Federal laws and regulations do not restrict the prescription, supply or administration of narcotic drugs listed in Schedule II, III, IV or V, including methadone, for the treatment of pain when such treatment is deemed medically necessary by a licensed physician acting in the ordinary course of professional practice. 4. What is the maximum daily amount a doctor can prescribe for a weight loss medication? Uncontrolled Legend Medications: There is no expiration date for a prescription for an uncontrolled Legend medication. List II Controlled Substances: There is no expiry date for prescriptions for List II Controlled Substances. Schedule III-IV Controlled Substances: Prescriptions for List III-IV Controlled Substances expire 6 months after the written date on the prescription or after 5 renewals, whichever comes first.21 CFR § 1306.22Schedule V Controlled Substances: There is no expiry date for prescriptions written for V.21 CFR Controlled Substances § 1306.22EXCEPTION: Partial completion of a Schedule V is subject to the prescription of a six-month limitation order.21 CFR §1306.232. If a patient does not pick up their prescription and the drug is back in stock, what is the resulting expiration date? Controlled substances stored in locked areas of medication carts must also be counted by two nurses at each shift change and then compared to the controlled substance delivery record. If the count does not match the documentation file, the discrepancy must be reported immediately in accordance with agency guidelines. The Alabama Board of Medical Examiners (ALBME) specifies that physicians should only prescribe controlled substances for themselves or their immediate family members in certain circumstances; However, there is no such clarity regarding uncontrolled drugs. The American Medical Association (AMA) Code of Medical Ethics, Opinion 1.2.1, appears to be the standard adopted by ALBME only in 2017. This notice raises concerns related to issues that are not specific to controlled substances, such as: B.: compromised professional objectivity, personal feelings that influence professional judgment, lack of review of sensitive areas of medical history, patients who feel uncomfortable disclosing sensitive information, physicians who are inclined to treat conditions beyond their expertise/education, the development of tensions in a professional relationship with a family member, Concerns about patient autonomy and informed consent, as well as a reluctance to indicate a preference for another physician. ALBME has not published up-to-date guidance on the subject, so pharmacists are advised to use professional judgment when submitting such prescriptions for uncontrolled prescription drugs. See Figure 15.8 for an image of a nurse comparing drug information on drug packaging with patient MRA information. Another type of rectal medication is an enema.
An enema is the administration of a substance in liquid form into the rectum. Many enemas are formulated in disposable plastic containers. Heating the solution to body temperature before administration may be beneficial, as the cold solution can cause spasms. It is also helpful to encourage the patient to empty their bladder before administration to reduce the feeling of discomfort. Place an incontinence pillow under the patient and position it on the left side in the Sims position. Lubricate the container nozzle and expel the air. Slowly insert the lubricated nozzle into the rectum and gently push the contents into the rectum. Ask the patient to keep the enema according to the manufacturer`s recommendations. For more information on how to avoid medication errors as a student nurse, see ImSP`s Error-Prone Conditions that Lead to Student Nurse-Related Errors.
As you prepare to administer medication to your patients during clinical treatment, your instructor will ask you questions to ensure safe administration of medications. A prescription must be in ink or pencil or typed and signed manually by the doctor. A person may be appointed by the practitioner to prepare the recipes for his signature. The practitioner is responsible for ensuring that the prescription complies with laws and regulations in all material aspects.21 CFR § 1306.05 Regardless of the method of storage and dispensing of medications used in an institution, the nurse should continue to review the rights of drug administration in order to make an accurate and secure medication passport.