MEP Flashcards
1
Q
How long should a CD requisition form be kept for?
A
2 years
From last date of entry
2
Q
How long should a CD register be kept for?
A
2 years
From last date of entry
3
Q
How long should private prescriptions be kept for?
A
2 years
4
Q
How long should drug recall alerts be kept for?
A
5 years
5
Q
How long should responsible pharmacist records be kept for?
A
5 years
6
Q
How long should veterinary prescriptions be kept for?
A
5 years
7
Q
How long should a CD register with destructions be kept for?
A
7 years
8
Q
How long should patient medical records be kept for?
A
10 years
After patient death
9
Q
How long should dispensing error records be kept for?
A
10 years
10
Q
How long should dispensing error records leading to disability/ death be kept for?
A
20 years
11
Q
How many total dispensings will be there be for a “Repeat x2” script?
A
3 total
Original + 2 repeats
12
Q
What should be known about supervised consumption of methadone?
A
It is not a legal requirement, even if stated
13
Q
What must a representative have, if collecting methadone on behalf of a user?
A
A letter from the methadone user
14
Q
What should be known about naloxone in emergency situations?
A
Can be given without a prescription
15
Q
What should be considered for forged prescriptions?
A
Professional judgement
Send to police or NHS counter fraud services
16
Q
What should be known for faxed prescriptions?
A
Not legitimate - dispense at own discretion
Schedule 2/3 should NEVER be supplied
17
Q
If prescribing on NHS forms, what should be considered for dental prescriptions?
A
Only prescribe from Dental Prescriber’s Formulary
18
Q
(1) What must the Responsible Pharmacist have on display? (2) What information must this contain?
A
(1) Responsible Pharmacist sign
(2)
- Name of Responsible Pharmacist
- GPhC number
- “The Responsible Pharmacist is in charge of the pharmacy”
- Pharmacist needs to keep record of time they arrived and left
ø (inc. absences)
19
Q
What is the longest period of time that the Responsible Pharmacist can be absent for?
A
2 hours
20
Q
Is ordering/ receiving/ putting away stock from the wholesaler permissible without the Responsible Pharmacist?
A
Yes
Except CDs
21
Q
Is ordering/ receiving/ putting away CD stock from the wholesaler permissible without the Responsible Pharmacist?
A
No
Non-CD only
22
Q
Is date checking permissible without the Responsible Pharmacist?
A
Yes
Except CDs
23
Q
Is stocking pharmacy shop floor permissible without the Responsible Pharmacist?
A
Yes
24
Q
Is cleaning permissible without the Responsible Pharmacist?
A
Yes
25
Is accessing PMR permissible without the Responsible Pharmacist?
Yes
26
Is responding to enquiries permissible without the Responsible Pharmacist?
Yes
27
Is collecting prescriptions permissible without the Responsible Pharmacist?
Yes
28
Is processing dispensed prescriptions permissible without the Responsible Pharmacist?
Yes
29
Are medicine deliveries to patients permissible without the Responsible Pharmacist?
Yes
30
Is receiving patient returns permissible without the Responsible Pharmacist?
Yes
Except CDs
31
Is receiving patient CD returns permissible without the Responsible Pharmacist?
No
32
Which activities are permissible with the Responsible Pharmacist signed in and not supervising at all?
(1) Selling GSLs
(2) Taking medication returns (exc. CDs)
33
Which activities are permissible with the Responsible Pharmacist signed in and not physically supervising?
(1) Accuracy checking
(2) Making labels
(3) Picking medication
(4) Assembling items
(5) Labelling items
34
Which activities are permissible with the Responsible Pharmacist signed in and physically supervising?
(1) Clinical/ legal check
(2) Supplying P meds
(3) Handing out medication
(4) PGD services
(5) Medicine wholesale
(6) Emergency supply
35
What are the requirements for the revalidation process?
SIX submissions to be made each year
- 4 CPDs (2 planned)
- Peer discussion
- Reflective account
36
What are the prescription requirements?
- Prescriber signature/ address/ particulars
- Prescription date (28 days CD2/3/4)
- Patient name + address
- Age of patient (if under 12yrs)
37
When is the age of a patient required on a prescription?
When they are under 12 years old
38
What are the labelling requirements for a prescription?
- Patient name
- Name + address of pharmacy
- Dispensing date
- Medication name/ directions/ precautions
39
What are the CD prescription rules?
- CD2/ CD3 should be prescribed on separate scripts to other meds
- Valid for 28 days (6 months for schedule 5)
- Private scripts for CD2/ CD3 must be on a standardised FP10PCD
- Vet CDs should be kept for 5 years
- ID should be requested
40
Which CD(s) prescriptions are valid for 6 months?
CD5 only
41
What are the CD prescription requirements?
- Prescriber signature + address (UK only)
- Date
- Medication name/ form/ strength/ dose/ quantity/ total quantity
- Quantity (no more than 30 days supply, but NOT legal requirement)
- Total quantity (words + figures)
- Patient name + address
- Instalment direction (refer if 3 days of methadone missed)
- Dental prescriptions ("For dental treatment only")
42
Is a maximum of 30 days supply of a CD a legal requirement?
No.
Not a legal requirement, just good practice.
43
What can be listed for address on a prescription if a patient is homeless?
NFA
No Fixed Abode
44
What specific requirement is only required for dental prescriptions?
"For dental treatment only"
45
What should be considered for destruction of CD returns/ expired stock?
CD2/ CD3/ CD4i must be denatured
46
When is an authorised witness required for unwanted/ expired stock?
CD2
Good practice for another member of staff to be present for CD3
47
Is an authorised witness required for patient returns of CDs?
No
48
Do CD returns need to be entered into the CD register?
No
Keep separate record for CD2
49
Who needs to approve an authorised witness?
An accountable officer
50
When are CD register records needed?
CD1 or CD2
Also needed for Sativex (CD4i)
51
In what order should records in the CD register be made?
Chronologically
52
How soon after dispensing a CD1 or CD2 should a record in the CD register be made?
Enter by end of following day
53
What must be adhered to if a pharmacist is to make alterations to a CD register?
- Alterations must be made in margin/ footnotes
- Pharmacist name
- GPhC number
- Signature
54
What are the CD register requirements for receiving CD1 or CD2 stock?
- Date of supply received
- Name + address of supplier
- Quantity
55
What are the CD register requirements for supplying CD1 or CD2 stock?
- Date of supply
- Patient name + address
- Prescriber name + license number
- Quantity of medication
- Details of person collecting + ID requested/ provided
56
Which CDs are subject to safe custody?
- CD1
- CD2
- CD3 (buprenorphine/ tempazepam ONLY)
- CD4i (Sativex ONLY)
57
Which CD3s are subject to safe custody?
(1) Buprenorphine AND temazepam
58
How many medication groups, relating to drugs and driving, are there?
2
Group 1 and Group 2
59
What are the group 1 drugs, relating to drugs and driving?
- Cannabis
- Cocaine
- Heroin
- Ketamine
- LSD
- MDMA (ecstasy)
- Methylamphetamine
60
What are the group 2 drugs, relating to drugs and driving?
- Amphetamine
- Methadone
- Opioids (morphine/ codeine/ tramadol)
- Benzodiazepines (COLD FT):
ø Clonazepam
ø Oxazepam
ø Lorazepam
ø Diazepam
ø Flunitrazepam
ø Temazepam
61
Relating to drugs and driving, are group 1 medications considered to have low limits or higher limits?
Low limits for Group 1
62
Relating to drugs and driving, are group 2 medications considered to have low limits or higher limits?
Higher limits for Group 2
63
What type of script is needed for POM-V prescriptions?
Written
64
Who prescribes on POM-V prescriptions?
Vet surgeons
65
Who can supply POM-V prescriptions?
Vet surgeons or pharmacists
66
What type of script is required for POM-VPS prescriptions?
Written script only needed if supplier is not the same as prescriber
67
Can GSLs or P meds be sold for animals?
Illegal
Unless, prescribed under the cascade
68
What are the veterinary prescription requirements?
- Prescriber name/ address/ telephone number/ qualification/ signature
- Name + address of owner
- Animal name/ species/ address (if different to owner)
- Drug name/ quantity/ dose/ administration directions
- Necessary warnings/ withdrawal periods
- "Prescribed under the cascade", if necessary
69
What additional requirements are there for CDs on a veterinary prescription?
- "the item has been prescribed for an animal/ herd under the care of the veterinarian"
70
What are the steps of the veterinary cascade?
(1) Vet med with a UK/ GB marketing authorisation (MA) for species and indication must be used if it exists + is clinically appropriate
(2) Vet med with NI MA for species + indication
(3) Vet med with UK/ GB/ NI MA for other species/ indication
(4) Human med with UK/ GB/ NI MA or vet med with MA outside of UK
(5) Extemporaneous/ specially prepared medicine
71
What requirement is there for a human medicine to be prescribed for an animal?
"Prescribed under the veterinary cascade"
72
What are the labelling requirements for a veterinary medicine?
Unless already appears on the box:
- Name of surgeon
- Name + address of owner
- Name + address of pharmacy
- ID + species of animal
- Date of supply
- Expiry date of medication
- Product name/ quantity/ dose/ storage instructions
- Withdrawal periods
- "For animal treatment only"
- "Keep out of reach of children"
73
For how long must be veterinary prescription records be kept for?
5 years
74
For which types of veterinary prescriptions are records required for?
Needed for POM-V and POM-VPS
75
What details must be recorded for veterinary prescriptions?
- Medication name + quantity
- Date of supply/ receipt
- Batch number
- Name + address of supplier/ recipient
76
For how long must a signed order for wholesale dealing be kept?
2 years
OR enter into the POM register
77
Which records must be kept for wholesale dealing?
(1) Keep signed order for 2 years
OR
(2) Enter into POM register
78
What details must be kept for wholesale dealing?
- Entry date
- Name/ quantity/ formulation/ strength
- Name/ address/ profession of person supplied
79
What requirement is there for wholesale dealing of CDs?
Must be requested on approved CD requisition form
80
In wholesale dealing, for which CDs are CD requisition forms required for?
CD2 + CD3
81
On which form must a CD requisition form, for wholesale dealing, be on?
FP10CDF
82
What details are required on a CD requisition form?
- Name/ address/ profession/ signature of recipient
- Total quantity of drug
- Purpose of requisition
83
What are the requirements for EEA/ Switzerland prescriptions?
- Patient prescriber/ medication details
- Prescriber signature
- 6 month validity
84
Which CDs are valid on an EEA/ Switzerland script?
CD4 ONLY
85
Which CDs are not valid on an EEA/ Switzerland script?
CD1/ CD2/ CD3
86
Is phenobarbital valid on an EEA/ Switzerland script?
No
87
Can products without a UK MA be prescribed on a EEA/ Switzerland script?
No
UK MA products only
88
For emergency supply at the request of the prescriber, how soon after must a prescription be provided?
Maximum 72 hours after
89
What should be written on the label of an item that has been supplied as part of an emergency supply?
"Emergency Supply"
90
Which CDs cannot be supplied under emergency supply?
CD1/ CD2/ CD3
CD3 - Phenobarbital CAN be supplied for epilepsy
91
When can phenobarbital be supplied under emergency supply?
For treatment of epilepsy
92
What duration of phenobarbital can be supplied under emergency supply?
5 days
93
What is the maximum duration of supply for CD4 and CD5 under emergency supply?
5 days
94
What is the maximum duration of supply for non-CD POMs under emergency supply?
30 days maximum supply
95
When can a supply larger than 30 days be supplied for non-CD POMs?
When pack cannot be split
e.g. insulin pens/ inhalers
96
For emergency supply of non-CD POMs, what should be done when a pack size cannot be split?
Provide smallest pack size available
97
What are some POM to P reclassifications?
- Amorolfine
- Anti-malarials
- Chloramphenicol drops/ ointment
- Emergency contraceptives
- Fexofenadine
- Mometasone nasal spray
- Lidocaine (for teething)
- Orlistat
- PPIs
- Sildenafil
- Sumatriptan
- Tamsulosin
- Tranexamic acid (age 18-45)
98
What is the maximum legal supply of pseudoephedrine?
720mg
99
What is the maximum legal supply of ephedrine?
180mg
100
What should be known about supply of ephedrine and pseudoephedrine?
One OR the other
CANNOT supply both in same transaction
101
What is the maximum legal supply of paracetamol?
100 tablets (non-effervescent only)
102
What is the maximum legal supply of aspirin?
100 tablets (non-effervescent only)
103
What is the maximum legal supply of effervescent paracetamol?
No limit on effervescent supply
104
What is the maximum legal supply of effervescent aspirin?
No limit on effervescent supply
105
What is the maximum legal supply of codeine?
32 tablets
3 days supply
106
What is the maximum legal supply of dihydrocodeine?
32 tablets
3 days supply
107
What is the last date a medication can be used that has an expiry of 12/27?
31/12/2027
108
What is the last date a medication can be used that has a 'Use By' of 12/27?
30/11/2027
109
What is the last date a medication can be used that has a 'Use Before' of 12/27?
30/11/2027
110
What are the levels of study designs?
(1) Meta-analysis
(2) Systemic reviews
(3) Randomised controlled trials
(4) Cohort studies
(5) Case control studies
(6) Case series/ case reports
(7) Editorials/ expert opinions
111
What are the different classes of MHRA recalls?
Class 1: Life-threatening/ serious risk to health
Class 2: Harm to patient, but not serious (within 48hrs)
Class 3: Unlikely to cause harm to the patient (within 5 days)
Class 4: No threat to the patient (advise caution to the patient, no need to recall)
112
What is an example of a Class 1 MHRA recall?
Contamination with NDMA which has genotoxic and carcinogenic potential
113
What is an example of a Class 2 MHRA recall?
Identification of nitrosamine above the acceptable limit
114
What is an example of a Class 3 MHRA recall?
Microfibres of the API present on the surface of the tablet
115
What is an example of a Class 4 MHRA recall?
Outdated version of the PIL is still in the packaging?
116
What is the Yellow Card Scheme?
(1) For any adverse event associated with a NEWER product
(2) Serious events associated with ANY drug
117
What is a black triangle drug?
(1) For any adverse event associated with a NEWER product
(2) Serious events associated with ANY drug
118
What is an example of a black triangle drug for a newer product?
Dupixent
Rash associated with Dupixent (dupilumab)
(If different, verify in BNF)
119
What is the Yellow Card Scheme relevant to?
- All medicines (vaccines/ herbal/ homeopathic)
- Defective and counterfeit medicine
- Medical devices
- Nicotine-containing devices & refill containers
120
What is the national stance on reporting errors?
"Just culture"
Allows us to learn from mistake and take accountability (between punitive/ no-blame)
121
What is the main issue with punitive culture, with regards to error reporting?
Stifles learning
122
What is the main issue with no-blame culture, with regards to error reporting?
Lack of accountability
123
Where should errors be reported to?
National Reporting and Learning System (NRLS)
124
(1) Should near misses be recorded? (2) Why?
(1) Yes
(2) Reviewing and training
125
With regard to communication to the patient, what is very important when reporting errors?
Apologise to the patient
126
What are the different stages of change?
(1) Pre-contemplation (not thinking about it)
(2) Contemplation (thinking about it)
(3) Preparation (getting ready)
(4) Action
(5) Maintenance
(6) Relapse
