Medical Office Pharmacology: Review For Medical Assistant Students and Professionals
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Disposal of Medications
For medical assistants who need to brush up on certain areas in pharmacology as it applies to a medical office.
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Disposal of Medications

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 Disposal of Medications...
The need for trained medical assistants remains at an all-time high! At any given moment thousands of job offers for medical assistants and other healthcare professionals open and close! Most require knowledge of certain medical office procedures and basic principles of pharmacology.

Medications Down the Drain?
Medical offices not only prescribe and dispense medications, they also must dispose of expired medication in a manner that's safe for people and the environment, and complies with the law. There are no laws that forbid putting medications in the trash if they are not considered hazardous waste. Usually pharmaceuticals that are likely to be considered hazardous waste are those prescribed for cancer chemotherapy.

In response to a growing concern about the improper disposal of unused or expired medications and the recent media coverage about medication misuse, not every medical office is sure what the proper procedures of pharmaceutical disposal are. Medications are still flushed down the sink, or toilet,  thrown into the trash, dumped into the sharps container, or sent back with the pharmacy drug reps.

Medical assistant takes notes!Consider the following:
As a trained healthcare professional you should make a conscious effort to find out what the proper procedures are to dispose of expired or excess medications.

Discard Medications Responsibly!
One person came up with an incredibly clever solution: "Pack them all up and donate them to the poor". Yeah, great! Let's all remember this for next time... (not!).  It goes to show that many medical assistants and medical office managers do not know the proper procedures of what to do with their expired medications.

The FDA advises that the following drugs can be flushed down the toilet:
Actiq (fentanyl citrate)
Daytrana Transdermal Patch (methylphenidate)
Duragesic Transdermal System (fentanyl)
OxyContin Tablets (oxycodone)
Avinza Capsules (morphine sulfate)
Baraclude Tablets (entecavir)
Reyataz Capsules (atazanavir sulfate)
Tequin Tablets (gatifloxacin)
Zerit for Oral Solution (stavudine)
Meperidine HCl Tablets
Percocet (Oxycodone and Acetaminophen)
Xyrem (Sodium Oxybate)
Fentora (fentanyl buccal tablet)

Note: always refer to printed material accompanying their medication for specific instructions.

  Ponder this:
1. When you  decide to just give your expired medication samples back to the drug rep, can you imagine what he/she might be thinking? If you are lucky, they will take them, but obviously, they didn't come by the medical office for THAT. Their job is to drop off more samples, in hopes the doctor will give them out before they expire. Now they are stuck with the old samples.

2. When prescription or over-the-counter drugs are thrown into the garbage, or flushed down the sink or toilet, their chemical components may be added to the water supply or soil. Can you imagine what will happen to fish and wildlife on antibiotics, steroids, antihistamines, and anti-inflammatories? Not so good! Eventually this will come back around to affect people.

3. It is against the law to discard controlled substances in the regular trash, and it is against HIPAA and privacy rules, to simply discard medication bottles into the trash with patient information labels still attached to them.

4. Medications fallen into the wrong hands can be a potential hazard (out of the trash).

5. With so little answers, I am not so sure, whether it is 'flat out' illegal to throw other medications into the garbage, or down the drain, especially at home in the household trash.

6. Common controlled substances include codeine, phenobarbitol, and anabolic steroids. It is illegal for household hazardous waste centers to accept certain prescription medications known as "controlled substances". These are drugs that have a potential for addiction and/or abuse such as narcotics and tranquilizers.

  What You Can Do:
If you don't know if a medication falls under the controlled substances, check with your doctor or pharmacist. If they tell you that it is a controlled substance, dispose of it as such.
Ask the medical drug rep next time you see them what you should do with their expired medications.
Check to see if your pharmacy has a drug recycling program that disposes of unused or expired drugs in an environmentally safe manner. Most pharmacies do and programs to incinerate unused drugs
Find out if there are community pharmaceutical take-back programs that allow the public to bring unused drugs to a central location for proper disposal. Some communities have pharmaceutical take-back programs or community solid-waste programs that allow the public to bring unused drugs to a central location for proper disposal. Where these exist, they are a good way to dispose of unused pharmaceuticals.
Call your City Hall and speak to the waste management department. Ask whether their hazardous waste collection station accepts medications. Some have hazardous waste drop-off only once a year, where people can bring their medications along with their old paint cans, motor oil, and such. Explain your situation and ask for their recommendations.
Prevent excess medications by advising patients to take drugs as directed by the doctor or pharmacist, and don't allow pharmacy reps to overstock your medication closet with unnecessary, or unneeded medication samples.

California law mandates that medications are disposed of in special containers that resemble sharps containers, except they have a blue lid and they are destroyed in a specific way for medications.

Illinois EPA created a fact sheet on disposal

Attention! Remember: mercury fever thermometers are also considered hazardous waste.


To report illegal prescription drug sales and/or rogue pharmacies operating on the Internet call the anonymous Pharmaceutical Drug Abuse Hotline: 1-877-RxAbuse (1-877-792-2873).
More info at: DEA Website
Buying drugs online may be illegal!
Federal law prohibits buying controlled substances such as narcotic pain relievers (e.g., OxyContin®, Vicodin ®), sedatives (e.g., Valium®, Xanax®, Ambien®), stimulants (e.g., phentermine, phendimetrazine, Adderall®, Ritalin®) and anabolic steroids (e.g., Winstrol®, Equipoise®) without a valid prescription from a doctor. This means there must be a bonafide doctor-patient relationship, which by most state laws requires a physical examination to receive a prescription. Prescriptions written by "cyber doctors" relying on online questionnaires are not legitimate under the law.

Buying controlled substances online without a valid prescription may be punishable by imprisonment under Federal law and it is a felony to import drugs into the United States and ship to a non-DEA registrant.

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