Handling of DD & controlled substances

Yap Lye Leen

 All items listed in Schedule 1 of DDA and Psychotropic Substance under Poison Act has to be kept in a lock & key cupboard It transaction needs to be recorded in a book
Supplying to ward Dispensed to patient Receive of stock from supplier/general store

Commonly used items in Hospital

Cocaine Fentanyl Thiopental Ketamine Diazepam Lorazepam Alprazolam Midazolam Methadone Morphine Oxycodone Pethidine Dihydrocodeine Remifentanil Methylphenidate Clonazepam

Dispensing DD & Psychotropics

Has to have a legal prescription
Name & IC (or MRN) of patient Name of drug, dose, frequency, duration Signature & chop of prescriber Name & address of clinic

Prescription to be kept for 2 years Check that quantity is not questionable (abuse?) Check for frequency of prescription

Keeping record
The particulars needed to be recorded:
Date Type of substance Amount Prescriber (if dispensed) Signature Invoice number/ DO number Balance

 In English or BM Chronological order Entry must be made on the day of the transaction (if not possible, the next day) No cancellation or alteration to entry If need to do correction marginal note or footnote & specify date of correction Record must be kept for 2 years from the date of last entry

 Record has to be tally with the physical stock at all times Periodic check & found needs to be done by pharmacist Enforcement will do inspection periodically spot-check

Controlled substances (non DD or Psychotropics)

Controlled substance
Pseudoepherine, ephedrine Dextromethorphan

Group C items can be sold/dispense without a prescription by pharmacist Does not need to be kept in key and lock cupboard Requires record of transaction of these items Record has to be tally at all times

Expiry
Items expired needs to be kept aside Disposed with enforcement officers present as witness Needs to tally with record of expiry Cannot simply dispose Enforcement officer will sign off upon disposal

Recording at store
Item: Date

Tab. Alprazolam 0.5mg

Obtained from/ Supply to Received Qty 1000 Supply Qty Balance Qty 1000 Signature YLL

1/8/11 Received from Zuellig Inv No: 1234 BN: AAA Exp: 4/13

3/8/11 Supply to Ward A (No. 567) 5/8/11 Supply to OPD (No. 864) 5/8/11 Returned from OPD (No. 865) 50

10 100 -

990 890 940

YLL YLL YLL

Recording at IPD, OPD

Item:

Tab. Alprazolam 0.5mg

Supply to / Received from MRN Supply Qty Receive Qty Balance Qty Prescriber Signature Witness

Date

5/8/1 Receive 1 d from Store (no. 864) 5/8/1 Return 1 to Store (no. 865) 6/8/1 Amin b. 1 Abdul

100

100

ABC

XYZ

50

50

ABC

ABU

2233

43

Dr Zul

ALI

ABU