that are written by an interstate based practitioner for S4 and S8 medicines be dispensed in WA? What information is required?
Yes, all S4 medicines and most S8 medicines
To be valid, the prescriptions must:
- contain all the information normally required by WA legislation
- be issued by a class of prescriber authorised under WA law
- interstate S8 prescriptions must contain all additional information required for these documents in WA such as patient DOB, exact repeat interval and precise directions for use
What S8 medicines require specific approval of the CEO of the health department to prescribe for interstate prescriptions?
> CEO doesn’t do this often so medications not dispensed by WA pharmacists
- opioid pharmacotherapy for treatment of dependence
- stimulants
- cannabis-Based Products (CBP)
- flunitrazepam, alprazolam or methadone
What does the department records monitor for S8 medicines?
- oversupply
- excessive doses
- patients visiting large numbers of prescribers
- prescribing without authority
- prescribing that does not match an authority issued (wrong medicine, dose, form)
- other high risk usage (e.g. inappropriate form, inadequate repeat intervals, excessive medicines in combination)
What is the WA prescribing code for S8 medicines?
What do patients need to know about S8 prescriptions?
- Prescriptions can only contain one Schedule 8 medicine per prescription.
- Prescriptions are only valid for only 6 months and after that time they have expired and cannot be dispensed
- Prescriptions for Schedule 8 medicines must meet strict legal requirements and require the following additional information that prescribers MUST include:
> patient’s date of birth
> specific instructions for use
> the interval between dispensing repeat prescriptions
- Prescriptions for Schedule 8 medications can take longer for pharmacists to dispense as they require additional checking and recording procedures to be followed. Therefore, this may mean that patients may have to wait slightly longer to collect their prescription
- If a prescriber orders a repeat then they MUST include a repeat interval and it is this interval that determines when patients can collect their next supply of medication. Pharmacists cannot dispense a Schedule 8 medication repeat earlier than the specified date.
- All prescription repeats of Schedule 8 medicines must be kept at the same pharmacy that dispensed the original prescription.
