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Pharmacy Law > 4: POMs 2 (TBL) > Flashcards

4: POMs 2 (TBL) Flashcards

1
Q

When dentists prescribe under the NHS, are there any restrictions?

A

-restricted to those drugs contained in:

“List of Dental Prepartations” in the Dental Practitioners Formulary (DPF)

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2
Q

Green Rx is

A 
FP10NC 
used by
-GP
-Community Nurse Prescribers
-IPs 
-SPs
-Hospital units
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3
Q

Blue Rx is

A

-FP10MDA
-Instalment dispensing Rx form
used by:
-GPs
-IPs
-SPs
-Hospital units

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4
Q

Lilac Rx

A

FP10P
used by
-Community Practitioner Nurse Prescribers
-Nurse independent/supplementary prescribers

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5
Q

Yellow Rx

A

FP10D
used by
-Dentists in primary care
-only items listed in DPF can be prescribed on this Rx

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6
Q

Is a fax a valid prescription? Why?

A

No it is not
Because:
-It is not written in indelible ink
-it has not been signed by an appropriate practitioner

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7
Q

What risks are associated with supplying medicines under faxed prescriptions?

A

1) Uncertainty that the supply has been made in accordance with a legally valid prescription
2) Risks of poor reproduction
3) Risks of non-receipt of the original prescription and therefore inability to demonstrate that a supply has been made in accordance with a prescription
4) Risks that the original prescription is subsequently amended by the prescriber, in which case the supply will not have been made in accordance with the prescription
5) Risks the “fax” being sent to multiple pharmacies and duplicate supplies are made
6. Risks that the prescription is not genuine
7. Risk that the system of sending and receiving the fax is not secure

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8
Q

Checklist to detect forged prescriptions

A
  • Large or excessive quantity and are these appropriate for medicine and condition treated?
  • Prescriber known to pharmacy? Uncharacteristic prescribing or method of writing by known doctor?
  • Patient known?
  • Title “Dr” inserted before or after signature?
  • behaviour of patients indicative? e.g. nervous, agitated, aggressive etc
  • medicine known to be commonly misused?
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9
Q

If you suspect a prescription is forged, what are 3 appropriate actions to take?

A

1) Scrutinise the signature carefully, compare to a known genuine Rx from the same prescriber
2) Confirm details with prescriber and their intention
3) Use contact details of prescriber obtained from source other than the suspicious prescription (e.g. Directory enquiries)

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10
Q

When is an electronic prescription valid?

A
  • created in electronic form
  • signed with an advanced electronic signature
  • send to the person dispensing it as an electronic communication
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11
Q

What is an advanced electronic signature?

A

-uniquely linked to the prescriber giving the Rx
-capable of identifying Rxer
-created using means that Rx-er can maintain under sole control
-linked so that any subsequent change is detectable
=any later change is identifiable

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12
Q

Advantages of electronic prescription service?

A

Makes prescribing and dispensing process more efficient and convenient for patients and staff

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13
Q

What does PSD stand for?

A

Patient-specific direction

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14
Q

POM supply in hospitals is often under a..

A

Patient-specific direction

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15
Q

Describe how PSDs work

A

Patient specific directions work against a written direction (PSD) of a prescriber, instead of a prescription

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16
Q

Are the requirements specified for prescriptions required for PSDs?

A

No, but any “written direction to supply” must be::

  • patient specific
  • given by appropriate practitioner
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17
Q

What does a PSD permit?

A

Sale or supply against a patient’s bed card (drug kardex) or in patient notes
=directions to administer

18
Q

For POM administration in hospital, do directions need to be in writing?

A

No, but it is good practice to do so

19
Q

Do hospitals formulate policies for administration of POM without written direction? If so, when?

A

Some hospitals do

  • emergency - requiring 2 nurses checking one anoter
  • routine administration of POMs (and P and GSL) should be carefully considered and agreed
20
Q

If in hospital, can POMs be administered without being in writing?

A

Yes, in emergency situations, requires 2 nurses checking one another

21
Q

Do records need to be made for sale/supply of NHS prescriptions?

A

No

22
Q

Do records need to be made for sale/supply of oral contraceptives?

A

No

23
Q

Do records need to be made for POMs by way of wholesale dealing?

A

No but must retain order/invoice relating to sale for 2 years

24
Q

Do records need to be made for private POMs?

A

Yes - in the POM book

25
Q

Do records need to be made for CD POMs in the POM register if a record has been made in the CD register?

A

No. CD register alone is fine.

26
Q

Can records for POMs be computerised in the pharmacy?

A

Yes, written or computerised records are fine

27
Q

Records in the POM register must be made when?

A

On the day of sale or supply
OR
if that day is not reasonably practical, on the day following that day

28
Q

How long must POM register records be kept?

A

2 years after relevant date

29
Q

Are POM records legally required records?

A

Yes, when they are needed

30
Q

What needs to go on POM records?

A
  • Date of supply or sale
  • Date on prescription
  • Medicine detail (name of medicine, quantity, pharmaceutical form, strength)
  • Name of prescriber
  • Address of prescriber
  • Name of patient
  • Address of patient
31
Q

How long do POM prescriptions need to be kept?

A
  • retained for 2 years from the date on which the POM was supplied or sold
  • or in the case of a repeatable prescription, the date on which the last supply was made
32
Q

When do prescriptions not have to be retained in the pharmacy for 2 years?

A
  • NHS prescriptions - sent off for pricing
  • Private Rx for CD Schedules 2 and 3 - send off
  • Note: this exemption does NOT apply to Rx for oral contraceptives
33
Q

What do labels for dispensed medicines have to contain?

A
  • Name of patient
  • Name and address of supplying pharmacy
  • Date of dispensing
  • Name of medicine
  • Directions for use
  • Precautions related to use of product
  • “Keep out of the sight and reach of children”
  • “Use this medicine only on your skin” if applicable
  • May contain (not have to) price for product, statement about how cost of product is met (taxpayers)
34
Q

for normal POMs, what changes are pharmacists allowed to make?

A

(Optimisations of medicines use)

  • Name of product or its common name
  • directions for use of the product
  • precautions relating to use
  • dose or duration for which medicine is taken (but keeping within overall ceiling of dosage or timeframe originall prescribed)
  • No need to attempt to contact Rx-er
35
Q

When can a pharmacist amend regular POMs, what does the pharmacist need to think?

A

-thinks that any detail is inappropriate
-may change and include as thinks is appropriate
NB. No requirement to contact Rx-er

36
Q

Where should labels go?

A

-legally acceptable to label outer packaging rather than actual container
BUT note that the outer container may be discarded by the patient and the labelling information could be lost

37
Q

What is the labelling guidance like for assembled medicines?

A

Includes medicines assembled by breaking down large packs/bulk containers into smaller quantities for use in dispensing

  • these can now be supplied from a different ‘legal entity’, provided both the premises at which the product is dispensed and the premises at which the product is supplied are registered pharmacies
  • all such assembled medicines must be relabelled before being supplied to a patient as a dispensed medicinal product
38
Q

What do labels of assembled medicines require?

A

Label must contain:

  • Name of medicine
  • Quantity of medicine in the container (i.e. ingredients, e.g. 10ml)
  • Quantitative particulars of the medicine (i.e. the ingredients, e.g. 2mg/ml)
  • handling and storage requirements
  • expiry date
  • batch reference number (e.g. LOT number or BN number)
39
Q

What is the guidance on use before dates?

A

if ‘use by’ or ‘use before’

-product should be used before the end of the PREVIOUS month

40
Q

What is the MHRA guidance on expiry dates? If the expiry date is 12/2017, when can the product not be used?

A

Product should not be used after 31 December 2017

Pharmacy Law (3 decks)

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