CD: Supply Flashcards
What are the prescription requirements for a schedule 2 or 3 CD?
- Signed by person issuing it w/ usual signature
- Dated
- Writing is indelible
- Address of person issuing
- Specify dose taken (take one as directed)
- Specify form
- Specify strength
- Total quantity/dose in words + figures
- If by dentists: ‘For dental treatment only’
- Specify name + address of patient
Schedule 2 or 3 CDs must not be supplied on a prescription…
- Unless it complies w/ requirements
- Unless prescriber address is w/in UK
- Before date on prescription
- Later than 28 days from date
Although it is not a legal requirement, how many days supply of schedule 2, 3 and 4 CDs are considered good practice?
30 days supply
When dispensing, what must be marked on a CD prescription?
Date of dispensing at the time of supply
Are repeat prescriptions for schedule 2 and 3 CDs allowed?
No
Are repeat prescriptions for schedule 4 and 5 CDs allowed?
Yes
For a repeat prescription, when should the first dispensing of a schedule 4 occur?
W/in 28 days of date
For a repeat prescription, when should the first dispensing of a schedule 5 occur?
W/in 6 months of date
For a private repeat prescription, is there a time limit when dispensing remaining repeats?
No
Outline the requirements for a schedule 2 and 3 private prescription
- On standardised form - FP10PCD (pink)
- Contains private prescriber’s identification no.
What happens to schedule 2 and 3 private prescription after dispensing?
- Original private prescription submitted to NHSBSA
- Copy kept for 2 years
Which technical errors on CD prescriptions allow for a supply?
- Contains minor typographical error or spelling mistake
- Total quantity of preparation or no. dosage unit not specified in words AND figures, but not both
If a technical error on a CD prescription occurs, what must a pharmacists do in order to supply the drug?
- Exercised due diligence + believes on reasonable grounds that the Rx is genuine
- Believes that they are acting in accordance w/ directions of practitioner
- Amends Rx in indelible ink
- Show they have amended (name, date, signature, GPhC no.)
What must occur when a patient is collecting a schedule 2 and 3 CDs?
Identify the person collecting:
- Pt/representative: ask for evidence of identity
- Healthcare prof: Ask for name, address + evidence of identity
Is it a legal requirement to ask for evidence of identity when supplying a schedule 2 CDs?
Yes
Is it a legal requirement to ask for evidence of identity when supplying a schedule 3 CDs?
No but good practice
What must be included in the CD register?
- Entries in chronological order
- Separate sections for each class, strength + form
- Drug class, strength + form must be specified
- Entries made on day of transaction
- No cancellation
- Kept for 2 years from last date of entry
What do you do if there is a mistake in the CD register?
Corrected by foot/margin note + date and signed
Which form is used for a requisition of a schedule 2 or 3 CD?
FP10CDF (Home office requisition form)
Outline the requirements of a requisition for CDs
- Signed by purchaser
- Name, address + occupation of purchaser
- Specify total quantity of CD required
- Specify purpose of CD required
- Pharmacy name + address
What happens to a requisition for a CD after it has been supplied?
- Sent to NHSBSA at end of month (except vet)
- Copy kept for 2 years
In an emergency, are you able to supply a doctor/dentist a schedule 2 or 3 CD without a requisition?
Yes but requisition must be supplied w/in the next 24 hours
What is the requirement for the destruction of a schedule 2 CD?
- Must be witnessed by authorised witness (authorised by Secretary of State)
- Authorised witness will record destroyed quantities in CD register
What are the roles of an accountable officer?
- Audit management, prescribing + use of CDs
- Sharing info regarding CDs
- Attendance at Local Intelligence Networks
- Appointment of authorised witnesses
Are pharmacies able to accept waste medicines from care homes that provide nursing care or CDs from healthcare professionals?
No
Destruction of a CD must be witnessed by another member of staff - legal requirement or good practice?
Good practice
Record of a schedule 2 CD that has been returned by a patient - legal requirement or good practice?
Legal requirement
What must be recorded when a patient returns a CD for destruction?
- Date received
- Received by (name + signature)
- Patients name + address
- Name of CD
- Form + strength
- Quantity
- Role of person returning CD
- Date destroyed
- By pharmacist
- Witnessed by
When can CDs in sched 2, 3 + 4 part I be placed into waste containers with other pharmaceutical waste?
After CD has been rendered irretrievable
Why are CDs denatured when destroyed?
- Prevents drug being retrieved + misused
- Prevents harm to env
- Ensures waste is transported safely w/ less risk
How are solid dose CDs destroyed?
- Grind/crush before adding to CD denaturing kit
- Small amount of water minimise risk of particles in the air
- If no kit: stir grinded tablet into warm soapy water, ensure drug is dissolved + poured onto appropriate product (cat litter)
How are liquid dose CDs destroyed?
- Mix CD liquid to CD denaturing kit
- If no kit: use appropriate product + add to general pharmaceutical waste bin
How are parenteral CDs destroyed?
- Ampoules containing liquid opened + emptied into CD denaturing kit. Ampoule disposed in sharps bin labelled ‘contains mixed pharmaceutical waste + sharps - for incineration’
- Ampoules containing powder, opened + dissolved in water, poured into CD denaturing kit
How are fentanyl/buprenorphine patches destroyed?
- Easy to dispose
- Remove backing of patch + fold w/ sticky side inside
- Place in CD denaturing kit
How are CD aerosols destroyed?
- Expelled into water
- Solution disposed as a liquid CD
Which CDs are registered midwives able to administer and posses?
- Diamorphine
- Morphine
- Pethidine
What are the requirements needed when supplying CDs to midwives?
- Midwife’s supply order signed by appropriate medical officer
- Name of midwife
- Occupation of midwife
- Name of person whom CD is to be administered
- Purpose of CD
- Total quantity