Law Flashcards
Out of the following scenarios, which supply can be made legally by a pharmacist in a community setting for an emergency supply? All of the following scenarios are being requested by patients
A 25-year-old man has run out of pregabalin. He has been taking it for neuropathic pain for 3 years
A 70-year-old woman requires Oxycodone Hydrochloride 10mg modified release tablets. She has run out and is under palliative care
A 30-year-old man who requires Gabapentin for epilepsy
A 24-year-old woman who requires Phenobarbital for epilepsy
A 50-year-old who has run out of their regular buprenorphine patches. It is 11am, and their GP surgery is open
D
RATIONALE: CONTROLLED DRUGS CANNOT BE LEGALLY
SUPPLIED AS AN EMERGENCY SUPPLY, UNLESS THE SUPPLY
IS FOR PHENOBARBITAL FOR THE INDICATION OF THE
TREATMENT OF EPILEPSY. IN THIS CASE, A MAXIMUM
SUOPPLY IS 5 DAYS. IT IS ALSO WORTH NOTING THAT
EMERGENCY SUPPLIES SHOULD NOT BE MADE WHEN THERE
IS A MEANS TO ACCESS A PRESCRIBER, WHICH ELIMINATES
OPTION E.
A young woman presents to your pharmacy presenting with a complaint of a headache. She would like to buy some soluble paracetamol as she finds the film coating troublesome to tolerate. The maximum number of paracetamol soluble tablets (500mg) that you can sell this patient in a pharmacy is:
16 tablets
32 tablets
There is no legal limit
96 tablets
100 tablets
C
RATIONALE: THE LEGAL RESTRICTION FOR PARACETAMOL
STIPULATES THAT NO MORE THAN 100 NON EFFERVESCENT
TABLETS OR CAPSULES CAN BE SOLD TO A PERSON AT ANY
ONE TIME. HOWEVER, THERE ARE NO LEGAL LIMITS ON THE
QUANTITY OF OVER THE COUNTER EFFERVESCENT TABLETS,
GRANULES OR LIQUIDS THAT CAN BE SOLD; PROFESSIONAL
JUDGEMENT SHOULD BE USED TO DEDICE THE APPROPRIATE
QUANTITY TO SUPPLY AND WHAT LIMITS TO IMPOSE.
You receive a prescription for oromucosal midazolam (10mg/mL) for the treatment of seizures. The prescription was written by the GP on the 19/02/2024. The prescription is valid up to:
18/03/2024
20/03/2024
06/08/2024
19/02/2025
22/02/2024
A
RATIONALE: SCHEDULE 2 AND 3 PRESCRIPTIONS HAVE AN
EXPIRY OF 28 DAYS FROM THE DATE WHICH THE
PRESCRIPTION HAS BEEN DATED. DO NOT CONFUSE THIS
WITH 30 DAYS, WHICH IS THE MAXIMUM SUPPLY THAT CAN
BE ISSUED ON EACH PRESCRIPTION FOR SCHEDULE 2 AND 3
CONTROLLED DRUGS.
A prescription for Morphine Sulphate 10mg/5mL oral solution is valid for:
6 months
28 days
30 days
1 year
7 days
6 months as schedule 5 CD
Two pharmacists are working in a community pharmacy, with one of them being the designated responsible pharmacist. This pharmacist goes on a lunch break and is absent for 90 minutes. The other pharmacist assumes the role of the responsible pharmacist. When the now responsible pharmacist eventually goes for their break, their maximum time they can be absent for the remainder of the working day until the pharmacy next opens is:
30 minutes
60 minutes
90 minutes
120 minutes
150 minutes
Max 2 hours
In record keeping for POM-V and POM-VPS items that have been issued against prescriptions, specific pieces of information are required for the register. Which of the following is not an information requirement for the veterinary prescription register?
Batch No.
Date of Supply/Receipt
Formulation of the POM-V or POM-VPS supplied
Name and address of the prescriber
Name and address of the supplier and recipient
C
Formulation supplied
RATIONALE: ALL OTHER OPTIONS ARE A REQUIREMENT FOR
THE REGISTER FOR THE SUPPLY OF VETERINARY PRODUCTS,
HOWEVER THE FORMULATION OF THE POM-V/VPS IS NOT A
REQUIREMENT. SEE THE MEP FOR MORE INFORMATION.
Within the Misuse of Drugs Act, illicit drugs are categorised into three substances: A, B and C. Based on this legislation, which of the following statements is true:
Cannabis and cocaine are both examples of Class A drugs
Class A drugs pose the most risk to health, whereas Class C drugs pose the least risk to health
Class C drugs post the most risk to health, whereas Class A drugs pose the least risk to health
Pseudoephedrine and Amphetamines are both examples of stimulants, also known as “speed.”
Methadone is an example of a Class B drug
B
RATIONALE: CANNABIS IS AN EXAMPLE OF B CLASS A DRUG, WHEREAS
COCAINE IS AN EXAMPLE OF A CLASS A DRUG. AMPHETAMINES ARE
REFERRED TO AS “SPEED” BUT PSEUDOEPHEDRINE IS OFTEN FOUND IN
OTC FORMULATIONS FOR SINUSITIS. METHADONE IS AN EXAMPLE OF A
CLASS A DRUG. CLASS A DRUGS POSE THE GREATEST TRISK TO
HEALTH.
You are the responsible pharmacist at a community pharmacy carrying out a controlled drug stock check. You are locuming at this community pharmacy and notice that all the drugs that are in the controlled cabinet have been entered in the controlled drug register. Which of the following controlled drugs are not legally required to be entered in the register?
Morphine Sulphate 10mg/5mL oral solution
Oxycodone 10mg modified release tablets
Methadone 1mg/1mL sugar free oral solution
Methylphenidate 5mg tablets
Ketamine 50mg/5mL oral solution
A
RATIONALE: MORPHINE SULFATE 10MG/5ML ORAL SOLUTION,
WHILST A CONTROLLED DRUG, IS SCHEDULE 5, AND
THEREFORE HAS NO LEGAL REQUIREMENT TO BE ENTERED IN
THE CONTROLLED DRUG REGISTER. KETAMINE,
METHYLPHENIDATE, METHADONE AND OXYCODONE ARE ALL
EXAMPLES OF SCHEDULE 2 CONTROLLED DRUGS, AND
THEREFORE MUST BE ENTERED IN THE CONTROLLED DRUG
REGISTER.
You are the ward pharmacist covering one of the general medical wards and are given a discharge letter for tramadol 50mg capsules. The patient has just had a laparotomy, and so requires 50mg to be taken up to four times a day when required for pain relief. The NHS trust’s electronic prescribing system has unfortunately crashed, so the discharge letters are being handwritten. You look at the prescription to ensure that it is legally valid. Which of the following particulars is not a prerequisite for the prescription to be valid for tramadol?
The dose must be specified in both words and figures
The patient’s address
The prescriber’s address
The quantity supplied must be specified in both words and figures
The strength of the medication
A
RATIONALE: REMEMBER THAT IT IS THE QUANTITY DOSE
UNITS OF THE REQUESTED CONTROLLED DRUG THAT MUST BE
WRITTEN IN BOTH WORDS AND FIGURES; NOT TO BE
CONFUSED WITH THE DOSE. THE DOSE DOES NOT NEED TO BE
WRITTEN IN WORDS AND FIGURES.
Schools can obtain supplies of adrenaline autoinjectors or salbutamol inhalers from a pharmacy on a signed order. You receive a requisition for a school who requires additional supply. The following does not need to be included on the signed order
Name of the school
Purpose for which the product is required
Signature of the headteacher
The product details (including brand)
Whether a designated member of staff is trained to administer medicinal products, as this will determine the quantity you can legally supply
Whether a designated member of staff is trained to administer medicinal products, as this will determine the quantity you can legally supply
You are a pharmacist working in the dispensary, and you are accuracy checking prescriptions that have been dispensed. Part of the checking process involves checking that the printed label is correct. Which of the following is not a legal requirement that must appear on dispensed medicinal products:
Date of dispensing
Directions for use of the medicine
‘Keep out of the reach and sight of children’
Name of the patient
Precautions relating to the use of the medicine e.g. (for external use only)
C
RATIONALE: WHILST LISTING ‘KEEP OUT OF THE REACH AND
SIGHT OF CHILDREN’ ON THE LABEL IS RECOMMENDED, IT IS
CONSIDERED GOOD PRACTICE, AND IS NOT A LEGAL
REQUIREMENT.
You are a ward pharmacist who is putting together a presentation to deliver to trainee pharmacists on the safe custody of controlled drugs. Which of the following does need to be kept under safe custody?
Quinalbarbitone
Phenobarbital
Midazolam
Temazepam
Pregabalin
D
RATIONALE: QUINALBARBITONE IS A SCHEDULE 2, BUT IS
EXEMPT FROM SAFE CUSTODY. MIDAZOLAM, PREGABALIN,
AND PHENOBARBITAL ARE ALL SCHEDULE 3, BUT ARE
EXEMPT FROM THIS. COMMON SCHEDULE 3 CDS WHICH
REQUIRE SAFE CUSTODY INCLUDE TEMAZEPAM AND
BUPRENORPHINE.
A 21-year-old gentleman presents to your pharmacy stating that he has been feeling unwell and proceeds to try and pay for two packs of Sudafed decongestant tablets (pseudoephedrine hydrochloride). Each pack contains 12 x 60mg tablets. You explain that you can only sell him one pack; the patient becomes quite irritable and impatient, demanding an answer as to why you cannot sell him both packs. The legal reason that you cannot make this supply is because:
It is unlawful to supply a combination of products that contain more than 720mg of pseudoephedrine without a prescription.
It is unlawful to supply a combination of products that contain more than 180mg of ephedrine without a prescription.
The patient’s age may be indicative of potential abuse of pseudoephedrine for illicit purposes
The patient’s request for a large quantity is indicative of potential abuse of pseudoephedrine for illicit purposes
The patient’s irritable behaviour and impatience is indicative of potential abuse of pseudoephedrine for illicit purposes
A
RATIONALE: WHILST IRRITIBLE BEHAVIOUR AND
IMPATIENCE ARE BOTH POTENTIAL INDICIATORS OF
SUBSTANCE MISUSE, THIS WOULD NOT BE LEGAL GROUNDS
TO REFUSE SUPPLY, THIS WOULD FALL UNDER
PROFESSIONAL JUDGEMENT. AGE AND GENDER ARE ALSO
NEVER A REASON TO ASSUME ONE MAY BE USING OTC
PRODUCTS ILLEGALLY. THE PRODUCTS IN QUESTION
CONTAIN PSEUDOEPHEDRINE RATHER THAN EPHEDRINE, SO
OPTION B IS NOT RELEVANT.
You are a locum pharmacist working in a busy community pharmacy in the middle of an airport terminal in the United Kingdom, so it is not uncommon for patients to bring prescriptions that have been written by approved healthcare professionals from other countries. Which of the following countries is not on a list of approved countries that are legally recognised in the United Kingdom?
Austria
Croatia
Czech Republic
Russia
Switzerland
D
RATIONALE: ALL THE OTHER OPTIONS FALL WITHIN THE
EEA, EEA AND SWISS REGISTERED APPROVED HEALTH
PROFESSIONALS CAN PRESCRIBE ALL PRESCRIPTIONS,
EXCLUDING SCHEDULES 2 AND 3, BUT INCLUDING
SCHEDULES 4 AND 5.
A 65-year-old woman presents to your community pharmacy with a prescription for sodium valproate. The prescription is for two months’ supply. You have just been explaining to your trainee pharmacist that certain medications fall under the pregnancy prevention programme, to which legislation differs slightly. Based on the pregnancy prevention programme:
You can dispense against this prescription, provided the prescription is no more than 7 days old, otherwise it is invalid
You can dispense against this prescription, provided that the patient is able to confirm a negative pregnancy status with a pregnancy test
You cannot dispense against this prescription as under the PPP, only a maximum of 30 days’ supply can be issued
You cannot dispense against this prescription as under the PPP, only a maximum of 7 days’ supply can be issued
You can dispense against this prescription with no issues
E
RATIONALE: IT IS WORTH NOTING THAT THE PREGNANCY
PREVENTION PROGRAMME IS APPLICABLE WHEN THE PATIENT IS
OF CHILD-BEARING POTENTIAL. IN THIS CASE, A 65 YEAR OLD
WOMAN IS INCREDIBLY UNLIKELY TO FIT IN THIS CATEGORY. ANY
OTHER OPTION WOULD BE INAPPROPRIATE AND COULD DELAY
TREATMENT.
You are a pharmacist independent prescriber who has just qualified after finishing the independent prescribing qualification. You are looking at your scope of practice, and refreshing your knowledge as to what you cannot legally prescribe. Which of the following controlled drugs cannot be prescribed by a pharmacist independent prescriber?
Buprenorphine for the treatment of substance dependence
Diamorphine for the treatment of substance dependence
Methadone for the treatment of substance dependence
Ketamine for chronic pain
Pregabalin for peripheral neuropathy
Diamorphine for the treatment of substance dependence
Some healthcare professionals can sell, supply, or administer certain medications under specific exemptions made under the Human Medicines Regulations 2012. Which healthcare practitioner is not covered by this exemption?
Midwives
Nurses
Optometrists
Paramedics
Podiatrists/Chiropodists
B
RATIONALE: MIDWIVES, OPTOMETRISTS, PARAMEDICS,
PODIATRISTS/CHIROPODISTS AND OCCUPATIONAL HEALTH
CAN SELL, SUPPLY OR ADMINISTER CERTAIN MEDICATIONS
UNDER THE HUMAN MEDICINES REGULATIONS 2012. SEE THE
MEP FOR MORE INFORMATION.
A middle-aged woman presents to your community pharmacy with a veterinary prescription for cetirizine 10mg tablets. The prescription is for her dog, Spot. Which of the following is a legal requirement that this prescription must satisfy, to be legally valid?
The prescription must state “for administration under the cascade.”
The prescription must state the strength of the medication
c. The prescription must be a request for a veterinary medicine
The prescription cannot be older than 28 days
The prescriber’s GMC number must also be included on the prescription
A
RATIONALE: SEE THE MEP 3.5 UNDER VETERINARY MEDICINES. IT IS
UNLAWFUL TO SUPPLY A HUMAN MEDICINE AGAINST A VETINARY
PRESCRIPTION UNLESS IT IS PRESCRIBED BY A VETRINARY SURGEON
AND SPECIFICALLY STATES THAT IT IS FOR ADMINISTRATION UNDER
THE CASCADE.
A patient presents to your community pharmacy and asks to buy some Esomeprazole 40mg tablets. He explains that he saw an advertisement of the television, which led him to believe that the tablet would effectively “cure” his acid reflux. He has been told by his GP that he should try and cut back on his alcohol intake and lose weight, but the patient feels that would take too long, and it’s easier to take a tablet. Regarding the advertisement of medicines in the United Kingdom, which of the following is not true?
Prescription Only Medications can never be advertised
The GPhC regulates all advertising of medicines
The MHRA will often vet medicines advertisements prior to their publication to assess their appropriateness
Unlicensed medications cannot be advertised
Websites are not allowed to have the names of prescription only medications in their web address
B
RATIONALE: THE GPHC DOES NOT REGULATE THE
ADVERTISING OF MEDICINES, THIS RESPONSIBILITY FALLS
WITH THE MHRA
An older gentleman presents to your community pharmacy with a veterinary prescription for his pet dog, Fido. The medication itself is licensed for use in dogs. Which of the following particulars is not a legal requirement to appear on the label for the dispensed product?
Address of the animal’s owner
Address of the pharmacy
Address of the prescriber
Name of the prescriber
Name/identification of the animal
C
RATIONALE: WHEN A MEDICINE IS SUPPLIED FOR USE UNDER
THE CASCADE, OPTIONS A, B, D AND E MUST APPEAR ON THE
DISPENSING LABEL UNLESS THEY ALREADY APPEAR ON THE
PACKAGING AND ARE NOT OBSCURED BY THE DISPENSING
LABEL. OTHER PARTICULARS INCLUDE THE DATE OF SUPPLY,
EXPIRY OF THE PRODUCT, NAME AND DESCRIPTION OF THE
PRODUCT, DOSAGE AND ADMINISTRATION INSTRUCTIONS,
SPECIAL STORAGE, NECESSARY WARNINGS, ANY APPLICABLE
WITHDRAWAL PERIOD, THE WORDS “FOR ANIMAL TREATMENT
ONLY” AND “KEEP OUT OF REACH OF CHILDREN”
You are a junior pharmacist running a cardiac medications webinar for patients who have recently been discharged from the cardiac ward. Patients who are started on medications for the treatment of acute coronary syndrome are invited to attend this webinar one week after discharge to be re-educated on the purposes of their medication, what they are for, and how to manage them. One patient asks you about the expiry date on her glyceryl trinitrate spray. On the packaging, the expiry date states: “Use by 12/2026”. She states she hasn’t needed it yet, so it hasn’t been opened. This means the patient should:
Not use it at any date past the 31st December 2026
Not use it at any date past the 30th November 2026
Not use it at any date past the 1st December 2026
Not use it at any date past the 1st January 2027
Not use it for two years from the point where the product is opened
A
RATIONALE: USE BY IMPLIES THAT AFTER THE END OF THE
MONTH STATED, IT IS NO LONGER FIT FOR USE AS STATED
BY THE MANUFACTURER.
Section 4 of the Road Traffic Act 1988 includes an offence of driving whilst impaired through drugs, regardless of whether the drugs are being used legitimately. This means that if a patient driving is found with specified drugs in their body above an acceptable limit, even if he or she is using them as prescribed, they may still be prosecuted. In which scenario could a statutory medical defence be raised:
The driver has no evidence that the drug has been prescribed or purchased legally, but their driving is not impaired
The driver has no evidence that the drug has been prescribed or purchased legally, but their driving is not impaired
The driver has evidence that the drug has been taken in accordance with instructions from a healthcare professional, but their driving is impaired
The driver has evidence that the drug has been taken in accordance with instructions from a healthcare professional that differs from that in the patient information leaflet, but their driving is impaired
The driver has evidence that the drug has been taken in accordance with instructions from a healthcare professional, but their driving is not impaired
The driver has evidence that the drug has been taken in accordance with instructions from a healthcare professional, but their driving is not impaired
E
RATIONALE: STATUTORY MEDICAL DEFENCE IS ONLY
APPLICABLE IN CASES WHERE THE PATIENT’S DRIVING IS
NOT IMPAIRED, BUT THE DRUG IS OVER AN ACCEPTABLE
LIMIT. ANY OTHER CIRCUMSTANCE WOULD NOT BE
ACCEPTABLE.
You are an owner of a community pharmacy, and you are going through old records. To tidy up, you are determining which records need to be kept for how long. The pharmacy record, which contains the responsible pharmacist register, must be kept for a minimum of:
1 year
2 years
5 years
10 years
15 years
5 years
