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Showing posts with label poison scheduling. Show all posts
Showing posts with label poison scheduling. Show all posts

Friday, 16 January 2015

Question 1g (answer Part 1)


The paper I'm working on is here
Poison scheduling info can be found here and here


The question is what is the legal classification of a cough syrup containing codeine 9mg/5ml and pseudoephedrine 30mg/5ml.

This is an interesting one.

You can start by thinking about whether there is any such cough medicine in your home country. Let's say for example if you are a UK pharmacist, do we sell any cough meds containing codeine and pseudoephedrine? Would the restricting drug which would ramp up the scheduling of this med be the codeine which may or may not be a dangerous drug, or pseudoephedrine, known for its illicit use of being converted into methamphetamine?

Codeine as a cough medicine has become a bit of a pariah, although in the UK it can be sold by a pharmacist without a prescription at the strength of 15mg/5ml. (We don't really like it though because of the potential for abuse and possible opioid related side-effects, but that is by the by.) Once you increase the strength, codeine becomes a POM, prescription only. Codeine 25mg/5ml liquid which is used for pain relief is prescription only.

The concept is similar in HK, below a certain threshold codeine is schedule 1, above it it becomes a schedule 3 and dangerous drug DD. You just need to find out what the cut off concentration is. The fact that it contains 9mg/5ml rather than 10mg might be a clue. Have a look here, codeine can be found under 'Alkaloids' (Don't ask me why they decided to do that, maybe in HK they like to make stuff like this seem more complicated than it should be).

Pseudoephedrine: this drug which started off as an innocent little sympathomimetic used for treating nasal congestion become controversial over the years as apparently people bought Sudafed from the pharmacy to turn into methamphetamine. Sounds kind of impressive, I have no idea how to do that and I'm a pharmacist. I remember when I worked in retail pharmacies we'd hide Sudafed out the back in the dispensary and go into a panic every time any one came in asking for it. The Sudafed team has now replaced pseudoephedrine with phenylephrine in most of its cold products. But it is still possible to buy Sudafed containing pseudoephedrine; in the UK and USA you need to ask the pharmacist for it, maybe kind of a step up from a 'Pharmacy' or P med. So that's kind of funny, like I'm supposed to look into the eyes of this person and determine whether they're a meth dealer or not. In HK such a drug may be considered a Schedule 1 drug where they take it a step further by stating in the legislation the pharmacist needs to actually know the buyer to be a 'fit and proper' person, and note down details of the transaction.

So, is pseudoephedrine a S1 drug in HK? Have a look.

Still confused? I can prepare a more full on answer for those who don't want to work it out and post it up later, go ahead and subscribe if you want to find out part 2 of this answer as soon as it comes out!

Tuesday, 10 July 2012

Poison scheduling

From MIMS online http://www.mims.com/

It is free to use the Hong Kong MIMS website, you just need to register. MIMS is convenient to use for looking up the classification of a branded product. So if you type in 'Amoxil' (which I'm assuming is pretty universal) it shows you the page for Amoxil with details like: amoxicillin, antibiotic, etc etc. I have discovered though that if you type in a generic name, for example 'Amoxicillin', it will still take you to a page for amoxicillin, but this page will not contain info on the drug classification, which in this case is 'antibiotic'. The obvious way to get around this is to find a branded product which contains the drug whose classification you are looking for. I also like to cross reference with other documents which contain the list of drugs per schedule, such as the what you'd find in the Ordinance.

Non-poison (NP)
May be sold by medicine retailers.

Part II poisons (P2)
May be sold within the registered premises of an Authorised Seller of Poisons (ASP), commonly known as pharmacy or dispensary, or a Listed Seller of Poisons.

Part 1 only Poisons (P1)
May be sold within the registered premises of an ASP, by registered pharmacist or in his presence & under his supervision.

Schedule 1 only Poisons (S1)
Other than those limitations applied to Part I only poisons, sale of P1S1 poisons is also subject to the following limitations:
a) the purchaser of P1S1 poisons shall be fit & proper person & known by the seller.
b) ASP should enter the particulars of the transaction in the poisons book & the entry should be signed by the purchaser & counter-signed by the registered pharmacist.

Schedule 3 Poisons (S3)
 Other than those requirements applied to Part I only poisons, & ASP shall only supply S3 poison on prescription given by a registered medical practitioner, a registered dentist or a registered veterinary surgeon. Corresponding entry should be made in the prescription record book.

Schedule 5 Poisons (S5)
Drugs with special labeling requirements as found in Schedule 5 of Chapter 138A, Pharmacy and Poisons Regulations.

Antibiotic (A)
Same requirements as applied to S3 poisons.

Dangerous Drug (DD)
Other than those requirements applied to S3 poisons, particulars of the transaction should also be recorded in dangerous drugs register. Refer to Dangerous Drug Ordinance.