Prep For Prof Practice Flashcards
(33 cards)
1
Q
What are the laws relating to CDs in healthcare?
A
- Misuse of Drugs Act (1971)
- Misuse of Drugs Regulations (2001, amended version)
- Misuse of Drugs (Safe Custody) Regulations (1973)
- Health Act (2006)
- Controlled Drugs (supervision of management and use) Regulations (2013)
2
Q
What does the MDA (1971) state?
A
- MDA (1971) imposes a total ban on the possession, supply, manufacture, import and export of CDs.
3
Q
What does the MDR (2001) state?
A
- MDR (2001) permits the possession, supply, manufacture, import and export of some CDs, under certain conditions.
- The Secretary of State has the power to grant a license to permit this via the Home Office.
4
Q
What is the MDR (2001) classification of controlled drugs?
A
- 5 different schedules of controlled drugs.
- 1 = strongest, most likely to be misused, 5 = least regulated and not likely to be misused
5
Q
What are Schedule 1 CDs?
A
- Drugs with no therapeutic use.
- A license needed for legal production, possession, or supply.
- I.e. Ecstasy (MDMA), Hallucinogens (LSD), raw opium.
6
Q
What are Schedule 2 drugs?
A
- Pharmacists have the general authority to possess and supply these.
- I.e. diamorphine, morphine, methadone, amfetamines, ketamine.
7
Q
What are Schedule 3 drugs?
A
- Minor stimulants which are less likely to be misused (+ less harmful) than Schedule 2.
- I.e. benzphetamine, buprenorphine, temazepam, tramadol, midazolam, phenobarbital
8
Q
What are Schedule 4 drugs?
A
- Split into two parts:
- Part 1 = benzodiazepines (bz), non-bz hypnotics (e.g. zopiclone) and Sativex (canniboid mouth spray).
- Part 2 = Most anabolic and androgenic steroids, clenbuterol, growth hormones.
9
Q
What are Schedule 5 drugs?
A
- Preparations which include certain CDs present in low strengths (i.e. codeine, pholcodeine, morphine)
- Can be POM or P
10
Q
Is medicinal cannabis legal in the UK?
A
- Under the MDR 2018, ‘cannabis-based products for medicinal use in humans’ were rescheduled to Schedule 2 instead of 1
- Cannabis products which don’t satisfy this definition = Schedule 1 still.
11
Q
What Schedules of CDs can prescribers (IP Pharmacists, Doctors, Dentists) supply?
A
- Schedules 2, 3, 4 and 5.
- Schedule 1 CDs still require Home Office License
12
Q
What are alternative routes for lawful possession of CDs (besides prescribers)?
A
- Home Office License
- Home Office Group Authority (e.g. paramedics for certain drugs)
- Laws that permit class of person (e.g. registered midwives)
13
Q
What are the two specific exemptions for when pharmacists can take possession of Schedule 1 drugs?
A
- When possession is for the purpose of destruction
- When possession is for the purpose of handing to the police
14
Q
What are the requirements for the import and export of CDs?
A
- Pharmacies importing or exporting Schedule 1, 2, 3, and 4 (part I and II) CDs require a license.
- License not needed when patients carry Schedule 4 (part II) CDs abroad or into the UK.
- Schedule 5 CDs have no restrictions on import or export.
15
Q
What should patients carrying CDs do when travelling abroad?
A
- Patients carrying less than three months supply of CDs DO NOT need a license.
- They are advised to carry a letter from prescriber (stating their name, travel plans, name of CD, total quantity carried and dose taken).
- Hand luggage liquid restrictions must be taken into account.
16
Q
What if patients travel abroad with more than 3 months supply of CDs?
A
- Need to register with a healthcare professional in the country they are in to access ongoing care.
17
Q
What are ’Safe Custody Requirements’?
A
- Included as a section under the MDR 1973.
- Dictate how we keep certain Schedule 2 and 3 CDs physically secure in the dispensary.
- i.e. in a ‘locked safe, cabinet, or room constructed to prevent unauthorised access.’
18
Q
What is described within these Safe Custody Requirements?
A
- Access to CDs should be documented, i.e. key log, electronic access systems.
- In community pharmacy, common for pharmacist to keep CD cabinet keys.
19
Q
What CDs need to be kept in safe custody?
A
- Schedule 1 drugs (if licensed), e.g. Cannabis resin.
- Schedule 2 drugs, e.g. morphine, methadone.
- Schedule 3 drugs, buprenorphine, temazepam (exceptions = phenobarbital, pregabalin, tramadol).
20
Q
How are CDs disposed of?
A
- All CD sch 2, 3, and 4 (part I) should be destroyed via denaturing and then put in a waste container to be sent for incineration.
- Using CD denaturing kits, add water, use protective equipment.
21
Q
What practice advice is given to pharmacists in the MEP around patient confidentiality and taking possession of CDs from patients?
A
- Patient confidentiality should be maintained, if police called, source will not be identified.
- However, if quantity is so large that drug not purely for personal use, the pharmacist may decide that it is necessary to reveal identity of source to police. - only after discussion with legal adviser.
- Under no circumstances can an illicit drug be handed back to a patient.
22
Q
What is a requisition?
A
A formal request for good or services.
23
Q
What type of medicines have requisition requirements?
A
- Since 2015, an approved form must legally be used to requisition Schedule 2 and 3 CDs.
- In England these are called FP10CDF.
- Hospitals don’t need to use approved forms if request is from within the facility.
24
Q
What are the legal requirements for what needs to be written on a Schedule 2 or 3 CD requisition?
A
- Name of recipient
- Signature of recipient
- Address of recipient
- Profession/Occupation
- Total quantity of drug
- Purpose of requisition
25
What are some other **Requisition** requirements?
- Requisition must be received **before** CD is supplied.
- In an **emergency**, prescriber can be supplied ahead of requisition, but it must be submitted **within the next 24hrs** or else it is an offence.
- Faxed or **photocopied** requisitions are **not legal**
26
How can midwives obtain CDs?
- Registered midwives may use **Midwife Supply Orders (MSO)** to obtain: **diamorphine, morphine, or pethidine (all sch 2)**
27
What do MSOs have to state?
- Name of midwife
- Occupation
- Name of person administered
-Purpose of required CD
- Total quantity issued
- Signature of Doctor or supervisor of midwife
28
How long are Sch 2 and 3 CD prescriptions valid for after the date of signing?
- **28 days**
- Also applies to Sch 4 CDs
29
Dose must be…
CLEARLY defined (i.e. not just ‘take as directed’)
30
Total quantity of CDs must be…
Written in BOTH words and figures (i.e. ‘Twenty eight, 28)
31
What is the recommended max dosage supply of Sch 2, 3, or 4 CDs on prescriptions?
- 30 days worth of supply
- However there is no legal restriction, if more should check if clinically justifiable.
32
What are 3 elements required by law on CD registers?
- Class
- Form
- Strength
Of drug
33
How long must a CD register be kept for?
- TWO years from the date of last entry
