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Pharmacy > MEP > Flashcards

MEP Flashcards

1
Q

What is the goal for medicines optimisation?

Acronym: SWEAP-O

A

1) improve patient outcomes
2) improve adherence
3) ensure patients are taking their medicines correctly
4) looking at polypharmacy - deprescribing if appropriate
5) reduce wastage
6) improve medicines and patient safety

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2
Q

What are the 4 principles of medicines optimisation?

Acronym: USER

A

1) understand the patient’s aim for treatment/ experience
2) evidence based choice of medicines
3) safe use of medicines
4) make medicines optimisation of routine practice

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3
Q

Which three classes of medications for humans under what regulations do pharmacists deal with?

A

1) GSL
2) P
3) POM

under Human Medicines Regulation 2012

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4
Q

Pharmacists deal with medicines for animal use. What regulations enable pharmacists to deal with medicines for animal use?

A

Veterinary Medicines Regulations

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5
Q

What does GSL stand for?

A

General Sale Medicines

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6
Q

Where can GSL medicines be sold?

A

In a registered pharmacy or retail outlet which can ‘CLOSE as to exclude the public’

(basically any registered pharmacy or retail outlet which can close to the public)

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7
Q

Within a pharmacy when can a GSL medicine be sold?

A

When a pharmacist has assumed the role of ‘responsible pharmacist’

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8
Q

The responsible pharmacist is allowed to be absent for how long within the working hours/ day of the pharmacy?

A

2 hours

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9
Q

If one premises has more than one responsible pharmacist, what is the total period of absence for all the responsible pharmacists within the working hours/day of the pharmacy?

A

2 hours

(does not matter if there is more than one responsible pharmacist, collectively both may only be absent for a period of 2 hours of the working pharmacy hours/day)

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10
Q

In the absence of the responsible pharmacist (< 2hours), which activities may be undertaken by pharmacy staff?

A

1) taking in prescriptions
2) sale of GSL medicines be trained pharmacy staff under documented operating procedures
3) assembling of prescriptions (i.e labeling, assembly of item(s), accuracy checking)

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11
Q

What activities require the RP to be present on the premises in order to carry out?

A

1) ‘professional check’ - legal and clinical check of a prescription
2) Sale/supply of POM (including: handing out dispensed medicines to recipient or to delivery driver)
3) supply of medicines under a PGD
4) wholesale of medicines
5) emergency supply at the request of patient or prescriber

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12
Q

What is a P medicine?

A

Pharmacy medicines - can only be sold at registered pharmacies by or under the supervision of the pharmacist

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13
Q

Can P medicines be available to the public for ‘self-selection’?

A

No

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14
Q

What does POM stand for?

A

Prescription only medicine

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15
Q

Why is there a restriction for the sale/ supply of pseudoephidrine and ephedrine containing products without a prescription?

A

Potential for misuse - used in the illicit production of methylamphetamine (crystal meth) –> Class A CD

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16
Q

What is the restriction in quantity for pseudoephedrine and ephedrine that can be supplied at any one time without a prescription?

A

720mg of pseudoephedrine containing products

180mg of ephedrine containing products

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17
Q

Can a product containing pseudoephedrine and ephedrine be sold at the same time without a prescription?

A

No - it is unlawful (Human Medicines Regulation 2012)

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18
Q

What two EHC products are available for purchase from the pharmacy?

A

Levonelle - levonorgestrel

EllaOne - ullipristal acetate

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19
Q

Levonorgestrel is licensed for EHC for women aged ……. and within ……….. hours of unprotected sex?

A

Aged 16 or above

Within 72 hours

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20
Q

Ullipristal acetate is licensed as EHC for women of what age and within how many hours of unprotected sex?

A

Women of ‘child-bearing’ age

Within 120 hours of unprotected sex

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21
Q

Medicines containing the following ingredients have been deemed unsuitable for children under 6yo for the treatment/ symptom relief of cough/ colds:

A

Antitussives: dextromethorphan, pholcodine

Expectorants: guaifenasin, ipecacaunha

Nasal decongestants: ephedrine, oxymetazoline, phenylephrine, pseudoephedrine, xylometazoline

Antihistamines: brompheniramine, chlorphenamine, diphenhydramine, doxylamine, promethazine, triprolidine

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22
Q

Cough and cold medicines for children aged 6-12yo containing antitussives, expectorants, nasal decongestants and antihistamines should only be used for how many days?

A

Used as second line to best practice

5 days use only

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23
Q

What is the current NICE guidelines referring to the concomitant use of ibuprofen and paracetamol in children?

A

Do not use ibuprofen and paracetamol together in children under 5yo

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24
Q

How long should records be kept for a POM that has been supplied from a private prescription?

A

2 years from the date of last entry in the register

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25
Q

What details need to be included in the POM register when a private prescription has been dispensed?

A

Date of supply
Date on the prescription
Medicine - name, strength, formulation and quantity
Prescriber details ( name and address of practioner)
Patient details

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26
Q

Does a ‘fax’ prescription fall into the remit of being a legally valid prescription, that medicinal products can then be dispensed against? If not, why?

A

No

Faxed prescriptions are not written or signed by an appropriate prescriber in indelible ink, which doesn’t make it a legal and valid prescription.

Faxed prescriptions can also pose undesired risks, such as the ‘fax’ being sent to duplicate pharmacies, which in turn will result in several supplies being made.

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27
Q

Can an emergency supply be made to a patient requesting phenobarbital, if the original prescription originates from an EEA or Swiss prescriber?

A

No.

Emergency supplies of schedule 1,2 and 3 CDs (including phenobarbital) can not be made at the request of a patient or EEA/Swiss prescriber.

28
Q

What records needs to be kept when an emergency supply has been made at the request of a patient?

A

Date POM was supplied
Name and address of patient
Name, strength, formulation and quantity of POM supplied
Reason why emergency supply was made, and why prescription could not be obtained

29
Q

What wording needs to be included on the label when dispensing an emergency supply?

A

‘Emergency supply’

30
Q

If an emergency supply of a Schedule 4 or 5 CD drug needs to be made, how long of a supply can be issued?

A

5 days only

31
Q

For POMs issued as emergency supply, what is the maximum supply that can be made?

A

30 days supply. Unless the medicinal product is of the following:

  • insulin
  • ointment/cream
  • inhaler for asthma
  • oral contraceptive (full cycle should be dispensed)
  • antibiotic in liquid form (smallest quantity which will provide the full course should be given)
32
Q

How long are prescriptions for isotretinoin valid for?

A

7 days

33
Q

What special controls are required when dispensing isotretinoin for females at risk of pregnancy?

A

Need to have a negative pregnancy test every month before supply can be made (unless prescriber agrees that there is no risk of pregnancy)

Maximum 30 day supply can be made. (A quantity for more than 30 days can be made by the prescriber, provided the patient is not under the Pregnancy Prevention Programme)

34
Q

What are the requirements for a veterinary prescription to be valid?

A

1) Name, address, telephone number and qualification of prescribing vet
2) Name and address of owner
3) Name and species of animal
4) Date
5) Signature of prescriber
6) Name, strength, formulation and quantity of medicinal product + any specific/ necessary warnings
7) Words ‘Prescribed under the veterinary cascade’ to be written on the prescription

35
Q

How long should records be kept when a veterinary supply has been made?

A

5 years

36
Q

Do CDs for veterinary prescriptions need to be written on a standardised form?

A

No

37
Q

What statement needs to be added to the prescription if a vet has prescribed a CD?

A

‘For the treatment of an animal or herd under my care’ is required for schedule 2 or 3 drugs

38
Q

Where CDs have been prescribed for a vet prescription, what additional details of the prescriber must be included?

A

Royal College of Veterinary Surgeons (RCVS) registration number.

39
Q

What additional requirements are needed on the dispensing label for a veterinary product?

A

Name of the prescribing vet surgeon
Name and address of owner
Identification and species of the animal
The words ‘for animal treatment only’

40
Q

Pethidine - Schedule 2 or 3?

A

Schedule 2

41
Q

Amfetamines - Schedule 2 or 3?

A

Schedule 2

42
Q

Ketamine - Schedule 2 or 3

A

Schedule 2

43
Q

Quinalbarbitone - Schedule 2 or 3?

A

Schedule 2

44
Q

Buprenorphine - Schedule 2 or 3?

A

Schedule 3

45
Q

How long are Schedule 2-4 prescriptions valid for?

A

28 days

46
Q

How long are Schedule 5 prescriptions valid for?

A

6 months

47
Q

Can EEA or Swiss prescribers legally prescribe Schedule 2-3 drugs?

A

No, including phenobarbital

48
Q

What are the legal requirements for a CD requisition?

A

Name, address and signature of recipient
Profession/occupation
Total quantity of drug
Purpose of requisition

49
Q

When a CD requisition is received for a schedule 1-3 drug, its is a legal requirement for the supplier to do what?

A

1) Mark the requisition for with suppliers name and address (e.g name of the pharmacy)
2) Send the original requisition to the relevant NHS agency (a copy should be maintained for 2 years as a matter of good practice)

50
Q

What are the legal requirements for Schedule 2 or 3 CDs instalment prescriptions?

A

1) Must have dose (amount of medicine) specified per instalment
2) must state the interval of time between instalments

51
Q

Must the first instalment be dispensed on the date the prescription was written or within 28 days?

A

within 28 days of the date the prescription was written

52
Q

A private prescription for a CD must include what additional details of the prescriber?

A

Prescriber identification number

this is different to the GMC number - which is the professional registration number

53
Q

How long do veterinary prescriptions for CDs need to be kept?

A

5 years

54
Q

Private prescriptions for CDs should be retained by the pharmacy for 2 years or be submitted to the relevant NHS agency?

A

Submitted to relevant NHS agency

55
Q

Can other non-CD medicines be prescribed on the same CD private prescription?

A

No

Has to be separate as the private prescription for CD needs to be submitted to relevant NHS agency, and non-CD drug prescriptions need to be retained by the pharmacy for at least 2 years.

56
Q

Which CD Schedule drugs need to be denatured before disposal?

A

Schedule 2,3 and 4 (part 1)

57
Q

Is an authorised witness required for the denaturing of patient returned CDs?

A

No, although preferable

58
Q

Does a record of destruction need to be kept for patient returned drugs?

A

Not in the CD register, but schedule 2 drugs should be recorded in a separate patient-returned CD record

59
Q

Is an authorised witnesse requrired for the denaturing of expired/unwanted CD stock?

A

Yes if schedule 2 drugs

60
Q

Does a record need to be made in the CD register for the destruction of CDs?

A

Yes, only for schedule 2 drugs

61
Q

What are the 9 standards for Pharmacy Professionals?

A

1) Provide person centered care
2) Work in partnership with others
3) Communicate effectively
4) Maintain, develop and use professional knowledge and skills
5) Use professional judgement
6) Behave in a professional manner
7) Maintain and respect confidentiality and privacy
8) Speak up about concerns or when things go wrong
9) Demonstrate leadership

62
Q

What are the legal requirements needed in order for prescriptions to be dispensed?

A

1) signature of prescriber in indelible ink
2) Address of prescriber
3) Particulars of prescriber (doctor, dentist, independent, supplementary etc)
4) date (valid for 6 months and 28 days for CDs)
5) Patient name
6) Patient address
7) Patient age if <12yo (can be age stated or DOB)

63
Q

What are the legal requirement to be able to dispense a EEA/Swiss prescription?

A

1) Prescriber details (full name, address, qualification and direct contact number)
2) Patient details (full name and address)
3) Prescribed medicines details (name (brand if applicable), strength, formulation, quantity and dose instructions)
4) Date of Issue (valid for 6 months, CDs 28 days)
5) Prescriber signature

64
Q

What constitutes the CPD cycle?

A

Reflection
Planning
Action
Evaluation

65
Q

How many CPD entries needs to written/ year?

A

9 with at least 3 starting at reflection

Pharmacy (35 decks)

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