NARCOTICS- POLICY AND PROCEDURES FOR ITS USE

This document outlines policies and procedures for handling narcotic and controlled drugs in NABH accredited hospitals.

1. Narcotic policy dr. ahana haroon Clinical pharmacist

2. POLICY AND PROCEDURES FOR USE OF NARCOTIC DRUGS AND 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 OF PRESCRIPTION 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

13. Thank You 13