W15 52 drug and law: drug abuse Flashcards
What drugs can dentists prescribe?
Medication that has use in dentistry and meets the dental needs of the patient.
What is the medicines act 1968?
Law enshrines the manufacture, distribution and importation of all medicines for human and animal use ensuring safety and efficacy.
What are the 3 classes of medicinal products?
GSL - general sales list - sold or supplied other than under the direction of the pharmacist
P - pharmacy medicines - medicinal products sold over the counter from a pharmacy with a pharmacist present at time of sale
POM - prescription-only medicines - can only be supplied from pharmacies in accordance with a prescription from an approved practioner.
What is the misuse of drugs act 1971?
Controls the unlawful production, supply, possession and exportation of specific medicines considered to be dangerous or harmful (controlled drugs).
Give examples of the classes of drugs?
CLASS A - cocaine, heroin, LSD, ecstasy, pethidine
CLASS B - oral amphetamines, ketamine, codeine
CLASS C - bentos, anabolic steroids, GHB
What is the misuse of drugs regulations 2017?
Misuse of drug regulations provide a legal framework for legitimate use of controlled drugs (CDs), allow possession, supply, prescription, storage and administration as practicing professionals.
What are the prescription writing requirements for controlled drugs?
(Only for DENTAL pain)
- name and address of patient
- dose to be taken
- form (eg tablets) and strength
- frequency (or ‘as directed’)
- total quantity in words and figures
- the words ‘for dental treatment only’
- signature of prescriber and date
Dentists need to add their name, address and qualifications to the prescription form to comply with the misuse of drugs regulations.
What drugs are included in the dental practitioners formulary of controlled drugs? - NHS
Diazepam
Dihydrocodeine
Midazolam
Temazepam
What additional info is needed to prescribe privately?
A six-digit prescriber identification number which must be included on the pink private prescription forms (FP10PCD)
What are drugs of abuse?
The illlegal, non-medical use of a limited number of substances, most of them drugs, which have properties of altering the mental state in ways that are considered by social norms and defined by statute to be inappropriate, undesirable, harmful threatening or at minimum, culture alien.
What are the major drugs of abuse, legal and illegal?
Legal - ethanol, tobacco
Illegal - ecstasy, amphetamines, opium, heroin, cocaine
What is psychological, physical, and habituation dependence?
Psychological - necessity to prevent the unpleasant psychological reaction on stopping a drug
Physical - abnormalities of behaviour and physiological symptoms on withdrawal
Habituation - powerful ‘mindful’ stimulus to need to take a drug
How can you detect drug abuses?
A routine check of vital signs may also alert to the presence of substance intoxication or withdrawal at presentation
Eg needle track marks, candle to dissolve heroin injecting soot to tattoo veins
What are the generic issues with drug abuse relevant to dental practice?
Dealing with difficult patients
Demands for substances (for misuse)
Adverse oral effects of drugs of abuse (D of A)
Special need for dental care (ADA II/III)
Medical issues
What medical issues are there with drug abusers?
Abscesses at injection sites
Viral hepatitis/HIV
Endocarditis
Anaesthetic complications
Problems with dental sedation
Drug interactions
