Emergency Supply Flashcards
what is an Emergency Supply?
In an emergency and under certain conditions a pharmacist working in a registered pharmacy can supply POMs to a patient without a prescription if requested by a prescriber or the patient
what is the Underpinning legislation for an ES?
1) Human Medicines Regulations (HMR) 2012 (Part 12)
2) Scotland – national PGD allows supply of medicines for urgent provision of current repeat medicines
what are the two types of emergency supply
1) request made by prescriber
2) request made by patient
outline an Emergency Supply-Request Made by Prescriber
1) the Prescriber contacts pharmacy: phone, fax etc
2) Make sure the phone message is clear-
- pharmacist should take the call and confirm what is required
3) Must be registered in the UK or EEA/Switzerland
4) Pharmacists must be satisfied that:
- the request is made by an appropriate prescriber- check qualification
- For reason of some emergency is unable to provide a prescription
5) The prescriber promises to supply a prescription within 72 hours
6) The POM is sold or supplied in accordance with the directions of the prescriber
7) The POM is not a CD schedule 1, 2, or 3 except phenobarbital used in the treatment of epilepsy
8) An entry is made in the POM register on the day of supply or next day
9) Usual labelling requirements apply
list the Prescribers who can request an Emergency Supply
Made at the request of a:
1) Doctor
2) Dentist
3) Supplementary prescriber
4) Community practitioner nurse prescriber
5) Independent prescriber (nurse, pharmacist, optometrist, podiatrist, physiotherapist
6) EEA or Swiss health professional (EEA – European economic area-doctor, dentist, nurse, midwife, pharmacist defined within meaning of Council Directive 2005/36/EC)
what is the legislation surrounding an emergency supply when the prescriber is EEA/Swiss?
1) Must be registered in the UK or EEA/Switzerland
2) Where a request is made by EEA/Swiss prescriber, the POM is not a Schedule 1,2 or 3 CD (including phenobarbital) but can be sch 4 or 5
3) EEA/Swiss prescribers request medicines with a marketing authorisation valid in the UK.
duiring an emergency supply It is good practice to clinically validate the emergency supply, especially if its a new medicine. explain what you would clinically check
1) patient age
2) dose
3) other medicines taken (PMR)
4) appropriate medication for the patient
5) Check patient exemption status (NHS)
outline what an emergency supply at a Prescriber’s request records would contain.
POM register must contain:
1) Date the medicine was sold or supplied
2) Name, form, strength, quantity of product
3) Name & address of prescriber
4) Name & address of patient
5) Date on prescription
6) Date prescription received
7) NHS paid/exemption, fee for private Rx*
8) Dosage of medication*
- *not legal requirement
outline a Emergency supply at Patient’s request
1) Patient asks for a supply of medicine without a prescription
2) usually visit the pharmacy in person
3) rarely a phone call from the patient
4) sometimes a representative is sent
- Parents/guardians, carers, relatives/ friends
5) pharmacist must interview the patient
during an emergency supply at Patient’s request the Responsible Pharmacist must interview the patient first. outline what criteria must be satisfied before granting the supply
1) Immediate need for the POM
2) Impracticable to obtain a prescription without undue delay
3) The treatment has previously been prescribed by a UK registered appropriate prescriber for the patient or EEA or Swiss health professional
4) It is an appropriate dose for that patient in the circumstances
what items can be supplied to a patient requesting an emergency supply and what quantity should be provided?
1) No greater than 30 days treatment should be supplied, except: Ointments, creams or aerosol – supply smallest pack
- Oral contraceptive – give full cycle
- Antibiotics in liquid form – supply the smallest quantity to complete the course
- Insulin – smallest pack
2) Controlled Drugs (CDs) schedule 2 and 3 cannot be supplied, except for phenobarbitone (phenobarbital) for epilepsy (sch 3 CD). Phenobarbitone or a schedule 4 or 5 CD can be supplied for no more then 5 days treatment. If prescriber is EEA/Swiss, cannot supply phenobarbitone
what is the legislation surrounding an emergency supply at the request of a patient
1) A record in the POM register must be made on the day (or next day if impractical)
2) Patient of an EEA or Swiss health professional is not permitted to obtain Schedule 1-3 CD or medicines without UK marketing authorisation
3) List of other substances that cannot be supplied to a patient as an emergency supply is included in the MEP and Dale and Appleby
list 5 substances that cannot be supplied to a patient on an emergency supply
1) Calcium bromide
2) Methohexitone sodium
3) Potassium bromide
4) Ammonium bromide
5) Sodium bromide
what is the criteria for an Emergency supply at patients request in the event of a Pandemic
1) Do not need to interview the patient in the event of a pandemic
2) Need to be satisfied that the treatment has previously been prescribed by an appropriate practitioner and the dose is appropriate .
outline what the records for an Emergency supply at a Patient’s request must contain.
Record in the POM register must state:
1) Date the POM was sold or supplied
2) Name, form, strength, quantity of product
3) Name & address of patient requiring the POM
4) The nature of the emergency:Ref HMR 2012 (Schedule 23)
5) GP name and address*
6) Dosage of medication*
7) Amount paid or exemption/paid status if receiving a prescription retrospectively*
- * not legal requirement
