Written prescriptions for controlled drugs

Re: Written prescriptions for controlled drugs

Rob Loxley — Thu, 02 Feb 2012 18:23:17 GMT

[quote user="Gillian Mostyn"]Yep - judgement call. See point 10 in Bob's post from the VMD website.[/quote]

And from the BSAVA website page linked above: Written prescriptions for Controlled Drugs should be limited to 30 days’ supply

I'm inclined to go with the government VMD over the BSAVA on this

Re: Written prescriptions for controlled drugs

Gillian Mostyn — Thu, 02 Feb 2012 18:12:45 GMT

[quote user="robloxley"]Is there a rule that you can't prescribe more than 30 days of a CD2 or 3, or just advice to essentially engage one's judgement?[/quote]

Yep - judgement call. See point 10 in Bob's post from the VMD website.

Re: Written prescriptions for controlled drugs

Rob Loxley — Thu, 02 Feb 2012 18:08:19 GMT

You'll be pleased to know we too once faxed a repeatable prescription for epiphen to an online pharmacy... And that until recently one of the major wholesalers was taking CD2 requests by fax...

[quote user="Gillian Mostyn"]After further research I now know that these prescriptions should only be for 30 days[/quote]

Is there a rule that you can't prescribe more than 30 days of a CD2 or 3, or just advice to essentially engage one's judgement?

[quote user="Gillian Mostyn"]the prescription has to be handwritten[/quote]

AFAIK post-Shipman (2005) CD prescriptions (except the signature) can be computer produced, and in fact this may be better as a paper trail is left behind.

You do however need the tablet count in numbers and words.

Also am I correct in saying that you shouldn't mix CDs and POM-Vs on the same prescription?

Re: Written prescriptions for controlled drugs

Gillian Mostyn — Thu, 02 Feb 2012 17:59:01 GMT

[quote user="Martin Atkinson"]What it actually says is: 'Written prescriptions are valid for 28 days'. Does that mean it has to re-written every month or that it has to be redeemed within 28 days? [/quote]

That means that it has to be redeemed within the month. But it wasn't that which I was querying - it was the 'no repeat prescriptions' rule which the BSAVA guidelines didn't seem to have any flexibility on. However, I now realise I should have gone to the VMD website instead....embarrassed...again...

Re: Written prescriptions for controlled drugs

Gillian Mostyn — Thu, 02 Feb 2012 17:56:27 GMT

[quote user="bob lehner"]'repeat prescriptions' (single prescriptions, with multiple repeats (within 28 days of issue) are allowed for drugs in all Schedules as a prescription can legally be issued without a consultation. It is considered good practice, however, that a patient should be reviewed before prescribing a Schedule 2 or 3 drug but this is a clinical decision not a legal requirement.[/quote]

Thanks for that Bob. Not how the BSAVA worded it but as long as I'm legal I'm happy!

Re: Written prescriptions for controlled drugs

bob lehner — Thu, 02 Feb 2012 17:42:28 GMT

With regard to disposal of Sch 2 CDs - disposal of small remnants, such as the residue in a vial of morphine, does not have to be witnessed. Destruction of larger volumes, such as on out of date bottle, must be witnessed by a Police Officer, VMD medicines inspector, PSS inspector or another MRCVS not connected with the practice.

Re: Written prescriptions for controlled drugs

Hannah Wynne Richards — Thu, 02 Feb 2012 17:34:54 GMT

Gillian I don't thinkyou have tosee the animalevery month-but you need to know and trust your owners-if someone flogs it on tothe localdruggies after the pet has died-it's your head on the block

Martin Yes phone the local police station Mine just tell me to pour it down the drain,as they're too busy to come out-but it's on record thta I've asked them toattend

Wynne

Re: Written prescriptions for controlled drugs

bob lehner — Thu, 02 Feb 2012 17:33:41 GMT

See VMD Guidance Note 20 - Controlled Drugs.

(Phenobarb is a Sch3 CD).

'Prescriptions
7. A prescription for any CD that is listed in Schedule 2 or 3 (excluding temazepam) must meet all the requirements below, in addition to those already listed in the VMR (detailed in VMGN 3 Guidance for Retailers - under Distribution Categories, which is
published on the VMD‟s website
http://www.vmd.defra.gov.uk/public/vmr_vmgn.aspx

A prescription for any CD listed in Schedule 4 or 5 must meet all the requirements listed in the VMR only. This includes human drugs prescribed under the cascade. For further information please refer to VMGN 13 Guidance on the Use of the Cascade, which is published on the VMD website
http://www.vmd.defra.gov.uk/public/vmr_vmgn.aspx

8. If a written prescription is issued, it may be hand-written, typed in a computerised form or computer generated, but must be signed by the person issuing it. It is an offence to supply against a faxed or emailed prescription. It must also contain:
a declaration that the CD is prescribed for an animal or herd under the veterinarian‟s care; the full name and address of the owner plus the name of the animal to whom the CD prescribed is to be delivered; the name and form of the drug; the amount of the product prescribed in both words and figures; the strength of the preparation (if more than one strength is available); the dose to be administered (“Take as directed” or “Take as required” is not acceptable); and
It is also good practice to add the prescribing veterinary surgeon‟s Royal College of Veterinary Surgeons (RCVS) registration number.

9. A written prescription for a CD in Schedules 2, 3 and 4 is valid for 28 days only. As with all other veterinary medicines, prescriptions for Schedule 5 drugs are valid for six months.
VMGN No 20
7

10. For all CDs it is considered good practice for only 28 days worth of treatment to be prescribed unless in situations of long term ongoing medication, for example, when treating epilepsy in dogs. If more than 28 days worth of treatment is prescribed the veterinary surgeon must be assured of the competence of the owner regarding the safe use of the product.

11. 'Repeat dispense' prescriptions (multiple prescriptions issued at the same time, setting out doses to be supplied over a period of time, usually up to a year) are not allowed for CDs in Schedules 2 and 3. This is due to the fact that a prescription for these drugs is only valid for 28 days. However, 'repeat prescriptions' (single prescriptions, with multiple repeats (within 28 days of issue) are allowed for drugs in all Schedules as a prescription can legally be issued without a consultation. It is considered good practice, however, that a patient should be reviewed before prescribing a Schedule 2 or 3 drug but this is a clinical decision not a legal requirement.

Re: Written prescriptions for controlled drugs

Kate Richardson — Thu, 02 Feb 2012 16:19:50 GMT

I haven't had to do a prescription for phenobarbitone as yet or any other controlled drug, but we usually will only supply owners with 30 days of it at a time, but we don't see the dog every 30 days, unless there are concerns with control. Can you not just supply a new prescription every 30 days, but still only actually see the animal every 3 months? I didn't know it had to be a hand written prescription either, what a pain!

Re: Written prescriptions for controlled drugs

Martin Atkinson — Thu, 02 Feb 2012 16:19:26 GMT

What it actually says is: 'Written prescriptions are valid for 28 days'. Does that mean it has to re-written every month or that it has to be redeemed within 28 days? What I thought was interesting was this: 'Schedule 2 Controlled Drugs must not be destroyed, except in the presence of a person authorized by the Secretary of State'. Does that mean I have to get on the blower to the Ministry every time I chuck a part used vial of morphine in the controlled drugs bin or just a man from the ministry has to be at CPC when they incinerate it?