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PHCY 310 > L 49 > Flashcards

L 49 Flashcards

1
Q

What is a standing order?

A

silimar like a prescription
written by authorises prescriber to supply/administration of certain specified medicines to certain group of people by any specified health professional in certain circumstances.

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2
Q

Where patients can use standing orders? Examples

Original x1 + evolve x4

A

Originally was used in hospitals when a doctor or medical practitioner is not available.

Use evolved though to

  • Ambulance services
  • Non-emergency services to populations e.g diabetics, sexual health services, etc.
  • Rural areas where there are limited doctors services
  • Rest homes
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3
Q

what pharmacists can do with standing order?

A

it is a pathway for pharmacists to be able to supply Rx medicines.

Influenza vaccines

Meningococcal vaccines

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4
Q

What must a standing order be in accordance with?

A

A standing order must be in accordance with any applicable regulations written.

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5
Q

Who can issue a standing order?

A

A practitioner, a nurse practitioner, and a prescribing optometrist.

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6
Q

What does a practitioner mean?

A

Medical practitioner or a dentist.

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7
Q

Match the following terms to their colloquial definition:

A

Act, fine print, regulations, big picture.
Act: big picture
Regulations: fine print

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8
Q

What’s the deal with midwives issuing a standing order?

A

The medicines act says that they can issue one, but they have are not included in the regulations therefore they are not actually allowed to issue a standing order.

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9
Q

Who can act under a standing order?

A
  • people who can supply/administer the medicine which is identified in the SO.
  • The class of person are (e.g registered nurses, pharmacists, paramedics, NZ defense force medical personnel, physiotherapists).
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10
Q

What medicines can be supplied/administered?

A

A prescription medicine or specified controlled drug.
Controlled drug = a drug listed in certain parts of the MDA 1975.
Note: pharmacy only and restricted medicines are also included.

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11
Q

What a standing order must contain? x7

A
  • issuer
  • Why issued
  • who is the person permitted to supply, and class of people it will be supplied to
  • what level of competency required to supply/administer it
  • for how long circumstances/treatments SO applies for
  • Medicine, indications, dose, method of administration
  • If countersigning is required during an audit at least Once a month.
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12
Q

What is countersigning?

What would the process be if there was no countersigning?

A

the person will signs off to assure that the treatment been provided.

If every time want to see the issuer then the medicine provider and SO issuer will sign each time 24-48 hr of supply

otherwise at least once/month.

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13
Q

Example of a standing order x1

A

CPAMS in a pharmacy

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14
Q

A person supplying/administering the medicine under the SO must…. x2

A
  • Competent accordance with the SO

- can Record or can identify patient assessment, treatment, monitoring and follow up.

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15
Q

How often must standing orders be reviewed?

A

At least once each year

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16
Q

How pharmacist can use of SO?

Example:CPAMS

A

to modify warfarin doses dependent on INR results.

supply of warfarin to selected patients and have the authority to modify warfarin prescriptions in collaboration with GP colleagues.”

17
Q

What is an unapproved medicine?

A

A medicine that has not been through the medsafe regulatory process, however can still be prescribed in NZ

18
Q

Why would unapproved medicines be used?

A
  • For rere disease
  • We cant access into NZ approved medicine.
  • The medicines may be available in other countries, be effective and safe, but not have approval in NZ as it is not popular/necessary in NZ.
19
Q

We can access unapproved medicine in two process: S25 and S29

What does the s25 say about unapproved medicines?

A

An authorised PRESCRIBER can sell, supply, procure, administer, and arrange administration of an unapproved medicine.

(They can use any medicine for the treatment of a patient in their care, without being restricted to approved indications).

20
Q

What does the MA s29 say about unapproved medicines?

A

A MEDICAL practitioner may be supplied with an unapproved medicine for treatment of a particular patient.

21
Q

The MA s25 summary for practitioners: x2

A
  • All authorised prescribers can manufacture/supply/administer medicines to their patients or if another prescriber asks.
22
Q

The MA s29 summary for pharmacists: x3

A
  • Pharmacists can only supply medical practitioners (or their patients) with unapproved medicines
  • Information must be provided to DGOH
  • Other authorised prescribers must obtain unapproved medicines either from other authorized prescribers or by directly importing.
23
Q

Would an optometrist be able to get a section 29 medicine from the pharmacy?

A

No, they would have to directly import it themselves or get from another authorised prescriber.

24
Q

What are the 4 levels of pharmacy medicine classifications

A

Prescription only
Restricted medicine (pharmacist only)
Pharmacy-only
General sale

NOTE: there are also controlled drugs.

25
Q

How much prescription and restricted medicines be stored?

A

They must be stored in a way that prevents the public from gaining ready access to them.

26
Q

Pharmacy-only medicines must be sold …

A

By a pharmacist or someone under the supervision of a pharmacist

27
Q

Examples of “prescription only, except when….”

A

medicines
Influenza vaccines
Trimethoprim

28
Q

NOTE: classification status doesn’t guarantee that a product is able to be provided e.g there may not be an approved medicine that is able to be provided.
EXAMPLE:

A

Econazole for vaginal use is classified as a restricted medicine, but there is no registered vaginal product in NZ.

29
Q

Where would you find classifications and registration info?

A

NZF and medsafe website

30
Q

Can midwife give a standing order?

A

No

31
Q

what S20 says?

A

for a particular patient

32
Q

S29 for Pharmacist ki?

A

only supply unapproved meds to Medical Practitioners and provide their patients.

33
Q

In terms of ordering unapproved medicine, we need to order to holseller but they need following information?

A

Dr details
patinets details
what that used for etc.

PHCY 310 (65 decks)

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