Controlled Drugs - Destruction + PGD Flashcards
(17 cards)
Explain the importance of denaturing CDs. (3)
Prevents drug retrieval and misuse.
Prevents environmental harm.
Ensure that the waste is transported safely with less risk.
Explain the main features of out of date stock destruction. (6)
Out of date stocks that require safe custody must be kept segregated from other CDs in the CD cabinet.
Schedule 2 CD stock destruction must be witnessed by an authorised person (senior member of staff in an organisation who is NOT involved in the daily management or use of CDs.).
An accountable officer can’t be an
authorised person.
The authorised person will record the destroyed quantities in the CD register and sign the register entry.
For Schedule 3, it’s good practice to have another member of staff (another HCP) to witness the denaturing.
Explain the main features of patient returns. (6)
CD’s are to be destroyed ASAP and not allowed to accumulate.
CD’s should be segregated, stored appropriately and clearly marked for destruction.
Schedule 2 CDs must NOT be entered in the CD register.
Good practice to maintain a record of Schedule 2 CD (px returned)
Record kept for 7 years.
It’s good practice for another member of staff (HCP) to witness destruction.
Pharmacists aren’t able to accept waste medicines from care homes.
What particulars needs to be present when destroying a schedule 2 CDs? (11)
Received Date
Received by (name + signature)
Px’s name (if known)
Px’s address (if known)
CD Name, Form, Strength, Quantity.
Role of person returning the CD (if known)
Date destroyed
By pharmacist (name and signature)
Witnessed by (name and signature)
First 8 completed on CD receipt and last 3 are completed when CD is destroyed.
How are CD’s destroyed? (5)
Not to be disposed into the sewage system.
CDs in Schedule 2-4 (pt. 1) must be denatured before disposal.
Pharmacists are advised to use CD denaturing kits to denature CDs.
Ensure health and safety measures are taken when denaturing.
Denaturing kits containing denatured CDs can then be added to the general pharmaceutical waste bin which is sent away to be incernerated.
Explain the process of denaturing solid formulations. (4)
Grind/crush the tablets/capsules with a pestle and mortar before adding to the CD denaturing kit to ensure that whole tablets or capsules are not readily recoverable.
Use a small amount of water during grinding may minimise the risk of particles being released into the air.
Place ground/crushed powder into the CD denaturing kit and add water to fill the line, crew on lid and shake vigorously.
If no denaturing kit, can grind/crush tablets/capsules and place in warm, soapy water and stir to ensure the drug has been dissolved or dispersed. The resulting mix can then be poured onto an appropriate product (cat litter) and then added to the general pharmaceutical waste bin.
Explain the process of denaturing parenteral formulations. (2)
Ampoules containing liquids can be opened and pour out as much of the content as possible emptied into the CD denaturing kit then continue the process for liquids. The ampoules should be disposed of in a sharps bin.
Ampoules containing the CD in powder form can be opened, water is added to dissolve the powder and resultant mix poured into the CD denaturing kit then continue processing as for liquids. Ampoules should be disposed of in a sharps bin.
Explain the process of denaturing liquid formulations. (3)
Pour contents into the CD denaturing kit. Don’t ass liquid above the fill line on the kit. Add water to the fill like (if needed), screw on lid and shake vigorously.
If no CD denaturing kit, use an appropriate product (cat litter) and add this to the general pharmaceutical waste bin.
The empty bottle that contained the CD will need to be rinsed and rinsing poured into the kit. Empty bottle can be disposed of as general waste or recycled (any labels containing patient identifiable details are removed.)
Explain the process of denaturing patches. (2)
Remove the backing on the patch and fold the patch over on itself (sticky side inwards) and place in the CD denaturing kit.
Dispose in the pharmaceutical waste bin.
Explain the process of denaturing aerosol formulations. (3)
Expel into water (prevents droplets of drug from entering the air).
Resulting solution is disposed of in accordance to the liquid formulation destruction.
If this isn’t possible, expel content onto an absorbent material and add this to the general pharmaceutical waste.
How would you dispose methadone bottles? (4)
Methadone bottles (stock/px dispensed) are rinsed and liquid added to a CD denaturing kit and kit added to the pharmaceutical waste when full.
Liquid waste medicines mustn’t be poured down the sink/toilet as method of disposal.
It’s not necessary to record the disposal.
Dispensing labels must be removed before the clean, empty container is disposed of in the general waste bin.
How does drug tx services supply Naloxone? (7)
Naloxone: Opioid/opiate antagonist which can completely/partially reverse the CNS depression, especially respiratory depression caused by opiate overdose. POM.
Lawfully drug tx services can obtain Naloxone from a wholesaler and supply it to px without a Rx or PGD.
Supplied with an injection or nasal spray.
Anyone can administer Naloxone for the purpose of saving one’s life in an emergency.
It’s lawful to also supply it to anyone who may witness an overdose e.g. family member and friends.
Any supply should be given with information when it should be used and how to administer it.
Give e.g. of Schedule 2 CDs that can be included in PGDs. (3)
Morphine, Diamorphine.
(Only by registered nurses and pharmacists for immediate tx of a sick/injured person. Not for treating addiction.)
Ketamine
Give e.g. of Schedule 3 CDs that can be included in PGDs. (1)
Midazolam
Give e.g. of Schedule 4 CDs that can be included in PGDs. (2)
All drugs except anabolic steroids + injections used for treating addiction.
Give e.g. of Schedule 5 CDs that can be included in PGDs. (1)
All drugs.
Give e.g. of HCP that can’t administer or supply any CD in any schedule on a PGD. (4)
Dietitians
Speech and language therapists
Dental therapists/hygienists
Pharmacy technicians
