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Controlled Drugs Flashcards

(65 cards)

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1
Q

What legislation can be applied to CDs and pharmacy?

A
  1. Misuse of Drugs Act 1971
  2. Misuse of Drugs Regulations 2001
  3. Misuse of Drugs (Safe Custody) Regulations 1973
  4. The Health act 2006
  5. Controlled Drugs Regulations 2013
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2
Q

Explain the contents of the Misuse of Drugs act 1971

A

Prohibits the possession, supply, manufacture, import and export of CDs except where permitted by the 2001 Regulations or under license

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3
Q

Explain the contents of the Health Act 2006

A

Introduced ‘accountable officers’, requires healthcare organisations, and those providing services to them, to have SOPs in place for CD management

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4
Q

What are the recommended SOP topics for CDs?

A
  1. Security
  2. Ordering and receipt
  3. Record-keeping
  4. Prescribing and monitoring
  5. Administration
  6. Supply
  7. Denaturing and disposal
  8. Use and storage for patients
  9. Transport
  10. Investigation and reporting of concerns
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5
Q

What are the main roles of accountable officers?

A
  1. Oversight, monitoring and auditing
  2. Ensuring effective systems are in place for reporting
  3. Attend Local Intelligence Network meetings
    4.Submission of occurrence reports regarding concerns in a time frame
  4. Appointing authorised witness for destruction of CDs
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6
Q

What are schedule 1 drugs?

A

Most have no therapeutic use and a licence is usually required for productions

Eg. Hallucinogenic drugs, ecstasy-type substances and raw opium

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7
Q

What are the schedule 2 drugs?

A

Opiates (diamorphine, morphine, methadone, oxycodone, pethidine)

Major stimulants (amphetamines)

Quinalbarbitone

Ketamine

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8
Q

What is the abbreviation for schedule 2 drugs?

A

CD POM

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9
Q

What are the schedule 3 drugs?

A

Minor stimulants and others that are less likely to be abused and are less harmful

Buprenorphine
Temazepam
Tramadol
Midazolam
Phenobarbital
Gabapentin
Pregabalin

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10
Q

What is the abbreviation for schedule 3 drugs?

A

CD no register POM

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11
Q

What are the schedule 4 part 1 drugs?

A

Most benzodiazepines

Non-benzodiazepine hypnotics (zopiclone)

Sativex (cannabinoid mouth spray)

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12
Q

What is the abbreviation for schedule 4 part 1 drugs?

A

CD Benz POM

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13
Q

What are the schedule 4 part 2 drugs?

A

Most anabolic and androgenic steroids

Clenbuterol

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14
Q

What is the abbreviation for schedule 4 part 2 drugs?

A

CD Anab POM

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15
Q

What are schedule 5 drugs?

A

Preparations of certain CDs that are exempt from full control when present in specifically low strengths

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16
Q

How long are schedule 5 prescriptions valid for?

A

6 months

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17
Q

How long are schedule 2-5 prescriptions valid for?

A

28 days

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18
Q

What schedule of drugs cannot be on repeat prescription?

A

Schedule 2 and 3

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19
Q

What schedule of drugs cannot be given as an emergency supply?

A

Schedule 2 and 3

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20
Q

What schedule of drugs require retention of invoices for 2 years?

A

Schedule 3 and 5

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21
Q

What schedule of drugs doesn’t require a licence to import or export?

A

Schedule 5

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22
Q

Which schedule 3 drug, uniquely, is allowed to be given as an emergency supply?

A

Phenobarbital for epilepsy by a UK based prescriber

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23
Q

What regulation empowers doctors, pharmacists and dentists to possess CDs when acting in their professional capacity?

A

Misuse of Drugs Regulations 2001

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24
Q

What mechanisms exist to allow the lawful possession of CDs?

A
  1. Home office licence
  2. Home office group authority
  3. Class of person (Eg. essential to transport or administration)
  4. Class of drugs (Schedule 4 part 2 when in medicinal products, schedule 5 drugs)
  5. Patients with a prescription
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25
What are the requirements for the administration of schedule 1 CDs
Home office licence
26
What are the requirements for the administration of schedule 1 CDs
Home office licence
27
Who can administer schedule 2-4 CDs?
1. Doctor 2. Dentist 3. Nurse/ Nurse IP 4. Supplementary prescriber within their clinical management plan 5. Someone acting in accordance with the directions of a prescriber
28
For the administration of which specific drugs, is a home office licence required?
Cocaine, diamorphine and dipipanone when treating addiction only
29
When is a licence required by a pharmacy regarding import and export of CDs?
Schedule 1, 2, 3 and 4 part 1
30
Under what conditions is a licence not required for the import or export of schedule 4 part 2 CDs?
In scenarios of self-administration
31
What may be required for patients to take CDs abroad?
A personal license from the home office
32
In what circumstances is a personal license not required?
Carrying less than 3 months supply - a covering letter is still advised
33
What are the legal requirements for the requisition of a CD?
1. Signature of recipient 2. Name of recipient 3. Address of recipient 4. Profession/ occupation 5. Total quantity of drug 6. Purpose of requisition
34
What form is used for the requisition of CDs
FP10CDF
35
In what circumstances is an FP10CDF needed?
Supply of CDs to institutions within a different legal entity
36
When can an emergency requisition supply of a schedule 2 or 3 CD be given?
If the requisition will be supplied within 24h
37
What must be done when a requisition is received for a schedule 1-3 CD?
1. Mark indelibly with suppliers name and address - if a stamp is used it must be clear and legible 2. Send the original to the relevant NHS agency
38
How long are pharmacies advised to keep a requisition form?
2 years (5 for veterinary)
39
What drugs are included in a midwife supply order
Diamorphine Morphine Pethidine
40
What information must be on a supply order from a midwife?
1. Name of midwife 2. Occupation of midwife 3. Name of patient 4. Purpose 5. Quantity 6. Signature of appropriate medical officer
41
What information is required on a CD prescription?
1. Signature of prescriber 2. Date 3. Address of prescriber 4. Name of the CD (as in the SPC) 5. Formulation - abbreviations are acceptable but must be unambiguous 6. Strength - if there is more than one strength of a drug being ordered the name should be written each time 7. Dose - does not need to be in both words and figures, but must be clearly defined 8. Total quantity - in both words and figures 9. Quantity prescribed - no more than 30 days generally 10. Patient name and address 11. 'For dental treatment only' where applicable 12. Instalment direction where appropriate
42
What type of CD products have greater potential for abuse?
Sugar free and colour free - should only be supplied when specifically required
43
What information is required in an instalment direction for schedule 2 and 3 CDs?
1. Amount of medicine to be supplied per instalment (in addition to dose) 2. Interval between each time the medicine can be supplied
44
When should the first instalment of a schedule 2 or 3 CD instalment prescription be dispensed by?
28 days
45
What are pharmacists able to do in regards to schedule 2 and 3 CD instalment prescriptions, when valid direction is present?
1. Supply the rest of the instalment even if supply date is missed 2. Supply treatment prior to start date (if pharmacy is closed)
46
How many days of a schedule 2 or 3 CD prescription can be missed before contacting the prescriber?
3 days
47
What technical errors can pharmacists alter on schedule 2 or 3 CD prescriptions?
Typographical errors (minor) Words OR figures is omitted - can add ONE
48
What are the requirements for private prescriptions for schedule 2 and 3 CDs?
1. Standardised form 2. Prescriber identification number 3. Submission - submit form to relevant NHS agency
49
What exemptions are there regarding private veterinary prescriptions for schedule 2 and 3 CDs?
1. Do not need to be on a standardised form 2. Do not need to be submitted to relevant NHS agency
50
What is required to allow someone to collect CDs on the behalf of someone who misuses drugs?
Recommended to request a letter which names the representative - a separate letter is required for each supply Representative needs ID
51
What information is required when a healthcare professional is acting in their professional capacity on behalf of a patient?
1. Name 2. Address 3. ID - with discretion
52
What are the minimum requirements for safe storage of schedule 2 and 3 CDs?
In a locked safe, cabinet or room which is constructed to prevent unauthorised access to the drugs
53
What schedule 3 CDs are exempt from safe custody?
1. Gabapentin 2. Mazindol 3. Meprobamate 4. Midazolam 5. Pentazocine 6. Phentermine 7. Pregabalin 8. Tramadol
54
Where should patient returned CDs be kept when awaiting desruction?
In the CD cabinet, separate and clearly labelled
55
What is required to be allowed to destroy CDs?
A license T28 exemption
56
Which CDs need to be denatured before disposal?
Schedule 2, 3 and 4 part 1
57
Destruction of which CDs needs to be witnessed?
Pharmacy stock of schedule 2 CDs
58
For which CDs should a record be kept?
Schedule 1, schedule 2 and Sativex
59
What should be recorded on receipt of schedule 1 and 2 CDs?
1. Date 2. Name and address from whom received 3. Quantity
60
What should be recorded when supplying schedule 1 and 2 CDs?
1. Date 2. Name and address of recipient 3. Details of authority to possess 4. Quantity 5. Details of person collecting 6. Whether ID was requested and given
61
What is required to be at the top of each CD register page?
1. Class 2. Strength 3. Form
62
When should entries into the CD register be completed by?
At the latest, the day following supply, ideally the same day
63
How long should CD registers be kept after the last submission date?
2 years
64
When should CD stock checks be carried out?
At least every week, not legally, varies
65
What schedule CD are cannabis based medicinal products (CBMPs)
Schedule 2

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