Prescribing controlled drugs

Until recently, the numbers of individuals who may prescribe controlled drugs was fairly limited. However, with the onset of both supplementary and independent prescribing, the numbers of individuals who may prescribe controlled drugs has increased. 

It is good practice for prescribers not to prescribe controlled drugs for themselves or close family members unless in an emergency. 

Women of reproductive potential prescribed efavirenz should be counseled on its potentially teratogenic effects and the importance of birth control. Additionally, nevirapine, nelfinavir, ritonavir, lopinavir/ritonavir, and tipranavir/ritonavir have been shown to decrease the concentrations of estrogens and/or progestins in oral contraceptives, which could lead to failure.2 For patients prescribed these drugs, barrier forms of contraception are preferred to prevent pregnancy. DepoProvera may be... 

For all controlled drugs, prescriptions must be signed and dated by the prescriber and the following particulars included in the prescriber s own handwriting name and address of patient, form and strength of preparation as appropriate, total quantity in both words and figures and dose. 

While regular monitoring of plasma phenytoin levels can result in improved seizure control, the benefit derived from measuring other commonly prescribed anticonvulsant drugs is difficult to assess. Phenobarbitone, primidone, and carbamazepine will be discussed briefly. 

Immediately on referral it is important to check with the Home Office Drugs Branch to see if the patient has been notified to them and if any treatment, particularly the prescribing of controlled drugs, is currently available to them. This simple step will go some way to... 

All barbiturates have the potential to be abused and cause addiction. Different barbiturates are designated as schedule II, III, and IV drugs, which means that all barbiturates require a prescription from a doctor or health care provider and the prescription must contain the doctor s DEA number. Physicians must obtain a special license to get a DEA number in order to prescribe controlled or addictive substances such as barbiturates. Doctors are very cautious about prescribing barbiturates to patients who have a history of drug abuse. 

In the UK all veterinary medicines must be used in accordance with their UK product licence or as directed by the prescribing veterinary surgeon. Withdrawal times from the last day of treatment to the day of slaughter shall be at least double that time laid down in the product licence and shall not be less than 14 days in the case of controlled drugs or prescription-only medication (POM). The EU regulations stipulate twice the legal withdrawal period or, in the case of it not being specified, a 48-hour withdrawal. 

Temazepam is a benzodiazepine that was until recently the most popular hypnotic in the form of a soft gel liquid-filled capsule but, being readily injected, it was widely also abused and the formulation was withdrawn. Temazepam is now classed as a controlled drug it is available as a tablet, with a much longer absorption time and duration of action making daytime hangover effect more likely. Consequently it is much less often prescribed. 

Monitoring the prescribing of controlled drugs and other medicines of abuse. 

When local registered nurses working in home care settings of the terminally ill were interviewed, it became apparent that Shipman had frequently failed to deliver the full prescription of controlled drugs to patient s homes when he had collected them from pharmacies on their behalf. Shipman was effectively stealing up to 60% of the diamorphine prescribed for his patients. 

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