Question 1
Question
Aims of OST - Opioid Substitution Treatment (OST) (formerly known as: Methadone Maintenance Treatment (MMT)
-reduce or cease [blank_start]illicit[blank_end] opioid use
- reduce risk of [blank_start]blood-borne diseases[blank_end] transmitted by injecting
- reduce risk of [blank_start]overdose[blank_end]
- reduce rates of substance-related [blank_start]crime[blank_end]
- support the client, family and whānau through recovery and [blank_start]access[blank_end] to support systems
Answer
-
illicit
-
blood-borne diseases
-
overdose
-
crime
-
access
Question 2
Question
Methadone:
- A [blank_start]synthetic[blank_end] opioid agonist
- In NZ, Controlled Drug class [blank_start]B3[blank_end]
- Commonly prescribed for moderate to severe pain and treatment of opioid dependence
- Long elimination half-life of [blank_start]15 – 60[blank_end] hours has been reported (Medsafe), therefore with repeated administration, doses have to be [blank_start]adjusted[blank_end] carefully
- Takes [blank_start]5 - 6 days[blank_end] to reach steady state and thereafter may still need dose adjusting
- Common side effects include a [blank_start]dry[blank_end] mouth, constipation, [blank_start]drowsiness, dizziness, nausea, vomiting,[blank_end] dental problems..
Answer
-
synthetic
-
B3
-
15 – 60
-
adjusted
-
5 - 6 days
-
dry
-
drowsiness, dizziness, nausea, vomiting,
Question 3
Question
Methadone is the fifth most dispensed drug.
Question 4
Question
Misuse of Drugs Act 1975 Section 24:
Who can rx methadone:
- Prescribers in an authorised methadone maintenance treatment clinic (e.g. Specialist Addiction Services SAS)
- Individual GPs authorised in [blank_start]writing[blank_end] by a specific prescriber in a gazetted treatment service
- Emergency treatment for dependence in [blank_start]hospital[blank_end] and not exceeding [blank_start]3 days[blank_end]
Question 5
Question
When dispensing methadone, it needs to be prescribed on a Controlled drug H572/H572M prescription form.
Question 6
Question
It is recommended that methadone be kept in a locked safe at all times, but not required.
Question 7
Question
[blank_start]Suboxone[blank_end] - a combination of buprenorphine and naloxone. Class [blank_start]C4[blank_end] Controlled Drug.
Buprenorphine is an [blank_start]agoinist at 2 opioid receptors[blank_end]: µ (mu) opioid receptor partial agonist, and (kappa) opioid receptor antagonist.
Naloxone is an [blank_start]antagonist at opioid receptors[blank_end]:t µ (mu), δ (delta) and ĸ (kappa) opioid receptors
Naloxone is a deterrent.
- Does not -need- [blank_start]triplicate[blank_end] form (unlike methadone)
- No Controlled Drugs [blank_start]register[blank_end] (unlike methadone)
- Must be kept in a locked safe at all times.
Question 8
Question
Suboxone and methodone combo = [blank_start]Biodone[blank_end] .
- 3 strengths – 2mg/ml, 5mg/ml (Forte) and 10mg/ml (Extra Forte)
- Orange, clear and pink.
Question 9
Question
Pharmacists’ responsibilities
[blank_start]Confidential[blank_end] service reducing stigma
Comply with all [blank_start]legislative[blank_end] requirements for OST dispensing, recording and storage of medicines
[blank_start]SOP[blank_end] and auditable systems to minimise risk and errors
Ensure adequate [blank_start]supervision[blank_end] of the consumption of OST doses
Liaise with OST providers on a regular basis
When would a pharmacist liase with the OST provider?
Missed collecting more than [blank_start]one[blank_end] dose
Presented [blank_start]intoxicated[blank_end]
Abusive or [blank_start]threatening[blank_end] behaviour
Diversion of dose (refers to the [blank_start]selling or exchanging[blank_end] of prescribed opioid substitution medication)
[blank_start]Withdrawal[blank_end] symptoms
Deteriorates in physical, emotional and mental state (potentially increased injecting behaviour)
Pregnant?
Answer
-
Confidential
-
legislative
-
SOP
-
supervision
-
one
-
intoxicated
-
threatening
-
selling or exchanging
-
Withdrawal
Question 10
Question
Needle Exchange programme:
- IVDU is a [blank_start]health[blank_end] issue not criminal
- Harm reduction; reduce [blank_start]HIV, HEP C[blank_end] disease spread
- Needle Exchanges do [blank_start]not[blank_end] cause increase drug use