Legislation Flashcards
What does The Medicines Act (1968) state?
Medicines should be sold or supplied from registered pharmacies against a prescription written by a doctor or dentist
What are GSL medicines?
General sales list - able to purchase from shops (which are locked overnight) without pharmacist supervision as medications considered safe enough.
What do GSL medicines treat? Give 3 examples of a GSL medicine.
Treat minor, self limiting illnesses.
e.g. ibuprofen, hayfever tablets, CL sols and eyewashes
What are P medicines?
Pharmacy - kept behind the counter in a pharmacy, given with advise and warnings.
Generally safe but supervised and monitored to prevent misuse
What type of advise might a pharmacist give for P medicines?
Suitability of the medicine to the problem
Any contraindications
Any adverse drug reactions
Any interactions
Any specific precautions
What are POM medicines?
Pharmacy Only Medicine - can only be supplied against a prescription from a medical practitioner
Concentration of drugs high enough that one dose could have serious effects
What are CD medicines?
Controlled Drugs - controlled under the Misuse of Drugs Act 1971
Drugs with a strong potential for addiction
Controlled tightly to stop misuse, illegal obtainment and harm
Give 2 examples of a CD medicine
Morphine
Methadone
What are OTC medicines?
Over the counter - GSL or P
Anything that can be bought without a prescription - guidance from pharmacist or pharmacy assistant
Under which legislations can pharmacists supply certain POMs against a signed order from an optometrist?
POM Human Use Order 1997 (AKA ‘The POM Order’)
The Medicines (sale or supply) (Misc. Provisions) Regulations 1980
The Human Medicines Regulations 2012
Under what circumstances can an optometrist sell or supply specific POMs?
In response to an emergency situation (not defined - use professional judgment)
In the course of their professional practice
What changes occurred within The Medicines Act in 2005?
Relaxation of rules governing supply of GSL and P medicines by optometrists
Atropine and Pilocarpine removed from optometrist POM exemptions
Additional supply list was established (can only use with additional training)
What does ‘Sale and Supply’ mean?
Optometrist can sell or supply all relevant GSLs and Ps, and some POMs
What does ‘Use only’ mean?
POMs can be used by the optometrist but cannot be given to patient, e.g. local anaesthetics
Which POMs can be used in practice and supplied to the patient?
Chloramphenicol
Fusidic acid
Cyclopentolate hydrochloride
Tropicamide
Which POMs can be used in practice but not supplied to the patient?
All local anaesthetics
Which Ps are be used in the course of an optometrist’s professional practice?
Chloramphenicol (if px is over 2 years old, it’s for acute bacterial conjunctivitis, and for a max of 5 days)
Dipromopropamidine
Propamidine
Antihistamines
Which Ps have an optometric clinical use?
Mast cell stabilisers (Sodium cromoglicate, lodoxamide)
Adrenergic agonists (phenylephrine, xylometazoline)
Ocular lubricants
Staining agents
In the Yellow Card Scheme, what should be reported for new meds?
All suspected adverse drug reactions
In the Yellow Card Scheme, what should be reported for established meds?
All serious suspected ADRs
(includes off label, herbal, unlicensed)
What year was The Crown Report?
1999
What did The Crown Report recommend/propose?
All prescribers should take part in CPD
Inter-professional relationships should be improved
Changes to range and complexities of meds
Additional professions should be allowed to prescribe
What are the benefits of Optoms using ocular therapeutic drugs?
Ability to diagnose and treat common eye disorders
Reduces referrals and GP/Ophthalmologist workload
Increases quality of px care (get meds sooner)
Cost saving (for NHS - costs to train Optoms to appropriate level)
What year did the GOC change their rules to allow for SP/IP?
2000
When did the Health and Social Care Act come in and what did it allow?
2001
Allowed some healthcare professionals to become SP or IP
What year could Optoms become SP?
2005
What year could Optoms become IP?
2008
What are the responsibilities of an SP?
Prescribing for a px under a care plan set by an IP, continuing their care without the need to keep seeing the IP
e.g. in glaucoma
What are the responsibilities of an IP?
Assess px’s with undiagnosed conditions
Establish diagnosis
Determine treatment
What does IP allow for?
Effective treatment for emergency and non-sight-threatening eye conditions
What can an IP prescribe?
Anything for eye conditions and tissues around the eye within their area of expertise and competence
How long after qualification can you do SP or IP?
2 years post-qualification
What is a Patient Group Direction (PGD)?
Set of instructions describing how px’s with certain conditions should be managed/what can be prescribed in specific clinical situations
What is a Patient Specific Direction (PSD)?
Instructions for a named patient and the management of their condition which an SP follows
What GSL meds does an entry level Optom have access to?
All GSL meds for use in the course of their professional practice (e.g. CL sols)
What P meds does an entry level Optom have access to?
Chloramphenicol (px over 2, acute bact conj, max 5 days)
Propamidine
Dibromopropamidine
Antazoline
Sodium Cromoglicate
Lodoxamide (px over 4, allergic conj)
Phenylephrine
Xylometazoline
Fluorescein
Ocular lubricants
What POMs does an entry level Optom have access to for use and supply?
Chloramphenicol
Fusidic Acid
Tropicamide
Cyclopentate
What POMs does an entry level Optom have access to for use only?
Local anaesthetics (lidocaine, proxymetacaine, oxybuprocaine, tetracaine)
What additional POMs does an additional supply Optom have access to?
Azelastine
Emedastine
Ketotifen
Olopatadine
Diclofenac sodium
Lodoxamide
Nedocromil sodium
Acetylcysteine
Polymixin B
Atropine
Homatropine
Pilocarpine
Levocabastine
What can an additional supply Optom do?
Access defined list of extra ophthalmic drugs to treat non-sight threatening anterior segment conditions e.g. infective and allergic conjunctivitis, blepharitis, dry eye, superficial injuries
