An occasional feature, prepared in the Royal Pharmaceutical Society's Professional Standards Directorate, to highlight problems and inquiries currently being handled
The following is an amended version of the notice that appeared in last week's issue (p798) in which the use of bleach was advocated. Following advice from a company dealing with pharmaceutical waste, the advice to use bleach when denaturing Controlled Drugs has now been revised. It is now recommended that hot, soapy water is used when destroying solid dose and parenteral formulations. Problems can arise if bleach is used in pharmaceutical waste as residual bleach mixes with chemicals used to clean bins if they are to be recycled and toxic fumes can be produced as a result.
Pharmacists are reminded that they may destroy patient-returned Controlled Drugs without an authorised witness. Pharmacists are strongly advised to destroy returned CDs regularly to avoid quantities building up in the Controlled Drugs cupboard.
Problems may arise when a Controlled Drug is not denatured effectively before disposal. Therefore the procedure detailed below should be followed to ensure the CD has been rendered irretrievable before disposal. Although not a legal requirement, it is good practice to document the destruction and to require a member of staff to witness it. The record of destruction should be made somewhere other than the CD register - for example, at the back of the prescription register.
Liquid dose formulations Liquid dose formulations should be added to, and absorbed by, an appropriate amount of cat litter, or similar product.
Solid dose formulations Solid dose formulations should be crushed and placed into a small amount of hot, soapy water. The resultant mixture should be stirred to ensure that the drug has been dissolved or dispersed.
Parenteral formulations Ampoules should be crushed with a pestle inside an empty plastic container. After ensuring that all ampoules are broken, a small quantity of hot, soapy water or cat litter should be added.
Fentanyl patches The active ingredient in Fentanyl patches can be rendered irretrievable by removing the backing and folding the patch over upon itself.
Once the above procedure has been carried out, the resultant mixture should be added to the general pharmaceutical waste. It is advisable, therefore, to keep the liquid content to a minimum. Out-of-date stocks of CDs should not be destroyed in this manner without an authorised witness.