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MEP > MEP > Flashcards

MEP Flashcards

Revise all topics by first week of Jan

1
Q

What is the Schedule of Buprenorphine

A

CD 3

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2
Q

What is the schedule clonazepam

A

CD 4 pt 1

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3
Q

What is the schedule of Chlordiazepoxide

A

CD 4 pt 1

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4
Q

What schedule is Codeine phosphate

A

CD 5

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5
Q

What schedule is Diamorphine

A

CD 2

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6
Q

What schedule is Diazepam

A

CD 4 pt 1

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7
Q

What schedule is Dihydrocodeine Tartrate

A

CD 5

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8
Q

What schedule is Dipipanone

A

CD 2

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9
Q

What schedule is fentanyl

A

CD 2

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10
Q

What schedule is Gabapentin

A

CD 3

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11
Q

What schedule is Hydrocodone

A

CD 2

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12
Q

What schedule is Loprazolam

A

CD 4 pt 1

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13
Q

What Schedule is Lorazepam

A

CD 4 pt 1

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14
Q

What Schedule is methadone

A

CD 2

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15
Q

What Schedule is Methylphenidate hydrochloride

A

CD 2

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16
Q

What schedule is Midazolam

A

CD 3

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17
Q

What schedule is Morphine tablets

A

CD 2

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18
Q

What morphine solution has the Schedule of CD 5

A

10mg/5ml

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19
Q

What Schedule is Nitrazepam

A

CD 4 pt 1

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20
Q

What schedule is Oxycodone

A

CD 2`

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21
Q

What schedule is Pethidine

A

CD 2

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22
Q

What schedule is phenobarbital

A

CD 3

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23
Q

what schedule is pholcodine

A

CD 5

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24
Q

What schedule is pregabalin

A

CD 3

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25
Q

What schedule is Quinalbarbitone

A

CD 2

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26
Q

What schedule is Somatotropin

A

CD 4 pt 2

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27
Q

What schedule is Temazepam

A

CD 3

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28
Q

What schedule is Tramadol

A

CD 3

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29
Q

What schedule is Zolpidem

A

CD 4 pt 1

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30
Q

What schedule is Zopiclone

A

CD 4 pt 1

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31
Q

what is the maximum amount of pseudoephedrine that can be sold at any one time

A

720mg `

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32
Q

what is the maximum amount of ephedrine that can be sold at any one time

A

180mg

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33
Q

what are the 3 different emergency contraceptive

A
  • Cu-IUD
    -Oral ulipristal acetate
    within 120hrs/ 5 days
    30mg
    -oral levonorgestrel
    1500mcg
    >16y/o
    Within 72 hours
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34
Q

what are the other options of supply of contraceptives other than sale

A

-Family planning clinics
-PDG providers for oral emergency contraceptives
-Genitourinary medicine clinic

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35
Q

What are is the amount of paracetamol that can be supplied OTC

A

100 non-effervescent tablets
-3 packs of 32/ 6 packs of 16 in reality

There is no limit to effervescent tablets, powders, granules or liquids that can be sold to a person at any one time

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36
Q

What are is the amount of aspirin that can be supplied OTC

A

<100 non-effervescent tablets
3 packs of 32/ 6 packs of 16 in reality

There are no legal limits on the quantity of over-the-counter effervescent* tablets, powders, granules or liquids that can be sold to a person at any one time

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37
Q

Under what indication can OTC codeine and dihydrocodeine be supplies

A

short-term treatment of acute or moderate pain not relieved by paracetamol or aspirin alone

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38
Q

what pack size of codeine and dihydrocodeine is POM

A

Packs of more than 32 including effervescent.

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39
Q

What warning must be placed on seen the pack codeine pack and at which position

A

“Can cause addition. For three days use only”
in clear position on the front of the pack.

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40
Q

Are carbon copy prescription legal

A

Yes as along as they are signed in ink

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41
Q

Which languages can prescription be legally valid

A

This no rule about languages so therefore no law against prescriptions in welsh.

But is the pharmacist does not speak welsh, safety first is advice

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42
Q

What places are know as Crown dependants

A

Jersey
Guernsey
Isle of man

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43
Q

Can a prescription for CD 2 and 3 be dispensed if they are from Crown dependants

A

-yes but the prescribers address must be in the UK

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44
Q

On which prescriptions are repeatable prescriptions found

A

Private prescription

NHS prescriptions are not normally issue repeatable prescriptions

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45
Q

How many times can a repeatable prescription be dispensed

A

As many times as a prescriber indicate
If Not just one more time (2 in total)

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46
Q

Which schedule of drugs are allowed on repeatable prescription

A

Sch 4 and 5

NOT 2 or 3

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47
Q

Within how many months are the repeatable prescriptions valid

A

First dispensing must be done within 6 months for Sch 5

Schedule 4 must be done within 28 days

Subsequent dispensing has not legal time limit- use professional judgment

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48
Q

Are prescriptions and repeatable prescription for EEA and Switzerland legal

A

Yes

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49
Q

What details are required on a EEA & Swz prescription

A

Patient detail
Prescriber detail
-including email,
-qualifications and
-a telephone number or a fax number
-Work address
Prescribed medicine details
Date of issue
Signature

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50
Q

How long are EEA & swz prescriptions valid for

A

6 months

28 days for CD 4

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51
Q

What medicines cannot be used dispensed against EEA and SWZ prescriptions

A

SCH 1, 2 and 3
and medical products without marketing authorisations valid in the UK.

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52
Q

Can emergency supplies be made to EEA and SWZ citizen

A

YES - at the request of both the patient and prescriber

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53
Q

Which sch can’t be supplied as emergency

A

1, 2 and 3

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54
Q

what prescription are military prescriptions written on

A

FMed 269

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55
Q

What action should be taken when an Fmed 269 comes to a non-contract pharmacy

A

-Treat like a private prescription
-Do not invoice MOD directly but charge patient.
-Give them reciept to request a reclaim

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56
Q

What type of prescription is written in pink from

A

Sch 2 and 3 CDs on FP10PCD

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57
Q

Can Sch 2 or 3 CD on FMed 269 be dispensed

A

NO

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58
Q

List the legal requirements for labelling a drug

A

Name of patient
Name + Address of pharmacy
Date of dispensing
Name of medicine
Directions for use
Precaution relating to use of medicine

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59
Q

Is it a law to label the item in that is the container box

A

No

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60
Q

Can a pharmacist lawfully change the direction for use of a medication

A

Yes
If their professional judgment deems it so.

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61
Q

Must an audit trail of a change in medication direction

A

It is good practice but not a legal requirement

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62
Q

What is legally required for the assembly and pre-packaging medicine to other legal entities

A

Appropriate license from the MHRA

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63
Q

What are the labelling requirement for a medicine broken down from a bulk

A

Name of medicine
Quantity in the container
Qualitative qualities (Ingredients)
Handling and storage requirements
Expiry date
Batch reference : LOT or BN

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64
Q

what is the definition of covert administration

A

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

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65
Q

what is a patient specific directions

A

Written instruction by a MP and NMP for a medicine to be supplied to a patient

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66
Q

Within how many hours of an emergency request from a prescriber must a prescription be supplied

A

72 hours

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67
Q

Which schedules can be given as emergency

A

CD 4 and 5

Phenobarbital

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68
Q

Which record is kept for emergency supplies and how long must the record be kept

A

POM entry must be made on the day or the following day

Kept for 2 years

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69
Q

What must a pom entry include for an emergency prescription requested by a prescriber

A

Date of supply

Name of medication and quantity

Name and address of prescriber

Name and address of patient

Date on which the prescription is received

Date on prescription

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70
Q

Which record must be made for an emergency from a patient

A

• The date the POM was supplied

• The name (including strength and form where appropriate) and quantity of medicine supplied

• The name and address of the patient for whom the POM was supplied

• Information on the nature of the emergency, such as why the patient needs the POM and why a prescription cannot be obtained,

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71
Q

Can an emergency supply be made even when the GP/clinic is open

A

Yes but best interest of pt must be considered

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72
Q

What are the requirement for a POM to be supplied at request of pateint

A

An interview must be conducted with the patient

There must be an immediate need and it is not practical for a patient to obtain a prescription

Must have been used previously for a treatment

Pharmacist must be satisfied that they know the dose the pt takes

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73
Q

What are the requirement for a POM to be supplied at request of patient

A

Must have been used previously for a treatment

Pharmacist must be satisfied that they know the dose the pt takes

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73
Q

What are the requirement for a POM to be supplied at request of patient

A

Must have been used previously for a treatment

Pharmacist must be satisfied that they know the dose the pt takes

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74
Q

Are optometrist and podiatrist allowed to prescribe or supply POM

A

No unless they are independent or supplementary prescriber

Or is under a signed order

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75
Q

Under what circumstances can a pharmacist supply POM under a optometrist and podiatrist

A

If it is a signed patient order .

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76
Q

How can adrenaline auto injectors/ salbutamol inhaler be supplied to school

A

Under a signed order

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77
Q

What information is included in the sign order for a school

A

Name of school

Product details

Strength

Total quantity

signature of principal or head teacher

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78
Q

Is there a limit for the amount of product that can be order to a school through the signed order

A

No

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79
Q

What record is kept at the pharmacy for a signed order

A

Entry made in POM register
OR
A signed order must be kept for 2 years

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80
Q

What is Naloxone

A

It is an opioid antagonist that reversers CNS depression (completely or partially)

Used for opioid overdose

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80
Q

Who can obtain Naloxone form wholesaler or suppliers even though it is a POM without a prescription , PGD OR PSD

A

Staff engaged in lawful treatment services

This also includes nasal naloxone

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81
Q

Give examples of drugs that are high risk for pregnant women

A

oral retinoids,
valproate,
thalidomide,
lenalidomide
pomalidomide

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82
Q

Who/When can oral retinoid be prescribed under the PPP

A

When its done by dermatologist, GP with extensive role in dermatology or specialist dermatology nurse

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83
Q

What are the distribution controls for females at risk of pregnancy

A

Under PPP prescription only valid for 7 days
- Ideally dispensed on the day it is prescribed

Max 30 days supply

No repeats or free sample or faxed prescription.

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84
Q

When can an emergency supply of oral retinol be given

A

Under a telephone request from prescriber

Pregnancy status established with the last 7 days

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85
Q

What is Valproate used for

A

Epilepsy, Bipolar disorder and migraine

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86
Q

When a women is prescribed Valproate what must the pharmacist do ensure the patients safety

A

Have conversation with patient

Those planning to get pregnant to get a review with their treatment

Dispense Valporate in it’s original pack

Do not cover warning

Report suspected side effect via yellow card scheme

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87
Q

Why is a biosimilar drug not a generic medicines

A

Because they have complex structures and greater molecule size of biologics and heterogeneity they cannot be identical.

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88
Q

How are biosimilars usually prescribed

A

By brand name

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89
Q

What details should be provided when an adverse effects of biosimilars is reported

A

Brand name and batch number is provided therefore these should be recorded by pharmacist

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90
Q

Which classes of drugs can dentists prescribe

A

2-5 and any POM

But when prescribing on a yellow form they can only prescribe what is on the formulary

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91
Q

Which emergency supplies can dentist authorise

A

schedule 4 and 5 and phenobarbital

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92
Q

Does a veterinary prescription for a CD 2 or 3 be on a standardised form

A

No but must have RCVS registration number

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93
Q

Can vets authorise emergency supplies

A

No

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94
Q

What drugs can physiotherapists prescribe

A

ORAL : diazepam, lorazepam, temazepam, dihydrocodeine, morphine, oxycodone

Injection: Morphine

Transdermal: Fentanyl

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95
Q

Can the same person to prescriber and dispense medication

A

Yes but to ensure patient safety these functions should be done by 2 different people

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96
Q

Can the a prescriber, prescribe medicine for the themselves or close family

A

Yes but it is poor practice

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97
Q

What is required when trading medicines to someone other than a patient

A

A wholesaler licence (WDA)

Complying with good distribution practice

Have a suitable experienced responsible person named on the licence

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98
Q

Under which condition is whole distribution authorisation exempt

A

When pharmacy supplies to another pharmacy within same legal entity

Registered pharmacies and hospitals supplying small quantifies to HCP for treatment.
- only happens on occasional basis
-small quantity
-Supply not made for benefits
- Supply is not for onward wholesale

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99
Q

Which licences is needed along with WDA(H) by pharmacies

A

Home office CD licence for CD drugs

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100
Q

List the persons that can receive supplies from wholesalers

A

Doctors
* Dentists
* Registered pharmacies
* Hospitals, clinics and independent medical agencies
* Midwives
* Chiropodists/Podiatrists
* Optometrists and AdditionalSupply Optometrists
* Paramedics
* Owner or Master of Ship
* Orthoptists
* First aid organisations
* Certified first aiders
* Working for National Lifeboat Institution
* Occupational health schemes
* Drug treatment services
*NHS Trusts

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101
Q

Is there a legal requirement for a POM entry to be made if the supply invoice is kept

A

No but it is good practice

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102
Q

How long must a supply involve be kept for

A

2 years

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103
Q

What details must be included in the POM register for supply of medicine for signed order.

A

Date of POM Supply

Name and quantity and Formulation and strength when it is not apparent

Name and address of trade of the person to whom the supply was made

Purpose for which it was sold

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104
Q

What are the prescription requirements for vets

A

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

Name and address of owner

Species of animal and identification and it’s address

Date: valid for 6 months or shorter if the patient states it.

signature

Name, quantity, strength dose and administration instruction of medicine

Warning and withdrawal period

If appropriate: “Prescribed under veterinary cascade”

If repeated: number of repeats

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104
Q

If a vet medication is a CD 2 or 3 what must be written on the prescription

A

“the item has been prescribed for an animal or herd under the care of a veterinarian”

105
Q

How long are veterinary prescription kept for

A

5 year

106
Q

What are the steps the cascade

A

1: Vet medicine in GB or UK wide for species and condition
2. Vet medicine with NI marketing license for species and condition
3. GB, NI, OR UK wide vet medicine for another species or different condition
4a. GN,NI, UK human medicine 4b. vet med outside UK
5. speciality manufacture

107
Q

What must a pharmacist do legally when supplying or prescribing NFA-VPS or POM-VPS`

A

Advice on how to use product safely
Advice on warning and contra-indications
Be satisfied with the recipient intends to use medication correctly
Prescribe or supply minimum quantity required for treatment

108
Q

Legal requirement for Label for veterinary supplies prescribed under the cascade if they are not shown on the package and are not obstructed by the label

A

Name of the prescribing veterinary surgeon

Name and address of owner

Name and address of pharmacy

Date supply

Identification and species of animal

Date of supply

Dosage and administration of product
special Storage instruction if appropriate

Expiry date of the product

Necessary warnings

Withdrawal period

The words “For animal treatment only”

The words “Keep out of reach of children”

109
Q

What must be in the POM-V and POM-VPS record/register

A

Name of medicine
Date of the receipt/supply
Batch number
Quantity
Name and address of supplier or recipient
Name and address of prescriber -keep prescription

110
Q

How long must a Veterinary POM record be kept for

A

5 years

111
Q

How often is an audit done for the supply of POM-V and POM-VPS

A

Annually

112
Q

Where is the adverse reaction of vet medicines reported

A

Adverse reaction scheme for veterinary medicine

113
Q

What can be reported on the Adverse reaction scheme for veterinary medicine

A

Adverse reactions experienced by both animals and humans

Problems with microchips

114
Q

What is needed to be able to sell vet medicines online

A

Meeting the Accredited internet retailers Scheme.

115
Q

What is the role of an accountable officer in the case of CD drugs

A

Oversee the monitoring and audit management, prescribing and use of CDs

Ensure a system is in place for recording concerns and incidents

Attend local intelligence network meetings

Submit occurrence reports

Can authorise other persons to witness the destruction of CD

116
Q

What are the lawful ways in which to someone can possess CDs

A

Home office licence

Home office group authority

Legislation: class of a person

Certain classes of drugs can be possessed lawfully

A patient that has been prescribed a CD

117
Q

When are the circumstances in which pharmacists can possess CD 1

A

When it is with intent to destroy or to had over to police officers

118
Q

who can prescribe cocaine, diamorphine and dipipanone for the treatment of addiction?

A

Only does that hold a special licence from the Home secretary or Scottish government’s medical officers

119
Q

When is a licence not require to prescribe cocaine, diamorphine and dipipanone

A

when it is for an organic disease or injury

120
Q

Which Schedule of medication can be exported by a pharmacy under a licence

A

Schedule: 1, 2, 3, 4a and 4b

121
Q

When is licence not required for a scheduled drug import or export

A

When it is a Sch 4b drugs that is self-administered by the person.

When it is a Sch 5 drug

122
Q

To requisite sch 2 and 3 CDs what forms are required

A

A mandatory requisite form: FP10CDF

123
Q

What needs to be written in the Requisite form for a control drug

A

1.Name of recipient
2. Address of recipient
3.Signature of recipient
4.Profession or occupation
5.Total quantity of drug
6.Purpose of the requisition

124
Q

If a prescription had the name of a prison and address on it does the patient have to pay for it

A

No, as they are exempt by having HMP in the address

125
Q

Which locations are exempt from using a requisite form

A

Hospice and prisons
and
Hospitals where the pharmacy is part of the legal entity.

126
Q

In the case of an emergency within how many hours must a requisite form be produced

A

24 hrs

127
Q

Can a supply of CD be made using a fax or photocopy of a requisite form

A

No

128
Q

What are the legal requirements upon receiving a requisition form

A

Mark the requisite indelibly with the supplier’s name and address

Send the original requisition to the NHS agency

129
Q

Is it a legal requirement that a Copy of the Requisition form be kept

A

No

130
Q

How long should a copy of the requisition form be kept for

A

2 years

131
Q

What are the prescription requirements for a CD 2 or 3 prescription

A

The same as a normal prescription

Quality must be written in numbers and figures

The dose must be clearly defined : As directed is not sufficient

Instalment directions

identification on a private prescription

132
Q

Which has more addictive potential: Sugar free or products with sugar

A

Sugar free

133
Q

what must be stated if the CD is for Dental puposes

A

For dental treatments only

134
Q

What is required in the instalment direction for schedule 2 and 3

A

Amount of medicine to be supplied

The interval between each medicine that should be supplied

The dose for the instalments must also be included

Date of each supply

No more than 14 days treatment. (including days when pt does not collect medication)

135
Q

Within how many days can the instalments be made

A

First instalment within 28 days of appropriate date

Appropriate date meaning:
- Signature date
- Other date indicated by prescription
–The prescription must be marked with the date of each supply.

136
Q

If 3 days prescribed dose is missed by a patient what are most appropriate steps

A

Contact the prescriber to discuss appropriate steps

137
Q

What are private CD 2 or 3 written on

A

On a standardised form- FP10PCD

138
Q

What must be included on a private CD 2/3 prescription

A

Prescriber’s identification number- NOT registration number

139
Q

Are medicines in that are in CD 4 AND 5 allowed to be written on the same prescription s CD 2 and 3

A

No

140
Q

What is needed when a CD drug is collected by a representative of a Drug misuse patient

A

A letter from the drug misuser that authorises and names the representative

141
Q

Must a drug misuse patient be seen weekly for the medicine to be continued to be dispensed

A

It is not required by Law but it is GOOD practice to see them at least once a week.

142
Q

How many times does an instalment prescription need to be signed

A

Once

143
Q

when a person comes to collect a prescription what is considered good practice.

A

For the person to sign the reverse space on the prescription

144
Q

Which medications should be kept under safe custody

A

Schedule 1 drugs

Schedule 2 drugs

Schedule 3 drugs unless they are exempt

145
Q

Which medications are exempt from being under safe custody

A

Some liquid Schedule 2 drugs and Quinalbarbitone

–gabapentin

–pregabalin

–mazindol

–meprobamate

–midazolam

–pentazocine

–phentermine

–phenobarbital

–tramadol

146
Q

What are the requirements of safe custody in prisons

A

The CD cabinets should meet the “Solid secure silver standard”

CD 3, 4 and 5 may be treated like CD 2 if the risk assessment deems the place unsecure.

147
Q

Where is the access of CDs documented

A

Within a policy

148
Q

When patients return their medication, to avoid accidental supply how is the medication handled

A

The stock is segregated from the other pharmacy stock

The stock should be marked
“‘patient returns waiting to be destroyed’

OR

‘out of date, waiting authorised witness to destroy’,

149
Q

Prior to the disposal of CD drugs what must be done to them

A

They must be denatured

150
Q

what is the name of the exemption that allows pharmacies to denature CDs without a license

A

T28 exemption

151
Q

Which CDs schedules must be denatured before disposal

A

CD 2, 3 and 4 (Part 1)

152
Q

Which drugs need to be witnessed when denatured

A

Schedule 2 that has expired or is part of unwanted stock

153
Q

Which drugs do not require a witness when they are denatured

A

medicines returned by patients- inludes Sch 2,3 and 4a

154
Q

In prison which drugs usage and destruction’s audit trail is required by law and which is recommended

A

Schedule 3 CDs is required by law

Schedule 4 CDs (Diazepam and Chlordiazepoxide) is recommended

155
Q

Why is the usage and destruction of medicines recorded

A

For a robust audit trail

156
Q

what and where are should records be made when CD medicines are destroyed

A

for expired Sch 2 CDs medicines: an entry should be made in the CD register.

Returned drugs: No record made in the CD register but records of Sch 2 should be made but kept separately from the CD register

157
Q

what precaution should be taken when denaturing CD drugs

A

It should be done in a well ventilated area
Suitable PPE should be worn: Gloves, masks, goggles

158
Q

What is the method of destruction for solid dosage forms

A

The drugs should be ground with a small amount of water

Then Denaturing Kit should be added.

159
Q

What is the method of destruction for liquid dosage forms

A

Pour into an appropriate size CD denaturing Kit

Rinse the bottle and pour into denaturing kit

The bottle can be recycled or general waste without obvious packages or labels

160
Q

What is the method of destruction for ampoules and vials

A

Pour liquid ampoules into denaturing kit or dispose of the same as liquid dosage forms

For powdered ampoules: open and pour water to dissolve it then pour into denaturing kit.

Ampoules disposed of is sharps pharmaceutical waste

OR

Ampoules crushed with a pestle and warm soapy water is added

Then added to the denaturing kit

161
Q

What is the method of destruction for patches

A

The back should be removed and should be folded on itself

Then add to the denaturing kit or waste disposal kit

162
Q

What is the method of destruction for aerosols

A

Expel into water and dispose into denaturing kit.

Or Dispel into absorbent material and place into pharmaceutical waste

163
Q

What schedule is sativex

A

Schedule 4 part 1 `

164
Q

What details should be recorded when CD drugs are received

A

Date of supply

Name and address from whom received

Quantity received

165
Q

What details must be recorded when CD drugs are supplied to/for a pt

A

-Date supplied
-Name and address of recipient
-Quantity supplied
-Details of authority to possess: Prescriber or licence holder details
-Details of person collecting a Schedule 2: Pt/Pt’s representative or HC representation

165
Q

What details must be recorded when CD drugs are supplied to someone

A

-Date supplied

-Name and address of recipient

-Details of authority to possess: Prescriber or licence holder details

-Details of person collecting a Schedule 2: Pt/Pt’s representative or HC representation

-Whether proof of identity was requested and provided

166
Q

By law what must be written on the top of a CD Registration page

A

Class

Strength

Form

167
Q

What are the legal requirements for a CD book

A

It must be bound

Different classes are kept in different part of the register

Separate pages must be used for different strengths and formulation for each drug.

Multiple books for the same class are allowed

168
Q

What are the legal requirements for a CD book in prison

A

Prisons have one legally complaint register that requires all the details

Because prisons have multiple areas, each areas should a CD record books

169
Q

What are the nature of the CD entries

A

Must be chronological

The entry must be made on the day of transition or the following day

Must be made in ink

Entries cannot be cancelled or altered: corrections should be made in the margin
-Register should be marked to show who amended it
- Name, inital/signature, GPhC

170
Q

How many times should a stock balance be done

A

At least once a week but can me more frequent or less depending on:
-Risk assessment
-frequency of past irregularities
-Many pharmacist in a short period of time
On the same day every week

170
Q

How is a balance check done on liquid CDs

A

A visibility check is done and the volume check periodically

171
Q

List the licensed Cannabis-based products

A

THC combined with CBD: Sativex
Nabilone
CBD: Epidyolex
Dronabinol

172
Q

What schedule is Dronabinol

A

Sch 2 CD

173
Q

What is the legal category of Nabilone

A

POM CD 2

174
Q

What are the 3 requirement that Cannabis based products need to satisfy for it to be used medicinally

A
  1. Contain cannabis, cannabis resin or cannabidiols
  2. Must be for human use
  3. Product is regulated as a medicine product or an ingredients of a medicinal product
175
Q

who can prescribe Cannabis based medicinal products (CBMP)

A

Clinicians on the specialist register on the GMC

176
Q

what prescription form must private CBMP be written on

A

On a FP10PCD

177
Q

What must cannabidiol oils not contain

A

THC

178
Q

What Schedule is Epidyolex

A

Sch 5 CD

179
Q

Do liquid medication need to be emptied before they are disposed of.

A

No unless they are controlled drugs

180
Q

Do Pharmacies within a prison need to registered with the GPhC

A

No but it is good practice to follow guideline

181
Q

What are some reasons why child resistant locks may not be wanted

A

At the request of the patient

Original pack may not have it

182
Q

Are licenses required for homeopathic medicine

A

They are not required for homeopathic medicines

183
Q

What is the marketing authorisation of herbal medicines based on

A

Safety

Quality

Efficacy

Traditional herbal registration

184
Q

What is required to be marked on medical devices

A

A CE or UKCA mark to show compliance to medical regulation

185
Q

When a pharmacist re-packages a medicine from a manufacture’s original packaging what is it considered as

A

Off licence

186
Q

What are alternatives to multiple compliance aids

A

Medicine administration record

Labels with Pictograms

Labels print labels

Information Sheets

Reminder alarms

IT solutions

187
Q

What is the purpose of ‘statutory medical defence’

A

To protect patients who may test positive for specific drugs as a result of taking medicine in accordance to advice form HCP or PIL

188
Q

Which drugs when found in the body above a limit are counted as an offence, regardless of whether someone’s driving is impaired

A

Cannabis (THC)

Cocaine

Heroin

ketamine

LSD

MDMA

Methamphetamine

189
Q

Which licensed medicine (group 2), when found in the body above a certain limit are counted as an offence, regardless of whether someone’s driving is impaired

A

Amfetamine

Clonazepam

Diazepam

Lorazepam

Oxazepam

Temazepam

Flunitrazepam

Methadone

Morphine or opiate and opioid-based drugs, e.g. codeine, tramadol

190
Q

What is the responsibility of a Responsible pharmacy

A

-Secure the safe and effective running of the pharmacy

-Display a notice

-Complete the pharmacy records

-Establish, maintain and review pharmacy procedure

191
Q

what needs to be on a display notice

A

The name of the RP

The GPhC registration number

The fact that that the responsible pharmacist is in charge

192
Q

In what format does a pharmacy record need to be kept

A

In Writing

Electronically

or Both

193
Q

What is a pharmacy record

A

It shows who the responsible pharmacist at any date and time

194
Q

What must be included in the pharmacy record

A

-The responsible pharmacist’s name

-Time and date when the pharmacists becomes the RP

-If and when they are absent from the premises
-Time they left and returned

195
Q

How long must the pharmacy record be kept for

A

5 years

196
Q

How regularly should the pharmacy procedure (SOP) be reviewed

A

Once every 2 years

After an Incident

197
Q

Can temporary adjustments be made to the procedure

A

Yes

198
Q

If a temporary amendment to the SOP is made what details are needed to an audit trail

A

Which procedures are in place
• Which procedures were previously in place
• The responsible pharmacist who amended the procedure
• The date on which the amendment was made

198
Q

If a temporary amendment to the SOP is made what details are needed to an audit trail

A

what procedures are in place

Which procedure were previously in place

RP who amended the procedure

Date in which amendment was made

199
Q

How long can a RP be absent from the pharmacy

A

Up to 2 hours

even if there are more than 1 their total number of hour still needs to be 2

200
Q

What activities can take place in the store when there is a RP on the premises which require the pharmacist to supervise and be physically present?

A

Prescription checks
Sale and supply of P medicine
sale/Supply of POM
Supply of PGD medicines
wholesale of medicines
Emergency supplies

201
Q

What activities can take place when the (supervising/RP) pharmacists is not physically present on the pharmacy but requires supervision from a pharmacist.

A
  • Generating a dispensing label
  • Taking medicines off the dispensary shelves
  • Assembly of the item (e.g. counting tablets)
  • Labelling of containers with the dispensing label
  • Accuracy checking
202
Q

What activities can take place without a RP in charge, but requires the support staff to be trained

A

Order stock from wholesaler

Receiving and putting away stock

Date checking

Stocking pharmacy with consumables

cleaning the pharmacy

Responding to enquires

Accessing the PMR

Receive prescriptions from EPS system, patients and collection from a surgery.

Processing prescription forms that have been dispensed

Delivery of medicines to patients

Receive return medicine from patients

203
Q

Which activities can take place with a responsible pharmacist in charge of the pharmacy (but does not require supervision of a pharmacist)

A

Sale of GSL medicine

Process waste stock medicines or patient return medicines

204
Q

Within how many months must repeat prescriptions be dispensed

A

Human prescription: No time limit

Vet: Within 6 months

205
Q

what are the different categories of veterinarian medicine

A

POM-V: Prescription only medicines prescribed by Vet surgeon only and supplied by vet surgeon and pharmacist

POM-VPS: Prescription only medicine prescribed by Vet surgeon, pharmacist or suitably qualified person and supplied by vet surgeon and pharmacist with oral or written prescription
Written when the prescriber is not the supplier.

AVM-GSL: Authorised veterinary medicine that is available on general sale

NFA-VPS: Medicine for non-food animals prescribed by Vet surgeon, pharmacist or suitably qualified person and supplied by vet surgeon and pharmacist with oral or written prescription

Not accessible by the public

206
Q

How any days supply for schedule 2 and 3 is considered good practice

A

Should not exceed 30 days for Human

28 days for vet prescription

207
Q

When importing or exporting medicine when is a personal licence not required

A

When the person has less than 3 month’s supply, however letter from and signed by their prescriber is advised.

208
Q

What should be included in the letter provided by prescribers when a patient is exporting medicine

A

confirms the name of the patient,

travel plans,

name of the prescribed CDs,

total quantities

dose

209
Q

what is the name of the requisition form

A

FP10CDF

210
Q

Who must sign a hospital requisition form

A

The person in charge of the hospital issue as well as a doctor or a dentist employed in that same hospital

211
Q

How long is a vet requisite form kept for

A

5 years

212
Q

In which cases are original requisite forms retained and how long are they retained for?

A

when the person dispensing and supplying is made by someone working at a:

Hospital

Care home

Hospice

Prison

Organisation providing ambulance service

Kept for 2 years instead of been sent to the relevant agency

213
Q

For which CDs are midwife supply orders required

A

Diamorphine

Morphine

Pethidine

214
Q

What must be on a midwife supply order

A

Name and occupation of midwife

Name of person to whom CD is to be administered or supplied

Purpose for CD requisition

Total quantity

signature of appropriate medical officer (Doctor authorised by supervising authority)

214
Q

what are the specific home office approved wordings that can be used on instalments

A

1 Please dispense instalments due on pharmacy closed days on a prior suitable day.
2 If an instalment’s collection day has been missed, please still dispense the amount due for any remaining day(s) of that instalment.
3 Consult the prescriber if three or more consecutive days of a prescription have been missed.
4 Supervise consumption on collection days.
5 Dispense daily doses in separate containers.

215
Q

What are steps of the incident decision tree

A

1: Deliberate harm test
2: Health test
a: substance abuse b&c: Physical or mental illness
3: foresight test
a: Agreed protocols b: Are protocols workable and in routine use c: Did individual knowingly depart from the protocol

if yes move to step 4
4: substitution test
5: Mitigating circumstances

216
Q

What are the error reporting standards

A

Standard 1: Open and honest
Standard 2: Report to appropriate local or national report programme
Standard 3: Learn
Standard 4: Share
Standard 5: Act
Standard 6: Review

217
Q

what factors should be considered when doing a risk assessment when making a clinical judgment

A

-Hazards
-The risk: Likelihood
-The degree of harm likely
-Who may be harmed
-Any preventative measures
-Record the outcome
-Monitor and review

218
Q

In what cases can the Legal defence against criminal persecution be used when an error has been made

A
  1. The medicine has been dispensed in a registered pharmacy

AND

  1. Dispensing by and under the supervision of a registered pharmacist

AND

  1. Supplied against the prescription PGC or directions from a prescriber

AND

  1. Promptly notified the Standard patient once pharmacy team is aware
219
Q

What should be recorded when Safeguarding issues are suspected

A

Concerns and suspicion

Decision taken

Reasons for whether further action is taken or not

220
Q

What does the Fraser guideline outline about supplying contraception to under 16s

A

Their maturity and intelligence to understand the nature purpose and implication for the treatment

They cannot persuade the girl to tell her parent or the practitioner to tell them

They are very likely to begin or continue having sexual intercourse with or without contraceptive treatment

Their physical or mental health is likely to suffer unless they receive the advice or treatment

The advice or treatment is in the young person’s best interest

221
Q

when taking a medication history, what details should be made about each medicine

A

Generic name of drug’

Brand name

Strength

dose: both the prescribed and the actual dose

formulation

Route of administration

Frequency of administration

Length of therapy

administration device or brand of

222
Q

where are Suspected ADR for animal reported?

A

This is a blank card

223
Q

What factors are considered when making a risk assessment

A

Hazard
The risk
The degree of harm likely
Who may be harmed
Any preventative methods
Record of outcome
Monitor and review

224
Q

What type of pateints are categorised as vulnerable adults ?

A

-Suffers from mental or physical disability

-Has learning difficulties

-Is frail or elderly

-Is in an abusive relationship

-Is a substance misuser.

225
Q

Signs of abuse in adults

A

Physical: Unusual/unexplained injury

Neglect: Failure to thrive/ Malnourishment

Emotional abuse: Evidence of self-harm/self-mutilation. Inappropriate verbal abuse. Fear of certain people.

Financial abuse: Sudden changes in finance (debt)

Delays seeking medical treatment

226
Q

what steps to take when suspecting abuse or neglect of a vulnerable adult

A

In emergencies: Take immediate action to ensure safer

Consider whether the patient had capacity to consent.

If and when consent is given refer to relevant body ie social services, CQC

Then record and raise again if circumstances change

227
Q

What is a clinical audit

A

A systematic review of care to improve the quality of patient care and outcome. This is compared to explicit standard and best practice and improvements based on that.

228
Q

Which schedule of medications return should be destroyed.

A

Schedule 2, 3 and 4

229
Q

what size insulin pack should be given in an emergency supply

A

1 pen

230
Q

which medication have been reclassified from pom to P medicine

A

-Amorolfine

-Chloramphenicol Eye drops and ointments

-Desogestrel

-Emergency Contraceptives

-Mometasone nasal spray

-Oral lidocaine

-orlistat

-sildenafil and tadalafil

-sumatriptans

231
Q

What needs to be on a prescription for it to be legal

A

> Patients name and address
Age if they are less than 12 y/o
The prescribers signature
Date
Particulars of a prescriber
Address of prescriber

232
Q

How can an audit trail of a repeatable prescription be made

A

write on the prescription:

> The name and address of the pharmacy where the supply had been made
Date of Supply

233
Q

which schedule of medication are repeatable

A

Sch 4 or 5

234
Q

Can owing of POMs and Schedule 5 medication for patietns on the PPP be collected after 7 days

A

Yes as long as the pharmacist follows the PPP checklist and to ensure there is no risk of pregnancy

235
Q

within how many days should sch 2,3 and 4 drugs be collected

A

Within 28h days of the date on the written prescription.

236
Q

In which register is the record of private prescriptions for SCh 2 and 3 CDs made in?

A

A POM register

237
Q

what details are made in the record for Sch 2 and 3 private prescriptions?

A

Supply Date

Prescription date

Medicine details

prescriber’s details

Patient details

DETAILS must be made on the day of sale or supply takes place and if not practical the day following.

238
Q

Under what circumstance can a drug be supplied on a faxed image of a prescription,

A

when the pharmacists make an informed decision and take steps to safeguard patient safety and mitigate risks.

Make record of the decision-making process

239
Q

What forms must a military Sch 2 or 3 drug be written on

A

A pink FP10PCD

239
Q

what actions must be taken before a pharmacist signs a covert administration document

A

-Do a clinical medication review
-Advice on the administration of the medication - eg what to do if a patient only consumes part of their food.

240
Q

Examples of PSD found in the hospital

A

The instruction on an inpatient CHART.

241
Q

which specific opioids can pharmacist supply and/or administer under a PGD and for what reason

A

Diamorphine

Morphine

for immediate, necessary treatment of sick or injured persons

242
Q

which medications cannot be supplied as emergency medications

A

ammonium bromide,
calcium bromide,
calcium bromidolactobionate, embutramide,
fencamfamin hydrochloride, fluanisone,
hexobarbitone,
hexobarbitone sodium, hydrobromic acid,
meclofenoxate hydrochloride, methohexitone sodium,
pemoline,
piracetam,
potassium bromide,
prolintane hydrochloride, s
odium bromide,
strychnine hydrochloride,
tacrine hydrochloride,
thiopentone sodium

243
Q

what length of treatment should be given for emergency supplies: List all possible classes and formulations

A

CD 1-5: 5 days
POM: Up to 30 days
-If the POM is an insulin, ointment cream or inhaler: Smallest pack size
-If POM is an oral contraceptive: Enough for a full cycle
-If the POM is an antibiotic: the shortest most effective course

244
Q

What are the labelling requirements for an emergency made at the request of a patient

A

The standard requirements
+
The words ‘Emergency supply’

245
Q

which medications can Paramedic independent prescribe

A

-Morphine sulphate by oral administration or by injection

-Diazepam by oral administration or by injection

-Midazolam by oromucosal administration or by injection

-Lorazepam by injection

-Codeine phosphate by oral administration.

246
Q

Can Physiotherapist independent prescribers, prescribe all Schedule 2 to 5 drugs

A

No only :
-Oral diazepam, dihydrocodeine, lorazepam, diazepam, morphine, oxycodone, temazepam

Injection: Morphine

Patches: Fentanyl

247
Q

which HCP can sell supply or administer certain medications under exemption under the human medicines

A

Midwives

Opthoptist

Optometrists

Paramedics

Podiatrist/Chiropodist

248
Q

How may days worth of CD medication is good practice to prescribe for a vet?

A

28 Days

249
Q

on the prescription for CD 2 OR 3 vet prescription what detail about the prescriber must be on it?

A

It must have their RCVS registration number.

250
Q

How long should the invoice for CD sch 2 be kept for

A

2 years

251
Q

what are THE LEGAL REQUIREMENTS FOR A CONTROLLED DRUG REQUISITION form

A

1 Signature of the recipient
2 Name of the recipient
3 Address of the recipient
4 Profession or occupation
5 Total quantity of drug
6 Purpose of the requisition

252
Q

when an emergency supply is made to a doctor or dentist without a requisition form within how many hours must the form be sent?

A

24 hours

253
Q

within how many days must the first dose of an instalment prescription be dispensed

A

28 days

254
Q

What are the Home office approved wording that can be used in an instalment prescription for when the pharmacy is closed?

A

Please dispense instalments due on pharmacy closed days on a prior suitable day.

If an instalment’s collection day has been missed, please still dispense the amount due for any remaining day(s) of that instalment.

Consult the prescriber if three or more consecutive days of a prescription have been missed.

Supervise consumption on collection days.

Dispense daily doses in separate containers.

255
Q

What needs to be on a standardised private Rx form for it to be legal

A

A prescriber identification number must be included on standardised private prescriptions.

This number is not the prescriber’s professional registration number but a separate number issued by the NHS agency.

256
Q

When is it not necessary for the prescriber to be contacted when a representative come to collect a Schedule 2 or 3 CD that is meant to be taken under supervised.

A

if the person has been detained in police custody and the representative collecting the dose is a police custody officer or a custody healthcare professional.

257
Q
A

MEP (3 decks)

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