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Controlled Drugs

Controlled Drugs. Miranda and Natasha. Definition. “Controlled drugs are medicines which are subject to special legal control's because of their particular potential for harm if wrongly used.”

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Controlled Drugs

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  1. Controlled Drugs Miranda and Natasha

  2. Definition • “Controlled drugs are medicines which are subject to special legal control's because of their particular potential for harm if wrongly used.” • “Some prescription medicines are classified as controlled drugs e.g. morphine, pethidine and methadone. These medicines are prone to being misused, so have stricter legal controls on their supply to prevent them being obtained illegally.”

  3. Misuse of Drugs Act (1971 has been revised) • Main piece of legislation concerning drugs. • Under this act it is an offence to; posses/supply a controlled drug unlawfully or to allow premises you occupy/manage to be used for drug taking.

  4. Classes • Class A: Includes Methadone, Diamorphine and Cocaine. Highest penalty given and most harmful when used. • Class B: Includes Codeine, Barbiturates and (oral) Amphetamines. • Class C: Includes anabolic and androgenic steroids and Meprobamate. Lowest penalty given and least harmful when used.

  5. Schedules • Schedule 1 are not used in clinically practice as they have a high potential for abuse. E.g. Cannabis and LSD. • Schedule 2 can lead to physical and psychological dependence due to its high potential for abuse also. E.g. Morphine, Diamorphine and Pethidine. • Schedule 3 has a lower potential for abuse but needs special precautions to be taken nether less. E.g. Temazepam, Barbiturates and Meprobamate • Schedule 4 has an even lower potential for abuse so only minimal control is needed. E.g. Benzodiazepines. • Schedule 5 has the lowest potential for abuse due to its low strength. E.g. Codeine Linctus.

  6. Methadone • Opioid Analgesic • Similar to Heroin (often used to replace Morphine in dependence treatment) • Used for relief from severe pain and cough suppressant in terminal illness • Forms; tablets, liquid and injections • Most common side effects; drowsiness and nausea. • Can be dangerous interacting with other medications E.g. Sedatives.

  7. Methadone Overdose • What are the symptoms of methadone overdose? • Body as a whole- muscle spasticityRespiratory- difficulty breathing - slow, shallow and laboured breathing - stopped breathing (sometimes fatal within 2-4 hours) Eyes, ears, nose, and throat - pinpoint pupils - bluish skin - bluish fingernails and lips Gastrointestinal- spasms of the stomach and/or intestinal tract - constipation Heart and blood vessels- weak pulse - low blood pressure Nervous system- drowsiness- disorientation - coma

  8. Prescription • Special regulations are applicable to the supply of controlled drugs to addicts. For example; a doctor may prescribe controlled drugs on a daily basis for an addictive person only if he holds a licence issued by the secretary of state. In emergencies however, this can be over ridden. • Refer to NMC Guidelines for the Administration of Medicines (2004) for the requirements. E.g. signature and dates, etc. • Regulations in place for professionals with ability to prescribe controlled drugs. Doctors, dentists, specially trained nurses, pharmacists and midwives (although limited range) are allowed.

  9. Administration • Always a administrator and a checker. • Keys kept on body of nurse in charge. • Always kept lock and secured to wall. • All contents checked daily against last entry in control drug record book. • Book contains date, time, patients name, stock balance and 2 signatures of professionals. • (Unused controlled drugs should be returned to local general practitioner or pharmacist to protect others. Disposal should be witnessed and recorded.)

  10. Example Harold Shipman Inquiry (Department of Health)

  11. References • BMA. New Guide to Medicines and Drugs. 6th Edition. 2004 • BNF. September 2006 • Downie,G Mackenzie and Williams, A. Pharmacology and Drug Management for Nurses. 1995 • NMC. Guidelines for the Administration of Medicines. 2004 • http://bbc.co.uk/crime/drugs/drugsandthelaw.shtml • http://drugs.homeoffice.gov.uk/drugs-laws/misuse-of-drugs-act/ • http://www.patient.co.uk/showdoc/40024943/ • http://www.nhsdirect.nhs.uk/GetImaage.asp?intImageID=222 • http://www.nhsdirect.nhs.uk/articles/article.aspx?articleId=1391

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