MEP Flashcards
What are the four principles of medicines optimisation?
- Aim to understand the patient’s experience.
- Evidence-based choice of medicines.
- Ensure medicines use is as safe as possible.
- Make medicines optimisation part of routine practice
What are the 9 standards for pharmacy professionals?
- Provide person-centred care.
- Work in partnership with others.
- Communicate effectively.
- Maintain, develop and use their professional knowledge and skills.
- Use professional judgement.
- Behave in a professional manner.
- Respect and maintain the person’s confidentiality and privacy.
- Speak up when there are concerns or when things go wrong.
- Demonstrate leadership.
What is the problem with a punitive culture?
Stifles learning and reporting.
Reduction in patient saety and quality of care.
What is the problem with a no-blame culture?
Lack of accountability.
Not acceptable to society: unfair.
What term describes medicines that are GSL but can only be sold or supplied via a pharmacy?
PO
Which of the following is correct?
It is unlawful to supply a product or combination of products that contain more than 720mg of pseudoephedrine AND 180mg of ephedrine at any one time without prescription.
It is unlawful to supply a product or combination of products that contain more than 180mg of pseudoephedrine OR 720mg of ephedrine at any one time without prescription.
It is unlawful to supply a product or combination of products that contain more than 720mg of pseudoephedrine OR 180mg of ephedrine at any one time without prescription.
It is lawful to supply a product or combination of products that contain more than 720mg of pseudoephedrine OR 180mg of ephedrine at any one time without prescription.
It is unlawful to supply a product or combination of products that contain more than 720mg of pseudoephedrine OR 180mg of ephedrine at any one time without prescription.
The supply of which EHC to under 16s is not contraindicated by the manufacturer?
EllaOne, levongest 16+
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?
0 1 2 3 4
1 charge:
Same drug with the same formulation but different strengths is classed as one prescription charge.
To be a valid prescription for a Schedule 2 CD from a doctor who has seen a patient privately, how must the prescription be presented?
Be computer generated Be hand written Be prescribed on the NHS only Be on an approved form Be on letter-headed paper
Private prescriptions for Sch2 and 3 CDs must be on an approved form.
Normally, when a requisition form for Sch 2 or 3 CDs is recieved by a community pharmacy, and the request is from a hospital, community health provider (e.g. GP) or a veterinary surgeon, an approved form must be used.
What are the exceptions to this?
If the request is from a hospice or a prison an approved form does not need to be used.
Which of the following is not a legal requirement for a CD requisition?
Signature of recipient Name of recipient Address of the recipient Profession or occupation Purpose of the requistion Details of patients to recieve requested CDs
The details needed are: Signature of recipient Name of recipient Address of the recipient Profession or occupation Purpose of the requistion Total quantity of CD
No information regarding patients is needed.
In which of the following circumstances is an approved form not needed? (regarding CDs)
GP requisition received by a community pharmacy
Veterinary requisition received by a community pharmacy.
Requisition from a ward in the same hospital received by a hospital pharmacy
Requisition from a ward or department in a different legal entity recieved by a hospital pharmacy
An approved form is not required if the request for CD is from a ward or department in the same legal entity.
In which of the following circumstances is an approved form not needed? (regarding CDs)
GP requisition received by a community pharmacy
Veterinary requisition received by a community pharmacy.
Requisition from a ward or department in a different legal entity recieved by a hospital pharmacy
Requisition from a hospice recieved by a community pharmacy
If the request is from a hospice or a prison an approved form does not need to be used.
In an emergency, a doctor or dentist can be supplied with a Sch2 or Sch3 CD on the undertaking that a requistion will be supplied within the next 24 hours. Failure to do so would be an offense on the part of who?
The doctor or dentist
Where CD stock is collected by a messenger on behalf of a purchaser, a written authorisation must be provided to the supplying pharmacist that empowers the messenger to recieve the medicines on behalf of the purchaser.
How long must this authorisation be retained by the pharmacist/pharmacy?
2 years
Which of the following does not legally require the use of an approved form (regarding CD requisitions)?
GP requisition received by a community pharmacy
Veterinary requisition received by a community pharmacy.
A request received from another GPhC registered pharmacy premises by a community pharmacy
Legislation does not provide that requests between GPhC registered pharmacies use an approved form BUT the Home Office advises that supplies from one registered pharmacy to another registered pharmacy only be made after recieving a written requistion on an approved form.
Growth hormones are contained in what sch?
Sch 4 part II
Legally, invoices of which of the following DO and DO NOT need to be retained for 2 years:
Sch 2 Sch 3 Sch 4 (part I) Sch 4 (part II) Sch 5
Sch 2: NO Sch 3: YES Sch 4 (part I): NO Sch 4 (part II): NO Sch 5: YES
NICE advise that organisations should consider retaining all CD invoices for 6 years for the purpose of HM Revenue and Customs.
NICE recommends keeping records of the destruction of a patient’s own returned controlled drugs for a minimum of what?
7 years
Invoices for CDs 6 years
What is the maximum length of time it would be required to keep a CD register for?
1 year 2 years 3 years 5 years 7 years
Normally 2 years from last entry.
However, if a record of patient returned and subsequent destruction of CDs is also recorded in the CD register book it would need to be kept for 7 years.
When a requisition for a Schedule 1, 2 or 3 CD is received, it is a legal requirement to:
Mark the requistion indelibly with the suppliers name and address (pharmacy name etc)
AND
Send the original requisition to the relevant NHS agency.
When do these processing requirements NOT apply?
These processing requirements do not apply when the suppy is made:
By a person responsible for the dispensing and supply of medicines at a hospital, care home, hospice, prison or organisation providing ambulance services who must mark and retain the original requisition for two years.
By pharmaceutical manufacturers or wholesalers.
Against veterinary requisitions (the original should be retained for five years)
NB: as a matter of good practice, pharmacies should rtain a copy of the requisition for two years from the date of supply.
A registered midwife may use a midwife supply order to obtain what CDs? (3)
Diamorphine
Morphine
Pethidine
A registered midwife may use a midwife supply order to obtain diamorphine, morphine or pethidine.
Which of the following is NOT required on the order?
Name of the midwife
Occupation of the midwife
Address of the midwife place of work
Name of the person to whom the CD is to be administered or supplied.
Purpose for which the CD is required.
Total quantity of the drug to be obtained.
Signature of an appropriate medical officer.
Do not need address details of midwife.
A registered midwife may use a midwife supply order to obtain diamorphine, morphine or pethidine.
Which of the following is NOT required on the order?
Name of the midwife
Occupation of the midwife
Name of the person to whom the CD is to be administered or supplied.
Purpose for which the CD is required.
Total quantity of the drug to be obtained.
Signature of the midwife
Signature of an appropriate medical officer must be present not midwife.
Which of the following are examples of doses that ARE legally acceptable on CD scripts:
As directed PRN Per chart One PRN Decrease dose by 3.5ml every four days Weekly
The following are okay: One as directed. Two when required. One PRN One or two when required.
Which ONE of the following is a legal requirement?
The date of birth of a patient if under 12
The dose of the medicine when entering a private prescription in the POM register
The dose of the medicine on a prescription issued by a doctor in Norway
For an Es at request of a patient, the surgery must be closed.
For an Es at request of the doctor, the prescription must be received within 48 hours
The age of the patient if under 12 is a legal requirement.
Which of the following is NOT an off-label use of a licensed drug?
Amitriptyline for neuropathic pain.
Metformin for PCOS
Quinine sulphate for nocturnal leg cramps
Seretide Evohaler for COPD
Temazepam for conscious sedation in dental procedures.
Quinine for nocturnal leg cramps is only licensed one.
Which of the following pieces of legislation regulating the activities of pharmacists and pharmacies applies to:
A pharmacist who wanted to take part in the new NHS influenza vaccination service.
Controlled Drugs (supervision and management of use) Regulations 2013
Human Medicines Regulations 2012
Medicines Act 1968
Misuse of Drugs Regulations 2001 (as amended)
NHS (pharmaceutical and local pharmaceutical services) regulations 2013
Pharmaceutical servises (advance and enhanced services) (England) Directions 2013
Responsible Pharmacist Regulations 2008
Veterinary Medicines Regulations 2013
Pharmaceutical servises (advance and enhanced services) (England) Directions 2013
Which of the following pieces of legislation regulating the activities of pharmacists and pharmacies applies to:
A pharmacist who destroys certain patient returned medicines and who has a SOP in place to cover this would be complying with:
Controlled Drugs (supervision and management of use) Regulations 2013
Human Medicines Regulations 2012
Medicines Act 1968
Misuse of Drugs Regulations 2001 (as amended)
NHS (pharmaceutical and local pharmaceutical services) regulations 2013
Pharmaceutical servises (advance and enhanced services) (England) Directions 2013
Responsible Pharmacist Regulations 2008
Controlled Drugs (supervision and management of use) Regulations 2013
Which of the following pieces of legislation regulating the activities of pharmacists and pharmacies applies to:
Your pharmacist colleague has been repeatedly selling cetirizine tablets to the owner of a cat who has a skin complaint as a result of flea bites. Under which legislation may the colleague be committing an offence?
Controlled Drugs (supervision and management of use) Regulations 2013
Veterinary Medicines Regulations 2013
Human Medicines Regulations 2012
Medicines Act 1968
Misuse of Drugs Regulations 2001 (as amended)
NHS (pharmaceutical and local pharmaceutical services) regulations 2013
Pharmaceutical servises (advance and enhanced services) (England) Directions 2013
Responsible Pharmacist Regulations 2008
Veterinary Medicines Regulations 2013
Who is responsible for a dispensing doctor’ practice which has a pharmacy attached to it, where stock is purchased via the dispensing doctor’ practice for both the dispensing services and the two businesses share facilities for refrigeration and CD storage?
Care Quality Commission (CQC)
GPhC
Health and Safety Executive
Healthwatch
MHRA
NHS England
Trading standards at your Local Authority
Care Quality Commission
Who is responsible for investigating a pharmacy suspected to be the original source of a number of counterfeit medicines in the locality?
Care Quality Commission (CQC)
GPhC
Health and Safety Executive
Healthwatch
MHRA
NHS England
Trading standards at your Local Authority
MHRA
The price of certain drugs which may be available as a branded product or a generic product is calculatec based on the manufacturers’ price for branded products and the generic product price. If not generic product is available the pharmacist will be paid for the cost of the branded product if they endorse on the rx.
Which of the following best describes the category of payment for basic prices of drugs described above?
Category A Category B Category C Category E Category M
Category A: Drugs which are readily available.
The Secretary of State determines the prices for Category A drugs to be the weighted average of the prices listed by the following four manufacturers and suppliers; AAH, Alliance Healthcare (Distribution) Ltd, Teva UK and Actavis on or before the 8th of the month being reimbursed. In the weighted formula, AAH and Alliance Healthcare (Distribution) Ltd prices have a weighting of 2, the prices from the other suppliers have a weighting of one.
Category B: Drugs whose usage has declined over time.
Category C: Drugs which are not readily available as generic and price is determined by Secretary of State based on that listed by supplier.
Category E: ???
Category M: Drugs which are readly available and price determined on information supplied by manufacturers - not an average.
Which of the following best describes the time in which the pharmacist has to react to a satisfactory but needing some improvements report by the GPhC Inspector?
2 days to respond to confirm accuracy, 10 days to resolve any other outstanding issues in the action plan.
2 days to respond to confirm the accuracy, 14 days to resolve any other outstanding issues in the action plan
5 days to respond to confirm the accuracy, 10 days to resolve any other outstanding issues in the action plan
5 days to respond to confirm the accuracy, 20 days to resolve any other outstanding issues in the action plan
7 days to respond to confirm the accuracy, 28 days to resolve any other outstanding issues in the action plan
5 days to respond to confirm the accuracy, 20 days to resolve any other outstanding issues in the action plan
Your pharmacy premises are being inspected by a GPhC inspector who has serious concerns about the policies and procedures you have in place.
One major concern is that you record keeping for date checking is poor and there is a significant amount of stock on the shelves that is out of date and not fit for purpose.
From the scenario above, which of the following principles would a pharmacy premises most likely be in breach of?
Principle 1 - governance arrangements
Principle 2 - empowered and competent staff
Principle 3 - managing pharmacy premises
Principle 4 - delivering pharmacy services
Principle 5 - equipment and facilities
Delivering pharmacy services
In mid-2015 it was decided that a new advanced service for seasonal influenza vaccination is to be provided via community pharmacies in addition to the general medical services.
Which of the following bodies would be the most appropriate body to
commission or provide the need identified in the scenario above?
CCGs Health and Wellbeing Board (HWB) Local Authority NHS Pharmaceutical Services Negotiating Committee (PSNC)
NHS
Which of the following groups is least likely to be considered an appliance by the NHS?
Bandages Catheters Diabetic blood monitoring machine and test strips Dressing packs Irrigation systems
Diabetic blood monitoring machine and test strips
GPhC inspection: premises are very dirty, shelving has not been cleaned in ages, evidence of rodent infestation on the floor in the dispensary. Which of the following principles would the pharmacy premises most likely be in breach of?
Principle 1: goverance arrangements.
Principle 2: empowered and competent staff.
Principle 3: managing pharmacy premises
Principle 4: delivering pharmacy services
Principle 5: equipment and facilities
Managing pharmacy premises
Which of the following information is least necessary to be included on the dispensing label for a vet med for a milk producing cow?
A withdrawal period Batch number of product supplied Dose or admin instructions Identification and species of animal The words 'for animal treatment only' or similar
Not batch number on label.
Which of the following situations can you sell Sumatriptan OTC?
66 year old Epileptic taking carbamazepine 5 migraine attacks in the last year Takes candesartan for hypertension Migraines usually last 36 hours without treatment
5 migraine attacks in last year.
All others are contraindications to sale.
Which of the following statements regarding Clinical Management Plans is least accurate?
A CMP is part of a voluntary relationship between an independent prescriber and a patient.
A CMP must be individualised for each patient.
CMPs enable a supplementary prescriber to prescribe medication without needing repeated approval from an independent prescriber.
CMPs must state the circumstances that require a patient to be referred back to the independent prescriber.
CMPs must not include options for the prescribing of a Controlled Drug
Can include CDs
Which of the following situations is most applicable to Pharmacist Independent Prescribers?
They need to have a clinical management plan in place
They cannot prescribe any Controlled Drug
They cannot prescribe GSL medicines
They can only prescribe items included on their Practioners Formulary
They can only prescribe if their GPhC register entry is annotated with the letters IP
They can only prescribe if their GPhC register entry is annotated with the letters IP
Locally commissioned services may be commissioned by NHS England area teams, local authorities or CCGs.
Which of the following statements is least accurate?
The commissioning body can determine how a service is provided but must provide the service to a nationally agreed minimum standard.
NHS England oversees public health services provided by local authorities
NHS England and Clinical Commissioning Groups are both able to commission enhanced services
Locally commissioned services must follow the nationally negotiated templates for locally commissioned services
Health and wellbeing boards ensure public health services are provided effectively and are responsible for creating pharmaceutical needs assessments.
NHS England and Clinical Commissioning Groups are NOT both able to commission enhanced services.
Local NHS England teams commission all services in the NHS Community Pharmacy Contractual Framework (CPCF), i.e. Essential, Advanced and Enhanced Services. Other commissioners cannot commission these services from community pharmacies.
The services that CCGs commission include planned hospital care, rehabilitative care, urgent and emergency care (including out-of-hours and accident and emergency services), most community health services, maternity services, mental health and learning disability services.
Clobazam is allowed on NHS if endorsed SLS for any patient, for the treatment of what?
Epilepsy
Cyanocobalamin Tablets are allowed on the NHS for the treatment or prevention of vitamin B12 deficieny if endrosed SLS for what patient groups?
A person who is a vegan or who has a proven vitamin B12 deficiency of dietary origin.
NB: Cyanocobalamin tablets are not suitable for treatment of vegans as the tablets contain products of animal origin. The injection would be better.
A person with asthma is deemed to be ‘at clinical risk’ if what criteria is met?
They have asthma which requires continuous or repeated use of inhaled or systemic steroids or with previous exacerbations requiring hospital admission.
Nizoral Cream is allowed on the NHS for the treatment of what condition in any patient group so long as it is endorsed SLS by the prescriber?
Seborrhoeic dermatitis and pityriasis versicolor.
Can pharmacy staff amend SLS to a prescription for Niferex Elixir 30ml Paediatric Dropper Bottle can only be prescribed to infants born prematurely for prophylaxis in the treatment of iron deficiency that the prescriber forgot to endorse themselves?
Prescribers must endorse prescriptions for these products ‘SLS’. If the ‘SLS’ endorsement is missing, the prescription should not be dispensed and will not be passed for payment by NHS Prescription Services. Pharmacy staff cannot make the SLS endorsement themselves.
Borderline substance list:
Will pharmacies be paid for borderline substance products dispensed that were not endorsed ACBS by prescriber?
YES
