MDA Flashcards
(17 cards)
OST
Opiate substitution therapy
75 percent of pharmacies do this most common methadone or buprenorphine replaces heroin or other opiates/opioids.
Both have longer t½ -> once daily dosing at adequate doses works
Instalment prescribing
Supervised consumption
Primary aim is retention in treatment as this facilitates all other outcomes.
OAT
Opioid Agonist Therapy
MAT
methadone assisted treatment
Pharmacist and nurse independent prescribers can also prescribe controlled drugs for addiction except
diamorphine, cocaine and dipipanone (cannot be added to DH list)
what colour is FP10MDA
blue
Can prescribe drugs to treat dependence on regular green FP10s, but if instalment dispensing required must use
FP10MDA
FP10MDA used by GPs and specialist centres/clinics
what installments can be prescribed on FP10MDA
Can only prescribe any Sch 2, buprenorphine and diazepam in instalments
Can order other drugs on these forms but not by instalments.
Can prescribe maximum of 14 days supply on FP10MDA
Repeat’ private Rxs allowed
not allowed under MDA for Sch 2 or 3 CDs
Private Rxs can be prescribed in instalments for Sch 2 and 3 on the required form (FP10PCD).
prescription requiremnets for a CD
Remember ALL CD Sch 2 and 3 Rxs valid for 28 days from date specified
As long as 1st instalment within 28 days of appropriate date the later instalment dates can run beyond 28 days from this date
Name [not legal but necessary]
Form
Strength (if more than one exists)
Specific directions
TOTAL quantity in words and figures (e.g. twenty eight [28])
What does instalments need in their wording
The quantity to be dispensed in each instalment must be stated and the interval between them to be observed
e.g. ‘Dispense 90mls daily’
‘Dispense 270mls every third day’
‘Dispense 630mls weekly’
Remember you also legally need the dose specified, even if it is the same as the instalment amount, as would be the case with daily instalments of methadone
e.g. ‘90mls to be taken once a day’
‘Dispense 90mls daily’
‘90mls to be taken once a day’ ‘Dispense 270mls every third day’ ‘90mls to be taken once a day’ ‘Dispense 630mls weekly’ Quantity of instalment to cover weekends/bank hols must be stated e.g. ‘Dispense 180mls on Saturdays to cover Sundays’ ‘Cover when closed’ not technically acceptable
How many missed doses is classified as dangerous
Three or more consecutive missed doses of methadone can be dangerous if a dose is taken on day 4 due to loss of tolerance – another set of approved wording covers this
what is the set office approved wording
*‘Please dispense instalments due on pharmacy closed days on a prior suitable day’
*‘If an instalment’s collection day has been missed, please still dispense the amount due for any remaining day(s) of that instalment’
‘Consult the prescriber if three or more consecutive days of a prescription have been missed’
‘Supervised consumption on collection days’
‘Dispense daily doses in separate containers’
can phramacist suppy equiplent usied in preperation of injecting illicit drugs
Risk of BBV transmission including Hepatitis C & HIV if shared
Pharmacists can supply for harm reduction purposes:
Swabs
Cookers (preparation vessels)
Citric acid-Acids used to convert bases to soluble forms
Ascorbic acid
Filters
Foil
CDAO
Controlled Drug Accountable Officers- don’t have their own
* Community pharmacies
* Medical practices
* Dentists
* Care homes
* Prison healthcare
Controlled Drug Accountable Officers mitigate that risk
Robust governance and procedures
* Responding to incident reports
* Monitoring activities – reconciling supply and usage
If you have a concern about controlled drug use, you must report it
* To your own organisation
* To the Controlled Drugs Accountable Officer
LAO
Lead Accountable Officers (LAOs) are senior individuals—usually in NHS England or regulatory bodies—who oversee the safe and lawful use of controlled drugs across a region or network.
what do LAOs do
Authorise witnesses for destruction of Schedule 2 controlled drugs
They approve who can supervise the legal destruction of strong medicines like morphine and fentanyl to prevent misuse or diversion.
✅ Approve private prescribers for Schedule 2 and 3 controlled drugs
They allow doctors, dentists, or independent prescribers working privately (outside the NHS) to legally prescribe high-risk medicines like opioids and some stimulants.
✅ Request and review incident summaries from other Accountable Officers
They gather information from other local Accountable Officers to spot trends, safety issues, or areas of concern across different healthcare organisations.
✅ Seek assurance from organisations without their own Accountable Officer
If a small clinic or care home doesn’t have its own AO, the LAO checks in to ensure they are still handling controlled drugs safely and legally.
✅ Monitor prescribing of controlled drugs
They look at prescribing patterns—especially for high-risk or high-volume use—to detect overuse, misuse, or potential abuse.
Essentially, Lead Accountable Officers provide oversight, coordination, and governance for the safe use of controlled drugs in a broader area, helping to prevent harm and ensure legal compliance.
