CAPT Frank Chapman

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Ancillary ServicesChap. 8

• CAPT Frank Chapman
• SMO Course 2009

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Pharmacy

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Pharmacy

• Pharmacy AMAL - Formulary
• Current Supply System
• SRI and OSI Inventory Consolodation
• Controlled Drugs
• Deployment Maintenance Medications
• P-MART (Pre-Deployment Medication Analysis and
  Reporting Tool
• TMOP (Tricare Mail Order Pharmacy)
• OTC Program

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Pharmacy AMAL - Formulary

• NOV 2005 CVN Pharmacy AMAL Established
• Based on DoD Basic Core Formulary
• CNAF update 2008
• CNAF Formlary published
• Drug categories sorted for providers
• Description for Supply Petty Officers

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Shipboard Formulary

• Each ship expected to have published formulary.
  CNAF Formulary coming.
• OTCs
• sickcall screener
• IDC drugs
• Non-AMMAL drugs at discretion of SMO
• AMMAL change requests to TYCOM

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Current Supply System

• SRI
• OSI
• MED LOG Prime Vendor
• Problems
• Changing NSNs
• Flow through OSI to SRI
• Expired Meds
• Budget Variation

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Deployment

• Maintenance Medications
• P-MART (Pre-Deployment Medication Analysis and
  Reporting Tool
• TMOP (Tricare Mail Order Pharmacy)

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CNAF Health Services Suppply

• Supply Single inventory
• Buy Out SRI Singles store room
• OSI Levels - dynamic with phase of operations
• Sks restocking medical nightly with 7 days
  supplies

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Lincoln Experiment

• Defense Logistics Agency Prime Vendor
• Procurement
• Website for Ship
• Direct ordering on Website
• R supply entry to obligate funds
• Guaranteed Returns Program direct credit to
  ships account
• (10,000s returns already fall 2005)

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Controlled Substances

• Responsibility
• Each ship must maintain detailed records
• Purpose is to affix accountability for receipt,
  custody, transfer, survey, dispensing, loss, and
  to prevent unauthorized use of controlled
  medicinals
• Senior Medical Officer is responsible for
  requisitioning, dispensing, survey, loss and
  procedures pertaining to usage of all controlled
  medicinals

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Definition

• Alcohol, barbiturates, hypnotics, stimulants,
  narcotics, and other substances requiring special
  custodial care are collectively called controlled
  substances.

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Controlled Substances

• Controlled Substance Custodian (Bulk)
• Must be an Officer assigned in writing - MAO
• Can not be a Medical or Dental Officer with
  prescribing authority
• Can not be a Supply Corps Officer
• Only Controlled Substance Custodian (Bulk) or SMO
  is authorized to sign for receipt of controlled
  medicinals arriving on board
• Controlled Substance Custodian (Working Stock)
• Pharmacy Technician is normally the custodian of
  the working stock

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Controlled Substances

• Controlled Substances Inventory Board
• appointed in writing by CO
• 2 of 3 members must be officers
• third member other than HM or DT may be senior
  enlisted in pay grade E-8 or E-9
• Inventory
• Quarterly, and monthly if issued per MANMED
  Chapter 21
• conducted upon change of Bulk Custodian or
  Pharmacy Technician

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Controlled Substances

• Security
• Limit access
• Usually have safes for bulk stores, breakout
  lockers, ward stock
• Safe combinations changed upon personnel
  transfer, new custodian, compromise of
  combination or at least yearly

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Controlled Substances

• Dispersal of Controlled Meds
• Planning for combat / mass casualty dispersal of
  narcotics from bulk stores to BDS important
• Narcotic analgesics for aircrew survival kits ..?

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Controlled Substances

• Controlled Substances Surveillance Program
• NAVMEDLOGCOM monitors controlled med orders
• Non-AMMAL controlled meds require TYCOM approval
• Narcotic Paraphernalia
• includes needles and syringes
• must be destroyed after use or upon disposal
• must be kept under lock and key

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Prescription Policies

• Use DOD Single and Multiscript pads
• No controlled substances on Multiscript
• Must contain printed name and signature of
  provider (SSN for controlled meds)
• Must be serially numbered per CNAF 6000.1
• Record of Prescriptions
• Do not countersign, rewrite, or refill civilian
  prescriptions
• All dispensed drugs (including OTCs) must be
  properly labeled
• Maximum quantity is 90 day supply (7 days for
  controlled meds)

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Disposal of Medicinals

• Nothing goes over the side
• Pharmacy shall maintain a Survey/ Destruction Log
  for non-controlled substances
• Check local / state regulations in port
• Controlled Substances destroyed in accordance
  with MANMED Ch. 21

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CBR Drugs

• Separate location under lock and key
• Must be tracked in the SLEP program for shelf
  life extension through CNAF
• Suppo custodian under lock and key

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CBR Drugs

• Should be evenly distributed to each BDS
• Subject to quarterly BDS inventory
• Store in locked cabinet or PML not accessible to
  all hands
• Monthly inventory not required

Questions?