Locked medications, which ones?!

[dc529]

Hi guys,

I have one more semester before I graduate with my RN and am currently working as a LPN in a psychiatric facility. Anyways this is a dumb question about the lock box that we keep our narcotics in ie. Norco, Xanax, Ativan, Valium, etc. What medications are technically supposed to be kept in the lock box? This facility is old school and we use a med cart that has a separate drawer that has it's own lock that we keep these meds in. I am just curious is this a facility policy on which meds are locked in there or is it a certain law that says we have to lock certain ones?

Also, we have our PO Ativan in the locked narc drawer but the IM Ativan is in the refrigerator in its own box with a lock on it but I was told not to lock that one.. since it is the same medication shouldn't it be too?

I know this is a silly question but I appreciate the help! Thanks guys :)

[Fireman767]

Well those drugs you listed are all Controlled substances (class 3-5), none of those are narcotics. Narcotics are generally class 2, although certain places will call those narcotics. Anyway, mainly controlled substances are kept in lock boxes because they are benzodiazepines, and if overdosed can be a hazard to health (or deadly). If you want to know what would be in that lock box, just look for a list of class 2-5 controlled substances (anything from oxycodone, adderal, morphine, fentanyl to gabapentin, valium, diazepam) However the unit may or may not keep narcotic pain killers on the floor, but the class 2's you listed make sense as they are often used to reduce CNS synapse and promote sedation or relaxation.

In addition it may be the facility policy, however its common for controlled substances to be counted. if those medications go missing the DEA comes down pretty hard. as for the IM ativan, id ask the unit manager but if i was to guess it would be because it may be used in emergencies or its not a high risk because of the injection being neccessary and lack of access to the fridge (if its in the back of the facility)

[kbrn2002, ADN, RN]

Federal law under the DEA controlled substance act requires that controlled substances be locked up. There are also guidelines for inventory ie drug counting, these records must be retained for 2 years. The DEA guidelines are available on the web if you are curious and would like to learn more.