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NARCOTIC
POLICY
DR. AHANA HAROON
CLINICAL PHARMACIST
POLICYAND PROCEDURES FOR USE OFNARCOTIC
DRUGSAND PSYCHOTROPIC SUBSTANCES
PURPOSE
To ensure safe and
rational use of
narcotics and
psychotropic
substances
SCOPE
Purchase
Pharmacy- sale
Hospital wide- storage
RESPONSIBILITY
Doctors
Nurses
PTC
DEFINITION
NARCOTICS is a
drug that in moderate
doses dulls the senses,
relieves pain, and
induces profound
sleep but in excessive
doses causes stupor,
coma, or convulsions
POLICY
NARCOTIC
DRUGS
NARCOTICS is a drug that in
moderate doses dulls the
senses, relieves pain, and
induces profound sleep but in
excessive doses causes stupor,
coma, or convulsions
3
Narcotic drugs (Available in our
Pharmacy)
• Inj. Morphine sulphate 15mg/ml
• T. Morphine sulphate 10mg
• Inj. Pethidine hydrochloride 50mg/ml
• Inj. Fentanyl citrate 100mcg/ml
• Fentanyl transdermal patch 12.5mcg/hr
• Fentanyl transdermal patch 25mcg/hr
NARCOTIC POLICY
4
1.1 Narcotic drugs and psychotropic substances shall be used as per
Narcotic drugs and psychotropic substances Act.
1.2 A proper record of its uses, administration and disposal shall be
maintained at all the places wherever narcotic drugs are stored.
1.3 Only appropriate personnel shall handle these drugs in accordance with
policies.
1.4 Narcotic and psychotropic medicines shall be issued only on registered
medical practitioner’s prescription.
1.5 The Narcotics shall be stored under double lock and key to ensure its
rational usage throughout the hospital.
1.6 Other than narcotic drugs, no items are permitted to be stored in the
narcotic drug cupboard including money.
5
1.7 Issues shall be under perpetual declining inventory and against prescription from
the medical practitioner. Security clause for storage: All containers used for holding and
storing narcotic drugs shall be properly labelled. Appropriate registers shall be
maintained to have enough information on its usage.
1.8 Pharmacist shall be notified if any medicines or register is missing.
1.9 The narcotic drugs register must incorporate a record of all receipt and issue
involving narcotic drugs.
1.10 The narcotic drugs register must be a bounded book with consecutively numbered
pages.
1.11 A separate page must be used for each narcotic drugs.
1.12 Weekly audits are conducted by Medical Superintendent and chief pharmacist.
STORAGE
IN PHARMACY
• All narcotic drugs are stored
in double lock and key vault.
• The drug is stored here for
supplying to different ICUs,
OT and specific departments.
• List of such drugs used in the
facility is available at central
pharmacy and all other
locations where these drugs
are stored.
IN DEPARTMENT
• These facility has a policy to
treat the narcotic drugs with
extra precaution to prevent
any misuse.
• Narcotics are to be kept in
separate cupboard under
double lock and keys. Two
keys are with different people
to ensure the safety of the
drugs.
• The key holder are
responsible for maintenance
of locker and inventory of
their departments. 6
DOCUMENTATION
PHARMACY
• Register is to be maintained for all narcotics in which transaction are recorded
• In RECEIPT entry
• Date
• Invoice number
• Drug description quantity
• Batch number, Expiry date
• MRP
• In ISSUE entry
• Date
• Opening stock
• Name of ward/ department
• Quantity issued
• Batch number, Expiry date
• Sign of pharmacist who issued
• Sign with ID of staff who came to receive
• Closing stock
7
• To prevent the misuse, keep all the empty ampoules of these drugs and discard it in central pharmacy and
noted
• Here we get the date, details of patient, quantity dispensed, doctors name, opening and closing stock
• All records are kept for a period of 2 years from the date of last entry.
8
USER DEPARTMENT
• Separate records are maintained for each drug
• For IV NARCOTICS
• Date and time
• Patient name
• UHID
• Previous balance
• Dose
• No of ampoules used
• Batch number
• Expiry date
• Ordered by doctor
• Discard by sign
• Witness sign
• Balance stock
• Sign of nurse incharge
• Sign of nurse superintendent
DOCUMENTATION
9
• For ORAL NARCOTICS
• Date
• Opening stock
• Quantity dispensed
• UHID
• Name, address, contact number of patient
• Closing stock
• Doctors sign
• Senior staff sign with ID no
• Staff in charge sign with ID no
• All records are kept for period of 2 years from the documentation of prescription.
10
• Separate forms are maintained for prescription of different narcotic drugs. This form
include following informations.
• Date of prescription
• Patient name
• UHID
• Drug description, quantity and dose
• Doctor’s name, register number and sign
• 3 different colour copies (Triplicate forms) of prescription are obtained from
physician.
• White copy is issued to patient along with discharge summary.
• Pink copy is retained in pharmacy/ department from where it is issued to the
patient
• Yellow copy is to be retained in the central pharmacy.
DOCUMENTATION OFPRESCRIPTION
11
• We inform it to assistant drug controller and to excise officer and it their presence it is
discarded in the proper way
DAMAGED/ EXPIRED DRUGS
12
THANK YOU
13

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NARCOTICS- POLICY AND PROCEDURES FOR ITS USE

  • 2. POLICYAND PROCEDURES FOR USE OFNARCOTIC DRUGSAND PSYCHOTROPIC SUBSTANCES PURPOSE To ensure safe and rational use of narcotics and psychotropic substances SCOPE Purchase Pharmacy- sale Hospital wide- storage RESPONSIBILITY Doctors Nurses PTC DEFINITION NARCOTICS is a drug that in moderate doses dulls the senses, relieves pain, and induces profound sleep but in excessive doses causes stupor, coma, or convulsions POLICY
  • 3. NARCOTIC DRUGS NARCOTICS is a drug that in moderate doses dulls the senses, relieves pain, and induces profound sleep but in excessive doses causes stupor, coma, or convulsions 3 Narcotic drugs (Available in our Pharmacy) • Inj. Morphine sulphate 15mg/ml • T. Morphine sulphate 10mg • Inj. Pethidine hydrochloride 50mg/ml • Inj. Fentanyl citrate 100mcg/ml • Fentanyl transdermal patch 12.5mcg/hr • Fentanyl transdermal patch 25mcg/hr
  • 4. NARCOTIC POLICY 4 1.1 Narcotic drugs and psychotropic substances shall be used as per Narcotic drugs and psychotropic substances Act. 1.2 A proper record of its uses, administration and disposal shall be maintained at all the places wherever narcotic drugs are stored. 1.3 Only appropriate personnel shall handle these drugs in accordance with policies. 1.4 Narcotic and psychotropic medicines shall be issued only on registered medical practitioner’s prescription. 1.5 The Narcotics shall be stored under double lock and key to ensure its rational usage throughout the hospital. 1.6 Other than narcotic drugs, no items are permitted to be stored in the narcotic drug cupboard including money.
  • 5. 5 1.7 Issues shall be under perpetual declining inventory and against prescription from the medical practitioner. Security clause for storage: All containers used for holding and storing narcotic drugs shall be properly labelled. Appropriate registers shall be maintained to have enough information on its usage. 1.8 Pharmacist shall be notified if any medicines or register is missing. 1.9 The narcotic drugs register must incorporate a record of all receipt and issue involving narcotic drugs. 1.10 The narcotic drugs register must be a bounded book with consecutively numbered pages. 1.11 A separate page must be used for each narcotic drugs. 1.12 Weekly audits are conducted by Medical Superintendent and chief pharmacist.
  • 6. STORAGE IN PHARMACY • All narcotic drugs are stored in double lock and key vault. • The drug is stored here for supplying to different ICUs, OT and specific departments. • List of such drugs used in the facility is available at central pharmacy and all other locations where these drugs are stored. IN DEPARTMENT • These facility has a policy to treat the narcotic drugs with extra precaution to prevent any misuse. • Narcotics are to be kept in separate cupboard under double lock and keys. Two keys are with different people to ensure the safety of the drugs. • The key holder are responsible for maintenance of locker and inventory of their departments. 6
  • 7. DOCUMENTATION PHARMACY • Register is to be maintained for all narcotics in which transaction are recorded • In RECEIPT entry • Date • Invoice number • Drug description quantity • Batch number, Expiry date • MRP • In ISSUE entry • Date • Opening stock • Name of ward/ department • Quantity issued • Batch number, Expiry date • Sign of pharmacist who issued • Sign with ID of staff who came to receive • Closing stock 7
  • 8. • To prevent the misuse, keep all the empty ampoules of these drugs and discard it in central pharmacy and noted • Here we get the date, details of patient, quantity dispensed, doctors name, opening and closing stock • All records are kept for a period of 2 years from the date of last entry. 8
  • 9. USER DEPARTMENT • Separate records are maintained for each drug • For IV NARCOTICS • Date and time • Patient name • UHID • Previous balance • Dose • No of ampoules used • Batch number • Expiry date • Ordered by doctor • Discard by sign • Witness sign • Balance stock • Sign of nurse incharge • Sign of nurse superintendent DOCUMENTATION 9
  • 10. • For ORAL NARCOTICS • Date • Opening stock • Quantity dispensed • UHID • Name, address, contact number of patient • Closing stock • Doctors sign • Senior staff sign with ID no • Staff in charge sign with ID no • All records are kept for period of 2 years from the documentation of prescription. 10
  • 11. • Separate forms are maintained for prescription of different narcotic drugs. This form include following informations. • Date of prescription • Patient name • UHID • Drug description, quantity and dose • Doctor’s name, register number and sign • 3 different colour copies (Triplicate forms) of prescription are obtained from physician. • White copy is issued to patient along with discharge summary. • Pink copy is retained in pharmacy/ department from where it is issued to the patient • Yellow copy is to be retained in the central pharmacy. DOCUMENTATION OFPRESCRIPTION 11
  • 12. • We inform it to assistant drug controller and to excise officer and it their presence it is discarded in the proper way DAMAGED/ EXPIRED DRUGS 12