Chapter 8: Chapter Discussion Questions

1. Why should pharmacists be concerned about proper management and documentation of

controlled substances?
- Pharmacists should be concerned about proper management of controlled substances
because these have a greater risk of causing negative outcomes for patients. These
medications have increased potential for abuse, misuse; and the federal and state laws
require increased oversight by the health-system pharmacists.

2. Discuss factors that influence the need for pharmacists involvement in controlled substances
management?
- First, pharmacists must ensure that all federal and state laws and regulations are obeyed.
Second, pharmacists need to ensure that controlled substances are used safely with
minimal medication errors resulting in adverse patient outcomes. Last, pharmacists must
ensure that controlled substances are used appropriately to achieve optimal health for
patients.

3. Discuss criteria that pharmacists should consider when adding any controlled substances to the
formulary?
- Some criteria considered are the storage requirements such as refrigeration, physical
security requirements at the location, appropriate stocking levels, authorized access to the
medication by health care staff, requirement for prescribing restrictions, and health care
staff and patient education requirements.

4. Compare and contrast physical security and storage requirements for controlled substances
versus non-controlled substances.
- Physical security and storage for controlled substances require a securely locked,
substantially constructed cabinet to deter theft and diversion. Some of these cabinets also
have minimal stock levels, and limited access to health care staff. While non-controlled
substances may have lesser restrictions compared to controlled substances. These may not
have limited access to health care staff and may not contain intrusion detection devices or
locks.

5. Compare and contrast the pharmacist involvement in the handling of controlled substances during
the ordering and dispensing process in an institutional environment versus retail ( outpatient )
environment.
- Pharmacist involvement in handling controlled substances during the dispensing process
and other activities are done under the hospitals DEA registration. The practitioner
should also be engaged in the usual course of professional practice and are advised to seek
out state regulations. Established formulary prescribing restrictions are also utilized.
While in the retail environment, strict requirements for container labeling are
implemented. Prescriptions for controlled substances are also subject to strict legal
requirements. Both pharmacists involvement require strict implementation to minimize
negative patient outcomes.