schedules and extras Flashcards
PHARMOCOLOGY
is the study of the actions and effects of drugs on physiological systems
generic name
a drug is its shortened, simplified
version of its chemical name.
• E.g. para-acetyl-amino-phenol (chemical name)
• Paracetamol (generic name)
• Panadol/Panamax/Heron (brand/trade name)
brand name/trade name
is the registered trademark of the drug company to identify its preparation of a specific drug.
ad and disadvantages of different brands
Advantages
– Price
• Disadvantages:
– May not be interchangeable or bioequivelant e.g. different brands of coumadin (warfarin vs. marevan)
– May not be absorbed or act in the same way
– Client confusion. Not looking the same as their original prescription
– Doctors and nurses confusion. This is why nurses and doctors learn drugs by their generic name
OVER THE COUNTER
PREPARATIONS (OTC’s)
• Available in chemists and supermarkets • Available without a prescription • Often without restriction or supervision by a health professional • Used for minor complaints • e.g. Paracetamol in small quantities
Standard for the Uniform
Scheduling of Drugs and Poisons
(SUSDP)
• Standard through which a uniform
national approach to medicine availability,
labelling and packaging is achieved.
safe schedules appropriate level of control required
over access and availability to protect
public health and safety.
Unscheduled – Available for
general sale
Can be sold in supermarkets, grocery stores,
health food stores as well as pharmacies,
with labels about safe use if needed.
• Examples:
– Cough and cold remedies, non-prescription
pain relief such as aspirin and paracetamol,
vitamins, herbal supplements
Schedule 2 (Pharmacy Only):
Poisons for the therapeutic use which are available to the public only from pharmacies.
• Available on the shelf at pharmacies. A pharmacist or
pharmacy assistant must be available for advice if
required
Schedule 3 (Pharmacist-only medicine):
Poisons for therapeutic use, which are dangerous or so liable to abuse to warrant their availability to the public being restricted and include solid dose antihistamines and bronchodilator sprays.
• Only available behind the counter at a pharmacy, but no prescription required. A pharmacist must be consulted
• Schedule 4:
Poisons that should in the public
interest be restricted to medical, dental,
veterinary prescription or supply. These
substances or preparations intended for
therapeutic use, the safety and efficacy of which
requires further evaluation. This schedule covers
all prescription only medicines not included in
schedule 8.
• Examples: antibiotics, antihypertensive drugs,
and cardiac drugs.
• Advertising not permitted
Schedule 8 (Controlled drug):
Poisons to
which restrictions recommended for drugs of
dependence should apply.
• Must be prescribed by an authorised
healthcare professional, who may need
another permit to prescribe these medicines
• Examples: Very strong pain relief medicines
(eg, morphine), medicines used to treat drug
dependence (eg, methadone)
Schedule 11: “drugs of dependence”,
“drugs of dependence”, includes all Schedule 8 poisons and some Schedule 4 poisons including benzodiazepines, appetite suppressants (Duromine, Tenuate Dospan) and dextropropoxyphene (Doloxene, Digesic)
Schedule 5, 6 &7
Some medicines are also included in Schedules 5 and 6 of the SUSDP, for example head lice preparations and some essential
oils. Schedules 5 and 6 list substances with a low to moderate potential for causing harm, the extent of which can be reduced
through the use of appropriate labelling and packaging.
• For your interest:
– Schedules 5,6 7 include many substances used in industrial, agricultural and domestic applications - generally considered toxic
substances
– Eg. Schedule 5 poison: hydrochloric acid
– Eg. Schedule 6 poison: ‘Ratsak’
– Eg. Schedule 7 poison: paraquat (a widely used herbicide)
possession of schedule 4 and 8
administration to patients under their care, in
accordance with:
– The instructions and authorisation of a medical
practitioner for a specific patient
– The approval of the Secretary (of the Department of
Health) in specified circumstances, e.g. immunisation
nurse; forensic nurse examiner; and midwife.
Written instruction of a medical practitioner (the most common option)
• Oral instructions of a medical practitioner if, in the opinion of the medical
practitioner, an emergency exists (e.g. telephone orders)
• Written transcription (of emergency oral instructions) by the nurse who
received those instructions
• Directions for use on a container supplied by a medical practitioner or
pharmacist (e.g., administration of a person’s own lawfully supplied
medication)
• In accordance with provisions of regulation 5 (e.g. standing orders)
• Some hospitals hold HSPs , (Health Services Permit), with conditions
authorising the hospital to generate Standing Orders, for the emergency
administration of specified drugs in specified circumstances. In such cases,
the hospital’s PCP will also contain details of the framework that has been
established to generate Standing Orders.
difference between administer and supply
“administer” means to personally introduce a medication or
personally observe its introduction to a patient’s body. “supply” means to provide a medication for administration at a later time.
Records of Transactions
Records of all administrations of Schedule 4 and
Schedule 8 poisons must be true and accurate,
retained in a readily retrievable form for 3 years
and produced, on demand, in writing to an
authorised officer of DPRG.
• For Schedule 8 poisons a separate record (e.g. a
drug register or administration book that shows
the true and accurate balance remaining after
each transaction) is required (regulation 41) –
called the DD book in acute care.
WHAT NEEDS TO BE WRITTEN IN
THE DD BOOK:
• clients name and UR Number
• prescribed drug and dosage
• date and time of administration
• balance of medication
• signature of two nurses who check the preparation and administration
• any errors should be ruled out in ink so it can still be read
• any remaining drug from the ampoule needs to be
disposed of with witness from another nurse and both
should sign the DD Book, to say that they witnessed the disposal.
destruction of schedule 8
To clarify the situation relating to an accepted and
necessary practice, regulation 51 specifically authorises a nurse to destroy (i.e. discard) the remaining, unused
contents of a previously sterile container (e.g. a partially
used ampoule) – provided the nurse makes an
appropriate record. Note: A witness is not mandated
although many establishments have a policy that
requires a witness when another nurse is available.
what needs to be on drug chart
Patent identification details: • Date:-Day, Month & Year • Drug name:. • Dose: • Frequency and Administration Times: • Route: • Prescriber signature: • Allergies/Adverse Drug Reaction-ADR:
Telephone Orders
• date prescribed
• generic name of medicine
• route of administration
• dose to be administered
• date and time medicine is to be administered
• name of doctor giving verbal order
• initials of two nurses to confirm that verbal order
heard and checked
• time of administration when done
• The telephone order MUST be signed, or
otherwise confirmed in writing, within 24 hours
Withholding Medication
REASON FOR NURSE NOT ADMINISTERING (Codes MUST be circled on the medication chart) • Absent: A • Fasting: F • Refused – notify Dr: R • Vomiting: V • On Leave: L Not available: N (Obtain supply or contact Dr) • Withheld: W (enter reason in Clinical Record) • Self Administering: S
