Law Flashcards
Audit cycle
- Set standards
- Measure current practice
- Compare results to standards
- Reflect, plan and implement change
- Re-audit;
EEA Rx legal requirements
- DOB
- Prescriber email address, tel no, fax number, work address
Which CD needs to be denatured in the presence of an authorised witness?
1, 2
What Sch is buprenorphine?
3
What Sch is methylphenidate?
2
What is the legal age of consent?
13
What is an audit?
Improving pt care by looking at what you doing, learning from it and if necessary changing practice
If the pharmacist has not arrived at the pharmacy yet can you open the pharmacy?
No
Instruct the pharmacy remain closed until locum arrives. don’t:
- generate labels
- remove items from shelves
- assemble items or label med containers until the pharmacist signs in as RP
Pt return CD
should preferably be witnesses by a registered HCP
What register would you have to complete for Morphine tablets?
- CD
- No POM
How often should an audit be undertaken for POM V and VPS?
1 yr
How long do you keep electronic CD registers
2 yrs
EEA Rx – SCH 5
can be dispensed legally
e.g. co-codamol
It is preferrable to confirm the reg status of the prescriber, but it is not a legal requirement
How long do you keep SCh 3 invoices for?
2 yrs
Which CD Rx lasts 6 months?
Sch5
CD INV POM/P
How many days emergency supply can you give for non CD POM?
30 days
Who must complete revalidation?
Pharmacists + techs
What Sch is cannabidiol?
5
How many days is a Sch 2,3,4 CD Rx valid for?
valid 28 days AFTER the prescribed date
Acitivities that can take place without the supervision of the pharmacist
- processing waste stock medicines or patient returned medicines (excluding CDs)
- receiving Rx directly from EPS systems, patients or collecting from a surgery
- taking medicines off the dispensary shelves e.g., when expiry date checking
Do pt return CD need authorised witness?
- SCh1, 2 only for expired stock in CD cabinet
- Not for pt returns – don’t need witness but need tomake record in CD return register
EEA HCP requirements
Must have qualifications and direct contact details, if not then refuse supply
Which of the following schedules of Controlled drugs do you need to retain the invoice for a minimum of 2 years?
3 and 5
Military Rx
- Miliary have a contract with pharmacies
- Have a designated prescription form – Fmed 296
- If you are presented with FMed and you do not have a contract, treat it like private, charge the pt and the military with reimburse them
What is the designated Rx form for military?
FMed 296
What can community nurse practitioners not prescribe?
Schedule 2-5 CD
What can podiatrists prescribe
- dihydrocodeine,
- diazepamp
- lorazepam
- temazepam
NOT MORPHINE
How many cigarettes per pack?
20
Doctors can requisition:
Morphine for pain relief
Which drugs can you prescribe in instalments?
- All SCh 2, buprenorphine and diazepam
Vet record keeping
- batch number
- If there is a written rx, name address of prescriber
- Name of medicine
- Date of receipt or supply
- DO NOT NEED expiry date of product
CD req form
- In emergencies a doctor can be supplied with a sch 2 CD – requisition in 72 hrs
- Pharmacy must send the original req to the NHS
- Written authorisation needs to be kept 2 yrs
- Purpose of req needed
- The use of approved form applies to both reqs for human and vet use
- Supplies made against faxed reqs are not legally acceptable
When making an emergency supply do you have to make a record in the POM register
Yes
- An entry must be made in the POM register within 72h
Vet label requirements
- Date of supply
- Name and address of animal owner + pharmacy, vet
- identification and species of animal
- ‘For animal treatment only’
Do directions have to be written in english
Preferred but some latin abbreviations
Are number of days of treatment legally required?
NO
When splitting medication what must the outer package contain?
- medicine name and quantitiy
- batch number and expiry
- handling
- storage
How many charges is canesten combi?
2
Which prescriptions need to be put in a red separator?
- SSP
- Bulk
- HMP
- broken bulk claim
- expensive item £100+
- specials
- handwritten amendments
- OOP expenses
Do prisoners use FP10 forms?
No
unless its an emergency
Do prisoners pay for their medication?
No - exempt
Do prisons need to use standardised CD req forms?
No
Do inhouse prison pharmacies need to be registered with the gphc if they are supplying medication within the prison
No
What do HCPs need to show when collecting CDs on behalf of thier patients?
- Name
- address
- ID
- letter from pt to allow permission for a rep to collect meds
Can dentists prescribe anythign on an NHS Rx
- Dentists cannot legally prescribe any medication on NHS Rx
- Use formularly
- They can legally prescribe anything privately
SCh 4 part 1
- CPCS = 5 days
- total qty does not need to be in words and figures
- EEA and Switzerland = valid for 28 days same as UK
- Can be repeated
Writing in the CD register
- Chronological order
- Legible and indelible
- Errors should never be crossed out
- no time limit on how long registers can be open for
Rewuirements from CD entry for medicines received
- Date received
- Qty
- Name and address of supplier
Invoice no can be included but not legal
Sativex
- Sch 4 1
- Must be sprayed into water before denaturing
- Keep record of stock
- Keep in fridge
- Safe custody is not required
How do you denature sativex?
Spray into water before
Sativex storage requirements
Fridge
What schedule is sativex?
4 part 1
What Sch drugs need to be denatured?
2,3,4(I)
What schedule is morphine 10mg/5mL
5
Pt who is prescribed morphine is pulled over, test shows higher levels of morphine in system than the permitted amount. There is no evidence that their driving is impaired. What is the most likely outome?
A statutory medical defence can be raised as they are not impaired
- but only if pt is taking it in accordance with the prescribed directions
- and not impaired
BDZ with legal driving limit
Clonazepam
Oxazepam
Lorazepam
Diazepam
Flunitrazepam
BDZ with NO legal driving limit
Alprazolam
CD requisition forms
- standardised form
- Name, address, occupation and signature of recipient
- Purpose
- Total amount supplied
Signed order requirements
- Strength, quantity
- name of school
- purpose
- signature of headteacher
Is CD requisition form required in the same legal entity?
- When supply is being made within the same hospital, it is the same legal entitiy
- No approved form is required
Do POM VPS need a written prescription?
- Not if prescribed and supplied by the same person
- If they are different people, then a written prescription should be generated
If a vet medication is MCS, what is the next in line to prescribe under the cascade?
Northern Ireland licensed vet med for same species, same indication
When should you not recommend homeopathic medication?
In serious conditions
What data regarding homeopathic medications needs to be submitted?
only safety and quality, not efficacy data
What does the RP notice need to include?
- Name
- GPHC no
- the RP is in charge of the premises at that time
Revalidation criteria
- 4 CPDs (at least 2 planned, all 4 could be planned)
- Peer discussion
- Reflective account
Essential services
- DMS
- Dispensing meds
- Disposal of meds
- Healthy living pharmacies
- Public health
- Repeat dispensing
4 principals of medicines optimisation
- Understand pt experience
- Evidence based choice of meds
- Ensure meds use is as safe as possible
- Make medicines optimisation part of routine practice
A mother and daughter come into the pharmacy to ask for EHC. The daughter is 12 what is the most appropriate action to take?
- Report to police on the grounds that she is 12
- anyone under the age of 13 cannot legally consent
Can you dispense Sch 2 or 3 medication on a Rx outside of the UK
No
pt should be referred to the Dr for Rx
Medication with require PPP
- SV
- Topiramate
- Oral retinoids
- Thalidomide
- Lenalidomide
- Polmalidomide
How long should women start effective CP before isotretinoin treatment
1m
Can you supply EHC in advance to a pt
Yes
If you have assessed the need for it
Reporting black triangle medication
- undergo additional monitoring set by MHRA
- all adverse effects must be reported through yellow card regardless of severity
CD req
