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Why CONTROLLED SUBSTANCES are Most heavily regulated drugs?
Because of their high abuse potential
Controlled Substance is being moniter by which Government Adminstrations?
Closely monitored by the Drug Enforcement Administration (DEA)
Controlled Drugs & Substance Act, 1970?
- Regulate the administration, manufacturing, distribution and dispensing of drugs that have been found necessary to control
- Enforced by Drug Enforcement Administration (DEA)
- Consists of five (5) classifications (Schedules) of
- controlled substances
- No accepted medical use in U. S.
- High abuse potential
- GHB (gamma-hydroxybutyrate)
- Lysergic acid diethylamide (LSD)
- Medically used
- Needs prescription; no refills
- High abuse potential
- Container must have warning label
Schedule II examples?
- Opioid analgesics
- hydromorphone (Dilaudid)
- methadone (Dolophine)
- oxycodone (Oxycontin)
- oxycodone/acetaminophen (Percocet)
- Oxycodone/aspirin (Percodan)
- oxymorphone (Numorphan
- CNS stimulants
- methylpheniamide (Ritalin, Concerta)
- Barbiturate sedative-hypnoticsAmobarbital
- Less abuse potential than those in Schedule I &II
- May lead to psychological or physical dependence
- Androgens & anabolic steroids
- Empirin/codeine #3, #4, Fiorinal, Tylenol/codeine
- hydrocodone/acetaminophen (Vicodin)
Schedule IV? and examples
- Low abuse potential compared to drugs in S. III
- Widely used in practice
- Examples: Benzodiazepines
- flunitrazepam (Rohyphenol)
- alprazolam (Xanax)
- diazepam (Valium)
- lorazepam (Ativan)
- chlordiazepoxide (Librium)
- temazepam (Restoril) (sedative-hypnotic)
Schedule V? and Examples?
- Products containing small amounts of controlled substances
- Low physical or psychologic dependence
- May be dispensed without prescription but with some restrictions (depends on state)
- Robitussin with codeine (Robitussin A-C)
- diphenoxylate and atropine (Lomotil)
Nurses may NOT have controlled substances in their possession unless which of the following conditions is met?
- 1.The nurse is giving them to the patient for whom they are ordered
- 2.The nurse is the individual designated responsible for the control of the supply of medications of a unit
- 3.The nurse is the patient for whom a physician has prescribed the medication
How Nurses Handling controlled Substances?
- Do Inventory at each shift change
- Verify all drugs delivered to unit
- Inspect all items for signs of tampering
- Visually check each drug thoroughly prior to administration
- REPORT ALL DISCREPANCIES OR SIGNS OF TAMPERING TO THE NURSE MGR/SUPERVISOR, PHARMACY AND SECURITY DEPARTMENT
Nurses Handling controlled substances
- The controlled substances will be counted each shift by 2 RNs
- The nurse who accepts the keys is RESPONSIBLE for
- a correct count
- At all times the NARCOTIC KEYS must be maintained in an unbroken chain of custody
Nurses Handling Controlled Substances
- Drug is wasted by having a second RN witness disposal into the sink drain. This is then recorded on the narcotic record
- Staff RNs can obtain narcotics from pharmacy with proper ID
- Patient discharged on a Schedule II drug or Schedule IV Benzodiazepine, the physician must complete an OFFICIAL NEW YORK STATE PRESCRIPTION Form.
Alcohol and controlled substances?
NEVER go together