Emergency supply Flashcards
emergency supply can be requested by:
- patient
-prescriber
how can prescribers make an emergency supply
Prescriber contacts pharmacy
by phone
personal visit
by fax/emailing prescription to the pharmacy?
Make sure the phone message is clear-
pharmacist should take the call
confirm what is required
ask for further details if necessary
which prescribers can request an emergency supply
Doctor
Dentist
Supplementary prescriber
Community practitioner nurse prescriber
Independent prescriber (nurse, pharmacist, optometrist, podiatrist, physiotherapist)
EEA or Swiss health professional
(EEA – European Economic Area - doctor, dentist, nurse, midwife, pharmacist defined within meaning of Council Directive 2005/36/EC)
Emergency supply at prescribers request checking eligibility
Prescriber must be registered in the UK or EEA/Switzerland
Pharmacists must be satisfied that the request is made by an appropriate prescriber- CHECK QUALIFICATIONS
Emergency supply at Prescriber’s request - what are the reequirements and law
For reason of some emergency is unable to provide a prescription
Prescriber promises to supply a prescription within 72 hours
POM is sold or supplied in accordance with the directions of the prescriber
-You need enough information to complete clinical check, label, dispense, supply, complete POM
register………………with no prescription
POM is NOT a CD Schedule 1, 2, or 3 except phenobarbital used in the treatment of epilepsy
Any quantity of medication can be requested
Usual dispensing label requirements apply
EEA/Swiss Prescribers
POM CANNOT be a Schedule 1, 2 or 3
CD (even phenobarbital)
Can only request medicines with a marketing authorisation valid in the UK
how can clinically validate emergency supply ( good practice)
It is good practice to:
Clinically validate the emergency supply, especially if a new medicine
Check:
Patient age
Dose
Interactions (PMR)
Is it an appropriate medication for the patient?
Check with prescriber whether private or NHS prescription will be written-Why?
Emergency supply at Prescriber’s request - records
The record in the POM register (same day or next day) must state:
Date the medicine was sold or supplied
Name, form, strength, quantity of product
Name & address of prescriber
Name & address of patient
Date on prescription
Date prescription received
Good practice:
Emergency supply-request of prescriber*
NHS paid/exemption, fee for private Rx*
Dosage of medication*
POM register reference number* (same number on dispensing label)
emergency supply at patients request
Patient asks for a supply of medicine without a prescription-
usually they have run out
Usually visit the pharmacy in person
Rarely a phone call from the patient
Sometimes a representative is sent:
-Parents/guardians
-Carers
-Relatives/ friends
what are the laws of emergency supply at patients request
No greater than 30 days treatment should be supplied
except:
-Ointments, creams or aerosol (e.g. inhaler) – supply smallest pack
-Oral contraceptive – give full cycle
-Antibiotics in liquid form –smallest quantity to complete the course
-Insulin – smallest pack
Controlled Drugs (CDs) Schedule 2 and 3 CANNOT be supplied, except for phenobarbitone (phenobarbital) for epilepsy ONLY (Sch 3 CD)
Phenobarbitone/phenobarbital or a Schedule 4 or 5 CD can be supplied for no more then 5 days treatment.
A record in the POM register must be made on the day (or next day if impractical)
Patient of an EEA or Swiss health professional CANNOT obtain any Schedule 1, 2 or 3 CDs (even phenobarbital) or medicines without a UK Marketing Authorisation (MA)
There is also a list of substances that cannot be supplied to a patient as an emergency supply HMR 2012 (Schedule 18)
what does the pharmacist need to do when emergency supply at request of patient?
Pharmacist (Responsible Pharmacist) MUST interview the patient him/herself and be satisfied that:
Immediate need for the POM
Impracticable to obtain a prescription without undue delay
Treatment has previously been prescribed by a UK registered appropriate prescriber for the patient or EEA or Swiss health professional (this is usually interpreted as regular medication)
It is an appropriate dose for that patient in the circumstances
what are substances not permitted for emergency supply at patients request?
Ammonium bromide
Hexobarbitone sodium
Prolintane hydrochloride
Calcium bromide
Hydrobromic acid
Sodium bromide
Calcium bromidolactobionate
Meclofenoxate hydrochloride
Strychnine hydrochloride
Methohexitone sodium
Tacrine hydrochloride
Fencamfamin hydrochloride
Pemoline
Thiopentone sodium
Fluanisone
Piracetam
Hexobarbitone
Potassium bromide
Embutramide
Emergency Supply at Patient’s Request in a Pandemic
Pharmacists:
Do not need to interview the patient
Need to be satisfied that the treatment has previously been prescribed by an appropriate practitioner and the dose is appropriate
Legislative change 29/04/2020:
CDs Schedule 2 and 3 can be supplied if:
Secretary of State makes a statement to allow it specifying:
Area covered (local area, region or country within UK)
Particular circumstances (e.g. a GP practice closure)
Timeframe for using this legislation
Emergency Supply at Patient’s Request –POM Register Records
Record in the POM register must state:
Date the POM was sold or supplied
Name, form, strength, quantity of product
Name & address of patient requiring the POM
The nature of the emergency
Ref HMR 2012 (Schedule 23)
AND
Emergency supply-request of patient*
GP name and address*
Dosage of medication*
Amount paid* …..or exemption/paid status if receiving a prescription retrospectively- ‘lending’ is common practice although not legally defined
POM register reference number (same number on dispensing label)
* Good practice but not legal requirement
Emergency Supply at Patient’s Request – Labelling Requirements
Container or packaging must be labelled as normal
PLUS the words “EMERGENCY SUPPLY”
Date of supply
Name, form, strength, quantity of product
Patient name
Name and address of the pharmacy
The words “Keep out of the sight and reach of children”
The words “EMERGENCY SUPPLY”
Summary of Emergency Supply at Request of Patient
Pharmacist must interview the patient him/herself except in a Pandemic
It must be an emergency
Must be previously prescribed by an appropriate prescriber
Must know appropriate dose
Not more than……………days supply for CDs Sch 3 (phenobarbital), 4 and 5
…….day maximum supply for other POMs except for………………………………………..
No CDs Sch 1, 2 and 3 except phenobarbital for epilepsy
For patients with an EEA/Swiss prescriber, CANNOT supply CDs Sch 1,2,3 at all and only supply medication with a UK MA
Must make records in POM register
Normal labelling requirements but in addition have the words “……………………….” on label
