MEP Flashcards
What is a ‘PO’ medicine?
GSL medicine where the manufacturer wishes to restrict sales through pharmacy only
Can GSL medicines be sold from a pharmacy without a responsible pharmacist?
No
What is a ‘P’ medicine?
Medicinal product that may only be sold from a registered pharmacy premises by the RP or somebody acting under their supervision.
Self selection should be prohibited - should not be accessible to the public
Why is the sale of psudoephedrine/ephedrine prohibited?
Can be misused in illict production of crystal meth
What is the maximum amounts of pseudoephedrine and ephedrine that can be supplied at one time without a prescription?
720mg pseudoephedrine or 180mg ephedrine
‘It is unlawful to supply a pseudoephedrine product at the same time as an ephedrine product without a prescription’
True or false?
True
Where can you report suspicions about somebody attempting to purchase ephedrine?
Local GPHC inspector
Which pharmacy medicines can be supplied for emergency hormonal contraception?
Levornogestrel 1500mcg or Ulipristal 30mg
When can levornogestrel be supplied?
Licensed for women over 16 within 72 hours of unprotected sex
How long following unprotected sex can EHC be supplied?
Levornogestrel - 72 hours / 3 days
Ulipristal - 120 hours / 5 days
What is the maximum amount of paracetamol tablets or capsules that can be sold to a person at one time?
100 tablets/caps
What is the maximum amount of calpol that can be sold to a person at one time?
No limit on paracetamol liquids
Should use professional judgement for an appropriate quantity to supply
How many aspirin tablets can be sold to a person at one time?
100 non-effervescent tablets
Which medicines are AVM-GSL?
Authorised veterinary medicines available on general sale
What is an ‘unauthorised veterinary medicine’?
Unlicensed medicine with no marketing authorisation or exemption for small pet animals. Can only be prescribed by a vet under the Cascade. Includes human medicine used for animals
‘All veterinary presciptions must include the presciber’s registration number from the Royal College of Veterinary surgeons’
True or False?
False
The RCVS reg number is only required on CD 2 + 3 prescriptions
All vet prescriptions must include the name, address, phone number, qualification and signature of the prescriber
Are veterinary prescriptions valid if they do not include the species of animal that they are intended for?
No, must include the species of the animal
How long are veterinary prescriptions valid for?
6 months
All repeat supplies should also be made in 6 months
CD 2,3+4 are valid for 28 days
May a vet prescribe treatment for a dog with the instructions ‘as directed’ on the prescription?
No
Prescription must include administration instructions and ‘as directed’ is not acceptable
In veterinary prescriptions what is the ‘withdrawal period’?
The time between when an animal recieves the medicine and when it can safely be used for food (should be inclduded on presciption if relevant)
Which declaration should CD2+3 veterinary prescriptions include to be deemed valid?
Statement highlighting ‘the item has been prescribed for the treatment of an animal under my care’ etc
Can veterinary prescriptions be repeated?
Yes - all supplied should be made within 6 months
Do veterinary CDs have to be prescribed on a standardised form?
No
If a vet was prescribing diazepam for a parrot, would the script need to read ‘ prescribed for the treatment of an animal under my care’?
No - because diazepam is a CD 4
Only applies to CD 2+3
How long would a veterinary prescription for oxycodone need to be retained for?
5 years
‘It is illegal to supply a human medicine against a veterinary prescription unless it states ‘for administration under the cascade’ ‘
True or false?
True
If a veterinary medicine exists but is licensed for a different species can this be supplied against a veterinary script?
Only if the script states ‘for use under the cascade’ or words to this effect
Can GSL medicines be sold for an animal?
No, can only be supplied under the Veterinary cascade
Which of does NOT need to appear on the label for a veterinary medicine?
- Name and address of animal owner
- Identification + species of animal
- Name of prescribing vet
- ‘for animal treatment only’
- ‘for use under the veterinary cascade’
‘for use under the veterinary cascade’
This is required on prescriptions
The label must states ‘for animal treatment only’
Is record keeping of POM-V products required?
Yes
Records should be kept for 5 years
What schedule is ketamine?
CD 2
What schedule is quinalbarbitone?
CD 2
Can emergency supply of CD2s be made?
No
Can emergency supply of CD3s be made?
No, except phenobarbital for epilepsy
What schedule is temazepam?
CD 3
What schedule is tramadol?
CD 3
What schedule is buprenorphine?
CD 3
What schedule is midazolam?
CD 3
What schedule is Sativex (cannabis extract)?
CD 4 (1)
Could oxycodone be prescribed by a doctor registered in the republic of Ireland?
No, CD2 so the address of prescriber must be in the UK
What schedule is diazepam?
CD 4 (1)
What schedule is clobazam?
CD 4 (1)
What schedule is zopiclone?
CD 4 (1)
What schedule is chlordiazepoxide?
CD 4 (1)
What schedule are Lorazepam 4mg/ml injections?
CD 4 (1)
What CD schedule are anabolic steroids?
CD 4 (2)
Could zopiclone be given as an emergency supply?
Yes - CD 4
What schedule is dihydrocodeine?
CD 5
What schedule is morphine oral solution?
CD 5
What schedule is kaolin + morphine?
CD 5
What schedule is pholcodeine?
CD 5
How long are CD 5 scripts valid for?
6 months
Is a script for chlordiazepoxide repeatable?
Yes- CD 4 (1)
Does a presciption for co-codamol have to state the amounts in words + figures?
No - CD 5 do not need prescription requirements
You are presented with a prescription for gabapentin oral solution with the quantity listed as ‘OP’, why can this not be supplied?
CD 3
Needs total quantity in words and figures
Liquids should be specified in mL
In which 2 circumstances may a pharmacist be in possession of schedule 1 CDs?
- for purpose of destruction
2. to hand to police
Can pharmacist independent prescribers prescribe controlled drugs?
Yes
Are there any restictions on travelling with CD5s?
No
A patient taking regular morphine asks for advice on travelling with their medicines, what do you tell them?
- A personal licence is not required if you are travelling with less than 3 months of supply
- Ask for a covering letter from the prescriber stating their name, travel plans, name + quantity + dose of medicine
- Check with the countries embassy to ensure the regulations of the country are complied with
What type of prescription can private CDs be written on?
FP10PCD (pink script)
Which CDs may midwives order a supply of?
Diamorphine, morphine and pethidine
Which of these is NOT a legal requirement of a schedule 2 or 3 controlled drug prescription?
- Total quantity in words and figures
- Prescribers address that must be in the UK
- Dosage form
- Name of medicine written in full
- Patient’s address
Name of medicine
This is necessary to identify the medicine requested but NOT a legal requirement
A dental prescription for schedule 2+3 CDs must include which statement?
‘for dental treatment only’
Would a CD prescription stating the form as ‘caps’ meet legal requirements?
Yes - the formulation must be stated
‘caps’ and ‘tabs’ are acceptable
Is listing the strength on a CD prescription always a legal requirement?
No, only needs to be stated if more than one strength is available
Which of these doses would be legally aceptable on a schedule 2 or 3 CD script?
- As directed
- Two PRN
- Weekly
- As per chart
Two PRN
The dose should be clearly defined
‘A schedule 2+3 CD presciption should be marked with the date and time that the supply is made’
True or False?
True
When should sugar-free controlled drugs be supplied?
Only if specified as they have a greater potential for abuse
Which prescriptions should be used for instalment directions?
FP10MDA
What is the maximum treatment allowed on an FP10MDA script?
Instalment dispensing - max 14 days
Which drugs are allowed to be prescribed on an FP10MDA (instalment script)?
All CD2s
Buprenorphine/suboxone
Diazepam
Which wording is approved for instalment prescribing that allows supply if the pharmacy is closed eg, on bank holidays?
‘Please dispense instalments due on pharmacy closed days on a prior suitable day’
When should the prescriber be notified if a patient has missed collection of instalment scripts?
If over 3 consecutive days are missed as there is a chance that the patient will lose tolerance to the drug
If a collection day is missed then any remaining days of that instalment may be given
Which technical errors are pharmacists permitted to change on CD 2 + 3 prescriptions?
- Minor spelling mistakes
- Minor typographical error
- Total quantity if missing words or figures (but not both)
Is it a legal requirement for the person collecting a schedule 2 or 3 CD to sign the back of the presciption?
No, not a legal requirement but good practice
If they do not agree to sign then it is the pharmacists discretion whether to supply or not
How should collection of a controlled drug by a representive for a drug misuser be handled?
- Should obtain a letter from the patient that names and authorises representative
- Should have a separate letter for each collection and the representative should bring ID
- Should see the patient once a week if possible
- Record details of representative in the CD register
Is supervised consumption a legal requirement?
No - but important
Should confirm that is is ok with prescriber if supervision is not possible eg, patients drug is collected by representative
Which schedule 3 CDs require safe custody?
Buprenorphine
Temezepam
Does safe custody apply to patient returns?
Yes - should be in safe custody until they can be destroyed
Which schedule 3 CDs have exemption from safe custody?
Tramadol, phenobarbital, midazolam, gabapentin, pregabalin
Which controlled drugs should be denatured before disposal?
CD 2 , 3 + 4 (1)
As advised by the home office
Does controlled drug destruction of CDs need to be witnessed by an authorised person?
No - good practice to be witnessed by another member of staff
Should be recorded in a separate register to CD register
Does denaturing of expired controlled drugs require an authorised witness?
- Yes if schedule 2
- For schedule 3 it is good practice to have destruction witnessed by another staff member
What schedule is pethidine?
Schedule 2
What drugs need be be recorded in the CD register?
Any schedule 1 or 2 CDs
Also Sativex
Which is the only CD 4 (1) that needs to be recorded in the CD register?
Sativex (cannabis extract)
Is it a legal requirement to show ID when collecting a controlled drug?
No, pharmacists discretion whether to supply or not
Should be recorded in CD register
How long should CD registers be kept?
2 years from last entry
Where should CD registers be kept?
On the premises to which they apply
‘In the CD register, legislation requires that the class, strength and form of the drug is specified at the head of each page and that a separate page is used for different strengths or formulations’
True or false?
True
Which of the following is not a requirement of an electronic CD register?
- Author of each entry must be identifiable
- Should be auditable
- Available on request to GPHC inspectors
- Entries cannot be changed at a later date
- Should also have a bound-book CD register
Should also have a bound-book CD register
This is an alternative to a bound-book CD register
How often should stock-checks of CDs usually be performed?
Once a week
‘The pharmacist has overall responsibilty for maintaining running balances and dealing with discrepancies in the CD register’
True of false?
True
Do Pregabalin and Gabapentin need to be denatured before disposal and does this require an authorised witness?
Yes they must be denatured before disposal
An authorised witness is not required but good practice to have another member of staff witnessing
Do Pregabalin and Gabapentin require safe custody?
No
Can a presciber based in France prescribe Pregabalin and Gabapentin?
No- address of the prescriber must be within the UK
Can Pregabalin and Gabapentin be given as an emergency supply?
No
Can Pregabalin and Gabapentin be repeated?
No
Do Pregabalin and Gabapentin need to be recorded in the CD register?
No
On what date were Pregabalin and Gabapentin rescheduled?
1st April 2019 - now CD schedule 3 (CD NO REG POM)
Do schedule 3 CDs need to be entered in the CD register?
No, only schedule 1+2