If you are seeking data about "Control of special classes of dru ",this assignment will be helpful to you and provide more and more information about different potential drugs and medicine with their uses .So hope that assignment will be beneficial for everyone. Please forgive my mistake .

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MAWLANA BHASHANI SCIENCE AND TECHNOLOGY UNIVERSITY
Santosh, Tangail-1902, Bangladesh
DEPARTMENT OF PHARMACY
ASSIGNMENT NO: 02
Course Code: PHAR-5101.
Course title: Hospital and Community Pharmacy.
Assignment title: Control of Special Classes of Drugs
Date of submission: 06 March,2024.
Submitted by:
Md Jahangir Alam
Student ID: PHA-19001
Session: 2019-20
Submitted to:
Nowrin Ferdiousi
Lecturer
Department of Pharmacy
Mawlana Bhashani Science and
Technology University.

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Control of Special Classes of Drugs
A controlled substance is a drug that the Drug Enforcement Administration (DEA) regulates to
ensure safety, facilitate medical use, and prevent misuse within legal guidelines.
The Controlled Substances Act was established in 1970 and categorizes drugs into five classes,
known as Schedules, which the Drug Enforcement Administration (DEA)oversees. This
system aims to balance a substance’s medical benefits and the risks of misuse and harm,
providing guidance for law enforcement, healthcare, and policymakers.
Special Classes of Drug
A drug or other substance that is tightly controlled by the government because it may be abused
or cause addiction. The control applies to the way the substance is made, used, handled, stored,
and distributed.
Mainly, there are five special classes of drugs:
✓ Narcotics,
✓ Depressants,
✓ Stimulants,
✓ Hallucinogens, and
✓ Anabolic steroids.
Why they are Special?
Because these drugs may be abused or cause addiction have serious adverse effects on an
individual's life. It can affect them physically and mentally while also affecting them in work,
school, or their relationships. Proper education, law and word of mouth to the community is
required for prevention the abuse of these drugs.
According to The Narcotic Control Act 1990; Section 12,
Without written permission of Director General, Doctor cannot prescribe any of the intoxicants
mentioned in classes A & B as medicine. Anyone other than the Doctor cannot prescribe any
of the intoxicants mentioned in class C as medicine.

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Controlled drugs are typically classified based on their potential for abuse and dependence, as
well as their recognized medical uses. These classifications may vary between countries, but
they often follow similar principles. Here's a common classification system used in many
places:
Schedule 1:
In the United States, Schedule 1 drugs are substances classified Trusted Source as having a
high potential for misuse, no current medical use, and a lack of safety even under medical
supervision. As a result, medical professionals do not generally prescribe Schedule 1 drugs.
Here are some common Schedule 1 substances:
• Heroin: A highly addictive opioid drug derived from morphine, causing a rapid onset
of euphoria followed by sedation.
• LSD (lysergic acid diethylamide): A powerful hallucinogenic drug that alters
perception and mood.
• Methaqualone: A sedative-hypnotic drug that gained popularity as a recreational drug,
leading to its classification as a controlled substance.
• Psilocybin-containing mushrooms: Psychedelic mushrooms containing psilocybin, a
hallucinogenic compound. Some states have decriminalized or authorized medical use,
creating a disconnect between state and federal classifications.
• Cannabis (marijuana): While it is legal for medical or recreational use in some states,
it remains a Schedule 1 drug at the federal level, creating a regulatory inconsistency.
The federal government is currently reviewing whether to reclassify it.
Schedule 2 and 2N :
Schedule 2 and Schedule 2N substances in the United States are drugs considered to have a
high potential for misuse but with acknowledged medical uses under strict regulation.
Medical professionals can prescribe these drugs, but there are strict regulations in place to
monitor their distribution and use. Schedule 2 drugs have the tightest regulations Trusted
Source compared with other prescription drugs.
Here are some common Schedule 2 narcotics:
• Hydromorphone (Dilaudid): A potent opioid analgesic for the management of severe
pain.
• Methadone (Dolophine): An opioid used for pain relief. In controlled settings, it is
used for the treatment of opioid addiction.
• Oxycodone (OxyContin, Percocet): A powerful opioid prescribed for the
management of severe pain.

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• Morphine: An opioid analgesic for pain relief that comes from the opium poppy.
• Opium: A substance derived from the opium poppy, used for pain relief.
• Codeine: An opioid analgesic often used for mild to moderate pain.
Here are some common schedule 2N stimulants:
• Amphetamine (Dexedrine, Adderall): A stimulant medication for the treatment of
attention deficit hyperactivity disorder (ADHD) and narcolepsy.
• Methamphetamine (Desoxyn): A central nervous system stimulant that treats ADHD
and obesity.
• Methylphenidate (Ritalin): A stimulant for the treatment of ADHD and narcolepsy.
Schedule 3 and 3N:
Schedule 3 substances in the United States are considered to have a lower potential for abuse
compared with Schedule 1 and 2 drugs. They have accepted medical uses and a moderate to
low potential for physical and psychological dependence.
Here are some common Schedule 3 narcotics:
• Buprenorphine (Suboxone): Buprenorphine is a medication that treats opioid
dependence. It can help reduce withdrawal symptoms and cravings.
• Products containing no more than 90 milligrams of codeine per dosage unit
(Tylenol with Codeine): These are combination medications containing codeine, a
mild opioid analgesic, and are used for pain relief.
Here are some common schedule 3N stimulants:
• Benzphetamine (Didrex): Benzphetamine is a sympathomimetic amine, and it’s used
as an appetite suppressant for weight loss.
• Phendimetrazine: Phendimetrazine is another sympathomimetic amine doctors
prescribe for weight loss to suppress appetite.
• Anabolic steroids such as depo-testosterone: Anabolic steroids are synthetic
variations of the male sex hormone testosterone. They’re used medically for hormone
replacement therapy and illegally for performance enhancement in sports.

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Schedule 4:
Schedule 4 drugs in the United States are substances with a lower potential for misuse
compared to those in Schedules 1–3. They have a currently accepted medical use and a lower
risk of physical or psychological dependence than Schedule 3 drugs.
Here are some common examples:
• Alprazolam (Xanax): A benzodiazepine that treats anxiety and panic disorders.
• Clonazepam (Klonopin): Another benzodiazepine doctors prescribe for seizure
disorders and panic disorder.
• Diazepam (Valium): A benzodiazepine with various medical uses, including anxiety
and muscle spasms.
• Tramadol: A centrally-acting opioid analgesic used for pain relief.
• Carisoprodol (Soma): A muscle relaxant for the treatment of musculoskeletal pain.
Schedule 5:
Schedule 5 drugs in the United States are substances with a lower potential for misuse
compared with those in Schedules 1–4. They have a currently accepted medical use and contain
limited quantities of certain narcotics.
Here are some common examples:
• Cough preparations with less than 200 milligrams of codeine per 100 milliliters or
per 100 grams (e.g., Robitussin AC): A medication for cough suppression.
• Pregabalin (Lyrica): An anticonvulsant and neuropathic pain medication.
• Ezogabine (Potiga): An anticonvulsant used to treat epilepsy.

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In a summary:
Use of Sample:
In the context of controlling special classes of drugs, the term "use of sample" typically refers
to the practice of taking samples of drugs for testing and analysis. This is often done to ensure
compliance with regulations, monitor quality, and detect any adulteration or contamination.
For special classes of drugs, such as controlled substances or medications with a high potential
for abuse or misuse, sampling becomes particularly important due to the heightened regulatory
scrutiny and potential risks associated with these drugs. Regulatory agencies may require more
stringent sampling procedures and more frequent testing to ensure the safety, efficacy, and
proper handling of these drugs.
Sampling may involve randomly selecting batches of drugs from manufacturers, distributors,
or pharmacies for testing purposes. These samples are then analyzed for various parameters,
including potency, purity, contaminants, and adherence to labeling requirements. The results
of these analyses help regulatory authorities make informed decisions about the approval,
regulation, and oversight of special classes of drugs.
Overall, the use of sampling in the control of special classes of drugs plays a crucial role in
safeguarding public health and safety, maintaining regulatory compliance, and preventing the
illicit distribution and misuse of these substances.

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Key Aspects of Sample Control:
Storage and Rotation:
a) Organize samples by drug or drug group with labels facing out.
b) Separate medications with similar names and packaging in separate areas.
c) Rotate stock so that the oldest medications are dispensed first.
d) Separate medications by route of administration.
e) Store medications according to the manufacturer’s instructions.
Stock Checks:
a) Regular stock checks are essential to ensure accurate inventory.
b) The frequency of stock checks should be based on usage and controlled drug-related
incidents.
c) Recording stock checks and having two people present during checks (if possible) are
recommended practices.
Transportation:
a) Develop standard operating procedures for transporting controlled drugs.
b) Consider storage while in transit, security (e.g., locked doctor’s bags), and record-
keeping.
c) Ensure governance arrangements for safe transport, especially if using couriers or taxis.
Patient Education:
a) Inform people starting controlled drugs that they or their representative may need to
show identification when collecting the drugs.
b) Provide guidance on safe disposal of controlled drugs.
In patient Drug Order
Order: The direction for the drug, strength and frequency of administration as written on the
doctor's order sheet of the patient's medical record.
Doctors order for administration of control drugs:
Doctors order for the administration of ward stock- controlled drugs must be written on the
doctor's order sheet of the patient's chart. However, if the desired controlled drugs is not on
ward stock a complete controlled drug prescription must be written on a hospital prescription
blank. The signed prescription must be sent to the pharmacy. A notation must then be made on
the patient's chart by the doctor or nurse. indicating that the doctor's signature for the order is
in the pharmacy. A controlled drug order must be written by a licensed physician or a registered
intem or residents.

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Out-patient prescriptions
Prescribing controlled drugs in the outpatient department.
Prescriptions for schedule 2 (currently accepted medical use with severe restrictions) and other
controlled substances drugs may be dispensed from pharmacy and must include the following
information:
a) Patient's full name
b) patient's address or hospital number
c) Date
d) Name and strength of drug prescribed
e) Quantity of drug to be dispensed
f) DEA number and signature of physician
g)Frequency and route of administration
Ward Stock Drugs
Ordering Ward Stock Controlled Substances from the Pharmacy
1. A requisition for ward stock-controlled Substances is completed by placing a check mark
opposite the name, strength, form of the controlled substance desired. The completed form is
then sent to the pharmacy along with the empty containers and the nurse's inventory sheet.
2. Before any new controlled substance are issued to ward, the previous supply must be fully
accounted for. Therefore, each request for a new supply of drug is issued, it is accompanied by
one of these forms. This form serves three purposes:-
➢ A 24-hour administration record for all scheduled 2 substances (currently accepted
medical use with severe restrictions)
➢ Allows space for inventory count for each nursing shift and
➢ A section that serves as a record of losses and as a basis for review of error

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Narcotics
The English word narcotic is derived from the Greek narcotics, which means "numbing" or
"deadening.
Narcotics are addictive drugs that reduce the user's perception of pain and induce euphoria (a
feeling of exaggerated and unrealistic well-being).
Controlled Substances: A controlled substance is a drug or chemical whose manufacture and
possession or use is regulated by a government such as illicitly used drugs or prescription
medications.
Narcotics, also known as opioids, are categorized into different classes based on their potential
for abuse, medical use, and risk of dependence. Let's explore these classes:
1. Schedule I Narcotics:
- These drugs have no current medical use and a high potential for abuse and addiction.
- Examples: Heroin (a highly addictive opioid) is a Schedule I substance¹.
2. Schedule II Narcotics:
- These drugs have some medically acceptable uses, but they also have a high potential for
abuse and addiction.
- They can be obtained through prescription.
- Examples: Oxycodone, Fentanyl, and Morphine are Schedule II opioids¹².
3. Schedule III Narcotics:
- These substances have a moderate to low potential for physical or psychological
dependence.
- They can be obtained through prescription but are generally not available over the counter.
- Examples: Codeine (when combined with other medications) and some buprenorphine
formulations are Schedule III opioids.
4. Schedule IV Narcotics:
- These drugs have a very low risk of dependence and other issues for those who use them
medically.
- Examples: Tramadol and certain benzodiazepines fall into this category¹².
5. Schedule V Narcotics:
- These have the lowest potential for abuse and often little to no potential for dependence.
- They are some of the least risky controlled substances.
- Examples: Some cough preparations containing small amounts of codeine are Schedule V
opioids¹².

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Controls and Regulations of narcotics
Narcotics are subject to stringent controls and regulations to prevent diversion, misuse, and
illegal distribution. control measures include:
1. Prescription Requirements: Most narcotics can only be dispensed with a valid prescription
from a licensed healthcare provider, Prescriptions often have specific requirements, such as no
refills or a written prescription from the healthcare provider.
2. Record-keeping and Reporting: Pharmacies and healthcare providers are required to
maintain detailed records of narcotics, including the quantity dispensed, patient information,
prescribing physician, and date of dispensing. Suspicious activities or significant discrepancies
must be reported to regulatory authorities.
3. Storage and Security: Narcotics must be stored securely in locked cabinets or sales to
prevent unauthorized access, theft, or diversion. Healthcare facilities must adhere to strict
storage requirements to maintain the integrity and security of narcotics
Procurement and execution of order forms
The procurement and execution of order forms for narcotics involve a series of regulated steps
to ensure the legal and secure handling of these controlled substances. Here's a general
overview of the process:
1. Regulatory Compliance:
- Narcotics are regulated under international treaties and national laws to prevent misuse and
ensure they are used for legitimate medical and scientific purposes¹.
- Entities involved in the procurement of narcotics must comply with these regulations, which
include obtaining the necessary licenses and adhering to reporting requirements.
2. Order Forms:
- Specific order forms, often referred to as narcotic order forms or controlled substance order
forms, are used to request narcotics from licensed suppliers.
- These forms typically require detailed information about the quantity and type of narcotics
being ordered, the purpose of the order, and the credentials of the ordering party.
3. Execution of Orders:
- The execution of orders involves the verification of the order form by the supplier and the
appropriate regulatory authorities.
- Once verified, the narcotics are securely packaged and transported to the ordering entity,
with measures in place to prevent diversion or theft during transit¹.

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4. Record Keeping:
- Accurate record-keeping is essential in the procurement process. This includes maintaining
records of all order forms submitted, narcotics received, and their subsequent distribution or
use².
- These records are subject to inspection by regulatory authorities to ensure compliance with
the law.
5. Security Measures:
- Security measures are implemented at every stage of the procurement process to safeguard
against the loss, theft, or diversion of narcotics.
- This includes secure storage facilities, transportation protocols, and restricted access to
narcotics².
6. Audits and Inspections:
- Regular audits and inspections by regulatory authorities ensure that entities procuring
narcotics are adhering to the required procedures and maintaining proper records¹.
Dispensing of Narcotic Drugs in Hospitals
1. Prescription Verification: Pharmacists verify the validity of prescriptions for narcotic
drugs, ensuring they are issued by authorized healthcare providers and comply with regulatory
requirements.
2. Inventory Management: Hospitals maintain accurate records of narcotic drugs. including
inventory levels, usage, expiration dates, and restocking needs. Proper inventory management
helps prevent shortages, wastage, and potential diversion.
3. Secure Storage: Narcotics are stored securely in locked cabinets or safes with restricted
access to authorized personnel only. Controlled temperature, humidity, and lighting conditions
are maintained to preserve the integrity and stability of narcotics
4. Dispensing: Pharmacists dispense narcotic drugs based on valid prescriptions, ensuring
accurate medication selection, dosage, and patient-specific instructions. They also provide
counseling to patients about the medication's use, potential side effects, and storage
requirements.
5. Documentation and Record-keeping: Detailed documentation of narcotic dispensing
activities, including patient information, prescriber details, medication details, quantity
dispensed, and dispensing date, is maintained to ensure accountability and compliance with
regulatory standards.

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Implementing a New System for Hospital Narcotic Regulation
1. Needs Assessment:
Conduct a thorough assessment of current practices, challenges, and areas for improvement in
narcotic management to identify the requirements and objectives for the new system.
2. System Selection: Choose a comprehensive pharmacy management system or specialized
narcotic tracking software that meets the hospital's needs, integrates with existing systems, and
complies with regulatory requirements.
3. Implementation Plan: Develop a detailed implementation plan outlining timelines.
responsibilities, resources, and training requirements. Engage stakeholders, including
pharmacists, nurses, physicians, and IT staff, in the planning and execution process.
4. Training and Education: Provide comprehensive training and education to staff on the new
system's functionality, workflow processes, regulatory compliance, and best practices for
narcotic management. Ongoing support and refresher training should be available as needed.
5. System Integration: Ensure seamless integration of the new narcotic management system
with other hospital systems, such as electronic health records (EHRs), inventory management,
and billing systems, to facilitate data exchange and streamline workflow processes.
6. Monitoring and Evaluation: Implement monitoring tools and performance metrics to
assess the system's effectiveness, identify areas for optimization, and ensure compliance with
regulatory standards. Regular audits and reviews should be conducted to monitor adherence to
policies, detect discrepancies, and prevent potential issues.
7. Continuous Improvement: Continuously evaluate and refine the narcotic management
system based on feedback from users, changes in regulations, technological advancements, and
organizational needs to maintain its relevance, efficiency, and effectiveness over time.
Roles And Responsibilities of Pharmacist:
Role of Pharmacist in Drug Procurement:
a) By Direct purchase from the manufacturer & wholesale
b) By Buyers or suppliers from the manufacturer or whole sales
c) By Purchasing from Retail Pharmacy
d) By a contract purchase arrangement with manufacturer
e) By a contract Purchase through a Hospital purchases

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Roles & Responsibilities of Pharmacist for use of Controlled Substances in
Hospital:
Responsibility for purchase, storage, accountability, and proper dispensing of Bulk control
substances within hospital is under control of chief pharmacist or medical officer.
Procurement of Controlled Drugs
❖ Must have a DEA license.
❖ Must use special DEA order form (for schedule I and II).
❖ Must be shipped to address on license and once received become the responsibility of
the license holder.
❖ Shipments must be insured against theft and damage
Procedure for dispensing controlled substances for in patients
Doctor's order for administration→ Ordering of ward stock - from pharmacy Narcotics delivery
to the ward → Narcotics and controlled drugs on wards by nurse→ Charges for narcotics to
the patients.
Telephone Order: -
A Doctor may order a controlled drug by telephone in case necessary. The nurse will write the
order in order sheet, stating that it is a telephone order and will write the doctor's name and her
own initials. The controlled drugs may them be signed by doctor with his signature or his
initials within 24 hrs.
Verbal Order: -
A verbal order may be given by a doctor in an extreme emergency where the time dose doesn't
t permit waiting order. The nurse must write the order on doctor's order sheet with their
signature within 24 hrs.
Ordering Non-Ward Substances from Pharmacy
Drugs which or not stocked on the nursing station may be ordered from the pharmacy on written
prescription only. The number of drugs sent to nursing unit is the amount covered on
prescription by the doctor's signature. If more is needed a new signed prescription must be
obtained.

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The prescription must have the following details:
1. Date
2. Details of patients
3. Patient's hospital number
4. Amount of drug ordered
5. Strength
6. Name of the prescriber and their signature
Procedure For Dispensing Controlled Substances for Out Patients
PRESCRIBING CONTROL DRUGS IN O.P DEPARTMENT. Dispensing from o.p information pharmacy
must include following:-
1. Date
2. Details of patients
3. Patient's hospital number
4. Amount of drug ordered
5 Strength
6. Name of the prescriber and their signature.
Dispensing control drugs for house use when pharmacy is closed:
Occasionally patients require drugs for use at home when they are discharged from hospital or
released from emergency ward during hours when pharmacy is closed. A prescription Signed
by the staff who is a registered medical practitioner and also authorized to prescribe narcotics
& other controlled substances is required for this purpose.
Hospital narcotic regulation
Hospital narcotic regulation refers to the set of rules and procedures that govern the handling,
distribution, and administration of narcotic drugs within a hospital setting. Here's a brief step-
by-step explanation:
1. Licensing and Registration:
Hospitals must obtain the necessary licenses and registrations from relevant regulatory
authorities to handle narcotics. This typically involves demonstrating compliance with specific
regulations and requirements.

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2. Procurement:
Hospitals acquire narcotics through licensed suppliers or wholesalers. These suppliers must
also adhere to regulatory guidelines regarding the sale and distribution of narcotics.
3. Storage:
Narcotics must be stored securely to prevent unauthorized access and theft. Hospitals typically
have designated storage areas, such as locked cabinets or safes, with restricted access limited
to authorized personnel only.
4. Inventory Management:
Hospitals must maintain detailed records of their narcotics inventory, including quantities
received, dispensed, and remaining. Regular audits may be conducted to ensure accuracy and
identify any discrepancies.
5. Dispensing and Administration:
Narcotics are dispensed to patients by authorized healthcare professionals, such as doctors or
nurses, based on prescriptions from licensed practitioners. Strict protocols are followed to
verify patient identity, dosage, and frequency of administration.
6. Documentation and Reporting:
Comprehensive documentation is essential for tracking the use of narcotics within the hospital.
This includes recording each instance of dispensing or administration, as well as any waste or
disposal of unused narcotics. Hospitals are also required to report certain information to
regulatory agencies as per legal requirements.
7. Monitoring and Compliance:
Hospitals must regularly monitor their narcotic handling practices to ensure compliance with
regulations and identify areas for improvement. This may involve internal audits, staff training
programs, and collaboration with regulatory agencies for inspections or investigations.
8. Adverse Event Reporting:
Hospitals are obligated to report any adverse events related to the use of narcotics, such as
medication errors, adverse reactions, or incidents of diversion or misuse. Timely reporting is
crucial for patient safety and regulatory compliance.
9. Continual Review and Improvement:
Hospital narcotic regulation is an ongoing process that requires continual review and
improvement. Regulatory requirements may evolve over time, necessitating updates to
policies, procedures, and staff training to maintain compliance and enhance patient care.
By following these steps, hospitals can ensure the safe and responsible management of
narcotics, minimizing the risk of diversion, misuse, or harm to patients.

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Floor Stock Drugs
Floor-stock drugs means those drugs consisting of emergency drugs and controlled substances
which are routinely maintained on patient care units and accessible by nursing staff for patient
administration.
Under this system the drugs the nursing station carries both charge and non-charge
medications, which are administered to the patients according to the medication chart/order of
the physician.
Only the commonly used drugs in considerable quantities are stocked on the floor stock or in
the ward.
Advantages & Disadvantages
Advantages: The drugs are readily available for administration-
a) Minimum return of drugs
b) Reduced in patient Rx orders
c) Reduction in the number of pharmacy personnel required
Dis-Advantages:
✓ Increase in chances of medication errors due to lack of review by pharmacists)
✓ Greater opportunity for misuse of drugs resulting in financial loss Increase in drug
inventory
✓ Greater chances for pilferage.
✓ Drug deterioration problems due to lack of proper storage facilities and due to
unnoticed drug degradation.
✓ Greater load upon the nurse time
Charge floor stock Drugs
Medicines which are stocked on the nursing station at all times and charged to the patient's
account after they have been administered to them.
List of drugs includes injections or other unit dosage forms:
▪ Anti-allergics:
▪ Diphenhydramine HCl inj.,

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▪ Hydrocotisone sodium succinate etc..
▪ Antibiotics
▪ procaine penicillin,
▪ streptomycin sulphate, etc.
▪ Anti-coagulants:
▪ Heparin inj
Non-charge floor stock drugs:
Non charge floor stock drugs are the medicaments that are placed at the nursing station for
the use of all patients on the floor.
These drugs, there shall be no direct charge from the patient's account.
The list of Non-charge floor stock drugs includes fallowing drugs:
▪ Ampoules: Adrenaline 1 ml,
▪ Aminophylling 10 ml,
▪ Atropine Sulfate 25 ml, 2 ml,
▪ Digoxin 2 ml etc...
Capsules and Tablets:
✓ Aspirin 150 mg. Paracetamol 500 mg. Dulcolax 5 mg, multivitamins, etq.... Powder,
Ointments, Creams, suppositories, Solutions, etc
Selection of Charge Floor Stock Drugs:
❖ Selection of these drugs in various wards is decided by "The Pharmacy and
Therapeutic Committee".
❖ Representatives of nursing service, pharmacy and administration should be consulted
for guidance and advice.
❖ Once the floor stock list is prepared, it becomes the responsibility of the hospital
pharmacist to make the drugs available
❖ Pharmacist should also re-submit the list to the pharmacy and therapeutic committee
for reviewing and making any additions, deletions or alterations in the view of later
experience and trends.
❖ The list of drugs may vary from hospital to hospital. Further In the same hospital the
suitability of the drugs to be procured for the floor stock system may change from
time to time es per recommendations of pharmacy and therapeutics committee.

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Selection of Non-charge Floor Stock Drugs:
✓ Non-charge floor stock drugs consist of a pre- determined list of medication available
at every nursing unit of the hospital.
✓ The non-charge floor stock drugs are selected on the basis of cost of drugs, quantity
required, reimbursement from third-party payers (e. g. insurance).
✓ The list of drugs will vary from hospital to hospital, where such a list is exceptionally
small and therefore, the patient receives bill for numerous single doses of drugs.
✓ This of course, produces bad effects on public relations and the pharmacist and the
administrators should do all in their power to apply corrective measures to rectify the
situation.
Labeling of Floor Stock Drugs
➢ It is quite interesting that stock drugs in the ward are not labeled with the direction for
use.
➢ This is so because number of patients may be receiving the same type of medication
but under different therapeutic regimen.
➢ If one set of direction is affixed to the container, it may cause confusion and error
may result.
➢ Therefore, stock medications bear a label which shows the ward number, name and
strength of the preparation as well as any other related information.
A label for a charge floor stock-
Ward-
Phenobarbitone
Tablet
Each Tablet contains
Phenobarbitone-60mg

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A label for non-charge floor stock drug
Ward-
Paracetamol Tablet
Each Tablet contains:
Paracetamol 500gmquency of use, and the effect on the hospital budget and
Inspection of nursing (dispensing) drug cabinets
Once a large supply of drugs is placed in the nursing station, it is the responsibility of the
hospital pharmacist to be sure that drug supplies on the pavilions are being properly cared for
through personal inspection of the drug cabinets.
In order that the inspection program be successful, it should be carried out by pharmacy and
nursing personnel on a regular basis. In addition, there should be developed a Fregular
checklist of points to be looked for during each spection tour.
Inspection of drug cabinets
The following is a checklist that may be used for the inspection of drug cabinets on the
nursing station of any hospital
➢ Check lock mechanism for security.
➢ Check lighting and refrigeration.
➢ Check the uniformity of containers)
➢ Check the uniformity and completeness of labeling.
➢ Check to see that minimal and maximal inventories are being adhered to.
➢ Check to see that internal use medications are separated from external use products.
➢ Ascertain that all dated pharmaceuticals and related products are still usable.
➢ Determine whether non-dated drugs have deteriorated.
➢ Check whether research drugs are properly labeled and segregated
➢ Eliminate any samples, non-approved drugs, or non- drug items from the cabinet.

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➢ Check the storage and rotation of IV solutions. Check emergency or "crash carts" for
appropriate drug labels and status of drugs if dated.
➢ Check to see if previous inspection citations have been adequately corrected. Check
the general appearance of the drug preparation area.
Narcotics are not only the drugs that save our life but can also ruin our life.
Limit the narcotic use for therapeutic purpose only as prescribed by the physician.