MEP Flashcards
When can you buy a GSL product in other stores other than pharmacy?
Whenever as they are located on public unrestricted access due to the nature of the property.
When can you purchase a GSL or any non pharmaceutical products in a pharmacy?
After the RP has signed in
Does the RP have to be present for GSL sales to go ahead?
No as long as they have signed in it can go ahead while RP is absent
When can a P med be sold?
Only When RP is PHYSICALLY present
Not available for self selection
When can a Pom be given?
When there is an prescription for the item from an appropriate prescriber. Or emergency supply is necessary under discretion of the RP
What must the RP notice include?
Name, GPHC No, self declaration of RP status
RP register requirements
- In writing, electronic or both
- should be done by pharmacist
- Identify who made amendments
- back up electronic records
- Record absences + times
- Retain for 5 years
Labels should include what?
1) Name of patient
2) Name and address of pharmacy
3) Dispensing date
4) Name of medicine
5) Directions for use
6) Caution labels
What is the maximum Pseudoephedrine dose OTC can be sold?
720mg pseudophedrine
What is the maximum Ephedrine dose OTC can be sold?
180mg ephedrine
Can Pseudophedrine and Ephedrine be sold together?
No unless a prescription is present
What is the age restrictions for Levonorgestrel 1500mcg?
Over 16 years
What are the age restrictions for Ulipristal 30mg?
Any age however:
- under 13 years can not consent
Can OTC Emergency contraception be supplied in advance?
Yes but ensure they are competent enough. What is the reason?
Travelling? Worry about failing contraception? Unable to get the contraception at a location easily?
Can religious grounds be a reason for not making sale of EHC?
Yes
What are the signed order requirements for salbutamol + Adrenaline?
1) Need Signed order by head
2) State school name + purpose of needing + quantity required
3) No legal limit on quantity, use judgement
4) Retain signed order for 2yrs + Pom register
Adrenaline for Anaphylaxis requirements?
- Able to give to anyone for the purpose of saving a life
- Must also call 999
Naloxone supply requirement?
Staff working in lawful drug treatment services can obtain from wholesaler and make direct supply to patients.
What is a pharmacists role when giving out sodium valproate?
1) Check AWARENESS or Risks and if on PPP (Pregnancy protection programme)
2) Advise to see doctor if planning pregnancy
3) Do not stop taking it become pregnant
What is an advisable common risk of Oral retinoids?
Risk of Foetal malformation and spontaneous abortion
How long is an Oral retinoid prescription valid for?
7 days
1) Dispense Asap
2) After this it is invalid
What is the maximum quantity allowed to supply for oral retinoids?
30 Days maximum
Can oral retinoids be Faxed or repeated??
NO
Can oral retinoids be supply on an emergency supply?
Yes but only by emergency supply prescriber request only if done by a PPP (Pregnancy prevention programme) specialist.
Prison ‘In house’ pharmacy regulation needs?
If meds are only supplied to prisoners, They DO NOT need to be registered with the GPHC.
Prison pharmacy - when do they need to be registered?
If the pharmacy is providing elsewhere, they may need registration/ wholesale licence.
Requests for poisons or chemicals regulations?
1) If licence is required, pharmacy must check it is valid, unaltered and matches product request.
2) To Add details of transaction to licence
3) Substances must be labelled suitably
Are carbon copies of NHS RX acceptable?
Yes, as long as it is signed in ink
Can a prescription be dispensed before date indicated or signed?
No cannot be dispensed before that date indicated
Need for drug particulars on a human prescription?
No there is no legal need for drug particulars
Do Prescriptions have to be written in English?
No, it can be in any language as long as suitable translation can be done
Can Channel Islands dispense normal uk prescriptions?
Yes as long as it meets legal requirements
Can a child collect medication from the pharmacy?
Case by case it should be decided, no firm yes or no.
What should be considered when allowing a child to pick up medication?
Knowledge of child - is child known?
Maturity - capable of delivering
- confident they won’t misuse
Nature of medicine - abusable?
Prior arrangements made?
Reason for collection - good reason?
Wholesale dealing key things to do
Make an entry in POM register
OR
Retain the signed order for 2yrs from date of supply. (Both do gd practice)
Wholesaling dealing, who can have supply?
Chiropodist
Doctor
Dentist
Midwife
Optometrist
Paramedic
Pharmacy
Shop Captain
Where should medicine be disposed of?
In a secure container away from other fit to use medication
Sharps disposal?
If accepted, keep in sharp containers
Process of medicine disposal
Destroy patient identifiable information
Do not remove tablets from blister (can remove blister from box tho)
Put into correct container bin
Drugs and driving rule?
Road traffic act: offence to drive whilst impaired through drugs, regardless if being used legitimately.
Can be prosecuted if driving whilst impaired.
Medical defence for drug driving
Lawfully prescribed/ purchases otc and taken in accordance with advice by prescriber
And
Driving not impaired
Driving whilst on medication counselling
DO NOT drive if sleepy/dizzy/unable to concentrate
Alcohol can exacerbate effects
Retain evidence of prescription/receipt in case pulled over.
Signed orders from optometrist or podiatrists?
Pharmacy can supply in accordance with signed order
Must be from list allowed to sell/supply not just administer
Signed order should have enough information - No Rx needed
Dispense/label as normal
POM record
SATIVEX - Record keeping?
Pharmacist must keep record of sativex (CD 4 schedule part 1)
SATIVEX storage?
CD cabinet
Rx requirements for SATIVEX?
CD Rx requirements Do not apply
Licensed SATIVEX products
THC Combined with CBD
Nabilone
CBD (Epidyolex)
Accountable Officer’s responsibilities?
Responsible for supervising and managing CD’s in an organisation.
Overseeing monitoring and auditing management, prescribing and CD use.
Ensure systems in place to record CD concerns - submit reports
Appoint authorised witness for destruction.
CD Rx requirements?
- Signature of prescriber
- Date (28days valid)
- Address (Uk)
- Dose (one as directed not as direct..)
- Form
- Strength
- Quantity (in words and figures)
Importance of Signature of prescriber on CD Rx?
Someone else can sign but address must be same
CD reg record prescriber and not signatory
Electronic okay for eps 2+3
Private prescription requirements?
+ Standardised form required for CD 2+3
+ Prescriber identification number present on rx,
Not gmc, issued by NHS
+ DO NOT PRESCRIBE NON CD’s on form as have to send off
Therefore cannot retain in pharmacy for 2years.
CD Rx technical errors?
Minor spelling errors can be changed
If words or figures are missed, can amend (BUT NOT IF BOTH)
-Endorse name, date, signat, Gphc no.
Prescriber adjustment must not be on a cover letter + no other amendments
Treatment of addictions?
Only special license holders may prescribe cocaine, diamorphine or dipanone for treating addiction.
CD DESTRUCTION, which first?
CD 2, 3 + 4 (part 1) must be denatured first
When does CD Destruction need witness?
When CD entries will be made, witness must be present
PATIENT RETURNS DO NOT NEED WITNESSING!!!!
Authorised witnesses must be appointed (usually not inv CD daily)
Do patient returned CD need witnessing?
NOOOO
Which CD’s are safe custody?
> SCHEDULE 1 +2
SCHEDULE 3 except phenobarbital, gabapentin, pregabalin, tramadol
> Applies to patient return and out of date stock until able to destroy; segregate
What is a requisition of a CD?
To acquire a CD drug from one pharmacy to another or to doctor/dentist. (CD 2/3 can be supplied in emergency to doctor/dentist if requisition provided within 24 hours)
Requisitions for CD must include?
Signature of recipient
Name and address if recipient
Profession
Total quantity
Purpose of requisition
If handed to representative - written authorisation needed - retain for 2yrs
Mark requisition with indelible ink with suppliers name and address
CD Receiving records include?
- Date of supply
- Name/Address from whom received
- Quantity
CD Supplied records include?
- Date supplied
- Name/Address of recipient
- Details of authority to possess
- Quantity
- Collectors details
- Proof of ID requested + if supplied
CD Entries must be…
Chronological
Unedited - corrections made in margins/ footnotes (NOT CROSSED OUT) Alter with name, Gphc no., sign
Retain for 2 years from last entry
Dispensing: CD Installment prescriptions
First instalment must be dispensed within 28 days of date - rest according to directions
UNLESS DON’T DISPENSE BY DATE IS PRESENT
If one dose is missed, still can give rest of that installment
HOWEVER IF 3 DAYS MISSED, CONSULT PRESCRIBER
Handing out: CD Instalment Rx
If user wants a representative to collect- a letter must be obtained from misuser that authorises name of person.
INCLUDING POLICE CUSTODY - letter given to officer to give to pharmacy
A SEPARATE LETTER IS NEEDED EVERY TIME A REPRESENTATIVE COMES
It is good practice to see patient at least once weekly
If Rx states supervision needed, CONTACT PRESCRIBER before giving to representative
1) verbal consent is legally okay
2) make record of conversation
How long is an CD Sch5 Rx valid for?
6 months
How long is CD Sch 2 Rx valid for?
28 days
How long is CD Sch 3 Rx valid for?
28 days
How long is CD Sch 4 Rx valid for?
28 days
Who can prescribe CD sch 2 or 3?
UK ONLY
Who can prescribe CD sch 4 or 5?
UK or EEA
Are CD Sch 4 and 5 repeatable?
YES
Are CD Sch 2 and 3 repeatable?
NO
Can you emergency supply CD sch 2 or 3?
No however for Cd sch 3, phenobarbital can be emergency supplied. EXCEPTION = phenobarbital
Can you emergency supply CD sch 4 or 5?
Yes
For which CD sch a requisition needed?
CD 2 or 3
Ensure requisition form is marked by supplier
(NOT 4 or 5)
Which CD Sch invoices need to be retained for 2 years?
CD 3 and 5
Which CD’s require a licence for import/export?
CD 2/3/4 (part 2 not required if by person for self administration)
CD 5 DOES NOT REQUIRE LICENCE
What does POM-v mean?
Prescription Only Medication veterinary
Can only be supplied against a written vet prescription.
What is POM-VPS?
Prescription Only Medicine Veterinarian, pharmacist, suitable qualified persons
Oral or written rx. Written is only needed if supplier isn’t prescriber.
What is a NFA-VPS?
Non-food animal - veterinarian, pharmacist, suitable qualified person
It is non food animal, written Rx is not needed.
How much quantity should be given for vet CD 2/3 rx?
Good practice to only do 28 days unless longer can be justified
VET CD RX requirements?
- Name/Address of owner
- Identification/species of animal
- Prescriber details (inc. RCVS no. If CD 2+3)
- 6 months valid unless indicated by prescriber + repeatability if applicable
Cd = 28 days - Medicine particulars - mdu not acceptable
- Cd: quantity in words and figures
-Necessary warnings - Highlight when prescribed under cascade
- If CD 2 +3 state cared by vet
Vet Cascade?
Firstly choose licensed vet medicine?
If none available for that species use on licensed in another
If none available choose human, “for administration under cascade”
Cannot sell OTC human products if vet has told to buy it.
Record keeping for Vet rx?
- Retain for 5 years
- Record receipt and supply of POM -V and POM-VPS
INCLUDE:
Name of med
Date of receipt/supply
Batch number
Quantity
How to label for a vet Rx?
Include:
Name of vet
Name and address of animal owner
Name and address of pharmacy
Identification and species of animal
Date of supply
Expiry date of product
Product name
Dose
Special storage if applicable
Warnings
Withdrawal period (if food animal)
“For animal treatment only”
KOOROC????
Wholesailing of vet meds?
Authorised retailers can supply to another without a wholesale dealers authorisation if:
-Qualified to do so
- Relieve a temporary supply storage
What is the Audit cycle in correct order?
1) Prepare for the audit
2) Select criteria to review
3) Measure performance level
4) Make improvements
5) Sustain improvements
What are the 7 Pillars of Clinical Governance?
1) Clinical Audit
2) Clinical effectiveness
3) Risk Management
4) Use of information
5) Education and training
6) Staffing/staff management
7) Client/ Carrier experience and involvement
C C R U E S C Bold text
What are we stages of change?
1) Pre-contemplation
2) Contemplation
3) Preparation
4) Action
5) Maintenance
6) Relapse
PCPAMRE bold text
What is pre contemplation in stage of change?
Having no intention on changing behaviour
What is contemplation in the stage of change?
Being aware a problem exists but with no commitment to action
What is preparation in stage of change?
Intent on taking action to address the problem
What is action in stages of change?
Active modification of behaviour
What is maintenance in stages of change?
Sustained change; new behaviour replaces old
What is relapse in stages of change?
Fall back into old patterns of behaviour
The point of Stage of change?
It is an upwards spiral, to learn from each cycle of relapse
What is a yellow card?
Adverse drug reaction card
What is a blue guide?
Advertising and Promotion of medicines in the UK
What is green book?
Uk Immunisation schedule
What is the orange guide?
Rules and Guidance for pharmaceutical manufactures and Distributors
How would you revalidate or renew registration as a pharmacy professional/pharmacist?
As of 2019:
- Submit 6 records each year
( 4 CPD RECORDS which of 2 are planned) ( 1 peer discussion) (1 Reflective account)
End of 2018:
-submit 4 CPDS (2 minimum planned and maximum 2 unplanned)
What is the professional duty of candour?
Gphc highlight openness and honesty by signing joint health regulators statement. Essential duty.
What does a P Value > 0.05 indicate?
The result is not statistically significant and hence don’t reflect the null hypothesis
What does a P Value < 0.05 indicate?
The result is statistically significant. Generally, reject the null hypothesis in favour of the alternative hypothesis.
What does a P Value < 0.01 indicate?
The result is highly statistically significant, and thus rejects the null hypothesis in favour of the alternative hypothesis.
Published trial order?
1st Randomised control trials (Gold)
2nd Cohort studies
3rd Case controlled studies
4th Case series
5th Case based reasoning or expert opinions.
Name 5 observational studies?
1) Case report
2) Case series
3) Cross-sectional study
4) Case control study
5) Cohort study
What is a case report?
Reports on single patients (no control)
What is case series?
Collection of reports on the treatment of individual patients (no control)
What is cross sectional study?
Collect data from a whole population at a single point in time.
What is case control study?
Patients who have had treatment are compared to patients who have not had the treatment (retrospective)
What is cohort study?
Patients receiving a treatment are compared to patients who are not receiving the treatment (Prospective). Two groups are not controlled.
Name 3 controlled studies?
1) Randomised Controlled trial (RCT)
2) Systemstic Reviews
3) Meta-analysis
What is randomised controlled trial (RCT)?
Gold standard - 2 groups of patients are randomised to intervention and control groups
What is systemic reviews?
Review of studies which are combined to answer predetermined criteria
What is meta-analysis?
Additional application of statistical tests to combine results of several studies as if there were one large study.
What does the RPS say about audits?
Clinical effectiveness
Continuing professional development (CPD)
Involving people who use your services
Staffing management
Risk management
GDPR and data protection - ensure compliance with the gdpr and uk data protection act 2018 which came into force 25th may 2018
