3: POMs Flashcards
Define a POM
A medicinal product which only may be sold/supplied by retail in accordance with a prescription give by an appropriate practioner
Appropriate prescribers for Rx POMs (5)
- Doctors
- Dentist
- Supplementary prescriber
- Nurse independent prescriber
- Pharmacist independent prescriber
Name 7 types of independent prescriber
- Pharmacist
- Nurse
- Optometrist
- Physiotherapist
- Podiatrist
- Therapeutic radiographer
- Community practioner nurse
What are the limitations on prescribing for optometrist IPs?
They can prescribe -any POM BUT -not CDs -not partenterals
What are the limitations on prescribing for chiropodist IPs?
Any POM,not CDs, no parenterals other than:
- diazepam (oral)
- dihydrocodeine (oral)
- lorazepam (oral)
- Tamezepam (oral)
What are the limitations on prescribing for physiotherapist IPs?
Any POM, no CDs or parenterals apart from:
- diazepam (oral)
- dihydrocodeine (oral)
- fentanyl (transdermal)
- lorezepam (oral)
- morphine (oral or injection)
- oxycodone (oral)
- temazepam (oral)
What are the limitations on prescribing for therapeutic radiographer IPs?
POMs but not CDs, other than:
- codeine
- fentanyl
- midazolam
- morphine
- temazepam
- tramadol
What can community practioner nurses prescribe?
What is the NPF?
Certain POMs
NPF= Nurse prescribers’ formulary
-co-danthramer (capsules, oral suspension)
-co-danthrusate (capsules, oral suspension)
-mebendazole (tablets, oral suspension)
-miconazole (oral gel)
-Nystatin (oral suspension, pastilles)
-streptokinase and streptodornase topical powder
-water for injections
What is supplementary prescribing?
the voluntary prescribing partnership betweeen an independent prescriber and a supplementary prescriber, to implement an agreed patient-specific clinical management plan with the patient’s agreement
Name 8 supplementary prescriber types
- pharmacist
- registered midwife
- registered nurse
- chiropodist
- physiotherapist
- radiographer
- registered optometrist
- registered dietician
What is the criteria for lawful supplementary prescribing?
- Independent prescriber (IP) must be a doctor or a dentist
- there must be a written clinical management plan for a NAMED patient, specific to that patient’s conditions
- Arrangement to plan must be RECORDED by: patient, IP and SP
- IP and SP must share access to, consult and use SAME common patient record
For supplementary prescribing, what must a clinical management plan contain?
a) name of patient
b) illnesses/conditions that may be treated by SP
c) date on which plan takes effect and when to be reviewed by the doctor or dentist
d) reference to class or description of medicinal product which may be prescribed/administered
e) any restrictions or limitations, re medicinal product strength/dose of any product, period of warning or use
f) relevant warnings (sensitivities of patient) or known difficulties of patient
g) arrangements for notification of suspected or known ADRs
h) circumstances in which SP should refer to, or seek advice of IP
Is there a formulary or list or medicines or supplementary prescribing?
No
Medicines which may be included in a clinical mangement plan for SP
- all GSL and P, appliances and devices and other borderline substances
- all POM, including parenteral
- medicines for use outside their licensed indictions (off label prescribing)
- unlicensed drugs as part of a recognised clincal trial
What is a EEA health professional?
=a person in a relevant European State who is... -doctor of medicine -nurse responsible for general care -dental practioner -midwife -pharmacist =registered to practise in EEA country or Switzerland --> legally valid in the UK -not permitted to prescribe CD Sch1-3
What can an EEA professional NOT prescribe?
CD Schedules 1-3
How do you check the registration of EEA/Swiss health professionals?
GMC
GDC
Nurse and midwifery council (nurses only)
What is the NHS prescription charge? Where in the UK is it applicable?
-Rx-charge in England only
£8.40
Who pays for a private prescription?
- patient pays full cost (drug and dispensing fee)
- may get reimbursed if have private medical insurance
Prescription requirements for POM
1 - be signed in INK by the appropriate practioner
2 - be written in ink or otherwise so as to be indelible
3. includes typewritten & advanced electronic prescriptions
4. particulars of prescriber
5. Name of patient
6. Address of patient
7. Age of patient (if under 12 years old)
What is the date requirement on NHS Rxs?
Shall not be dispensed after the end of the period of 6 months from the appropriate date
Define appropriate date
-date on which signed
or
-date indiciated by prescriber as date before which it shall not be dispensed
-If Rx for Sch2,3,4 CDs then 28 days
Define the appropriate date length for CD Schedules 2,3,4
28 days
Define the appropriate date length for CD schedule 5
same as POM
6 months
What is a repeatable Rx?
Rx that contains a direction that it may be dispensed more than once
-not permitted under NHS
Can NHS prescriptions be repeatable?
No, only private ones can
Repeatable Rx rules for dispensing
- for the first time must be within 6 months from appropriate date
- if doesn’t specify the number of times it may be dispensed then…
1) it shall not be repeated on more than one occasion UNLESS the Rx is for oral contraceptives. It may be dispensed 6 times (repeated 5 times) - if sch4 CD - 28 days
Are prescriptions for sch2 and 3 CDs repeatable?
No
Are prescriptions for sch3 and 4 CDs repeatable?
Yes
What are the Rx requirements for Rx’s issued in the EEA or Switzerland?
- Patient full names
- Patient DOB
- Prescriber full names
- Prescriber professional qualifcations
- Prescriber direct contant details (including email address AND telephone/fax number WITH international prefix, work address (including the country they work in)
- Prescribed medicine details name (brand name where appropriate), pharmaceutical form, quantity, strength and dosage details
- prescriber signature
- date of issue
How long is a Rx from the EEA or Switzerland valid for, if dispensed in UK?
Same as UK issued
6 months unless CD 2,3,4 in which case it is valid for 28 days
Are Norway and Iceland in the EEA?
Yes
Is an Rx still valid if it is a Swiss/EEA Rx written in foreign lanuage?
Yes, provided:
-pharmacist has enough information to enable safe supply
AND
-Rx is compliant with legal requirements
