Controlled Drugs - FP10MDA

Question 1

What type of Rx are FP10MDAs? (1)

Answer 1

Instalment Rx

Question 2

Give e.g. of CDs that can only be Rx on FP10MDA. (5)

Answer 2

Any Schedule 2 CDs
Buprenorphine/ + Suboxone
Diazepam

Question 3

What is the max treatment duration of FP10MDA? (1)

Answer 3

14 days

Question 4

What must be included as part of instalment direction? (2)

Answer 4

Amount of medicine per instalment.
Interval between instalment.

Question 5

What is a legal requirement that needs to be present on FP10MDA? (3)

Answer 5

Instalment direction
Dose
Dispensing date may

Question 6

What can also be present on the FP10MDA Rx? (1)

Answer 6

A start date (if must still comply with and instalments run from that date)

Question 7

Explain the use of Home Office Wording on FP10MDA. (3)

Answer 7

Wording approved by the Home Office giving the pharmacist a degree of flexibility when making supply during missed doses and pharmacy closure days e.g. public holidays.

It provides a degree of protection to the pharmacist against the consequences of supplying such a Rx even if it’s not included in the legislation.

If an instalment Rx contains a different wording to the Home Office approved wording it would not provide the security for the dispensing pharmacist.

Question 8

What are the 5 statements of Home Office Approved Wording? (5)

Answer 8

Please dispense instalments due on pharmacy closed days on a prior suitable day.
If instalment’s collection day has been missed, please still dispense the amount due for any remaining day(s) of that instalment.
Consult the prescriber if 3 or more consecutive days of a prescription has been missed.
Supervise consumption on collection days.
Dispense daily doses in separate containers.

Question 9

Explain the process of unsupervised doses collected by a patient’s representative. (5)

Answer 9

It’s a good practice requirement to obtain a letter of authorisation from the patient on every occasion that that representative collects the medicine and letter is retained in the pharmacy.
Rx doesn’t have to state that it will be collected by a representative.
Pharmacist needs to be satisfied that the letter is genuine.
It’s good practice to insist on seeing the patient once a week, unless impractical.
Applies if a patient is detained in police custody.

Question 10

Explain the process of supervised doses collected by a patient’s representative. (4)

Answer 10

Supervision = not a legal requirement
Pharmacist can contact prescriber to see if they agree with having the supply given to a representative.
Confirmation from the prescriber isn’t necessary if the patient is in police custody as the administration of Sch. 2-3 CDs will be supervised by a HCP.
The Rx and PMR should be annotated to show that the dose hasn’t been supervised.