NU 578
Unit 2 Study Guide
Key Concepts & Exam Review
University of South Alabama.
This document provides a focused
study guide
It summarizes key concepts, lecture highlights, and
exam-relevant material to support efficient last-
minute review. The guide is structured to help students reinforce
understanding, identify weak areas, and prepare confidently for
the assessment.
, CH 30 pg 305
Controlled substances—what are the schedules and how are they set? For instance, is a
CS2 drug more or less addicting than a CS3 drug? Chart pg 306
Schedule I- Have a high potential for abuse and no approved medical use in the US. Have no approved
use and are not prescribed. Ex heroin
Schedule II-V all have approved applications. Drugs with increased abuse and dependence liability,
the DEA may choose to reassign it to a different Schedule. Ex. Hydrocodone (the opiate in Vicodin)
was recently switched from Schedule III to Schedule II.
The CSA places restrictions of prescribing drugs Schedules II-V. only prescribers registered with the
DEA are authorized to prescribe controlled drugs.
Schedule II-have the highest potential for abuse and dependence. All prescriptions must be typed or
filled out in ink or indelible pencil and signed by the prescriber. Prescribers may submit a prescription
using an electronic prescribing procedure. Oral prescriptions may be called in, but only in
emergencies and a written prescription must follow in 72 hours. Prescriptions for Schedule II drugs
cannot be refilled. However, a DEA rule issued in 2007 now allows a prescriber to writer multiple
prescriptions on the same day, for the same patient and same drug to be filled sequentially for up to
90 day supply. Must be: written in ink, dated the same day as signed, no refills, DEA number.
Schedule III-IV prescriptions for drugs III-IV may be oral, written, or electronic. If authorized by the
prescriber, these prescriptions may be refilled up to 5 times. Refills must be made within 6 months of
the original order. If additional medication is needed beyond the amount provided for in the original
prescription, a new prescription must be written.
Schedule V – If authorized by the prescriber, these prescriptions may be refilled up to 5 times. Refills
must be made within 6 months of the original order same as prescribing for III and IV. In addition,
Schedule V drugs may be dispended without a prescription provided the following conditions are
met: the drug is dispensed by a pharmacist, the amount dispensed is very limited, the recipient is at
least 18 years old. The pharmacist writes and initials a record indicating the date, name and
amount of the drug, and the name and address of the recipient and state. Local laws do not prohibit
dispensing Schedule V drugs without a prescription.
, Controlled Substances
Controlled substances: any drug use controlled by the federal government.
1. Opiates
2. Sedatives
3. Stimulants
4. GI drugs (antidiarrheals and wt loss drugs)
5. Anabolic hormones
Controlled Substance Act (CSA) and DEA
The DEA regulates every step of controlled substances from manufacture to dispensing
The goal is to prevent diversion from legitimate use
States may require more stringent regulations than the controlled substance act mandates (no state
may place something lower in the schedule than the Feds have)
Federal law govering the issuance and filling of prescriptions can be found in the Code of Federal
Regulations, Title 21, Section 1306 and the United States code (USC)-controlled Substances Act, Title
21 Section 829
Orders for controlled substances
Orders must be issued for legitimate medical purposes
By a practitioner in the usual course of his/her professional practice
Not for self-use (even if this is not mandated by law)
, Chapter 22 Opioids analgesic, opioid antagonists, and nonopioid centrally acting
analgesics pg 203
Opioids-is any drug, natural or synthetic, that has actions similar to those of morphine. Opiate is
more specific and applies only to compounds present in opium (morphine, codeine).
Opioids receptors: mu, kappa, delta. Opioid analgesics act primarily by activating mu
receptors, also produce weak activation of kappa receptors. Opioid analgesics do not react with
delta receptors. Opioid analgesics, endogenous opioid peptides act through all three opioid
receptors, including delta.
Mu receptors responses includes: analgesia, respiratory depression, euphoria physical
dependence, decreased GI motility (constipation) and sedation.
Kappa receptors produces analgesia, deceased GI motility (constipation) and sedation. In
addition, may cause psychotomimetic effects seen with certain opioids.
Pure opioid agonists activate mu receptors and kappa receptors. May produce: analgesia,
euphoria, sedation, respiratory depression, physical dependence, constipation and other
effects. 2 groups: strong opioid agonists (morphine) and moderate to strong opioid agonist
(codeine).
Agonist -Antagonist Opioids or partial agonists- available in oral (PO) form: pentazocine,
butorphanol and buprenorphine. When administered alone, they produce analgesia.
However, if given to a patient who is taking a pure opioid agonist, these drugs can antagonize
analgesia cause by the pure agonists. Can cause withdrawal in the opiate user.
Pure Opioid Antagonists- antagonists at the mu and kappa receptors. Do not produce analgesia
or any other effects caused by opioid agonists. Their principal is to reverse respiratory and CNS
depression caused by overdose with opioid agonist. Methylnatrexone treats opioid-induced
constipation. Naloxone (Narcan) is used to reverse pure opioid agonists/overdose.
Unit 2 Study Guide
Key Concepts & Exam Review
University of South Alabama.
This document provides a focused
study guide
It summarizes key concepts, lecture highlights, and
exam-relevant material to support efficient last-
minute review. The guide is structured to help students reinforce
understanding, identify weak areas, and prepare confidently for
the assessment.
, CH 30 pg 305
Controlled substances—what are the schedules and how are they set? For instance, is a
CS2 drug more or less addicting than a CS3 drug? Chart pg 306
Schedule I- Have a high potential for abuse and no approved medical use in the US. Have no approved
use and are not prescribed. Ex heroin
Schedule II-V all have approved applications. Drugs with increased abuse and dependence liability,
the DEA may choose to reassign it to a different Schedule. Ex. Hydrocodone (the opiate in Vicodin)
was recently switched from Schedule III to Schedule II.
The CSA places restrictions of prescribing drugs Schedules II-V. only prescribers registered with the
DEA are authorized to prescribe controlled drugs.
Schedule II-have the highest potential for abuse and dependence. All prescriptions must be typed or
filled out in ink or indelible pencil and signed by the prescriber. Prescribers may submit a prescription
using an electronic prescribing procedure. Oral prescriptions may be called in, but only in
emergencies and a written prescription must follow in 72 hours. Prescriptions for Schedule II drugs
cannot be refilled. However, a DEA rule issued in 2007 now allows a prescriber to writer multiple
prescriptions on the same day, for the same patient and same drug to be filled sequentially for up to
90 day supply. Must be: written in ink, dated the same day as signed, no refills, DEA number.
Schedule III-IV prescriptions for drugs III-IV may be oral, written, or electronic. If authorized by the
prescriber, these prescriptions may be refilled up to 5 times. Refills must be made within 6 months of
the original order. If additional medication is needed beyond the amount provided for in the original
prescription, a new prescription must be written.
Schedule V – If authorized by the prescriber, these prescriptions may be refilled up to 5 times. Refills
must be made within 6 months of the original order same as prescribing for III and IV. In addition,
Schedule V drugs may be dispended without a prescription provided the following conditions are
met: the drug is dispensed by a pharmacist, the amount dispensed is very limited, the recipient is at
least 18 years old. The pharmacist writes and initials a record indicating the date, name and
amount of the drug, and the name and address of the recipient and state. Local laws do not prohibit
dispensing Schedule V drugs without a prescription.
, Controlled Substances
Controlled substances: any drug use controlled by the federal government.
1. Opiates
2. Sedatives
3. Stimulants
4. GI drugs (antidiarrheals and wt loss drugs)
5. Anabolic hormones
Controlled Substance Act (CSA) and DEA
The DEA regulates every step of controlled substances from manufacture to dispensing
The goal is to prevent diversion from legitimate use
States may require more stringent regulations than the controlled substance act mandates (no state
may place something lower in the schedule than the Feds have)
Federal law govering the issuance and filling of prescriptions can be found in the Code of Federal
Regulations, Title 21, Section 1306 and the United States code (USC)-controlled Substances Act, Title
21 Section 829
Orders for controlled substances
Orders must be issued for legitimate medical purposes
By a practitioner in the usual course of his/her professional practice
Not for self-use (even if this is not mandated by law)
, Chapter 22 Opioids analgesic, opioid antagonists, and nonopioid centrally acting
analgesics pg 203
Opioids-is any drug, natural or synthetic, that has actions similar to those of morphine. Opiate is
more specific and applies only to compounds present in opium (morphine, codeine).
Opioids receptors: mu, kappa, delta. Opioid analgesics act primarily by activating mu
receptors, also produce weak activation of kappa receptors. Opioid analgesics do not react with
delta receptors. Opioid analgesics, endogenous opioid peptides act through all three opioid
receptors, including delta.
Mu receptors responses includes: analgesia, respiratory depression, euphoria physical
dependence, decreased GI motility (constipation) and sedation.
Kappa receptors produces analgesia, deceased GI motility (constipation) and sedation. In
addition, may cause psychotomimetic effects seen with certain opioids.
Pure opioid agonists activate mu receptors and kappa receptors. May produce: analgesia,
euphoria, sedation, respiratory depression, physical dependence, constipation and other
effects. 2 groups: strong opioid agonists (morphine) and moderate to strong opioid agonist
(codeine).
Agonist -Antagonist Opioids or partial agonists- available in oral (PO) form: pentazocine,
butorphanol and buprenorphine. When administered alone, they produce analgesia.
However, if given to a patient who is taking a pure opioid agonist, these drugs can antagonize
analgesia cause by the pure agonists. Can cause withdrawal in the opiate user.
Pure Opioid Antagonists- antagonists at the mu and kappa receptors. Do not produce analgesia
or any other effects caused by opioid agonists. Their principal is to reverse respiratory and CNS
depression caused by overdose with opioid agonist. Methylnatrexone treats opioid-induced
constipation. Naloxone (Narcan) is used to reverse pure opioid agonists/overdose.
