Controlled Drugs

This chapter reviews the legal regulation of treatment of depression as it exists in England and Wales, where medicinal products are regulated largely by the Medicines Act 1988 and the Misuse of Drugs Act 1971. The Medicines Act divides medicinal products into pharmacy only medicines, which can only be purchased under the supervision of a pharmacist, over-the-counter medicines, and prescription only medicines. The Misuse of Drugs Act is concerned with controlled drugs. These are divided into three classes according to their perceived degree of harmfulness. This chapter considers treatment with valid consent and two pieces of legislation that govern people who are sufficiently ill and need to be admitted to hospital: the Mental Health Act 1983 (MHA) and the Mental Capacity Act 2005 (MCA). It also discusses treatment of mentally incapacitated patients and the issue of liberty regarding the admission of a compliant but incapacitated patient to hospital. Finally, it looks at three types of non-medical prescribing in England, issued by independent prescribers, supplementary prescribers, and community practitioners.

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Application of Microextraction-Based Techniques for Screening-Controlled Drugs in Forensic Context—A Review

Molecules ◽

10.3390/molecules26082168 ◽

2021 ◽

Vol 26 (8) ◽

pp. 2168

Author(s):

Samir M. Ahmad ◽

Oriana C. Gonçalves ◽

Mariana N. Oliveira ◽

Nuno R. Neng ◽

José M. F. Nogueira

Keyword(s):

Environmental Sustainability ◽

Illicit Drugs ◽

State Of The Art ◽

Cost Benefit ◽

Future Trends ◽

Present Contribution ◽

Controlled Drugs ◽

Related Compounds ◽

Innovative Techniques ◽

Great Simplicity

The analysis of controlled drugs in forensic matrices, i.e., urine, blood, plasma, saliva, and hair, is one of the current hot topics in the clinical and toxicological context. The use of microextraction-based approaches has gained considerable notoriety, mainly due to the great simplicity, cost-benefit, and environmental sustainability. For this reason, the application of these innovative techniques has become more relevant than ever in programs for monitoring priority substances such as the main illicit drugs, e.g., opioids, stimulants, cannabinoids, hallucinogens, dissociative drugs, and related compounds. The present contribution aims to make a comprehensive review on the state-of-the art advantages and future trends on the application of microextraction-based techniques for screening-controlled drugs in the forensic context.

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Short Onset and Enhanced Analgesia Following Nasal Administration of Non-Controlled Drugs in Nanovesicular Systems

Pharmaceutics ◽

10.3390/pharmaceutics13070978 ◽

2021 ◽

Vol 13 (7) ◽

pp. 978

Author(s):

Elka Touitou ◽

Hiba Natsheh ◽

Shatha Boukeileh ◽

Rania Awad

Keyword(s):

Lipid Bilayers ◽

Analgesic Effect ◽

Drug Level ◽

Nasal Delivery ◽

Nasal Administration ◽

Mice Model ◽

Noninvasive Treatment ◽

New Approach ◽

Controlled Drugs ◽

Peak Value

Nasal nanovesicular delivery systems (NVS) containing the noncontrolled analgesic drugs Ketoprofen, Butorphanol or Tramadol, incorporated in a phospholipid nanovesicular carrier, were designed and investigated. The systems were first characterized for their physicochemical properties. Due to their composition, comprising propylene glycol as a lipid bilayers fluidizer, these systems contain soft vesicles. Pharmacokinetic profiles of Tramadol in plasma and brain and of Ketoprofen in plasma were also assessed. The analgesic effect of each of the three tested drugs was evaluated in the acetic acid mice model for pain. One important result obtained in this work is that the concentration of Tramadol in rats’ plasma and brain increased rapidly after administration, reaching a peak value 10 min after administration with a Cmax of 2 to 5 folds greater than that for the oral or nasal non-vesicular treatments, respectively. In the case of Ketoprofen, the peak of the drug level in plasma was measured 10 min post nasal administration in NVS. The Cmax was three-fold higher relative to oral administration of this drug. In the experiment testing analgesia, a rapid and improved analgesia was observed for the tested drugs when delivered nasally in the nanocarrier. On the other hand, a weaker analgesic effect was observed for oral and nasal control systems. This new approach suggests that nasal delivery of non-controlled drugs in soft nanovesicles may open the way for better and noninvasive treatment of severe pain.

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Drugs have gone missing from the controlled drugs cabinet. The recording system was not up to date and suspicion has fallen on the nursing team. What can I do?

Veterinary Nursing Journal ◽

10.1080/17415349.2017.1282080 ◽

2017 ◽

Vol 32 (3) ◽

pp. 62-62

Author(s):

Nicky Ackerley

Keyword(s):

Recording System ◽

Controlled Drugs ◽

Nursing Team

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COMMUNITY PHARMACY ROLE IN UNIVERSAL HEALTH COVERAGE IN MOMBASA COUNTY

EPRA International Journal of Multidisciplinary Research (IJMR) ◽

10.36713/epra5722 ◽

2021 ◽

pp. 331-341

Author(s):

Kailong J. M ◽

Aggrey A ◽

Mulinya S

Keyword(s):

Community Pharmacy ◽

Universal Health Coverage ◽

Close Contact ◽

Health Planning ◽

Essential Medicines ◽

Bivariate Analysis ◽

Community Pharmacies ◽

Health Coverage ◽

Controlled Drugs ◽

Universal Health

Community pharmacy role in universal health coverage was a qualitative study that entailed close contact to the role played by community pharmacies in healthcare provision. As a "small healthcare" in provision of pharmaceutical services, community pharmacies are required to be included in realization of Universal Health Coverage in Mombasa since it is among the Big 4 Agenda of the national government (MOH, 2013). The objective of the study was to determine community pharmacy role in universal health coverage. A descriptive cross sectional study design was used to collect both qualitative and quantitative data and the design estimate the prevalence of the outcome of interest commonly for the purpose of public health planning. A sample size of 196 was calculated using fishers formula. Data was collected using in-depth interviews and structured questionnaire were administered on a target population of community pharmacies health providers and clients seeking services respectively. The collected data was analysed using SPSS version 20 and interpreted using tables and pie charts. On community pharmacy practitioners respondents; 58% were male, 90.3% diploma holders in pharmacy, 39.8% registered with PPB and 65% had practised for less than two years. 78% of the respondents agree that community pharmacy has a role in UHC and there was 74% affordability of community pharmacy medicines. Bivariate analysis findings show that training and inspection on UHC (P=0.003) Covid 19 (p=0.000) and inspection fee (p=0.000). Accessibility; location of community pharmacies (p=0.000) and doctors attitudes (p=0.000). Essential medicines; acyclovir 200mg tablets (p=0.000), chlorpromazine 100mg tablets (p=0.000) and tetanus toxoid vaccine (p=0.000). Key determinants of community pharmacy role in UHC were diploma (AOR 666.7; CI 129.6-3429.5), Erythromycin 125mg suspension (AOR 120.3; CI 15.4-940.8), Acyclovir 200mg tablets (AOR 46.823; CI 17.7-124.1) and Occupation (AOR 45.271; CI 15.363-133.404. The study recommends reduction of tax on essential medicines, MOH revise the UHC policy to incorporate community pharmacies and empowerment on management of controlled drugs and vaccines in order to realize effective and efficient UHC in Kenya

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The Price Effect of Drug Price Ceilings: Intended and Unintended Consequences

Management Science ◽

10.1287/mnsc.2021.4166 ◽

2021 ◽

Author(s):

Jun Li ◽

Di (Andrew) Wu

Keyword(s):

Drug Price ◽

National Level ◽

Healthcare Management ◽

Unintended Consequences ◽

Production Costs ◽

Economic Conditions ◽

Price Effect ◽

Price Inflation ◽

Price Ceiling ◽

Controlled Drugs

Policy makers in many developing countries use maximum price or markup policies to control pharmaceutical costs, which represent 20%–60% of their overall healthcare expenditure. We study the price effect of price ceiling policies by exploiting a major policy shift in China: the elimination of longstanding ceilings on retail drug prices. We collect weekly price and characteristics data on more than 4,500 drug stock keeping units (SKUs) from a leading pharmacy chain. By comparing the rate of discontinuous price jumps across drugs with and without price ceilings during the years before and after the policy change, we find that while price ceilings are effective in containing the prices of some drugs, they can lead to higher prices for others, particularly if the ceilings are set at the national level irrespective of local economic conditions. About 5% of nationally controlled drugs (or more than 125 drugs) had inflated prices because of price ceilings, with an average price inflation of 10%. We attribute this perverse price effect to focal point pricing and asymmetric information about production costs. Further supporting this view, we find the perverse price effect most prominent in lower-income regions where the centrally set price ceilings are arbitrarily high considering their poorer economic conditions. Moreover, drugs with highly concentrated production and less elastic demand face heightened risks of inflated prices under price ceilings. Finally, based on a sample of drugs with available price ceiling data, we find that drugs with manufacturer-specific ceilings are 100% more likely to be priced at or near their ceilings and 70% more likely to experience price drops once the ceilings are removed compared with other drugs with regular ceilings. Overall, this paper documents the unintended perverse effect of price ceilings in pharmaceutical markets and sheds lights on the ongoing debate of drug price regulation. This paper was accepted by Stefan Scholtes, healthcare management.

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