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mep Flashcards

1
Q

what is a “PO’ medicine

A

pharmacy only medicine.

it’s a medicine that is licensed as GSL but the manufacturer only wants it to be sold in pharmacies

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2
Q

when can GSL medicines be sold

A

only when a pharmacist has taken on the role of the responsible pharmacist. however they can still be sold if the pharmacist is absent for a limited period of time (as long as they are still under the role of responsible pharmacist).

(pharmacist is still legally responsible for sales even though they are absent from the premises)

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3
Q

what is a “P” medicine

A

pharmacy medicine.

it can only be sold from a registered pharmacy premises by the pharmacist or staff acting under pharmacy supervision

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4
Q

what medication classifications make up OTC medicines

A

GSL, PO and P

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5
Q

what is the law around selling pseudoephedrine and ephedrine containing medicines

A
  • it is illegal to sell a product or combination of products that has more than 720mg of pseudoephedrine or 180mg of ephedrine at the same time without a prescription
  • it is illegal to sell a pseudoephedrine product at the same time as an ephedrine product without a prescription
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6
Q

what are the 2 medicines licensed to be sold for emergency hormonal contraception in a pharmacy

A
  • levonorgestrel 1500mcg (levonelle)

- Ulipristal acetate 30mg (EllaOne)

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7
Q

what is the licensing for the sale of levonorgesterel (levonelle)

A
  • must be 16 years or over

- within 72 hrs (3 days of unprotected sex)

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8
Q

what is the licensing for the sale of ulipristal acetate 30mg (EllaOne)

A
  • can be sold to any woman for child-bearing age

- within 120 hrs (5 days) of unprotected sex

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9
Q

which emergency hormonal contraceptive can be sold to under 16s

A

EllaOne (ulipristal acetate 30mg)

it can be sold to any woman of child-bearing age

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10
Q

Can pharmacists provide emergency hormonal contraception before a patient has had unprotected sex (in advance)

A

Yes

This is known as advance supply of EHC. Pharmacists can provide EHC before unprotected sexual intercourse or incase a contraceptive method fails however the pharmacist needs to assess that the patient is competent to use it properly for its intended use.

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11
Q

what should you consider if you decide to sell emergency hormonal contraception to someone under 16

A
  • children under 13 are legally too young to consent to any sexual activity. (you should report this to social services unless there are any exceptional circumstances for not sharing this information which should be documented)
  • sexual activity with children under 16 is illegal but may be consensual. (the law doesn’t prosecute mutually agreed sex between young people unless it is abuse or exploitation)
  • confidentiality applies to sale of EHC to under 16s. if you want to share information, gain consent (unless child’s welfare overrides information confidentiality)
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12
Q

what is the legal limit of the amount of paracetamol that can be sold OTC

A
  • can sell max 100 capsules or tablets (non-effervescent)

in practice due to 16/32 pack sizes, legally 96 can be sold

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13
Q

what is the legal limit when selling OTC PARACETAMOL effervescent tablets / powders / granules / liquids

A

legally there is no limit on the amount of paracetamol effervescent tablets, powders, granules or liquids.

use professional judgement

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14
Q

what is the legal limit of the amount of aspirin that can be sold OTC

A
  • can sell max 100 capsules or tablets (non-effervescent) tablets

(in practice due to 16/32 pack sizes, max 96 can be sold)

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15
Q

what is the legal limit when selling OTC ASPIRIN effervescent tablets / powders/ granules/ liquids

A

no legal limit when selling aspirin in these formulations (effervescent tablets/ powders/granules/liquids)

use professional judgement

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16
Q

what are the only indications where you can sell otc medicines containing codeine or dihydrocodeine

A

can only be used for short-term acute, moderate pain where paracetamol, ibuprofen or aspirin alone hasn’t worked.

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17
Q

what is the largest pack size you can have for otc medicines containing codeine or dihydrocodeine

A

max 32 pack size.

larger pack size = POM

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18
Q

what patient information must be on the label/packaging medicines containing codiene or dihydrocodeine

  • what must be on the PIL
A
  • “can cause addiction”
  • “for three days use only”

PIL must state:

  • the indication
  • that the medicine can cause addiction or headache if used for more than three days
  • warning signs of addiction
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19
Q

how many packs of medicines containing codeine or dihydrocodeine should be sold OTC

A

recommend only one pack

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20
Q

Do welsh prescriptions have to be bilingual (written in english as well)

A

No, the law doesn’t specify which language a prescription has to be in.

  • if pharmacist can’t understand prescription, its their responsibility to put patient first
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21
Q

TRUE OR FALSE:

for prescriptions for schedule 2 and 3 drugs, the prescribers address must be in the UK

A

true

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22
Q

what are “repeatable prescriptions”

A

private prescriptions that have a direction from the prescriber that they can be dispensed more than once

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23
Q

how many times can you repeat a “repeatable prescription” if a number of repeats is not stated

A
  • can only be repeated once (dispensed twice) unless the prescription is for an oral contraceptive then it can be repeated 5 times (dispensed 6 times)
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24
Q

TRUE OR FALSE:

a “repeatable prescription” for an oral contraceptive that doesn’t state the number of repeats can be repeated 5 times

A

true

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25
Q

which schedule of controlled drugs CAN NOT be on a “repeatable prescription”

A

schedule 2 and 3

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26
Q

which schedule of controlled drugs CAN be on a “repeatable prescription”

A

schedule 4 and 5

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27
Q

when must the first dispensing occur on a ‘repeatable prescription”

A

within 6 months of the appropriate date

no legal limit for the remaining repeats

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28
Q

what time frame do you have to dispense the remaining prescriptions on a “repeatable prescription”

A

there is no legal limit

29
Q

can a patient have their “repeatable prescription” dispensed from different pharmacies

A

yes.

to keep an audit trail mark on the prescription the name, address and date of supply

30
Q

what do prisons and other custodial secure environments use to generate prescriptions

A
  • they use the clinical IT system (not an FP10 but still considered an NHS prescription)
  • they can use FP10s but these are usually reserved for urgent meds
31
Q

how long do you have to dispense an owing on a prescription

A

must be dispensed within the validity period of the prescription e.g:

  • POMS, sch 5, P, GSL: must be within 6 months
  • Sch 2, 3 and 4: must be within 28 days
32
Q

how long do private prescriptions for POMs have to be kept in the POM register

A
  • 2 years from date of supply

- if it is a repeatable prescription, from date of last supply

33
Q

where do private prescriptions for schedule 2 and 3 drugs go

A

they are sent to the NHS agency

34
Q

what details of a medication are NOT a legal requirement for POM prescriptions

A

strength, form, quantity and dose

35
Q

does a patient who has just been released from prison have to pay for their FP10 prescription

A

no.

they are exempt if they have HMP in the address on the prescription

36
Q

are faxed prescriptions legal?

A

no because they are not written in indelible ink and have not been signed by a prescriber

37
Q

TRUE or false

dentists can legally prescribe any POM

A

true, however if they are prescribing on an NHS dental prescription, they are restricted to only the dental prescribers formulary

38
Q

where can a pharmacist report fraudulent prescriptions

A
  • police

- NHS counter fraud services (only for nhs prescriptions)

39
Q

can you legally dispense a prescription or repeatable prescription from an EEA country or switzerland

A

yes prescriptions from EEA countries or switzerland are legally recognised in the uk

40
Q

can you dispense an emergency supply for a patient who’s prescriber is registered in a EEA country or switzerland

A

yes

41
Q

can you dispense schedule 1, 2 or 3 drugs from an EEA country or switzerland prescription

A

No, you can’t dispense any of these or any other medicinal products without a marketing authorisation

(not schedule 4 and 5 can be dispensed)

42
Q

what do community pharmacies need in order to routinely dispense military prescriptions

A

a ministry of defence (MOD) contract

-

43
Q

what are military prescriptions written on

A

a military form (FMed 296)

44
Q

what should happen if a community pharmacy without a ministry of defence (MOD) contract, gets a military prescription

A

they should treat it as a private prescription and charge the fee to the individual

45
Q

what is a patient SPECIFIC direction (PSD)

A

a written instruction from a prescriber for a medicine to be supplied to a named patient

46
Q

TRUE OR FALSE

In a hospital ward, patient specific directions (PSDs) can be written on inpatient charts

A

True

47
Q

what are the legal requirements of what needs to be on a patient specific direction

A

nothing

there are no legal requirements of what needs to be on a patient specific direction.

48
Q

Can a patient be administered medication through verbal or telephoned directions in a hospital

A

yes

49
Q

what is a patient GROUP direction

A

written instructions that allow the supply/administration of specified medicines to a defined group of patients that need treatment for a specific condition

50
Q

when can pharmacists supply/ administer morphine or diamorphine to patients

A

under a patient group direction (PGD) for the immediate treatment of a sick or injured patient

51
Q

what class of medicines can pharmacists supply under an emergency supply

A

POMS , schedule 4 and 5 and phenobarbital (for epilepsy)

52
Q

when must you get a written prescription after an emergency supply

A

within 72 hours

53
Q

when should you legally make a record in the POM register after an emergency supply

A

record must be made on the day of the emergency supply or the day after

54
Q

when does a patient need to have had previous treatment with a medication in order for you to give an emergency supply

A
  • if it is an emergency supply requested by a patient, the patients needs to have had the treatment before
  • if it is an emergency supply requested by the prescriber then the patient doesn’t need to have had previous treatment
55
Q

TRUE OR FALSE

The pharmacist needs to interview the patient if they request an emergency supply

A

true

if interview not possible, pharmacist can use professional judgement to make supply

56
Q

what is the maximum quantity of phenobarbital and schedule 4 + 5 you can supply when a patient requests an emergency supply

A

maximum 5 days of treatment worth

57
Q

what is the maximum quantity of a POM that can be supplied when a patient requests an emergency supply

A

can supply max 30 days of treatment of a POM except:

  • if the POM is insulin, an ointment, cream or inhaler then the smallest pack available should be supplied
  • if the POM is an oral contraceptive, then a full treatment cycle should be supplied
  • if the POM is an antibiotic liquid, give the smallest amount that will cover the full course of treatment
58
Q

when do you need to write why an emergency supply was given in the POM register

A

if the emergency supply is requested by the patient.

don’t need to do this if requested by prescriber

59
Q

what labelling needs to be added to the dispensing label when suppling an emergency supply requested by the patient

A

need to be “emergency supply” to label

60
Q

what do optometrists or podiatrists need in order to authorise the supply of POMS

A

they need to be additionally qualified as independent or supplementary prescriber

61
Q

what does a signed patient order from a optometrist or podiatrist allow you to do

A

it allows you to supply POMS directly to the patients according to what is written on the signed order. The POM medicine must be one that the optometrist/ podiatrist can legally sell (not administer)

*note the signed order is not a prescription so doesn’t have prescription requirements.

62
Q

what do you need in order to supply salbutamol inhalers or adrenaline auto-injectors (AAIs) to schools

A

need a written signed order by the principal or head teacher at the school

63
Q

how many salbutamol inhalers or adrenaline auto-injectors (AAIs) can schools purchase from pharmacies under a written signed order

A

no limit (quantity depends on how many each school needs)

64
Q

how long should a written signed order be kept in the pharmacy

A

for 2 years from the date of supply

good practice to make a POM record as well as keeping the signed order

65
Q

what is naloxone and when can it be supplied

A

naloxone an opioid antagonist which reverses the effects of opioid overdose.

it is a POM but can be suppled to the public by pharmacies providing drug treament services (e.g needle exchange or methadone). pharmacies can make direct supples without a prescription/ patient specific direction (PSD) or patient group direction (PGD)

66
Q

which medicines should you ensure a patient is on a pregnancy prevention programme (PPP)

A
  • oral retinoids (include isotretinoin, alitretinoin and acitretin)
  • sodium valporate

both have high risk of cause teratogenic effects on baby

67
Q

what are “specials” medicines

A

unlicensed medicinal products manufactured in the UK for human use which have been specially prepared to meet a prescription ordered for individual patients without the need for the manufacturer to hold a marketing authorisation for the medicinal product concerned

68
Q

how long do you need to keep a record for “specials” medicines in the pharmacy

A

5 years

69
Q

what should be in the record that is kept for “specials” medicines

A
  • The source of the product
  • The person to whom and the date of which the product was sold or supplied
  • The prescriber’s details
  • The quantity of each sale or supply
  • The batch number of the product

MEP (1 decks)

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