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MEP Flashcards

1
Q

What are common themes in patient centred healthcare

A

Treating patients as people and equal partners in decision making

Putting them at the centre

Respect their preference

Compassion, dignity and empathy

Support for self care and independence

Patient choice control and influence

Good communication

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2
Q

What is medicines optimisation

A

Ensuring the patient gets the best possible outcome from their medicines.

Right patient right medicines right time

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3
Q

What can you help patients with in order to improve medicines optimisation

A 
Take medicine correctly 
Improve adherence 
Abound taking unnecessary medicines 
Reduce wastage of medicines 
Improve medicine and patient safety
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4
Q

What are the 4 elements of medicines optimisation

A

Aim to understand the patients experience

Evidence based choice of medicines

Ensure medicines use is safe as possible

Make medicines optimisation part of routine practice

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5
Q

What’s the benefits of a comprehensive medication review for patients on poly pharmacy

A

A reduction in problematic poly pharmacy

Improved health

Patients more likely to take meds

Fewer wasted meds

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6
Q

What is professional judgement

A

Use of accumulated knowledge and experience as well as critical reasoning to make and informed professional decision

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7
Q

What does professional judgement take into account

A 
The law 
Ethical considerations 
Relevant standards 
All other relevant factors 
Resonate the core values, attitudes and behavioural indicators of professionalism
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8
Q

How can you exercise professional judgement?

A

Identify the ethical dilemma or professional issue

Gather relevant info

Identify possible options

Weigh up the benefits and risk of each option

Choose an option

Record

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9
Q

What’s important about social media and being in a professional field

A

Should be responsible

Maintain boundaries

Respect confidentiality

Be aware of the potential audience and the circulation of things

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10
Q

What is professional indemnity

A

Insurance

Requirement to be covered if you’re registered with the GPhC before you start working in your role

The GPhC has adviced that the professional indemnity arrangement you have in place provides appropriate cover

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11
Q

What’s used as a consultation skill assessment

A

Medication related consultation framework (MRCF)

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12
Q

What is medicines reconciliation

A

Process of identifying an accurate list of a patients current medicine and comparing these with the medicines in use

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13
Q

What sources of information can be used when carrying out medicines reconciliation

A 
Patient or patient representative 
Patients own meds 
Repeat prescriptions 
GP referral letter
Patients GP surgery 
Hospital discharge summary 
Community patient medicine records 
Care home record 
Other healthcare clinics
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14
Q

What is a punitive culture

A

Based on assigning blame and punishment

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15
Q

How is patient care affected by a punitive culture

A

People fear being honest and the opportunity to learn is reduced

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16
Q

Disadvantage of a no blame culture

A

Can breed compliance or nonchalance which can impact patient safety

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17
Q

Why is a just culture needed in healthcare

A 
Removes fear 
Increases sharing 
Reports concerns 
Being able to learn from mistakes and incidences 
Being able to share lessons
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18
Q

What are the culture principles for patient safety incidences

A

Patient safety is paramount

Deliberate harm to patient safety should not be tolerated

Patient safety is maintained by professionals raising concerns and learning from incidents

Individual accountability should be fair

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19
Q

What’s the purpose of reporting near miss errors

A

Prevent similar mistakes from happening in the future

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20
Q

What needs to be submitted annually from the second year of registration as a revalodation of pharmacy professionals

A

4 cpd record - two must be planned learning activities

A peer discussion

A reflective account

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21
Q

What’s the purpose of RPS faculty

A

Pharmacy professional recognition programmes provides you with a way of identifying what you need to know at different levels of practice, across all sectors

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22
Q

What are the steps of the research process

A

Identify topic

Critically review evidence

Clarify research question and aim

Select research design and method

Develop research protocol and proposal

Ethics and research governance approvals

Data collection and analysis

Interpretation of findings

Dissemination of findings (present)

Evaluate activity and outcomes

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23
Q

What are the 3 classification of medicines

A

Gsl
P
Pom

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24
Q

What does the term PO mean for classifying medications

A

A product that is licensed as a GSL medicine but for which the manufacture wishes to restrict sales or supplies through pharmacies

Eg: fybogel 30 pack

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25
Q

Can gsl be sold in pharmacist without the pharmacist ?

A

No there needs to be a RP but it can be sold if they’re physically absent for a short period of time while remaining responsible

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26
Q

What are P medicines

A

Medicinal product that can be sold from a registered pharmacy premises by a pharmacist or under supervision from one

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27
Q

What classification of medicines make up OTC

A

Gsl and p

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28
Q

What appropriate practitioners can prescribe poms

A 
Doctor 
Dentist 
Supplementary prescriber 
Nurse independent prescriber 
Prescribing pharmacists 
Prescribing optometrists 
Podiatrist
Physiotherapist
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29
Q

Whats the maximum p supply for pseudoephedrine and ephedrine

A 
Pseudoephedrine 720mg (equivalent to 12x 60mg tabs)
Ephedrine 180 mg
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30
Q

Can you supply pseudoephedrine and ephedrine together otc

A

No

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31
Q

How can pseudoephedrine and ephedrine be misused

A

Can be used to make methylamphetamine

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32
Q

From what age is emergency contraception licensed to be sold otc

A

16

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33
Q

Can pharmacist give an advanced supply of oral EHC

A

Yes but they should ensure patient is competent, clinically appropriate and aware on the correct way to take the medicine

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34
Q

Which ehc should you give for children under 16 (any age for women of child baring age)

A

Ulipristal

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35
Q

What ages is sexual activity still an offence but may be considered consensual

A

13-16

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36
Q

Maximum otc supply of paracetamol or aspirin

A

No more than 100 non effervescent tablets

No limit on effervescent tablets, sachet etc

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37
Q

What indication can codeine and dihydrocodeine be sold otc

A

Treatment of acute moderate pain not relived by paracetamol, ibuprofen or aspirin alone

All other previous indications like cold flu cough sore throat have been removed

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38
Q

What are the prescription requirements

A 
Signature 
Address 
Date 
Particular (indicates appropriate practitioner)
Name of the patient 
Address of the patient 
Age of the patient

Prescriptions must be written in indelible ink (carbon copies must be signed in ink)

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39
Q

Can you dispense a prescription in Welsh

A

Yes no law specifying language

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40
Q

Can you supply a CD if the prescription is in another language

A

As long as the prescribers address is in the UK

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41
Q

Can control drugs be sent as a batch prescription

A

Each batch needs a script

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42
Q

What’s the time limit on an owing medication

A

The validity period on the date of a prescription

Poms and cd sch 5- 6 months
P and gsl- 6 months
Sch 2,3 and 4- 28days

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43
Q

How long should prescription records be kept

A

POM for 2 years

CD schedule 2+3 records made in a cd register and retained for 2 years

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44
Q

What information should be recorded in a certain register

A 
Supply date 
Prescription date 
Medicine details
Prescriber details 
Patient details
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45
Q

What can you look out for to help detect fraudulent prescriptions

A

Is it for a large or excessive quantity

Is the prescriber known

Is the patient known

Has the title Dr been inserted before the signature

Is the behaviour of the patient indicative

Is the medication known to be commonly misused

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46
Q

What medications are not available on an EEA prescription

A

Schedule 1,2 and 3 CDs

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47
Q

Requirement for an emergency supply

A

If the request originates from an EEA prescriber

Prescription needs to be received in 72 hours

Cd sch 1, 2 and 3 cannot be given

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48
Q

Legally what should be included on medicinal labels

A 
Name of patient 
Name and address of supplying pharmacy 
Date of dispensing 
Name of medicine 
Direction for use 
Precautions
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49
Q

What should packed down dispensed medication include

A 
Name of the medicine 
Quantity of medicines in the container 
Quantitative particular of the medicines (ie the ingredients)
Handling and storage instructions 
Expiry date 
Batch number
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50
Q

What is covert administration

A

When medicines are administered in a disguised format without the knowledge or consent of the person receiving them

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51
Q

What are the conditions for an emergency supply at the request of a prescriber

A 
Relevant prescriber 
Emergency 
Prescription within 72 hours 
Directions as per the prescriber
Not for CDs except phenobarbital 
Record kept in the POM register on day of supply or day after
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52
Q

What are the conditions for an emergency supply at the request of the patient

A

Interview the patient

There’s an immediate need

THEYVE had previous treatment

Dose is known

Not for CDs except phenobarbital

Length of treatment
(CD 5 days, Pom max 30 days, packs that can’t be split the smallest pack, contraceptives a full cycle)

Records kept in the POM register on day of supply or day after

Labelling ‘emergency supply’ should be added

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53
Q

Where can you refer a patient after refusing an emergency supply

A

Nhs walk in
A and e
111
Their gp

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54
Q

What changes have been made to emergency supply in a pandemic

A

Am interview would not need to take place

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55
Q

When can salbutamol be dispensed and stored by schools (since 2014)

A

If there’s a written order by the principal or head teacher

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56
Q

What information should be included in the signed order for sabutamol or adrenaline autoinjector pens for schools

A

The name of the school
The purpose of the product
The total quantity required

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57
Q

What records need to be kept for a supply of salbutamol inhalers or adrenaline autoinjector pens to schools

A

The signed order needs to be kept for 2 years

Good practice to record it including:
Date the Pom was supplied
Name, quantity, formulation and strength
Name and address of the person supplied to
The purpose of the supply

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58
Q

What else can be offered to schools when supplied salbutamol

A

Spacers

Counselling

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59
Q

Since when can adrenaline autoinjector pens be supplied to schools

A

October 2017

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60
Q

What else can be asked for the supply of adrenaline autoinjector pens for school storage

A

Instruction of administration
General info like storage, disposal, expiry
Importance of keeping a record

Strength varies with age and weight
Brands have different instructions

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61
Q

When was the supply of naloxone without a prescription on certain cases made acceptable

A

October 2015

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62
Q

Can emergency naloxone administration happen if the responsible pharmacist is not present

A

Yes

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63
Q

What should you be aware of when dispensing self prescribed prescription or prescriptions for close friend or family

A

Considered poor practice to self prescribe

Prescriber may be influenced or have poor judgement

Prescriber may be unable to conduct a proper clinical assessment

Professional bodies are told to avoid self prescribing

Abuse potential

CDs only prescribed in exceptional circumstances

Do the local guideline cover self prescribing

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64
Q

What is the pregnancy prevention programme

A

Education for the healthcare professionals and patients, therapy management and distribution control

To avoid patient getting pregnant while on treatment and a month after while on meds that are teratogenic

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65
Q

What’s biologic

A

Medicine made from a variety of natural sources that may be human, animal or microorganism

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66
Q

What’s a bio similar

A

Biological medicine that is similar to an already licensed biologic medicine in terms of quality safety and efficacy

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67
Q

How should biosimilars be prescribed

A

By brand names

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68
Q

What’s Pom-v

A

Prescription only medication that can only be prescribed by a vet surgeon and supplied by a vet surgeon or pharmacist with a prescription- records kept for 5 years

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69
Q

What’s poms vps

A

Prescription only medication that can be prescribed and supplied by a vet surgeon, pharmacist or suitable qualified person on an oral or written prescription

Written required if supplier is not a prescriber- records kept for 5 years

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70
Q

What’s nfa-vps

A

A catergory of medicines for non-food animals (eg: dogs) that can be supplied by a vet, pharmacist or suitable qualified person

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71
Q

What’s avm-gsl

A

An authorised vet medicine that is available on general sale

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72
Q

Which vet meds category require a prescription

A

Pom v
Pom vps
Medicines supplied under the veterinary cascade

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73
Q

For medicines prescribed under the vererinary cascade, Pom-v and Pom- vps
what must be present on the prescription

A

Name, address, phone number, qualification and signature of prescriber

Name and address of owner

Identification and species of the animal and its address

Date (6 month validity, cd 28 days)

Name quantity dose and administration instructions of the required medicine

Necessary warnings and withdrawal period

Statement showing the med is prescribed under the vet cascade

If CD drugs, state the item has been prescribed for an animal or herd under vet care

If prescription repeatable, number of repeats

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74
Q

When can human meds be given to animals

A

If it is supplied by veterinary surgeon and specifically states that it is for administration under the cascade

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75
Q

What is the veterinary cascade

A

Supply a licensed vet med

An existing licensed vet med for another species or different condition

A licensed human medicine or an EU licensed vet med

Extermporaneous or specially manufactured medicines

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76
Q

Can an animal owner purchase otc meds for the animal

A

No

It must follow the veterinary cascade

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77
Q

What must appear of a dispensed label for meds supplied under the veterinary cascade

A

Name of the prescribing vet surgeon

Name and address of the animal owner

Name and address of the pharmacy

Identification and species of the animal

Date of supply

Expiry date of product

Name and description of product

Dosage and administration instructions

Storage instructions

Warning

The words ‘for animal treatment only’

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78
Q

What must be recorded when supplying Pom v and pom vps

A 
Name of medicine 
Date of the receipt or supply 
Batch number 
Name and address of the supplier 
Name and address of prescriber 
Record kept for atleast 5 years

Annual audit required

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79
Q

When was the CDs classified

A

2001

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80
Q

Name the cd classification

A 
Sch1 CD lic POM
Sch2 CD POM
Sch3 CD no Pom register 
Sch4 CD benz Pom and CD anab Pom
Sch5 CD inv P and CD inv P
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81
Q

When what gabapentin and pregabalin rescheduled and to what

A

1/4/2019

To schedule 3

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82
Q

Which cd schedules are valid for 28 days

A

1-4

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83
Q

Which CDs require a home office license

A

Schedule 1

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84
Q

Which CDs need a license when travelling or being imported or exported

A

1,2,3,4a

4b licence needed unless it’s for a patient self administering

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85
Q

What are the legal requirements for a controlled drug requisition

A 
Signature of recipient 
Name of the recipient 
Address of the recipient 
Profession or occupation 
Total quantity of drug 
Purpose of the requisition
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86
Q

Prescription requirements for schedule 2 and 3 CD (some apply to 4)

A 
Signature 
Date (valid for 28 days including owing)
Prescribers address 
Dose (words and figures)
Form
Strength 
Quantity- in words and figures (recommended not to exceed 30 days)
Name of patients 
Address of patient 
‘For dental treatment’ if cd prescribed by a dentist 
Instalment directions
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87
Q

What technical errors can be amended by the pharmacist on a cd script

A

Spelling mistakes

Either words or figures (not both) of the total quantity is missing

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88
Q

What control drugs must be kept under safe custody

A

Schedule 1
Schedule 2 except liquid
Schedule 3 unless except

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89
Q

What control drugs need to be denatures before disposal

A

All CDs in schedule 2,3 and 4 (part 1)

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90
Q

For control drugs received what must be recorded

A

The date supply received
The name and address from whom received
Quantity received

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91
Q

For controlled drugs supplied what must be recorded

A 
Date supplied
Name and address of recipient 
Details of authority to possess 
Quantity supplied 
Details of person collecting 
Whether proof of identity was requested 
Whether proof was provided
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92
Q

Where does it need to be recorded if a patient has an adverse reaction

A

Yellow card scheme

Patients notes

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93
Q

First group driving offence drugs

A 
Cannabis 
MDMA (ecstasy)
Ketamine 
Methylamfetamine 
Cocaine 
LSD 
Heroin
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94
Q

Second group driving offensive drugs

A 
Clonazepam 
Diazepam 
Lorazepam 
Oxazepam
Temazepam 
Flunitrazepam 
Methadone 
Morphine 
Amfetamine
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95
Q

What does being the responsible pharmacist involve

A

Secure and effective running of the pharmacy
Display notice (name, gphc number)
Complete the pharmacy record
Establish, maintain and review pharmacy procedures

96
Q

What must be recorded in terms of responsible pharmacist

A

RP name
RP gphc number
Date and time they were RP for
If RP was absent from the premises (date, time left and returned)

Records must be kept for 5 years

97
Q

What’s the maximum length an RP can be absent

A

2 hours in a whole day

98
Q

What arrangements should be made if the RP is absent

A

Ensure the pharmacy can continue to run safely
Remain contactable and able to return
If not contactable, arrange another contactable pharmacist

99
Q

What’s the purpose of professional standards

A

To describe good practice, good system of care and good ways of working

100
Q

What are the standards for pharmacy professionals

A
  1. Provide person-centred care
  2. Work in partnership with others
  3. Communicate effectively
  4. Maintain, develop and use their professional knowledge and skills
  5. Use professional judgement
  6. Behave in a professional manner
  7. Respect and maintain the Persons confidentiality and privacy
  8. Speak up when they have concerns or when things go wrong
  9. Demonstrate leadership
101
Q

What are the standards/ principles for registered pharmacies

A
  1. The governance arrangements safeguard the health, safety and well-being of patients and the public
  2. Staff are empowered and competent to safeguard the health, safety and well-being of patients and the public
  3. The environment and condition of the premises from which pharmacy services are provided and any associated premises safeguard the health, safety and well-being of patients and the public
  4. The way in which pharmacy services, including the management of medicines and medical devices, are delivered safeguards and health, safety and well-being of patients and the public
  5. The equipment and facilities used in the provision of pharmacy services safeguard the health, safety and well-being of patients and the public
102
Q

Under what circumstances may it be appropriate to disclose confidential information

A

Has consent from the person under their care

By law

Should do so in the public interest and /or must do so in the vital interest of the person receiving treatment or care

103
Q

What are the two types of consent

A

Explicit- getting consent verbal or written

Implied consent- getting consent indirectly (eg: patient bringing their prescription to the pharmacy)

104
Q

What makes consent valid

A

The patient having capacity

Must be acting voluntarily

Must have sufficient, balanced information to all an informed decision to be made

Be capable of using and weighing up information

Understand the consequence of not giving consent

105
Q

whats considered a child and whats considered a young person

A

child: under 16

young person 16 and 17

106
Q

are children presumed to have capacity

A

no, they must demonstrate they have capacity.

young people are presumed to have capacity.

107
Q

who can give consent for a child or young person without capacity

A

the parent or court

108
Q

can pharmacist give consent in urgent treatment

A

yes, if it is in the patients best interest

109
Q

How can you minimise the risk of dispensing error

A

organised to keep distractions to a minimum

atmosphere should encourage good concentration

alert staff of any dangers

keep a segregated area of of the dispensary workbench for the dispensing process

segregate prescriptions on the work bench to avoid mixing people meds

110
Q

what do you do in the event of a dispensing error

A

establish if the patient has taken any meds

ask to inspect the incorrect med

apologise

never try to minimise the seriousness

supply the correct meds

provide details on how to complain

establish how it happened

follow SOPs to report the error

record the error made to learn from it

inform the RP at that time

111
Q

How many cpds must pharmacist record per year

A

4

112
Q

EHC: If the patient vomits within how many hours of Levonelle/ Ella One should they take another dose?

A

2 hours of taking Levonorgesterel3 hours of taking Ella One (Ulipristal acetate)

113
Q

What medication can Levonorgestrel increase the toxicity of?

A

What medication can Levonorgestrel increase the toxicity of?

114
Q

Can EHC be used in breast feeding women?

A

Levonorgestrel appears in small amounts in breast milk- should not be harmful, but take tablet after a feed to allow maximal team until next feed.Ulipristal acetate is present in breast milk for 1 week after administration. Advise mother not to BF in this time but express and discard the milk to maintain lactation.

115
Q

Is it okay to issue carbon copies of prescriptions to patients?

A

Yes as long as they’re signed in ink

116
Q

What length of time to dispense requirements apply to EPS prescriptions?

A

Same things- must be dispensed 6 months from appropriate date, 28 days for CDs

117
Q

Are Rx’s for Sch 2, 3, 4 and 5 CDs repeatable?Are private prescriptions repeatable?

A

Rx’s for Schedules 2 and 3 CDs are NOT repeatable.Rx’s for Schedule 4 and 5 are.
Private prescriptions can be repeated, indicated by prescriber, e.g. ‘Repeat x 3’ means the Rx can be dispensed 4 times in total.

118
Q

If the number of repeats is not stated on an Rx- i.e. it just says ‘Repeat’, they can only be repeated once. What is the exception to this rule?

A

Prescriptions for an oral contraceptive. This can be dispensed 6 times if the number of repeats is not specified, within 6 months of appropriate date.

119
Q

You have OWINGS on a Rx for P meds and GSL meds. How long do you have to dispense these owed items?

A

6 months6 months for POMS + Sch 5 CDs28 days for Sch 2,3,4 CDs

120
Q

Prescriptions for What are exempt from having to be written in the POM register?

A

For oral contraceptives

For schedule 2 CDs- as these will be recorded in the CD register

121
Q

Can you dispense against a Faxed prescription?

A

No- not legally validNot written in indelible inkRisk not receiving an original prescriptionDo it as an emergency supply instead- then it is on their back to get the original prescription to you

122
Q

Emergency supplies cannot be made for CDs Schedule 1, 2, 3. With the exception of what?

A

Phenobarbital (also called phenobarbitone) for EPILEPSY by as UK-registered Doctor(NOT EEA)

123
Q

Maximum quantity for an Emergency supply for CD’s (Phenobarbital, Schedule 4’s and 5’s) is?
What about for POMs?

A

CD’s: 5 daysSo things like Zopiclone can only be given for max 5 days. POMs: 30 days

124
Q

How long are prescriptions for Isotretinoin valid for under the pregnancy prevention programme? What is the maximum quantity that can be supplied?

A

R valid for 7 days- I.e. have to dispense it within 7 days of date due to pregnancy test window. Rx’s presented after this 7 days are considered expired.Maximum of 30 days supply. If not under the Pregnancy prevention programme, more than 30 day

125
Q

You are working a Lloyds pharmacy and realise you do not have any spiriva inhalers left. Mrs P is due to come in an hours time to pick up her prescription and you know she is going away tomorrow. Can you ring up Boots down the road and request a spiriva inhaler to meet this patients needs, do you need a Wholesalers Dealers License to do so?

A

Community + Hospital pharmacies can obtain small quantities of a medicine from other pharmacies to meet patients needs.A Wholesalers dealers license is not needed for this, as it is considered as ‘Provision of healthcare services’, not seen as commercial dealing.

126
Q

Use by?

Expires?

A

Use by: End of previous month

Exipires: End of current month

127
Q

A patient returns some unwanted medicines to your pharmacy. Some of it is blister strips in their outer packaging, some of it is bottles of liquids. How should these be disposed?

A

Blister strips can be removed from their outer packaging (but do not pop out tablets from blister) and ensure and patient info is confidentially disposed of. Liquids- do not empty the contents into the waste container- just put the whole bottle in- could be hazardous otherwise.

128
Q

Whats the issue with using Adrenaline in patients on beta blockers?

A

Severe anaphylaxis in patients taking beta-blockers may not respond to adrenaline—consider bronchodilator therapy, e.g. IV salbutamol, adrenaline can cause severe hypertension and bradycardia in those taking non-cardioselective beta-blockers.

129
Q

What are the symptoms of anaphylaxis?

A

Rapid development of airway and/or hypotension.Skin and mucosal changes may be present, e.g. urticaria (hives like rash) and angio-oedema of the face.

130
Q

What 5 things relating to the Veterinary prescriber must be present on the prescription for it to be valid?

A

Name, Address, Telephone number, Qualification, Signature

If the Rx is for a Schedule 2 or 3 CD: Royal college of Veterinary Surgeons Qualification number is needed!!

131
Q

How long are veterinary prescriptions valid for? What if its a CD?

A

6 monthsSchedule 2, 3, 4 CD Rx’s valid for 28 daysSchedule 5 CD Rx’s for 6 months(This is the same as human Rx’s)

132
Q

Can veterinary prescribers use ‘As directed’ on their prescriptions?

A

No- not acceptable as an administration instruction, should state ‘with food’

133
Q

When must the words ‘Prescribed under the cascade’ be used on veterinary prescriptions?

A

The cascade allows the supply of medicines not licensed in animals. It is ILLEGAL to supply a human medication for an animal if this wording is not present.E.g:-A medicine authorised in the UK for human use but being used in an animal -A vet medicine not authorised in the UK but in another European country for use in any animal species and in accordance with an import certificate issued by the VMD

134
Q

When is ‘prescribed for an animal or herd under the care of the veterinarian’ required on a vet prescription?

A

For Schedule 2 or 3 CD’sNB: Usual CD prescription requirements apply here- words and figures for quantity,

135
Q

How long should veterinary prescriptions be retained for? What about records (e.g. POM book entries) and documents for Vet supplies in general?

A

Keep all of them for 5 years They do not get submitted to an NHS agency

136
Q

Are orignal private prescriptions for Schedule 2 and 3 CDs retained in the pharmacy? If so, for how long?

A

No- they must be sent of to the relevant NHS agency. NB: these Rx’s will be on standardised FP10PCD forms

137
Q

If a vet prescribes a product and writes ‘prescribed under the cascade’ on the Rx, but there is an alternative licensed vet medicine that could be used, what happens?

A

The cascade requires the Licensed veterinary product to be supplied, not the medicine only licensed for human use, this is because licensed veterinary products should be given where available, even if it is for use in a different species.

138
Q

What is the difference between POM-V and POM-VPS?

A

POM-V: Can only be prescribed by a VETERINARY SURGEON. The animal must be clinically assessed before these are prescribed. POM-VPS: Can be prescribed by a Registered qualified person- e.g. Veterinarian, Pharmacist. A clinical assessment of the animal is not needed in this situation, however sufficient info must be provided e.g. how the animal is kept. Minimum quantity should be prescribed.

139
Q

What is a NFA-VPS Vet medicinal product?

A

Can be SUPPLIED by a Registered Qualified Person e.g. a Vet, a pharmacist, and DO NOT need a prescription- i.e. the vet can give this directly to the animal without needing to write and Rx for it. Minimum quantity should be supplied.

140
Q

What is a AVM-GSL Vet medicinal product?

A

Products with no legal restrictions- same as OTC products.

141
Q

How often must pharmacies supplying POM-V and POM-VPS medicines undertake an audit?

A

ANNUALLY

142
Q

A woman comes to your counter with a pack of ranitidine tablets. You ask “are these for yourself?” and she says no “they’re actually for my dog”. Can you sell them?

A

It is unlawful to sell unlicensed veterinary medicines/ human medicines, including GSL and P medicines, unless this takes place under the cascade. This applies even if the Vet has told to owner to purchased an OTC human medicine. It is on your back.

143
Q

How does a patient go about taking Controlled drugs abroad on holiday?

A

A personal license is NOT required if they are carrying less than a 3 month supply A covering letter from their prescriber is advised

144
Q

Where a CD prescription is written by a dentist, what extra wording is required on the prescription?

A

“For dental treatment only”

145
Q

Is temazepam exempt from Schedule 2 and 3 CD prescription requirements? (e.g. Quantity in words and figures etc)

A

No- not exempt from prescription requirements as of June 2015.It is a CD schedule 3, only thing its exempt from is CD register requirements.Must be kept in CD cupboard

146
Q

The strength only needs to be written on a CD prescription if there is more than one strength available. True or False?

A

True

147
Q

How should quantities of liquids be expressed on CD prescriptions?

A

In millilitres- and best to write this out in full.Words and figures

148
Q

Is abbreviations like ‘tabs’ and ‘caps’ acceptable on a CD prescription?

A

Yes

149
Q

How long are instalment prescriptions valid for? (i.e. Methadone prescriptions)

A

The first instalment has to be dispensed within 28 days of the appropriate date on the prescription, then the rest can be supplied any time afterInstalment prescriptions on need to be signed once by the collector (but not a legal requirement)

150
Q

Most Schedule 3 (CD No Reg POMs) are exempted from being stored in the CD cabinet. Which two drugs are not exempt from this?

A

Temazepam

Buprenorphine

151
Q

True or false: CD register entries must be entered on the day of supply?

A

False- can be entered the following day

152
Q

A private prescription for buprenorphine tablets is presented to you. It is not on a standard FP10PCD form. The prescriber has included his General Medical Council number. You can dispense it. True or False?

A

False
ALL private CD Rx’s MUST be on the standard FP10PCD form, following the Shipman enquiry.Also the GMC number is NOT the correct number to include: must be the prescriber ID number issued by their relevant NHS agency!Only exception: Vet Rx’s. In hospitals if the private Rx was written by someone in that hospital. If it has come from outside the hospital: must be on FP10PCD.

153
Q

You receive a prescription on an FP10PCD for Morphine sulphate tablets, Zopiclone and ibuprofen. Is there any issues here?

A

You are required to send FP10PCD forms off to the relevant NHS agency. This is so they can keep track of CD’s being prescribed. The Zopiclone (sch 4) and ibuprofen need to be entered into the POM book and the prescription for these kept for 2 years. Therefore this would not be possible in this case.Need a separate prescription for the zopiclone and ibuprofen!

154
Q

Can a representative pick up for a drug misuser?

A

Yes if they have a letter from the drug misuser, a separate letter each time they pick up and ID and that the pharmacist sees the drug misuser at least once a week.
If the medication is supervised consumption- contact doctor- legally acceptable to confirm with Dr they are happy with this over the phone. This is because supervised consumption is not a legal requirement. If it was a police officer collecting as the person is in custody then don’t need to contact doctor- as consumption will be supervised by a HCP.

155
Q

Getting the person collecting a CD schedule 2 or 3 to sign the back the Rx is a legal requirement, true or false?

A

False.It is good

156
Q

Are there any schedule 2 CD’s that don’t have to be kept in the CD cupboard?

A

Quinalbarbitone (aka Secobarbital)Some liquid preparations

157
Q

Is keeping a running balance in the CD register a legal requirement?

A

No- good practice Be sure to notify the owner, superintendent, GpHC inspector, accountable officer or Controlled Drug liaison officer of any discrepancies.

158
Q

T or F:Pharmacist independent prescribers are able to prescribe and Controlled Drugs in Schedule 2 to 5.

A

TrueApart from diamorphine or cocaine for treatment of addiction (but can for pain/ organic disease)

159
Q

How long must the RP log be retained?

A

5 years from last entry

160
Q

In general, considering record keeping either involves 2 years or 5 years, what is the general rule (not just for vet stuff- for EVERYTHING)?

A

2 years for things to do with CDs and private Rx’s:

  • CD register (from date of last entry) (legal)
  • Requisitions (send off but keep copy) order records etc (legal)
  • Invoices for schedule 3 and 5 CDs (legal)
  • POM book- 2 yrs last entry, private prescriptions (legal)
  • MUR/ NMS records (legal)

5 years for:

  • Vet prescriptions- POM-V and POM-VPS (legal)
  • Responsible Pharmacist record (from date of last entry) (legal)
  • Extemporaneous dispensing records (legal- community, 13 yrs reference hospital)
161
Q

What are the extra requirements on a Vet label when compared to a human label?

A

For animal treatment only

Pet details and Owner details

Expiry date if not on box

Warnings for owner re administration etc

162
Q

How long are are vet prescriptions for CD’s 2 and 3’s valid for?

A

28 days

All the normal CD Rx requirements are followed as for humans e.g. total quantity in words and figures

163
Q

How many days worth of treatment for Vet CD’s is considered good practice?

A

28 days max quantity

Unless ongoing treatment needed e.g. epilepsy in dog

(differs to human which is 30 days)

164
Q

Human private prescriptions for schedule 2 and 3 CDs must be submitted to the relevant agency to track CD prescribing. Does this therefore apply to Vet private prescriptions for CD’s?

A

No

Just retain in pharmacy for 5 years

165
Q

Which should be first line: Prescribing a licensed human medicine for an animal Prescribing a licensed Vet medicine for another species or in a different condition

A

1) Prescribing a licensed Vet medicine for another species or in a different condition (basically Off-label)
2) Prescribing a licensed human medicine for an animal

166
Q

How many NHS prescription charges do warfarin 1 mg tablets and warfarin 5 mg tablets levy (assuming the patient is not exempt for NHS charges) for an NHS prescription written in England?

A

1 charge:Same drug with the same formulation but different strengths is classed as one prescription charge.

167
Q

A midwife may use a midwife supply order to obtain what 3 controlled drugs?

A
  1. Diamorphine2. Morphine3. Pethidine
168
Q

A Scottish lady asking for a emergency dutasteride for her husband who has taken his last tablet this morning. What should you do?

A

Need to speak to the patientEmergency supply at the request of a patient requires interviewing the patient

169
Q

After a GPhC inspection, what is the time limit to respond to confirm accuracy of report?

A

5 days

170
Q

Can you have an electronic CD register?

A

Yes

171
Q

Can you issue faxed prescriptions for oral isotretinoin?

Can you issue repeat prescriptions of oral isotretinoin?

A

No

172
Q

Do you need an authorised witness when destroying CD stock?

A

Yes if schedule 2
Good practice for schedule 3

Preferably a registered health care professional

173
Q

Do you need to make a record when destroying CD stock?

A

Yes in the CD register for CD2 drugs

174
Q

For a patient to have capacity and to be able to make an informed decision, what 4 things must they be able to do?

A

• Understand the information provided• Remember the information provided• Use and weigh up the information provided• Communicate their decision to the pharmacy professional (by any means).

175
Q

For emergency supplies, what is the max quantity that can be supplied for:1. CD 4 and 5s2. Any other POMsWhat are the exceptions to this?

A
  1. 5 day supply max2. 30 day supply maxExceptions include insulin, creams, inhaler where a pack cannot be broken down. The smallest pack available should be given.
176
Q

For MDA (methadone) scripts, what is the maximum number of days you can prescribe on one script?

A

14 day

177
Q

How long after having a baby are female patients eligible for free prescription charges?

A

Up to 12 months after having the baby

178
Q

How long are isotretinoin prescriptions under the pregnancy prevention programme valid for?

A

7 days

179
Q

How long can the responsible pharmacist be absent for?

A

Max of 2 hours in 24 hour period

180
Q

How long do you need to keep a record of an appliance use review?

A

12 months

181
Q

How long do you need to keep a record of an MUR for?

A

2 years

182
Q

How many CPD entries do you have to do a year to revalidate?

A

4

2 must be planned learning activities

183
Q

How much of a liquid antibiotic should you give in an emergency supply?

A

If an antibiotic in liquid form, smallest quantity that will provide full course should be supplied

184
Q

How much of an oral contraceptive should you give in an emergency supply?

A

If an oral contraceptive, a full treatment cycle should be provided

185
Q

How often should SOPs be reviewed in community pharmacy?

A

Every 2 years

186
Q

If a patient came into the pharmacy with a prescription for:Amoxicillin 500mg capsAmoxicillin 250/5mL solutionHow many charges would this be?

A

2 charges as different formulations

187
Q

If a patient is homeless, what should you put in the address section on a prescription?

A

No fixed abode

188
Q

If a repeat number is not stated on a repeat prescription, how many times can it be repeated?What is an exception to this rule?

A

Only once

so dispensed twice in total)Oral contraceptives can be repeated 5 times (dispensed 6 times in total

189
Q

If a veterinary surgeon has told the animal owner to purchase a human medicine for their pet, would you be able to do sell this?

A

No- it has to be prescribed under the veterinary cascade

190
Q

If the responsible pharmacist absence exceeds 2 hours, can the pharmacy still be open?

A

No- after the 2 hours in 24 hours, the pharmacy must close if the pharmacist needs to be absent

191
Q

In addition to standard labelling requirements, what else needs to be included on the dispensing label in an emergency supply?

A

The words “Emergency supply”

192
Q

In secure environments (prison) what is strongly recommended that is also on the label to identify the patient?

A

Prisoner number

193
Q

On prescriptions, if it states “repeat x times”, when must the first dispensing be done?What about controlled drugs?

A

Within 6 months (following this no time limit) CD2 and 3 are not repeatable CD4 within 28 days (following this no time limit for the remaining repeat)

194
Q

What schedule is tramadol?

A

CD3 - exempt from safe custody requirements

195
Q

maximum supply of codeine containing products otc

A

32 pack size max

any greater is POM

196
Q

what should codeine containing products have on the packaging when selling otc

A

can cause addiction, for 3 days use only

197
Q

cough and cold remedies containing the ingredients that cant be sold to <6, can be sold for 6-12 for what duration

A

5 days

198
Q

what are EEA/ swiss prescribers not allowed to prescribe in the UK

A

CD 1, 2, 3 or unlicensed medications

199
Q

what needs to be done if a patient wishes to collect their repeat prescription from different pharmacies

A

an audit trail needs to be kept of the number of repeats dispensed
the pharmacy must stamp their name, address and date supplied each time it is dispensed

200
Q

when giving an emergency supply at the request of the prescriber, what 3 dates need to be documented

A

date POM supplied
Date prescription received
and date on the prescription

201
Q

as a general rule, how long are records kept in a pharmacy

A

vet and RP records kept for 5 years

everything else pretty much 2 years

202
Q

why might batch number always be necessary when dispensing in part packs

A

you could get an MHRA batch number product recall

203
Q

what is patient group direction (PGD)

A

a written direction to supply or administer specified medication to a well-defined group of patients required treatment for a specific condition (POM supply without a prescription)

204
Q

what is patient specific directions (PSD)

A

written instructions for a medicine to be supplied or administered to a named patient after they are individually assessed

205
Q

if there was a pandemic declared by the department of health, would the pharmacist need to interview the patient to give an emergency supply

A

no

206
Q

when is a pharmacist except from requiring a wholesale dealers license

A

occasional basis
small quantity of medicines
profit is not made
not for onward wholesale distribution

207
Q

a pharmacy with a whole sale dealers license also supplying CD 2-5 also needs what

A

a home office license too

208
Q

what type of prescriptions do the legal requirements of vet prescriptions apply to

A

POM-V
POM-VPS
unlicensed pom under the vet cascade

209
Q

when is ‘keep out of reach of children’ a legal requirement, vet med or human meds

A

vet meds

210
Q

how often should pharmacies that supply vet med have an audit

A

annually

211
Q

where should adverse drug reaction for animals be reported

A

adverse reaction scheme for veterinary medicines (yellow card scheme equivalent)

212
Q

requirements for sch 1 CD lic pom

A

need home office license to possess, produce or supply

no therapeutic use

213
Q

requirements for a sch 2 CD pom

A 
record in CD register
CD rx required
28 day validity 
safe custody (except quinalbarbitone)
30 day supply
214
Q

requirements for a sch 3 CD pom no register

A

keep invoices
CD rx required
28 day validity
safe custody (except tramadol, phenobarbitone and midazolam)

215
Q

which CD dont allow emergency supply

A

cd 2 and 3 (except phenobarbital)

216
Q

which CD need invoices to be kept

A

sch 3 and 5

217
Q

all CDs have a 28 day validity except which one and how long is it

A

sch 5

6 months

218
Q

which CD does not need a license to import and export

A

sch 5 and sch 4 anab part 2 if it is for personal use as a medicine

219
Q

where should private CD 2/3 scripts be submitted and when

A

to the NHS agency at the end of the month

220
Q

why should POM and CD be prescribed seperately

A

because the POM needs to be kept for 2 years and the CD needs to be submitted at the end of the month

221
Q

what happens if a patient misses their installment cd 2/3

A

carry on with the other days and skip that one

refer if miss >3 days

222
Q

what CD thats not CD 1 or 2 needs to be added to a register

A

sativex CD 4 part 1

223
Q

if you need to disclose information, what should you do

A

get consent unless valid reason to not
anonymise it if possible
only disclose necessary information
release the information promptly
make sure the person receiving the info knows and treats it confidentially
make a record (who requested, what you disclosed, if consent was and and obtained)
be prepared to justify your decisions and actions

224
Q

what are the 6 principles for processing personal data under GDPR

A

Processed lawfully, fairly and in a transparent manner

collected for specific, explicit and legitimate purposes

adequate, relevant and limited to what is necessary

accurate and up to date

kept no longer that necessary

protected against unauthorised/ unlawful processing

225
Q

how long have you got to report confidentiality breach

A

72 hours from when youre aware

records must be kept

226
Q

according to the freedom of information act 2000, you can make a request for public information in writing and how long have they got as a legal obligation to respond

A

20 days

227
Q

what is capacity

A

a patients ability to make a specific and informed decision

228
Q

can you sell gsl meds if the pharmacist hasnt signed in

A

no

229
Q

can you sell gsl meds if the pharmacist has signed in but is absent

A

yes

230
Q

How many days should you supply for a CD emergency supply

A

5 days

231
Q

How long should an invoice for a Sch 3 CD taking account tax requirements be retained for

A

6 years

232
Q

How do you record residue CD liquids

A

You do not need to make a record of disposable irretrievable amounts of CD

233
Q

What are the 11 GPHC standards in the MEP

A

Standards for pharmacy professionals
Standards for registered pharmacies
Guidance on confidentiality
Guidance on consent
Guidance on raising concerns
Guidance on maintaining sexual boundaries
Guidance on religion personal values and beliefs
Guidance on responding to complaints and concerns
Guidance for registered pharmacies preparing unlicensed meds
Guidance for registered pharmacies providing pharmacy services at a distance including on the internet
Guidance to ensure a safe and effective pharmacy team

234
Q

What’s the minimum length of time CD decryption records should be kept

A

2 years

Patient returns 7 years

235
Q

What do the 6 legal requirements for a CD requisition include

A 
Recipients signature 
Name of recipient 
Address of recipient 
Profession/ occupation
Total quantity of drug 
Purpose of requisition
236
Q

What’s the time limit for repeat prescriptions (for cd and normal meds)

A

Normal meds the first repeat must be dispensed within 6 months then there is no legal limit must use clinical judgment

CD 4+ must first be dispensed within 28 days then clinical judgement after no legal limit

(Cd1-3 cannot be repeated)

Pre-reg (27 decks)

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