1. Administering Medications

2. DRUG LOG

3. System has been effective in reducing widespread diversion of these drugs into the illicit market. Controlled substances are classified into 5 classes according to their use or abuse potential Schedules I – V – Records must be kept for 2 years of received substances and outgoing substances

4. Where are they kept They must be in a securely locked substantially constructed cabinet or safe Must be in a DOUBLE locked container that can not be picked or moved. Usually access is limited to one or two people IF SUSBTANCES ARE LOST-it MUST be reported to the DEA AND LOCAL POLICE

5. Receiving Drugs You need to enter: – Date received – Invoice # – Supplier’s Name – Quantity Received in mL’s – Quantity on Hand in mL’s – Total Quantity Received & On Hand – Your initials +/- comments

6. Ketamine – Large Bottle Schedule III #3 #4 #5 #6

7. VTI HOUSTONPage # 12 4669 Southwest Freeway Houston, Tx 77027 KETAMINE 100mg/mL Drug Name / Concentration DateInvoice #Supplier Name & DEA #Quantity Received Quantity on HandTotal QuantityInitials 1/8/2010LTN976MWI2 bottles (20mLs)0.0 mLs20mLsKRW

8. A New Shipment Has Arrived You have just received 4 bottles of Ketamine 100mg/mL (10 mL vials) You need to log them into inventory before you can use them Invoice Number – KRO4861 You have a bottle currently in working stock: Bottle #2 has 4 mL’s

9. Placing Into Working Stock  Each bottle should be labeled with an individual number – (Easier) – Numerical Order  YOU SHOULD NEVER HAVE 2 BOTTLES IN WORKING STOCK AT THE SAME TIME  When you finish a bottle the end balance should be ‘0’  Then open next bottle  When you open a new bottle – You log:  Date opened  NEW BOTTLE # ____  Balance in Bottle  THEN ON THE NEXT LINE

10. LOGGING OUT DRUGS  YOU NEED TO ENTER: ◦ The date used ◦ Patient Name and Client Name ◦ Complete Address (clinic’s) ◦ Reason for selling, Dispensing, Administering, Disposal ◦ Amount Drawn up ◦ Balance Left in the Bottle ◦ Your Initials ◦ *** Each dose drawn up needs to be logged individually.***

11. Draw Up Drugs & Log Them You need to draw up ketamine for a patient: Remember your balance on hand from “receiving data” – should be logged “Frampton” owned by Jack Harris is coming in for a Mass Removal today, “Frampton” is needing 5.5 mL IV. Step 1 – Draw up remaining of previous balance & log

12. VTI HOUSTONPage # 11 4669 Southwest Freeway Houston, Tx 77027 KETAMINE 100mg/mL Drug Name / Concentration DatePatientReason for UsageAmount DrawnAmount RemainingInitials CONTINUE FROM PAGE 10 5.5 mLKRW 11/22/2009400NEUTER3.0 mL2.5 mLKRW 12/1/2009599OHE2.5 mLEMPTYKRW 12/5/2009 NEW BOTTLE # 2 10 mLKRW 12/8/2009698NEUTER4.0 mL6.0 mLKRW 12/22/2009100NEUTER2.0 mL4.0 mLKRW

13. VTI HOUSTONPage # 11 4669 Southwest Freeway Houston, Tx 77027 KETAMINE 100mg/mL Drug Name / Concentration DatePatientReason for UsageAmount DrawnAmount RemainingInitials CONTINUE FROM PAGE 10 5.5 mLKRW 11/22/2009400NEUTER3.0 mL2.5 mLKRW 12/1/2009599OHE2.5 mLEMPTYKRW 12/5/2009 NEW BOTTLE # 2 10 mLKRW 12/8/2009698NEUTER4.0 mL6.0 mLKRW 12/22/2009100NEUTER2.0 mL4.0 mLKRW 7/14/2010 Frampton, HarrisMass Removal4.0 mLEmptyKRW 7/14/2010 NEW BOTTLE # 3 10 mLKRW 7/14/2010 Frampton, Harris Mass Removal1.5 mL8.5 mLKRW

14. Buprinex – Small Bottle (1mL each) Schedule III # 20 #21 #22 # 23 #24 #25

15. There is no bottles of Buprenex open or available “Daffy” Jackson needs 1.2 mL of Buprenex for her OHE. “Muffy” Pickles needs 0.45 mL of Buprenex given in 5 doses for her post of Ear Flush pain medications.

16. BUPRINEX Drug Name / Concentration DatePatientReason for UsageAmount DrawnAmount RemainingInitials