Wk 18: CD Flashcards
What schedule are cannabis based products?
- Medicinal use = 2
- Raw = 1
- Epidyolex (contains CBD) = 5
Who can prescribed cannabis for medicinal use?
Doctor listed on specialist register of general medical council + specialist interest in condition treated
What is sativex?
- Cannabis based oral mucosal mouth spray (CBD + dronabinol)
- For mod/severe spasticity due to multiple sclerosis
- Sched 4 part 1
- Required to make record
- Stored in fridge
What is nabilone + dronabinol?
- Sched 2
- Synthetic cannabinoid
- Nabilone: N+V caused by chemo + unresponsive to anti-emetics
What are the diff. schedules?
- Schedule 1: CD lic
- Schedule 2: CD POM - opiates + major stimulants
- Schedule 3: CD no reg POM - barbiturates + minor stimulants
- Schedules 4 part 1: CD benz - benzodiazepines
- Schedule 4 part 2: CD anab - anabolic steroids
- Schedule 5: CD inv POM/P - lower strength
What are the exceptions to taking possession of schedule 1?
- For destruction
- Hand to police
What are the legal requirements of schedule 2 drugs?
- Safe custody (except quinalbarbital)
- Recorded in CD register
- Specific destruction
- Rx valid for 28 days
- Retained for 6 years
What are the legal requirements for schedule 3 drugs?
- Safe custody: temazepam, diethylpropion, buprenorphine + flunitrazepam
- Rx valid for 28 days
- Retained for 2 years
- No record in CD + destruction requirement
What are the differences of schedule 3 + 4 drugs legal requirement?
Sched 4:
- No restriction on import/export part II
- No restrictions on possession part II
- No need to be retained for 2 years
- No safe custody requirement
What are the legal requirements of schedule 4 drugs?
- Rx valid 28 days
- No need for CD register
What are the legal requirements for schedule 5 drugs?
- Invoice kept 2 years
- Rx valid 6 months
What are the prescription requirements for a CD?
- Indelible writing
- Name + address of patient (FNA)
- Signed by person issuing
- Prescribers address
- Date
- Strength if more than 1
- Dose taken (inc no.)
- Form in full writing
- Total quantity in words + figures
- Dentist: ‘for dental treatment only’
What are the legal requirements for instalment directions on FP10MDAs?
- Max 14 day supply
- Direction: Amount of med per installment + interval btw each installment
- Instalment direction + dose specified separately
- Marked each date of dispensing
- No start date: start w/in 28 days
- Record made as per requirement
Which medications can be prescribed on an FP10MDA?
- Sched 2
- Buprenorphine
- Buprenorphine/suboxone
- Diazepam
When would you not supply a schedule 2/3 prescription?
- Prescriber address not w/in UK
- Before date
- Later than 28 days after date
What is the good practice amount of CD drugs supplied at any given time?
30 days supply
What are the legal requirements for a private prescription for CDs 2 + 3?
- FP10PCD
- Prescriber’s priv CD identification no.
- Need CD register but good practice POM
- OG form sent to NHSBSA
- Kept for 2 yrs
Which private prescriptions for CD 2 + 3 do not need to be on FP10PCD + sent to NHSBSA?
Hospital private Rx, vet + prison
Which CDs can be on repeat prescriptions + which can’t be?
- Can’t: 2 + 3
- Can: 4 (28 days) + 5 (6 months)
- No time limit for repeats
What are the errors that a pharmacist can amend?
- Minor typographical error
- Minor spelling mistake
- Quantity is missing in words OR figures (not both)
Mark Rx showing amendment: name, date, signature + GPhC no. (if 2 pharmacist involved, both mark)
What are the legal requirements of requisitions forms?
- Signed by recipient
- State name, address, profession of recipient
- Total quantity of drug
- Purpose of use of CD
- no need to be in words or figures
What are the legal requirements of requisitions?
- FP10CDF (except hospice, prisons + hospital if same organisation)
- Sent to NHSBSA + kept for 2 years (good practice)
- Vet: not sent + kept 5 yrs (legal)
- Emergency = supply w/o CD requisition but sent w/in 24 hrs
- Schedule 2: good practice to keep record
If the purchaser sends another person to collect a CD requisition, what do they need?
- Statement: signed, dates, statement of authorisation
- Kept for 2 yrs
Can a midwife destroy a CD?
No surrender to appropriate medical officer
What must you include in the CD register if a CD is received?
- Date received
- Name + address of person giving
- Quantity
What must you include in the CD register if a CD is supplied?
- Date supplied
- Name + address
- Detail of authority to possess
- Quantity supplied
- Person collecting drug (healthcare = name + address)
- Proof
How long should the CD register be kept?
- 2 Years after last entry
- Includes destruction: 7 yrs
What must be stated with each supply for an installment prescription (FP10MDA)?
Each date of supply - also need to supply all products by date
When making amendments in the CD register, what needs to be added to identify the person making changes?
Name, signature, GPhC no. + date
What are the requirements for a CD electronic register?
- Author identifiable
- Entries can’t be altered
- Log of data kept + recalled for audit
- Back up
- Access controlled to prevent unauthorized access
- Able to view w/o disrupting dispensing process
What is good practice to do when a patient representative is collecting CD 2 medication for drug addiction?
- Sign name on FP10PCD
- Letter of authorisation from ppt obtained every occasion + retained in pharmacy - doesn’t have to state med can be collected
- See patient once a wk
- Applies if detained in police custody
What are the requirements for collecting CD 2 for supervised dose?
- Contact prescriber + see if it can be given to representative - verbal confirmation needed + documented
- Confirmation from prescriber not needed if in police custody
- Prescription + PMR annotated to show dose has not been supervised
