Special Sub-Topic: Everything's Under Control Part II
|To review, drugs listed on the Drug Enforcement Administrations's schedule I are illegal (with some exceptions), schedule II drugs have a high potential for abuse, and schedule V drugs have low abuse potential. Schedules III and IV fall between these extremes. Do you know to what schedule anabolic steroids such as testosterone usually belong?|
Schedule III. Patients recovering from extended hospital stays may receive testosterone to help rebuild muscle mass that was lost as a result of inactivity or the ravages of disease. Testosterone comes in a variety of dosage forms, including injections, transdermal patches, and topical gels.
Why are steroids controlled? People who want to build muscle the "easy" way may try to abuse steroids, actually harming their bodies in the process. So-called 'roid rage' is one well-known side effect.
|Controlled substances take many forms, including intravenous injectables, oral solids, oral liquids, transdermal patches, nasal sprays, and others. Do any controlled substances take the form of a rectal suppository?|
y. The suppository combination of belladonna alkaloids and opium is a schedule II controlled substance. This drug is used for (among other things) controlling pain resulting from bladder spasms.
|What is the generic name for the brand name drug Dalmane, a schedule IV controlled substance?|
Flurazepam. All four choices belong to the large family of benzodiazepines, a group of anxiolytic, sedative, or tranquilizing drugs. The drugs in this class are subject to dependency and abuse, and most of them fall into schedule IV. Temazepam is marketed as Restoril, diazepam is commonly known as Valium, and clonazepam's common brand name is Klonopin.
Whenever anyone asks me about temazepam, I tell them, "It's just tuh-MAZING!" I make a similar exclamation with carb-AMAZE-uh-pine, a nonscheduled anticonvulsant agent.
|Which of these drugs is NOT a controlled substance?|
Oxytocin. Oxytocin is a naturally occurring hormone that can also be synthesized and manufactured as a drug. It is sometimes given to induce labor. Once, I was taking a bunch of boxes of oxytocin to the labor and delivery unit of my hospital. A security guard who was riding the elevator with me apparently misread the labels as "Oxycontin." He made some smart alecky comment about how he could take away my "really powerful drugs." I replied that he could have some, but only if he was sure he wanted to have his baby RIGHT NOW.
|What is the brand name for the drug combination isometheptine with dichloralphenazone and acetaminophen?|
Midrin. With a generic name like that, it's no wonder people just call it "Midrin." Similar to Fioricet, Midrin is a triple combination drug designed to combat migraine headaches. One ingredient combats pain, another constricts dilated blood vessels, and the third is a sedative. The sedatives are the controlled ingredients - dichloralphenazone for Midrin and butalbital in Fioricet.
Butorphanol is another controlled substance that treats migraines. For some reason no one ever finds it amusing when I ask if it's made from orphans, or if it could possibly be an orphan drug.
|Which of these drugs is a controlled substance?|
Neither. While both are general anesthetics, etomidate (Amidate) is a colorless injectable solution, and propofol (Diprivan) is a milky white injectable emulsion.
A pharmacist once told me that some people refer to etomidate as e-vomit-ate, because when its anesthetic effect wears off, the patient may experience nausea and vomiting.
|To what schedule does the anticonvulsant drug lacosamide (Vimpat) belong?|
Schedule V. Available as oral tablets and a solution for intravenous injection, Vimpat appeared on the market in 2009. Vimpat has proven useful in patients with refractory seizures (that is, seizures that are poorly controlled by other drugs or treatments).
I once gave a fellow technician a friendly *pat* on the back in appreciation of her expert handling of Vim*pat*.
|What is the generic name for the brand name drug Nucynta, a schedule II controlled substance?|
Tapentadol. All of the choices listed appeared on the market between 2008 and 2010. Nucynta combines the benefits of an opioid narcotic and a norepinephrine reuptake inhibitor to effectively treat moderate to severe pain.
For the other choices given: Dronedarone, in the same cardiac antiarrhythmic family as amiodarone, masquerades under the brand name Multaq. Prasugrel (Effient) is a relative of the highly advertised antiplatelet agent clopidogrel (Plavix). Armodafinil (Nuvigil) may sound like some kind of mutant armadillo-daffodil creature, but is actually a close relative of Cephalon's "wakefulness-promoting agent" modafinil (Provigil). Nuvigil and Provigil are both schedule IV controlled substances.
|Which of these ingredients usually appears as the active ingredient in paregoric, a schedule III controlled substance?|
Anhydrous morphine or camphorated tincture of opium. Paregoric, like its close relative laudanum, may seem like an outmoded drug, but it is still useful. Narcotics like morphine, codeine, and opium, are not just powerful painkillers; they are also excellent for treating coughs and diarrhea.
One of my fellow technicians recalled a time in the not-so-distant past when one could walk into a pharmacy and just buy a bottle of paregoric without a prescription. (The process was similar to how pseudoephedrine or certain schedule V codeine-containing cough syrups might be sold in some states today.) However, the DEA eventually decided that the risk of narcotic dependency for paregoric users was too great, and changed the drug's status to schedule III, available by prescription only.
|Which of these drugs is associated with the slang term "chicleting"?|
Fentanyl transdermal patch. The use of illegal drugs (as well as the use of prescription medications other than exactly as prescribed by a doctor) is VERY dangerous! Despite the dangers, drug abuse persists, and the drug culture has written a veritable dictionary of slang terms relating to their addictions.
Chicleting refers to the ridiculously reckless act of freezing a fentanyl transdermal patch and chewing / sucking on the medicated matrix within, similar to how one might enjoy chewing gum. Rohypnol tablets (not legally available in the U.S.) are called "roofies" in slang terminology, and the term "speedball" may be applied to the illegal combination of heroin and cocaine.
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