How to handle controlled substances and medication safely.
ASHP’s Guidelines on Perioperative Pharmacy Services, published in the June issue ofAmerican Journal of Health-System Pharmacy, were updated from the previous guidelines, published in 1991.
“It is really hard for pharmacists to have a presence in this area. It is such a unique environment; the whole medication-use process is very different for the operating room,” co-author Julie Golembiewski, PharmD, clinical associate professor at the University of Illinois at Chicago College of Pharmacy and clinical pharmacy at UI Health, tells Drug Topics.
Rewriting the guidelines was a multi-year project. “We really wanted to bring guidelines up to the 21st century,” Golembiewski says
The new guidelines include:
1. Controlled substance management and surveillance:
“ACPs (anesthesia care providers) are unique in that they obtain and administer addictive substances, on a daily basis, to patients undergoing anesthesia, in order to provide analgesia (opioids, ketamine); blunt the stress response to intubation and surgical stimulation (opioids); induce general anesthesia (methohexital); and provide sedation, amnesia, and anxiolysis (benzodiazepines),” the authors write. “Exposure and access to such addictive substances, familiarity with the pharmacology of these drugs, the relative ease of diverting small quantities for personal use, and a high-stress work environment are factors that contribute to substance use disorder (SUD) in ACPs.”
As with all controlled substances, anesthesia-controlled substances must be:
2. Medication safety strategies: