DPP: MEP Flashcards
What are the classifcations of medicines?
- GSL (General Sales List):
- can be sold in retialers and pharmacies.
- Responsible pharmacist can be abscent for a period of time and sales still made
- PO: GSL medicines with restricted sales
- Pharmacy only: Can only be sold in a pharmacy by a pharmacist of person under the supervision of a pharmacist
- POM: prescription only: Requires a prescription by an appropriate practioner
Who are examples of approproate practioners?
- Doctors
- Dentist
- Independent pharmacist/ nurse presriber
- Optimitrist/ Podiatrist indepent prescriber
- Physiotherapist
- Radioologist independ prescriber
- supplemenatary prescriber
- VET
- EEA Swiss Doctor, dentist, N/P independent prescribe
- Community nurse
What are the legal issues regarding pseudoephedrine and ephedrine?
- Decongestent meds
- Can be used to make crystal meth
- Can’t be sold together without a prescription
- Can’t sell more than 720mg Pseudoephedrine or 180mg ephedrine without a prescription
- Must be sold by a pharmacist of pharmacy trained staff
What are emergency oral contraceptives licenced for use?
- Leveonogestetel 1500ug - Over 16s for 72hours after intercourse
- Ulipristal aceatate 30mg - not contraindicated in U16s. Use 120hr after intercourse
- Can supply advanced supplies
- Pharmacists should be involved in assessing suitability and sales
What are the legal issues surrounding aspirin and paracetomal
- Toxic in overdose
- Maximum OTC is 96 non-effervescent tablets
- No limit for effervescent
What are the legal issues surrounding codeine and dihydrocodeine
- Only used for short term treatment of acute-moderate pain that isn’t treated by paracetomal, aspirin or ibuprofen
- Max OTC pack is 32, above is POM (including effervescents). It is reccomened that not more than one OTC should be given as would defy smaller pack size
- Must be labeled “use for 3 days only - may cause addiction”
What are general prescription requirements?
- Signiture of prescriber
- Address of prescriber
- particulars of prescriber
- Name of patient
- Address of patient
- Date of prescription
- Age if U12
- Can be written in different languages
- Needs to be written in iledgible ink or computer generated
- What are repeatable prescriptions?
- How many times can they be repeated?
- What are exceptions to repeats?
- Private prescriptinos which can be dispensed more than once
- If no repeat stated repeat once (i.e. dispense X2) unless oral contraceptive - repeat 5 times (dispense 6)
- Can’t have repeat prescriptions for SC1,2 CD
- When must repeatable prescriptions be dispensed?
- POM - first dispesning must be done in 6months and the rest have no time frame
- CD 2,3,4 the first dispensing must be done in 28days -the rest have no time frame
What happens to a repeatable prescription once it has been dispensed?
- The prescription must be marked with the date of supply and name and address of the pharmacy
What records are required for private prescriptions
- A record must also be made into the POM register on the day or supply or if not the following day and kept for 2 years from the last date
- SC 2&3 CDs must also be submitted to the relevnt NHS agency
- Prescriptions also need to be retaine dfor 2 years from the date of supply or last date of supply
What record details for Private prescriptions need to be recorded in the POM reg?
What are the exemptions to the register?
- Name patient
- Address patient
- Name, quantity, strength, form medicine
- Name prescriber
- Address prescriber
- Date of supply
- Date of prescription
- Emergency oral contraceptives
- SC2 CD as entery made into CD reg
- What is an installment prescription?
- What is an incomplete prescription?
- Used to dispense CD is installments
- Some essential detials missing e.g. name, strength, quantity of med even though not legal requirement are essential
What is the falsified medicines directive?
They aim to ensure the safety of medicines for sale in the UK and reduce the risk of fake medicines
Are faxed prescriptions valid?
No - not signed in ink or written in iledgible ink
What are dental able to legally prescribe?
- Private: any POM within there areas of competance
- NHS: restricted to the dental formulary - no brands
In the event of a forged prescription what should you look out for and what actions should you take?
Consider:
- Behaviour of patient?
- Is the patient known?
- Is the prescriber known?
- Dr inserted in front of signiture?
- Excessive quanity?
- Medicine known to be abused?
Actions:
- Scrutinize signiture carefully
- Check with prescriber
- Don’t use patient as a source to obtain contact details of prescriber
Are prescriptions from EEA/ Swiss legal? What are they allowed to do?
- Prescriptions and repeatable prescriptions valid
- Emergency supplies allowed
- Can’t supply SC 2 or 3 CD including phenobarbtal
What are EEA/ Swiss prescription requirments?
- Patients full name and DOB
- Prescribers full name, work address, professional qualification, direct contact details (including email and telephone or fax no.)
- Name, quantity, strength, form, dosage details
- Signiture
- Date
- What is the appropriate date for EEA/Swiss prescriptions?
- What are the restrictions of what they can supply?
- The date on the prescriptions
- Cant prescribe SC1,2,3 CD or unlicenced medicines
What are the labelling requirements of a medicinal product?
- Name of patient
- Name and address of pharmacy
- Date of supply
- Name of medicine
- Directions for use
- Warnings/ precautions
- ‘Keep out reach/ site of children’
- ‘Apply to skin only’ IR
What is optimisation of labelling?
- Although not legal requirment, good practice to label bottle, inhaler as opposed to outer container
- If directions, name, precautions not approproate it is possible to subsite with words to the similar effect without contacting the prescriber
What are the labelling requirements of a pack broken down from bulk?
- Name of med
- quantity
- Expiry date
- ingredients or particulars
- Batch no.
- Special storage/ handling requirement
- normal labeling requirements
What does PSD stand for? What is it?
- Patient specific directions
- Can’t be specifically defined but generally accepted to be written instuctions from a doctor, dentists ot suitable medical professional to supply or administered specified medicine to a specified named person.
- Any competent and trained health profession is capable of supplying or administering
- PSDs apply to specific named patients but normal prescription requirements don;t apply
- HMR provides a rangeof exemptions on sale, supply and adminsitration, a number of which are under PSD
What are the exemptions to sale or supply of medicines without a prescription?
- Pandemic
- PSD
- PGD
- Emergency supply
- Optomistrist/ podiatrist signed orders
- Supply of salbutamol inhalers or adrenaline autoinjectors to schools
- Supply of naloxone to indivduals involved in drug treatment services
What is PGD? What is it also known as?
- Patient group directive aka URGENT SUPPLY
- Written instuction from a suitable practioner to allow the supply or administration of a certain medicine to a well defined group of people for a specific condition
When are pharmacists able to supply/ administer dimorphine or morphine? Why are they allowed too?
Under the PGD pharmacists can supply dimorphine or morphine for the immediate, necessary treatment or sick or injured patients
What are the steps taken in the PGD scheme?
- Interview patient to assess eligibility:
- Registered with GP in scotland (even temporaly)?
- Has the medicine being requested been previously prescribed for the patient by an appropriate practioner registered and practicing in the UK?
- Is the medicine allowed to be supplied on the PGD?
- Fill in CP4 form:
- Name and address patient
- CHI no. (if not DOB)
- GPHC number
- Pharmacy contractor code
- PAtient prescribe refence number
- Dosage instuctions
- Name, quantity,strength, form of medicine
- Dispense and Label medicine
- Patient signs back
- Stamp with name and address of pharmacy and date
- Send photocopy to prescriber
- Send original to NHS agency
What other alternative is there to PGD?
Emergency (aka TRUE) supply at request of an approproate practioner or patient
What steps are involved in emergency supply at request of a prescriber?
What are the restrictions?
- Approproate practioner? - allowed to prescribe this?
- Emergency/ immediate need? - If there an immediate need and it is unpractical to obtain a prescription?
- Prescription - prescriber agrees to send a prescription to be obtained within 72 hours of the request
- Directions - medicine to be supplied in accordance with prescriber
- Not for SC 2 or 3 excluding phenobarbitone
What Records need to be kept and what details are required?
- Entery into the POM reg on the day of supply of following day. Kept for 2 years
- Details:
- Name and address patient
- Name and address prescriber
- Name, quantity, strength, form of medicine
- Date of Supply
- Date of prescription recevial
- Date on prescripition
What labeling requirements are there?
Normal
What steps are involved in emergency supply at the request of a patiet?
Exceptions?
- Interview patient -
- immediate? - immediate need and it is inpractial to obtain a prescription due to the nature of the emergency without undue delay
- Has it previously been prescribed for patient?
- Pharmacist is satisfied at knowing dosage/ directions
- Not for CD 2 or 3 expept phenobrabital for epilepsy
What length of treatement can be prescribed?
What pack sizes shoulf be given?
- CDs - max treatment 5 days
- POM - max treatment 30 days
- Smallest pack size for creams, tubes, inhalers
- Oral contraceptives - full cycle
- liquid antibiotic - smallest quantity that gives full course
What records are required? What details are required in these?
- POM reg on day or following day of supply an kept for 2 years
- Details:
- Name and address patient
- Name, quantity, strength, form medicine
- Nature of emergency and why prescription not obtained
- Date of supply
What labelling requirements are there?
Normal bar ‘for emergency treastment’
What are pandemic exceptions?
- During pandemics legislation is in place which relaxes in emergecny supply requirements
- There is collection points for patients to collect medicines - doesn’t have to be a pharmacy and pharmacist not needed for sale
- Patient doesn’t need interviewed
What are optomitrost and podiatrist signed orders?
- Optomitrists can’t prescribe unless qualifrd as independent or supplementary presciribers to authoise POMS
- However they are able to prescribe using a signed order. This must be something they are allowed to suipply
- These aren’t prescriptions so normal prescription requirements don’t apply. Should be statisifed enough info given for patient to use medicine safely
- Normal labelling
- Patient info leaflet given
- POM reg made
When supplying salbutamol inhalers:
- Who can sign the order?
- What info is needed?
- How many can be requested?
- What records and details are needed?
- Is headed note paper required?
- Head or principle teacher
- Name of school, total quantity and purpose
- A small amount: depends on size of school, number of parts to school, no. children with ahstma, no. incidences of being unable to acess inhaler
- Signed order kept for 2 years from dtae of supply or enetry into POM. Info needed:
- Date POM supplied
- Name, quantity, strength, form
- Name, addresses, trade, business or profession of whom med supplied
- Purpose sold
- No but preferred
When supplying adrenaline autoinjectors:
- Who can sign the order?
- What info is needed?
- How many can be requested?
- What records and details are needed?
- What strngth is required?
- Discuss brands
- Head or principle teacher
- Name of school, total quantity and purpose
- A small amount: depends on size of school, number of parts to school, no. children with ahstma, no. incidences of being unable to acess inhaler
- Signed order kept for 2 years from dtae of supply or enetry into POM. Info needed:
- Date POM supplied
- Name, quantity, strength, form
- Name, addresses, trade, business or profession of whom med supplied
- Purpose sold
- Depends o body weight and age
- different brands have different instuctions
Disucss supplying naloxone to individuals in drug treatment services
- Naloxone opiod antagonist used to reduce completely or partially centeral NS depression from acute opiod overdose
- Staff involved in drug treatment services are able to obtain naloxone form wholesaler without prescription, PGD, PSD and given to patients
Is self dispensing allowed?
- Poorpratice - should be avoided
- Nurses and pharmacist indepenent prescribers should under no circumstanes unless exceptional circumstance
What are oral retinoids are what should be done whens supplying them?
- Used for serves skin conditions but can cause foetal malformations or spontanious abortions inuborn children
- Shouldn’t be given to women or girls or child bareaing age/ pregnant unless no suitable alternative
- Pharmacists should ensure on a PPP. Should at least be on it during use and for 1 month after stopping
What are special controls for females on oral retinods?
- Prescriptions valid for 7 days only - after need new one and may need to reconfirm preg status
- Max length treatment 30 days unless not on PPP
- No repeats or faxed prescriptions allowed
- Only telephone allowe dif form PPP specialist and have confirmed -ve pregn in last 7 days
- What is valporate used for?
- When should it be takne?
- What are the problems?
- WHat should pharmacists do?
- epilepsy, bipolar, migrane (unlnced)
- if no other alternative
- serious harm to unborn child
- Have convo to see if aware of risks and on PP. If planning preg make appointment with prescriber. If preg continue med but make apppointmnet urgently. Reoirt ti yellow card shceme
What are the prescribing restrictions for a doctor?
- Can supply SC 2-5 CD. And can supply dimorphine, cocaine for treating drug addiction
- Can prescibe unlinced med
- Can prescribe in emergency. Not Sc 2 or 3 bar phenobabital for epilepsy
What are prescribing requirments for an indepenent prescribing pharmacist?
- Can prescribe SC 2- 5 CD. Can’t prescribe dimorphine or concaine for treating drug addiction
- Can supply unlicenced medince
- Can prescribe in emergencies. Can’t prescribe SC2/3 unless phenobsrbital
What are the prescribing restrictions for a independent physiothepist prescriber?
- Can prescirbe certain CDs
- Can prescribe off-label medicines
- Can supply in emergencies - not SC2/3 CD including pheno
What are the prescribing restricitions for a podiatrist?
- Can prescibe certain CDs
- Can prescribe off-licence meds
- Can prescribe in emergencies - not SC2/3 CD including phenobarbital
What are the prescribing restrictions for a dentist?
- Can prescribe SC 2-5 CDs. Can’t supply dimorohine of cocaine for addiction
- Can prescribe off lincenced
- Can supply emergency - Not CD 2-5 bar pheno
What are the prescribing restrictions of a supplementary prescriber?
- Can supply SC2-3 CD. Can’t prescribe dimorphone or cocaine for treating addiction
- Can supply off-licnce med
- Can supply in emergency - bar SC 2/3 CD exp pheno
What are the prescribing restritctions for an independent nurse prescriber?
- Can supply SC2/3 CD. Not dimorphone or cocaine for addiction
- Unlinced med exlcluded from nurse formulary
- Can presribe in emergency - not SC 2/3 CD exp pheno
What are the prescribing restrictions of optomitrist?
- Can’t supply CDs
- Off label med
- Can supply emergecny
What are the prescribing restrctions of a independednt radiologist prescriber?
- CD undecided
- Can supply off label
- Can supply in emergency - not SC 2/3 CD inclufing pheno
What are the prescribing restrictions of a vet?
- Can prescribe SC2-5 CD
- Unlinced under vetenariy cascade
- Emergency - not applicable
What are the prescribing requirements of EEA/ Swiss?
- Can’t prescribe SC2/3 CD
- Can’t supply off licenced
- Emergecnysupply - not SC2/3 CD including phenobarbita;
What are the prescribing restritctions of a community nurse?
- Can’t prescribe CD
- Can’t supply unlinced
- Emergency
What are the prescribing restrictions of a paramedic?
- Can’t supply CD
- Off label
- Emergency - expt SC2/3 including pheno
If you notice a dispensing error what actions should you carry out?
- Contact patient urgently
- Make things right - contact prescriber?
- Offer appology
- Let those involved in mistake aware
What are examples of people/ organisations that can recieve medicatino via wholesaling?
- Doctors
- dentist
- pharmacies registered
- paramedic
- owner of ship
- midwives
What records are required for signed orders?
When POM suplied from pharmacy an entery needs to be made in POM or signed order kept for 2 years from supply date (good practice to do POM if kept:
- Date supply
- name, strenght, form, quantity
- name and address, trade, business, or profession
- purpose
SIgned orders don’t have set infor required but preferred if have the info needed for POM
What classifications of vet medicine is there?
- POM- V : prescription only medicine that can be prescribed by a vet surgeon and supplied by a vet surgeon or a pharmacist. Written prescription is required
- POM-VPS: Prescription only medicine than can be prescribed by a vet suregon, phamracist or suitabliliy qualified person and supplied by the same. An oral or written prescription needed. A written prescription is only needed if presciber and supplier aren’t same person
- NFS-VPS: Non food animals. Can be supplied by a vet suregon, pharmacist or suitabiliy qualified person
- AVM- GSL: authorised vetenarity medicines - GSL vet med
What prescription requirments are needed for POM-VPS/V
- Name, adress, qualifications, telephone no., signiture of vet sugen. vet registration number needed for SC2/3 CD
- Name and add of owner
- Identification and species of animal
- Date - valid for 6 months if POM or 28 days if CD 2/3/4. Repeat must be completed in the 6month period.
- WIthdrawl period or warnings
- Name, quantity, dose and administration instuctions (as directed not acceptable)
- ‘Prescribed under vet cascade’ IR
- If SC2/3 CD ‘ precribed under care of vet surgeon’
- If repetable no. times repeated
- Recommended ‘ keep out reach/ site children’
Human vs vet med
- Vet- standardised forms not needed
- HUmans - sF needed for SC2/3 CD PP
- Vet- prescriptions retained for 5 years. NOt submitted to NHS
- HU - SC 2/3 sunmitted to NHS
- Vet - CD 28 day tretament max
- HU - CD 2/3/4 30 day treatment MAX (unless exceptiion)
What steps are taken in the vetenariy cascade?
- Licenced vet med
- Licenced vet med for same condition in diff speices OR linced vet med for diff condition
- Licenced human med OR EU licenced vet med
- Exemptously prepared
Must say ‘under cascade’ for unlinced med. but licneced should also be chosen first
Can unlinced medicines for animals be sold?
ONLY if under cascade
What records are required to be kept fro vet meds?
- Records needed for POM-VPS/V
- needs to include
- Name med
- date of supply or recepit
- batch no.
- quantity
- nameand adress of supplier or reciepnt
- if written prescription also need na,e and add of prescriber and keep copy of prescription
- Records can be kept electronically
- Can keep all doccuments with required infoo or prescription for 5 years
- pharmacies suppying POM-VPS/V must under take annual sudits
What labelling requirments are required for VET meds?
- Name or prescribing vet surgeon
- Name and address animal owner
- Name and adress pharmacy
- Ifdentification and species of aniaml
- date of supply
- EX date
- name or description of med
- Dosage and admin instructions
- Storgae instructions
- warnings/ withdrawl periods
- ‘for animal treatment only’
- ‘keep out site/ reaxh children’
Where should adverese effecs of vet medicines be recorded?
Yellow card scheme
What is an accountable officer?
Respinsible for supervising and managing the use of CDs
What are the roles of an accountable officer?
- attend local network meetings
- appointment of authorised witnessed for CD destuction
- Ensure system in place for reporting concerns/ incidents involving CDs
- Submission of occurance reports
- Overiste and monitoring of udits for managing, prescribing and use of CDs
*
What classes of controlled drugs are they? What are they classed depending on?
Depending on the level of control
- SC1 - CD Lic POM
- SC2 - CD POM
- SC3 - CD no reg POM
- SC4- CD p1 Benz and p2 anab
- SC5 - CD Inv P/ POM
Describe SC1 CD
- Need licince for posession, supply, production
- No therapeutic use
- includes hallucingenics e.g. LSD, ecstacy type, cannabis and raw opium
Describe SC2 CD
- Subject to full controls - Safe custody, record keeping, prescription
- Liscnece needed for impot/ export
- meidincal use
- includes major stimulants (amphetamine), cannabis based and opiates (dimoprhine, morphine)
Describe SC3 CD
- Full controls expt some excemptions
- Includes minor stimulants (phenobarbital) and pregablin and gabapentin
Describe SC 4 CD
part one: includes barbituates and non-benzodiazipines hypnotics
Part two: Anabolic and addrogenic striods and growth hormones
Describe SC 5 CD
- COntains small amount of SC2 CD
- less likely to cause dependace - codeine/ morphine
- exmpt from full controls when in low strengths in medincal products
What ways can you possess/ supply control drugs?
- Certain people - DR, Denitists etc
- HO and HO group licence
- patients
When are pharmacists allowed to posses SC1 CD?
- For destruction
- handing over to a police officer
What should happen if a patient has SC1 CD?
- Police called but in understanding patient cofedentiallity maintained
- drugs should be hande dover with consent and not given back at any point. If refuse to give call police.
- If large quantity is okayto treveal identiy
WHat is needed for Administration of a SC1 CD?
When can SC2/3/4 CD be administered?
- HOL
- By a dr, dentist, indep pharm/ nurse acting in their own rights
- by a supplementaty prescriber in accordanc ewith a clincial managemnt plan
- a erson acting in accordance with the instuctions of a prescriber entitiled to prescibe CDs
For what drugs are linces needed for imort?
- SC 2,3,4p1
- schedule 4p2 doesn’t need if is being imported/ exported by a person for self administration
- A personal HO licence isn’t needed if travller is carrying less than 3 months supply. Recomened getting signed letter by precrb=iber with name, travle plans, name drug, quantity and dose
- What class of drugs are requisition forms needed for?
- Why are they needed?
- What are the requirments on the form?
- What are the form requirmentS?
- Human and Vet SC2,3 CD. Hospices and prisions expt
- Ensures all purchases od=f SC2/3 CD monitored
- Signiture of recipent
- Name of reciepent
- Adress of reciepent
- profession/ occupation
- Quantity
- purpose
- Needs to hand written - photocopied/ faxed not acceptable
- Don’t need to be in writing if pharmacy but preferred
- What drugs are not able to requisitioned?
- When is a requistion form not needed? what would need tohappen?
- SC1 CD
- if emergency for DR/DT but need to ibtain one in 24hrs
When processing requisition forms what needs to be done?
- need to be stamped with name and address and orignal sent to NHS agency
- good practive to keep photo copy for 2 years. Vet 5 years
Describe MId wife supply orders and what can be asked for
Registered midwives can use a midwife suply to obtain:
- dimorphine
- morphine
- pethidine
What beeds to be on the signed order?
- Name midwife
- occupation midwife
- patient dor
- reason its required
- quantity
- signed by approproate medical officer
What are the precription requirements for a SC2/3 CD?
- Name of patient
- Address of patient
- Name of prescriber
- Address prescriber
- Age if U12
- Particulars of prescriber
- Date - valid for 28 days if SC2/3/4 from AD
- Signiture
- Strength (if more than one)
- Form
- Dosage instructions/ directions
- quantitiy in words and figures - shouldn’t exceed 30 days (not legal)
- ‘For dental treatment only’
- Ilegible ink and can be conputet generated
Should sugar free or sugar products be prescribed?
Sugar free has higher chance of addiction so should only supply if specifically been prescribed
Is the name of the medince a legal requirment?
No. but it is essential
What is needed on an installement prescription?
What are date requirments?
- The quantity of medicine per installment
- Time interval between which the medicine can be supplied
- First installment must be done in the 28 days, after it should follow installment instructions even if runs beyond 28 days
- Prescrption needs to be marked with each date of supply
What happens if a patient misses a dose?
The remainer doses should be administered BUT if more than 3 days missed the prescriber should be contacted as may have lost tolerance and normal dose may result in over dose
What errors are toleratable, which are not?
Minor typographical or spelling mistakes or either words or figure missing from quantity. These can be changed without contacting the prescriber
The name, signiture, GPHC number and date should be noted next to it
IIf both missing not okay
What are private prescription requirements for SC2/3 CD?
- Human SC2/3 CD must be written on standardised forms. Vets don’t need
- SC2/ 3 must be submitted to the relevant NHS agency
- The prescribers identification no. also needs to be stated on prescription
Can non CDs and CDs be requested on the same form?
No - meds not CDs shouldnt be on same form as SC2/3
What is a requirment when collecting scheule 2 CD?
The identy of the person collecting must be determined, whether it be the patient, patient representative or health professional.
What is recommened for a patient drug missuser when collecting?
What if patient states dose should be supervised?
If a representative is to collect it is reccomened they write a letter with the represnetatives name on it. A new letter should be used each time. should see patient at least once a week
Can phone prescriber and ask if situ is okay. Is legally valid to do over phone. A record should be written but not legal requirement
If it is a health care representative collecting what should happen?
- Note Name
- Add
- Ask for ID
What other requirements is there for collecting SC2/3 CDs?
- Good practice to have back of prescription signed. Installments only need to be sgined once. Supply can be made if not signed. Delivery driver can sing
Which drugs need to be kept in safe custody, what does this mean?
What should happen if CDs are in locked cabinant?
SC2/3 - kept in a locked cabinent
Should be under direct person;al supervision of the pharmacist
Where should patient returned CDs be kept?
CD cabinent - seperated from good stock and CLEARLY labelled
What needs to have to CDs before disposal? what schedules does this apply too?
- They need to be denatured before being disposed off.
- Schedule 2, 3, 4p1
Patient returns:
- Do they need to be denatured first?
- Is an authorised witness needed?
- Are records required?
Out of date stock:
- Do they need to be denatured fist
- Is an suthorised witness needed?
- Are records required?
- If SC 2,3,4p1
- No - but good practice to have member of staff withness disposal
- Not in CD reg. If SC 2 CD should be written in seperate book
- Yes if SC 2,3,4p1
- An authorised witness is required for SC 2 CD. It is good practice to have a staff member witness the destuction of others
- SC 2 CD disposales need to be recorded in the CD register
How should CDs be denatured?
CD kits are generally used. They should be disposed of in appropriate waste containers for incineration - not down sewers
How should tablets/ capulses be disposed?
- SHould be grinded or crushed and poured into CD DK. a small smount of water shoulf be used during grinding/ crushing to prevent dust in air
- If CD DK not available dissolve/ disperse in warm soapy water then add to suitable liquid and pour into waste container for disposal
How should Liquids be disposed off?
- Added to DK
- If not available - add to suitable liquid and pour into waste container.
- Rinsings should go in DK or in suitable liquid as above. Can only dispose in sewer if have TEC
How should ampules and viles be disposed off?
- Pour into CD DK and ampoule in sharps bind
- If not available same as iquid
- Powder ampule can be added to water then to DK
- can also be crushed in empty blastic bottle and added to DK
How should patches be disposed off?
Folded over on self and diposed in CD DK
How ahould areosols be disposed off?
Expelled into water or absorbent material
What classes of drugs need a record to be made when disposed?
CD1 and CD2
Sativex
When a CD is being received by the pharmacy what details need to be recorded?
- The date
- The quantitiy
- The name and address of whom receieved
When CDs are being supplied what details need to be recorded?
- The date of supply
- quantity supplied
- Name and address of who receiving
- If identity of person collecting asked for
- If the ID is given
- Details of suthority to posses - prescriber or licence holders details
- Details of person collecting - if HC name adn add
What does the register need to be like?
- Needs to have class, strength and form of drug headed at top of each page
- needs to be a bound book or electronic
- Needs to have new part for each class of drug
- New page for each strength and form of drug
- needs to written in iledgible ink
- No corrections - footnote and date, inita./ sign, GPHC no.
- Chronlogical
- enetered promptly- day day after supply
- Record kept in premises and for at least 2 years from last date
How often do balance checks need to be done?
Weekly preferred
Stock checks signed, recorded, dated
How does disposal of methidone bottles occur?
Rinsed bottles into CD DK kit can bottles in general waste/ recycyling
Lables removed
What does used by/ use before mean and what does Expiry date mean?
Use by - use by the day before the next month
ex - use on the last day of the month
What are exceptions to child resistant packagings?
- If specifically requested or the oringal container not child resistant - may be reason
What is the responsible pharmacist and what are there responsibilities?
- Is it charge of the pharmacy at one time - can only be one repsonsibel pharmacist in a pharmacy at one time and they can only be in charge of one at any given time
- Secure the safe and effective running of the pharmacy
- display a notice
- complete the pharmacy record
- establish, maintain and review pharmacy procedures
What notice info is required?
- The name of the responsible pharmacist
- The GPHC number of the responsbile pharmacist
- That they are in charge of the pharmacy at the time
What happens if the pharmacist is temoiraly abscent?
Sign stays up if they are still RP. If changes so should sign
What do they pharmacy records show and what is required?
Records can be written or electronic
- Show the RP on any day at any time
- Name of RP
- Date and time they become RP
- Date and time they stopped being RP
- RP reg no.
- If abscent:
- Date of abscence
- Time RP left
- Time RP returned
How long should pharmacy records be kept for?
5 years
Abscence rules:
can be abscent for max 2 hours (inculdes other RP)
What does COSSH Require?
That employees control substances that are hazzardous to health
Risk assessment must be carried out for substances and proceedures by a competent person (doesn’t have to be pharmacist). If more than 5 employees - risk assessment needs written down. Good practice to always write
Who must employees protect?
Everyone from exposure to hazzard substances in the work place
What is hazzard and what is risk?
Hazzard - something which poses daner
Risk - the likelyhood of harm
What does COSHH not cover?
LEad, asbestoes and radio activew substances - these covered by other legislation
What does CLP apply too?
Substances and mixtures
not medicines - these covered by COSHH
What is the information Comissioners office?
Supervisory authority for data protection in the UK
What is personal info
Any info about a partcular living individual
What is a data controller?
Person who decides how and why to collect and use the data
What is the data processor?
Process data on behalf of controller
What is data processing?
Any operation performed on personal data e.g. collection, recording
Who is the data subject?
he person whom the personal data is regarding
Who is the data protection officer?
Company
