Define the five different schedules for controlled drugs and provide examples of drugs in each Schedule
Define the five different schedules for controlled drugs and provide examples of drugs in each Schedule
Discussion 2 NURS 676/ 2 Replies
Requirements: 100 words each reply
MondayMay 22 at 8:09pm
Dr. Falls and Class,
Choice #3. Controlled substances are categorized using a classification system. Define the five different schedules for controlled drugs and provide examples of drugs in each Schedule. Explain the reason why controlled substances need to be categorized. What are associated controls required in your state for prescribing in each Schedule?
Schedule I Controlled Substances (Iowa.gov, 2023)
Substances in this Schedule have no currently accepted medical use in the United States, a lack of accepted safety for use under medical supervision, and a high potential for abuse.
Some examples of substances listed in Schedule I are: heroin, lysergic acid diethylamide (LSD), marijuana (cannabis), peyote, methaqualone, and 3,4-methylenedioxymethamphetamine (“Ecstasy”).
Schedule II/IIN Controlled Substances (2/2N)(Iowa.gov, 2023)
Substances in this Schedule have a high potential for abuse which may lead to severe psychological or physical dependence.
Examples of Schedule II narcotics include hydromorphone (Dilaudid), methadone (Dolophine), meperidine (Demerol), oxycodone (OxyContin, Percocet), and fentanyl (Sublimaze, Duragesic). Other
Schedule II narcotics include morphine, opium, codeine, and hydrocodone.
Examples of Schedule IIN stimulants include amphetamine (Dexedrine, Adderall), methamphetamine (Desoxyn), and methylphenidate (Ritalin). Other Schedule II substances include amobarbital, glutethimide, and pentobarbital.
Schedule III/IIIN Controlled Substances (3/3N) (Iowa.gov, 2023)
Substances in this Schedule can be abused less than substances in Schedules I or II, and abuse may lead to moderate or low physical or high psychological dependence.
Examples of Schedule III narcotics include products containing no more than 90 milligrams of codeine per dosage unit (Tylenol with Codeine) and buprenorphine (Suboxone).
Examples of Schedule IIIN non-narcotics include benzphetamine (Didrex), phendimetrazine, ketamine, and anabolic steroids such as Depo-Testosterone.
Schedule IV Controlled Substances (Iowa.gov, 2023)
Substances in this Schedule have a low potential for abuse relative to substances in Schedule III.
Examples of Schedule IV substances include alprazolam (Xanax), carisoprodol (Soma), clonazepam (Klonopin), clorazepate (Tranxene), diazepam (Valium), lorazepam (Ativan), midazolam (Versed),
temazepam (Restoril), and triazolam (Halcion).
Schedule V Controlled Substances (Iowa.gov, 2023)
Substances in this Schedule have a low potential for abuse relative to substances listed in Schedule IV and consist primarily of preparations containing limited quantities of certain narcotics.
Examples of Schedule V substances include cough preparations containing not more than 200 milligrams of codeine per 100 milliliters or per 100 grams (Robitussin AC, Phenergan with Codeine) and ezogabine.
Why do controlled substances need to be categorized?
A drug or other substance that the government tightly controls because it may be abused or cause addiction. The control applies to how the substance is made, used, handled, stored, and distributed. Controlled substances include opioids, stimulants, depressants, hallucinogens, and anabolic steroids. Controlled substances with known medical use, such as morphine, Valium, and Ritalin, are available only by prescription from a licensed medical professional (NIH, 2023).
What associated controls are required in your state for prescribing in each Schedule (Florida Department of Health, 2023)?
In 2018, Florida passed the Controlled Substances Bill that establishes prescribing limits, requires continuing education on controlled substance prescribing, expands the required use of Florida’s Prescription Drug Monitoring Program, EFORCSE, and more.
Each prescribing practitioner registered with the United States Drug Enforcement Agency must take a Board-approved continuing education course unless the practitioner is already required to complete it under their practice act.
Prescription Limits for Acute Pain
A prescribing practitioner may prescribe or dispense up to a 3-day supply of a Schedule II opioid to alleviate acute pain. However, a prescribing practitioner may prescribe or dispense up to a 7-day supply for acute pain if the physician determines:
- more than a three-day supply is needed based on the professional judgment of the prescriber;
- indicates “acute pain exception” on the prescription, AND
- documents the justification for deviating from the 3-day supply limit in the patient’s medical record
Prescriptions for Nonacute Pain
If the prescriber prescribes a Schedule II opioid for treating pain other than acute pain, the prescriber must indicate “Nonacute Pain” on the prescription.
Prescription Drug Monitoring Program
Each prescriber and dispenser or their designee must consult the PDMP system regarding a patient’s controlled substance dispensing history each time a controlled substance is prescribed or dispensed to a patient age 16 or older unless a statutory exemption applies.
There is required consultation of the PDMP except:
- Patient is less than 16 years of age
- Drug being prescribed is a nonopioid Schedule V
- System is not operational
- Requestor has a technological or electrical failure
Failure to consult the PDMP may result in a non-disciplinary citation by the regulatory board or further discipline.
Reference
Florida Department of Health. (2023). Take Control of Controlled Substances. https://flhealthsource.gov/FloridaTakeControl/controlled-substances-bill/Links to an external site.
Iowa.gov. (2018). Definition of Controlled Substance Schedules. https://medicalboard.iowa.gov/sites/default/files/documents/2018/04/controlled_substance_defs-20180301.pdfLinks to an external site.Links to an external site.
NIH. (2023). Controlled Substance. https://www.cancer.gov/publications/dictionaries/cancer-terms/def/controlled-substanceLinks to an external site.
YesterdayMay 23 at 12:09pm
3. Controlled substances are categorized using a classification system. Define the five different schedules for controlled drugs and provide examples of drugs in each schedule. Explain the reason why controlled substances need to be categorized. What are the associated controls required in your state for prescribing in each schedule?
The United States Government developed the Federal Comprehensive Drug Abuse Prevention and Control Act (Controlled Substances Act) in 1970. The Controlled Substances Act categorizes specified medications into five different schedules based on misuse potential. Only registered practitioners with the Drug Enforcement Agency (DEA) are authorized to prescribe controlled substances.
Schedule Organization
- Schedule I: no therapeutic value and therefore cannot be lawfully possessed or prescribed. Examples: Marijuana, ecstasy, heroin, LSD, MDMA, and peyote.
- Schedule II: high potential for abuse which may lead to severe psychological or physical dependence Examples: Methamphetamine, cocaine, fentanyl, Vicodin, oxycodone, and Adderall.
- Schedule III: potential for abuse less than substances in Schedules I or II and abuse may lead to moderate or low physical dependence or high psychological dependence. Examples: Anabolic steroids, testosterone, suboxone, and ketamine.
- Schedule IV: low potential for abuse and low risk of dependence – Examples: Xanax, Ambien, Ativan, Soma, Darvon, Darvocet, Tramadol, and Valium.
- Schedule V: low potential for abuse relative to substances listed in Schedule IV and consist primarily of preparations containing limited quantities of certain narcotics. Examples: cough preparations containing not more than 200 milligrams of codeine per 100 milliliters or per 100 grams (Robitussin AC, Phenergan with Codeine), and ezogabine. (Kenny et al., 2022)
Legal responsibility for prescribing rests with the provider who signs the prescription, and it is the responsibility of the provider to prescribe within their own level of comfort, training, and competence. It is the provider’s duty to understand the drug they are prescribing, including any possible adverse effects, contraindications, and the need for appropriate monitoring. The provider should check for polypharmacy and the effectiveness of medication through regular monitoring and follow-up with the patient. It is important to perform med reconciliation; remove any unnecessary medications, review doses, and try to ensure that dosing regimens are as simple as possible to avoid confusion. It is crucial that providers who prescribe controlled substances of any kind establish an open dialogue with their patients about expectations. A discussion with the patient regarding the diagnosis, treatment management, and appropriate medication management should occur before prescribing.
Advanced Registered Nurse Practitioners (ARNPs) can prescribe controlled substances listed in Schedule II, Schedule III or Schedule IV as defined in s. 893.03 Florida Statutes. An ARNP who is certified as a Psychiatric Nurse can prescribe certain controlled substances pursuant to HB 977. For schedule II medication, the NP in Fl can only write a script for a 7 day limit, must be written on a separate prescription pad and/or electronic prescription and cannot be refilled. While, a Schedule III-V drugs may be prescribed with refills, but the total amount prescribed cannot exceed a 90-day supply.
References
Kenny, B. J., Preuss, C. V., & Zito, P. M. (2022). Controlled substance schedules. National Library of Medicine. Retrieved May 22, 2023, from https://doi.org/10.21019/9781582123042.appb
Answer preview for the paper on ‘Define the five different schedules for controlled drugs and provide examples of drugs in each Schedule’
APA 330 words
Click the purchase button below to download full answer…….