MEP Flashcards
Revise all topics by first week of Jan
What is the Schedule of Buprenorphine
CD 3
What is the schedule clonazepam
CD 4 pt 1
What is the schedule of Chlordiazepoxide
CD 4 pt 1
What schedule is Codeine phosphate
CD 5
What schedule is Diamorphine
CD 2
What schedule is Diazepam
CD 4 pt 1
What schedule is Dihydrocodeine Tartrate
CD 5
What schedule is Dipipanone
CD 2
What schedule is fentanyl
CD 2
What schedule is Gabapentin
CD 3
What schedule is Hydrocodone
CD 2
What schedule is Loprazolam
CD 4 pt 1
What Schedule is Lorazepam
CD 4 pt 1
What Schedule is methadone
CD 2
What Schedule is Methylphenidate hydrochloride
CD 2
What schedule is Midazolam
CD 3
What schedule is Morphine tablets
CD 2
What morphine solution has the Schedule of CD 5
10mg/5ml
What Schedule is Nitrazepam
CD 4 pt 1
What schedule is Oxycodone
CD 2`
What schedule is Pethidine
CD 2
What schedule is phenobarbital
CD 3
what schedule is pholcodine
CD 5
What schedule is pregabalin
CD 3
What schedule is Quinalbarbitone
CD 2
What schedule is Somatotropin
CD 4 pt 2
What schedule is Temazepam
CD 3
What schedule is Tramadol
CD 3
What schedule is Zolpidem
CD 4 pt 1
What schedule is Zopiclone
CD 4 pt 1
what is the maximum amount of pseudoephedrine that can be sold at any one time
720mg `
what is the maximum amount of ephedrine that can be sold at any one time
180mg
what are the 3 different emergency contraceptive
- Cu-IUD
-Oral ulipristal acetate
within 120hrs/ 5 days
30mg
-oral levonorgestrel
1500mcg
>16y/o
Within 72 hours
what are the other options of supply of contraceptives other than sale
-Family planning clinics
-PDG providers for oral emergency contraceptives
-Genitourinary medicine clinic
What are is the amount of paracetamol that can be supplied OTC
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
What are is the amount of aspirin that can be supplied OTC
<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
Under what indication can OTC codeine and dihydrocodeine be supplies
short-term treatment of acute or moderate pain not relieved by paracetamol or aspirin alone
what pack size of codeine and dihydrocodeine is POM
Packs of more than 32 including effervescent.
What warning must be placed on seen the pack codeine pack and at which position
“Can cause addition. For three days use only”
in clear position on the front of the pack.
Are carbon copy prescription legal
Yes as along as they are signed in ink
Which languages can prescription be legally valid
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
What places are know as Crown dependants
Jersey
Guernsey
Isle of man
Can a prescription for CD 2 and 3 be dispensed if they are from Crown dependants
-yes but the prescribers address must be in the UK
On which prescriptions are repeatable prescriptions found
Private prescription
NHS prescriptions are not normally issue repeatable prescriptions
How many times can a repeatable prescription be dispensed
As many times as a prescriber indicate
If Not just one more time (2 in total)
Which schedule of drugs are allowed on repeatable prescription
Sch 4 and 5
NOT 2 or 3
Within how many months are the repeatable prescriptions valid
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
Are prescriptions and repeatable prescription for EEA and Switzerland legal
Yes
What details are required on a EEA & Swz prescription
Patient detail
Prescriber detail
-including email,
-qualifications and
-a telephone number or a fax number
-Work address
Prescribed medicine details
Date of issue
Signature
How long are EEA & swz prescriptions valid for
6 months
28 days for CD 4
What medicines cannot be used dispensed against EEA and SWZ prescriptions
SCH 1, 2 and 3
and medical products without marketing authorisations valid in the UK.
Can emergency supplies be made to EEA and SWZ citizen
YES - at the request of both the patient and prescriber
Which sch can’t be supplied as emergency
1, 2 and 3
what prescription are military prescriptions written on
FMed 269
What action should be taken when an Fmed 269 comes to a non-contract pharmacy
-Treat like a private prescription
-Do not invoice MOD directly but charge patient.
-Give them reciept to request a reclaim
What type of prescription is written in pink from
Sch 2 and 3 CDs on FP10PCD
Can Sch 2 or 3 CD on FMed 269 be dispensed
NO
List the legal requirements for labelling a drug
Name of patient
Name + Address of pharmacy
Date of dispensing
Name of medicine
Directions for use
Precaution relating to use of medicine
Is it a law to label the item in that is the container box
No
Can a pharmacist lawfully change the direction for use of a medication
Yes
If their professional judgment deems it so.
Must an audit trail of a change in medication direction
It is good practice but not a legal requirement
What is legally required for the assembly and pre-packaging medicine to other legal entities
Appropriate license from the MHRA
What are the labelling requirement for a medicine broken down from a bulk
Name of medicine
Quantity in the container
Qualitative qualities (Ingredients)
Handling and storage requirements
Expiry date
Batch reference : LOT or BN
what is the definition of covert administration
medicines are administered in a disguised format without the knowledge or consent of the person receiving them,
what is a patient specific directions
Written instruction by a MP and NMP for a medicine to be supplied to a patient
Within how many hours of an emergency request from a prescriber must a prescription be supplied
72 hours
Which schedules can be given as emergency
CD 4 and 5
Phenobarbital
Which record is kept for emergency supplies and how long must the record be kept
POM entry must be made on the day or the following day
Kept for 2 years
What must a pom entry include for an emergency prescription requested by a prescriber
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
Which record must be made for an emergency from a patient
• 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,
Can an emergency supply be made even when the GP/clinic is open
Yes but best interest of pt must be considered
What are the requirement for a POM to be supplied at request of pateint
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
What are the requirement for a POM to be supplied at request of patient
Must have been used previously for a treatment
Pharmacist must be satisfied that they know the dose the pt takes
What are the requirement for a POM to be supplied at request of patient
Must have been used previously for a treatment
Pharmacist must be satisfied that they know the dose the pt takes
Are optometrist and podiatrist allowed to prescribe or supply POM
No unless they are independent or supplementary prescriber
Or is under a signed order
Under what circumstances can a pharmacist supply POM under a optometrist and podiatrist
If it is a signed patient order .
How can adrenaline auto injectors/ salbutamol inhaler be supplied to school
Under a signed order
What information is included in the sign order for a school
Name of school
Product details
Strength
Total quantity
signature of principal or head teacher
Is there a limit for the amount of product that can be order to a school through the signed order
No
What record is kept at the pharmacy for a signed order
Entry made in POM register
OR
A signed order must be kept for 2 years
What is Naloxone
It is an opioid antagonist that reversers CNS depression (completely or partially)
Used for opioid overdose
Who can obtain Naloxone form wholesaler or suppliers even though it is a POM without a prescription , PGD OR PSD
Staff engaged in lawful treatment services
This also includes nasal naloxone
Give examples of drugs that are high risk for pregnant women
oral retinoids,
valproate,
thalidomide,
lenalidomide
pomalidomide
Who/When can oral retinoid be prescribed under the PPP
When its done by dermatologist, GP with extensive role in dermatology or specialist dermatology nurse
What are the distribution controls for females at risk of pregnancy
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.
When can an emergency supply of oral retinol be given
Under a telephone request from prescriber
Pregnancy status established with the last 7 days
What is Valproate used for
Epilepsy, Bipolar disorder and migraine
When a women is prescribed Valproate what must the pharmacist do ensure the patients safety
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
Why is a biosimilar drug not a generic medicines
Because they have complex structures and greater molecule size of biologics and heterogeneity they cannot be identical.
How are biosimilars usually prescribed
By brand name
What details should be provided when an adverse effects of biosimilars is reported
Brand name and batch number is provided therefore these should be recorded by pharmacist
Which classes of drugs can dentists prescribe
2-5 and any POM
But when prescribing on a yellow form they can only prescribe what is on the formulary
Which emergency supplies can dentist authorise
schedule 4 and 5 and phenobarbital
Does a veterinary prescription for a CD 2 or 3 be on a standardised form
No but must have RCVS registration number
Can vets authorise emergency supplies
No
What drugs can physiotherapists prescribe
ORAL : diazepam, lorazepam, temazepam, dihydrocodeine, morphine, oxycodone
Injection: Morphine
Transdermal: Fentanyl
Can the same person to prescriber and dispense medication
Yes but to ensure patient safety these functions should be done by 2 different people
Can the a prescriber, prescribe medicine for the themselves or close family
Yes but it is poor practice
What is required when trading medicines to someone other than a patient
A wholesaler licence (WDA)
Complying with good distribution practice
Have a suitable experienced responsible person named on the licence
Under which condition is whole distribution authorisation exempt
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
Which licences is needed along with WDA(H) by pharmacies
Home office CD licence for CD drugs
List the persons that can receive supplies from wholesalers
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
Is there a legal requirement for a POM entry to be made if the supply invoice is kept
No but it is good practice
How long must a supply involve be kept for
2 years
What details must be included in the POM register for supply of medicine for signed order.
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
What are the prescription requirements for vets
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
If a vet medication is a CD 2 or 3 what must be written on the prescription
“the item has been prescribed for an animal or herd under the care of a veterinarian”
How long are veterinary prescription kept for
5 year
What are the steps the cascade
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
What must a pharmacist do legally when supplying or prescribing NFA-VPS or POM-VPS`
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
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
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”
What must be in the POM-V and POM-VPS record/register
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
How long must a Veterinary POM record be kept for
5 years
How often is an audit done for the supply of POM-V and POM-VPS
Annually
Where is the adverse reaction of vet medicines reported
Adverse reaction scheme for veterinary medicine
What can be reported on the Adverse reaction scheme for veterinary medicine
Adverse reactions experienced by both animals and humans
Problems with microchips
What is needed to be able to sell vet medicines online
Meeting the Accredited internet retailers Scheme.
What is the role of an accountable officer in the case of CD drugs
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
What are the lawful ways in which to someone can possess CDs
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
When are the circumstances in which pharmacists can possess CD 1
When it is with intent to destroy or to had over to police officers
who can prescribe cocaine, diamorphine and dipipanone for the treatment of addiction?
Only does that hold a special licence from the Home secretary or Scottish government’s medical officers
When is a licence not require to prescribe cocaine, diamorphine and dipipanone
when it is for an organic disease or injury
Which Schedule of medication can be exported by a pharmacy under a licence
Schedule: 1, 2, 3, 4a and 4b
When is licence not required for a scheduled drug import or export
When it is a Sch 4b drugs that is self-administered by the person.
When it is a Sch 5 drug
To requisite sch 2 and 3 CDs what forms are required
A mandatory requisite form: FP10CDF
What needs to be written in the Requisite form for a control drug
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
If a prescription had the name of a prison and address on it does the patient have to pay for it
No, as they are exempt by having HMP in the address
Which locations are exempt from using a requisite form
Hospice and prisons
and
Hospitals where the pharmacy is part of the legal entity.
In the case of an emergency within how many hours must a requisite form be produced
24 hrs
Can a supply of CD be made using a fax or photocopy of a requisite form
No
What are the legal requirements upon receiving a requisition form
Mark the requisite indelibly with the supplier’s name and address
Send the original requisition to the NHS agency
Is it a legal requirement that a Copy of the Requisition form be kept
No
How long should a copy of the requisition form be kept for
2 years
What are the prescription requirements for a CD 2 or 3 prescription
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
Which has more addictive potential: Sugar free or products with sugar
Sugar free
what must be stated if the CD is for Dental puposes
For dental treatments only
What is required in the instalment direction for schedule 2 and 3
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)
Within how many days can the instalments be made
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.
If 3 days prescribed dose is missed by a patient what are most appropriate steps
Contact the prescriber to discuss appropriate steps
What are private CD 2 or 3 written on
On a standardised form- FP10PCD
What must be included on a private CD 2/3 prescription
Prescriber’s identification number- NOT registration number
Are medicines in that are in CD 4 AND 5 allowed to be written on the same prescription s CD 2 and 3
No
What is needed when a CD drug is collected by a representative of a Drug misuse patient
A letter from the drug misuser that authorises and names the representative
Must a drug misuse patient be seen weekly for the medicine to be continued to be dispensed
It is not required by Law but it is GOOD practice to see them at least once a week.
How many times does an instalment prescription need to be signed
Once
when a person comes to collect a prescription what is considered good practice.
For the person to sign the reverse space on the prescription
Which medications should be kept under safe custody
Schedule 1 drugs
Schedule 2 drugs
Schedule 3 drugs unless they are exempt
Which medications are exempt from being under safe custody
Some liquid Schedule 2 drugs and Quinalbarbitone
–gabapentin
–pregabalin
–mazindol
–meprobamate
–midazolam
–pentazocine
–phentermine
–phenobarbital
–tramadol
What are the requirements of safe custody in prisons
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.
Where is the access of CDs documented
Within a policy
When patients return their medication, to avoid accidental supply how is the medication handled
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’,
Prior to the disposal of CD drugs what must be done to them
They must be denatured
what is the name of the exemption that allows pharmacies to denature CDs without a license
T28 exemption
Which CDs schedules must be denatured before disposal
CD 2, 3 and 4 (Part 1)
Which drugs need to be witnessed when denatured
Schedule 2 that has expired or is part of unwanted stock
Which drugs do not require a witness when they are denatured
medicines returned by patients- inludes Sch 2,3 and 4a
In prison which drugs usage and destruction’s audit trail is required by law and which is recommended
Schedule 3 CDs is required by law
Schedule 4 CDs (Diazepam and Chlordiazepoxide) is recommended
Why is the usage and destruction of medicines recorded
For a robust audit trail
what and where are should records be made when CD medicines are destroyed
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
what precaution should be taken when denaturing CD drugs
It should be done in a well ventilated area
Suitable PPE should be worn: Gloves, masks, goggles
What is the method of destruction for solid dosage forms
The drugs should be ground with a small amount of water
Then Denaturing Kit should be added.
What is the method of destruction for liquid dosage forms
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
What is the method of destruction for ampoules and vials
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
What is the method of destruction for patches
The back should be removed and should be folded on itself
Then add to the denaturing kit or waste disposal kit
What is the method of destruction for aerosols
Expel into water and dispose into denaturing kit.
Or Dispel into absorbent material and place into pharmaceutical waste
What schedule is sativex
Schedule 4 part 1 `
What details should be recorded when CD drugs are received
Date of supply
Name and address from whom received
Quantity received
What details must be recorded when CD drugs are supplied to/for a pt
-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
What details must be recorded when CD drugs are supplied to someone
-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
By law what must be written on the top of a CD Registration page
Class
Strength
Form
What are the legal requirements for a CD book
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
What are the legal requirements for a CD book in prison
Prisons have one legally complaint register that requires all the details
Because prisons have multiple areas, each areas should a CD record books
What are the nature of the CD entries
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
How many times should a stock balance be done
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
How is a balance check done on liquid CDs
A visibility check is done and the volume check periodically
List the licensed Cannabis-based products
THC combined with CBD: Sativex
Nabilone
CBD: Epidyolex
Dronabinol
What schedule is Dronabinol
Sch 2 CD
What is the legal category of Nabilone
POM CD 2
What are the 3 requirement that Cannabis based products need to satisfy for it to be used medicinally
- Contain cannabis, cannabis resin or cannabidiols
- Must be for human use
- Product is regulated as a medicine product or an ingredients of a medicinal product
who can prescribe Cannabis based medicinal products (CBMP)
Clinicians on the specialist register on the GMC
what prescription form must private CBMP be written on
On a FP10PCD
What must cannabidiol oils not contain
THC
What Schedule is Epidyolex
Sch 5 CD
Do liquid medication need to be emptied before they are disposed of.
No unless they are controlled drugs
Do Pharmacies within a prison need to registered with the GPhC
No but it is good practice to follow guideline
What are some reasons why child resistant locks may not be wanted
At the request of the patient
Original pack may not have it
Are licenses required for homeopathic medicine
They are not required for homeopathic medicines
What is the marketing authorisation of herbal medicines based on
Safety
Quality
Efficacy
Traditional herbal registration
What is required to be marked on medical devices
A CE or UKCA mark to show compliance to medical regulation
When a pharmacist re-packages a medicine from a manufacture’s original packaging what is it considered as
Off licence
What are alternatives to multiple compliance aids
Medicine administration record
Labels with Pictograms
Labels print labels
Information Sheets
Reminder alarms
IT solutions
What is the purpose of ‘statutory medical defence’
To protect patients who may test positive for specific drugs as a result of taking medicine in accordance to advice form HCP or PIL
Which drugs when found in the body above a limit are counted as an offence, regardless of whether someone’s driving is impaired
Cannabis (THC)
Cocaine
Heroin
ketamine
LSD
MDMA
Methamphetamine
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
Amfetamine
Clonazepam
Diazepam
Lorazepam
Oxazepam
Temazepam
Flunitrazepam
Methadone
Morphine or opiate and opioid-based drugs, e.g. codeine, tramadol
What is the responsibility of a Responsible pharmacy
-Secure the safe and effective running of the pharmacy
-Display a notice
-Complete the pharmacy records
-Establish, maintain and review pharmacy procedure
what needs to be on a display notice
The name of the RP
The GPhC registration number
The fact that that the responsible pharmacist is in charge
In what format does a pharmacy record need to be kept
In Writing
Electronically
or Both
What is a pharmacy record
It shows who the responsible pharmacist at any date and time
What must be included in the pharmacy record
-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
How long must the pharmacy record be kept for
5 years
How regularly should the pharmacy procedure (SOP) be reviewed
Once every 2 years
After an Incident
Can temporary adjustments be made to the procedure
Yes
If a temporary amendment to the SOP is made what details are needed to an audit trail
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
If a temporary amendment to the SOP is made what details are needed to an audit trail
what procedures are in place
Which procedure were previously in place
RP who amended the procedure
Date in which amendment was made
How long can a RP be absent from the pharmacy
Up to 2 hours
even if there are more than 1 their total number of hour still needs to be 2
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?
Prescription checks
Sale and supply of P medicine
sale/Supply of POM
Supply of PGD medicines
wholesale of medicines
Emergency supplies
What activities can take place when the (supervising/RP) pharmacists is not physically present on the pharmacy but requires supervision from a pharmacist.
- 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
What activities can take place without a RP in charge, but requires the support staff to be trained
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
Which activities can take place with a responsible pharmacist in charge of the pharmacy (but does not require supervision of a pharmacist)
Sale of GSL medicine
Process waste stock medicines or patient return medicines
Within how many months must repeat prescriptions be dispensed
Human prescription: No time limit
Vet: Within 6 months
what are the different categories of veterinarian medicine
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
How any days supply for schedule 2 and 3 is considered good practice
Should not exceed 30 days for Human
28 days for vet prescription
When importing or exporting medicine when is a personal licence not required
When the person has less than 3 month’s supply, however letter from and signed by their prescriber is advised.
What should be included in the letter provided by prescribers when a patient is exporting medicine
confirms the name of the patient,
travel plans,
name of the prescribed CDs,
total quantities
dose
what is the name of the requisition form
FP10CDF
Who must sign a hospital requisition form
The person in charge of the hospital issue as well as a doctor or a dentist employed in that same hospital
How long is a vet requisite form kept for
5 years
In which cases are original requisite forms retained and how long are they retained for?
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
For which CDs are midwife supply orders required
Diamorphine
Morphine
Pethidine
What must be on a midwife supply order
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)
what are the specific home office approved wordings that can be used on instalments
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.
What are steps of the incident decision tree
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
What are the error reporting standards
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
what factors should be considered when doing a risk assessment when making a clinical judgment
-Hazards
-The risk: Likelihood
-The degree of harm likely
-Who may be harmed
-Any preventative measures
-Record the outcome
-Monitor and review
In what cases can the Legal defence against criminal persecution be used when an error has been made
- The medicine has been dispensed in a registered pharmacy
AND
- Dispensing by and under the supervision of a registered pharmacist
AND
- Supplied against the prescription PGC or directions from a prescriber
AND
- Promptly notified the Standard patient once pharmacy team is aware
What should be recorded when Safeguarding issues are suspected
Concerns and suspicion
Decision taken
Reasons for whether further action is taken or not
What does the Fraser guideline outline about supplying contraception to under 16s
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
when taking a medication history, what details should be made about each medicine
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
where are Suspected ADR for animal reported?
This is a blank card
What factors are considered when making a risk assessment
Hazard
The risk
The degree of harm likely
Who may be harmed
Any preventative methods
Record of outcome
Monitor and review
What type of pateints are categorised as vulnerable adults ?
-Suffers from mental or physical disability
-Has learning difficulties
-Is frail or elderly
-Is in an abusive relationship
-Is a substance misuser.
Signs of abuse in adults
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
what steps to take when suspecting abuse or neglect of a vulnerable adult
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
What is a clinical audit
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.
Which schedule of medications return should be destroyed.
Schedule 2, 3 and 4
what size insulin pack should be given in an emergency supply
1 pen
which medication have been reclassified from pom to P medicine
-Amorolfine
-Chloramphenicol Eye drops and ointments
-Desogestrel
-Emergency Contraceptives
-Mometasone nasal spray
-Oral lidocaine
-orlistat
-sildenafil and tadalafil
-sumatriptans
What needs to be on a prescription for it to be legal
> Patients name and address
Age if they are less than 12 y/o
The prescribers signature
Date
Particulars of a prescriber
Address of prescriber
How can an audit trail of a repeatable prescription be made
write on the prescription:
> The name and address of the pharmacy where the supply had been made
Date of Supply
which schedule of medication are repeatable
Sch 4 or 5
Can owing of POMs and Schedule 5 medication for patietns on the PPP be collected after 7 days
Yes as long as the pharmacist follows the PPP checklist and to ensure there is no risk of pregnancy
within how many days should sch 2,3 and 4 drugs be collected
Within 28h days of the date on the written prescription.
In which register is the record of private prescriptions for SCh 2 and 3 CDs made in?
A POM register
what details are made in the record for Sch 2 and 3 private prescriptions?
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.
Under what circumstance can a drug be supplied on a faxed image of a prescription,
when the pharmacists make an informed decision and take steps to safeguard patient safety and mitigate risks.
Make record of the decision-making process
What forms must a military Sch 2 or 3 drug be written on
A pink FP10PCD
what actions must be taken before a pharmacist signs a covert administration document
-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.
Examples of PSD found in the hospital
The instruction on an inpatient CHART.
which specific opioids can pharmacist supply and/or administer under a PGD and for what reason
Diamorphine
Morphine
for immediate, necessary treatment of sick or injured persons
which medications cannot be supplied as emergency medications
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
what length of treatment should be given for emergency supplies: List all possible classes and formulations
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
What are the labelling requirements for an emergency made at the request of a patient
The standard requirements
+
The words ‘Emergency supply’
which medications can Paramedic independent prescribe
-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.
Can Physiotherapist independent prescribers, prescribe all Schedule 2 to 5 drugs
No only :
-Oral diazepam, dihydrocodeine, lorazepam, diazepam, morphine, oxycodone, temazepam
Injection: Morphine
Patches: Fentanyl
which HCP can sell supply or administer certain medications under exemption under the human medicines
Midwives
Opthoptist
Optometrists
Paramedics
Podiatrist/Chiropodist
How may days worth of CD medication is good practice to prescribe for a vet?
28 Days
on the prescription for CD 2 OR 3 vet prescription what detail about the prescriber must be on it?
It must have their RCVS registration number.
How long should the invoice for CD sch 2 be kept for
2 years
what are THE LEGAL REQUIREMENTS FOR A CONTROLLED DRUG REQUISITION form
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
when an emergency supply is made to a doctor or dentist without a requisition form within how many hours must the form be sent?
24 hours
within how many days must the first dose of an instalment prescription be dispensed
28 days
What are the Home office approved wording that can be used in an instalment prescription for when the pharmacy is closed?
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.
What needs to be on a standardised private Rx form for it to be legal
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.
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.
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.
