Categories and requirements

Question 1

POM-V?

Answer 1

Prescription Only Medication
prescribed by a VS only
- but VNs and owners can administer

Pet needs to be checked

Very common in practice

• antibiotics
• anti-inflammatories
• steroids

Question 2

POM-VPS?

Answer 2

Prescription Only Medication
can be prescribed by a VS, Pharmacist or Suitably Qualified Person

don’t need to see animal
mainly includes large animal (and equine) wormers

Question 3

NFA-VPS?

Answer 3

Non-Food Animal
don’t need a prescription - but still need discussion
can be supplied by a VS, Pharmacist or a Suitably Qualified Person

mainly wormers/parasite treatments for cats and dogs

Question 4

AVM-GSL?

Answer 4

Authorised Veterinary Medicine
General Sales List
- can be supplied by any retailer
- so can pick up and buy - but may still require a discussion

have low therapeutic value with small amount of activating products
- eg medicated shampoos

Question 5

controlled drugs?

Answer 5

a drug with active ingredients and potential to be misued and abused

named in misuse of drugs regulations

all category POM-V
- but broken down into different schedules

Question 6

schedule I?

Answer 6

little or no therapeutic value
high potential to abuse/misuse
only used for research purposes in practice
- if have research license

eg illegal/recreational drugs

Question 7

schedule II?

Answer 7

most common in practice

high therapeutic value
high potential for misuse/abuse as highly addictive
use is strictly controlled

eg. methadone hydrochloride and ketamine hydrochloride

Question 8

schedule III?

Answer 8

high therapeutic value
high potential for abuse/misuse
not additive

eg buprenorphine hydrochloride

Question 9

schedule IV?

Answer 9

some therapeutic value
some potential for abuse/misuse

eg chorionic gonadotropin

Question 10

schedule V?

Answer 10

some therapeutic value
some potential for abuse/misuse

eg codeine phosphate

easy to get from pharmacies so less controlled

Question 11

Schedule II control measures?

Answer 11

kept in lockable cupboard 
prescription validity 28 days 
CD register required 
witness destruction needed
invoice should be kept for 2 years

Question 12

schedule III control measures?

Answer 12

kept in a lockable cupboard 
- with some exceptions 
prescription validity 28 days 
no CD register required
no witness protection required 
invoice should be kept for 2 years

Question 13

schedule IV control measures?

Answer 13

don't need to be in lockable cupboard 
prescription validity 28 days 
no CD register required
no witness destruction required 
invoice should be kept for 2 years +

Question 14

schedule V control measures?

Answer 14

do not need to be kept in lockable cupboard
prescription validity 6 months
no CD registration required
no witness destruction required
invoice should be kept for 2 years

Question 15

types of pharmaceutical waste disposal?

Answer 15

sharps bin

• yellow
• used needles
• syringes with fixed needles
• broken single use vials/ampules

cytotoxic

• purple
• cytotoxic or cytostatic medications
• including syringes, needles, bottles/vials and other consumables (eg PPE)

pharmaceutical waste bin

• multiuse medication bottles
• used syringes

Question 16

disposal of controlled drugs?

Answer 16

needles, syringes and empty vials can be disposed of in same way as other pharmaceuticals

out-of-date or unused controlled drugs need to be denatured

• identify drugs to be disposed
• empty into a denaturing kit
• placed denaturing kit into the pharmaceutical waste bin
• record disposal
• have witness sign CD register to authenticate disposal

witness must be:

• Police Office (CD Liaison Officer)
• inspector appointed under the VMR
• VS from another surgeon - must state they are independent and provide their RCVS number

wait until you have enough CDs to fill the kit
- store safely/correctly in mean time

Question 17

waste vs stock?

Answer 17

waste
- witnessed denaturing isn’t required
- a small amount of medication left in a single use vial
- dose of medication is drawn but not administered
- an unusable amount of medication left over in a multiuse vial
already accounted for and need to keep on track of correct stock levels

stock

• witnessed denaturing is required
• any out of date controlled drugs
• any multiuse vial that is beyond 28 day validity (not just CDs)

Question 18

temperature controlled storage? why?

Answer 18

all medication should be stored in accordance to their Summary of Product Characteristics (SPC)
pharmacy temperature should be between 8°C - 25°C
pharmacy fridge should be between 2°C - 8°C
environmental temperatures should be monitored and recorded daily

extreme temperatures can cause denaturing
pharmacies must store VMPs in most effective way
and always comply with the VMR

Question 19

stock rotation considerations?

Answer 19

Shortest end by date at front and longest at back

Done every time a new order is in

Everyone is responsible for stock rotation
- but may have allocated staff

Can have ethical and economic impacts if not done correctly

• large amounts of waste can damage environment
• increases costs - less for staff and other things
• decreases revenue
• may cause shortage of in-date drugs causing a welfare issue

Question 20

stock levels?

Answer 20

a minimum stock level should be set and maintained

ordering systems in practices can be either:
automated 
- quick
- stops human error 
manual 
- spot anomalies/incorrect data 
- human errors

Question 21

record keeping?

Answer 21

practices and wholesalers are required to keep records (invoices) for all drug transactions

wholesalers - 3 years
practices - 5 years

for VMD audit purposes
so need to be ready and available for the VMD to inspect

Question 22

record keeping of controlled drugs?

Answer 22

a register of use must be kept for all schedule II drugs

• in a bound book
• or specific computerised system
• kept for 2 years after the date of the last entry

every entry should include

• date
• name of patient
• batch number
• amount dispensed
• amount remaining
• signature of VS (VNs can sign on behalf)