ANSWERS

1. Controlled drugs (CDs) are members of a sub-category of the Prescription Only Medicine Group (POMs) which are subject to the strictest controls over their supply to the public. Explain why.
   Controlled drugs (CDs) are those where the potential for abuse exists. Therefore, stringent regulations are in place regarding the production, supply, storage, possession and dispensing of such medicines.
2. State the 2 laws governing Controlled drugs (CDs).
   • The Misuse of Drugs Act 1971.
   • The Misuse of Drugs Regulations 1985.
3. There are 5 drug schedules within the Controlled drug group, Schedule 1 being those at the most serious risk of abuse. List 3 examples of drugs from this group and explain why veterinary surgeons are not allowed to possess or supply such drugs.
   • Cannabis.
   • Mescaline.
   • LSD.

   A veterinary surgeon does not have the authority to dispense drugs from this group to animals under his/her care since possession is illegal. The potential for abuse is extremely high and these drugs do not have a significant use in veterinary medicine.

4. Schedule 2 drugs include some opiate analgesics. List 3 Schedule 2 examples from this group that may be used in practice.
   • Fentanyl.
   • Morphine.
   • Pethidine.
5. Give 2 examples of Schedule 2 drugs not commonly used in practice.
   • Amphetamines.
   • Cocaine.
6. Etorphine is an extremely dangerous Schedule 2 drug known to be highly toxic in man if accidentally injected or absorbed by the skin or mucus membranes. State the trade name of a veterinary drug containing this preparation and its reversal agent.
   Etorphine is found combined with methotrimeprazine in Immobilon. This drug should never be used unless its reversal agent Revivon (Deprenorphine) is available.
7. List 4 precautions undertaken by law to minimise the abuse of Schedule 2 and some Schedule 3 controlled drugs.
   • They may only be obtained following a written request by the veterinary surgeon to the wholesaler or pharmacist.
   • They must be stored in a locked receptacle attached to a wall - ideally a purpose built "dangerous drugs" cabinet.
   • A bound record of purchases and outgoings must be kept.
   • Unwanted supplies may only be disposed of in the presence of a Home Office Inspector. NB. Schedule 3 drugs affected are diethyliproprion and buprenorphine.
8. In veterinary practice, why are Schedule 1 drugs not regulated in the same precautionary manner as listed in Q7?
   This is a trick question! It is illegal for veterinary practices to possess Schedule 1 drugs, therefore if they are not on the premises - there is no need for the above precautions!
9. Give 2 examples of Schedule 3 opiate analgesics.
   • Buprenorphine.
   • Pentazocine.
10. In addition to some opiate analgesics, what is the other main drug group found in Schedule 3. Give 2 examples.
    The barbiturate family, including pentobarbitone and phenobarbitone are examples of Schedule 3 drugs.
11. You are asked by the veterinary surgeon to collect a supply of pethidine tablets from the pharmacist. In addition to a prescription written and signed by the vet, what other document must you present?
    In order to obtain the pethidine, written permission from the veterinary surgeon authorising you to collect this drug will be required.
12. Schedule 2 and 3 drugs are subject to special prescription requirements. State the additional information that is desirable on a regular prescription, but legally, is required on a controlled drug prescription.
    • The quantity of the drug - in both words and numbers.
    • The strength of the drug - again, in both words and numbers.
    • Instructions for dosing.
13. Give 2 examples of Schedule 4 benzodiazepines.
    • Chlordiazepoxide.
    • Diazepam.
14. Describe the kind of drug found in Schedule 5, and explain why these are the least strictly controlled out of the 5 groups.
    Schedule 5 drugs contain very small quantities of potentially addictive substances. However, the amount of drug within the preparation is not considered large enough to pose a significant addiction risk.
15. Give 2 examples of Schedule 5 preparations.
    • Codeine cough linctus.
    • Kaolin and morphine antidiarrhoeal suspension.
16. List the criteria legally required within the Controlled drug register.
    • Details of purchases and dispenses are to be made by the veterinary surgeon within 24 hrs.
    • A separate register must be kept for each premise.
    • A separate section must be clearly made for each drug class.
    • The drug class must be a clear heading at the top of the page.
    • Entries are to be made in indelible ink and not altered in any way.
    • The register must be kept for 2 years following the last entry.