Читать книгу Fundamentals of Pharmacology for Children's Nurses - Группа авторов - Страница 30

Medicines can be grouped into four types in terms of access.

 General sales list

 Pharmacy medicines

 Prescription‐only medicines

 Controlled drugs.

Medicines within the general sales list are readily available in shops and there is no legal age restriction for the purchase of these medicines, although some shops have their own age limits for sales. GPs and nurses will not prescribe over the counter medications, such as paracetamol, for minor illnesses for a child or adult when they can be bought readily and at a cheaper cost to the individual and NHS, although there is a list of exemptions. The cost of prescribing over the counter medications to the NHS is approximately £136 million per year (NHS, 2018).

Pharmacy medications are also known as restricted medicines and are a small group of medicines that a pharmacist can prescribe without the patient seeing a doctor or a nurse.

Prescription‐only medicines are prescribed by a GP, nurse, dentist, midwife or a doctor working in environments other than general practice. The medications on this list are considered to be needed to be used under the supervision of a licensed healthcare practitioner due to the potential to cause harm. There are also many medicines that are used but are not licensed for CYP and these can only be prescribed by a paediatrician or hospital‐based doctor. In comparison to general sales and pharmacy medications, prescription‐only medicines are prescribed for an individual after assessment and the dose is calculated on the child or young person’s height and weight or surface area rather than a standard dose that is more often found with adults.

Controlled drugs are a group of medicines that can be abused and cause dependence and therefore they are controlled and regulated by the government. The term ‘control’ covers how and where the medicine is made, how it is used, the way that it is handled and stored as well as how it is distributed. In a hospital environment, GP surgery or community care environment such as a hospice or children’s unit, controlled drugs are stored in a metal locked cupboard inside another locked cupboard on a wall, usually in a specific room where medicines are checked and prepared. Access to the keys to the cupboards is limited and controlled. The stock levels of controlled drugs are checked daily by two people and new supplies are also often checked by two people and everything is recorded in a specific logbook (sometimes known as the controlled drugs register) according to local policy and procedure. When preparing a controlled medication to administer to a patient the stock level is checked against the logbook and the details of the patient including the dose, date and time are recorded and signed by two members of staff. The types of controlled substances most often used include opioids (morphine, diamorphine), sedatives (diazepam, temazepam), stimulants (amphetamines used in attention deficit hyperactive disorder), central nervous system depressants (diazepam), hallucinogens and anabolic steroids (testosterone).