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Paeds, MEP, OTC & Misc. > MEP Misc. > Flashcards

MEP Misc. Flashcards

1
Q

Which biosimilar medicines are subject to a black triangle status?

A
  • Adalimumab
  • Bevacizumab
  • Enoxaparin sodium
  • Epoetin alfa
  • Epoetin zeta
  • Etanercept
  • Filgrastim
  • Follitropin alfa
  • Infliximab
  • Insulin glargine
  • Insulin lispro
  • Rituximab
  • Somatropin
  • Teriparatide
  • Trastuzumab
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2
Q

Which benzodiazepines are in the Group 2 (higher limits) category?

A

COLD FeeT

Clonazepam
Oxazepam
Lorazepam
Diazepam

Flunitrazepam
Temazepam

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3
Q

fentanyl 25 mcg patches

What is the maximum recommended duration of supply on a single prescription for this medicine?

A

Fentanyl patches are a schedule 2 controlled drug. The validity of the prescription is 28 days but the recommended length of supply is up to 30 days.

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4
Q

Revalidation process

A
  • four CPD records (two of which must be planned events)
  • one peer discussion record
  • one reflective account record
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5
Q

Codeine and dihydrocodeine

A

Can supply < 32 dose units OTC

Effervescent packs > 32 dose units are POM

Labels:
- Indication
- Medicine can cause addiction or headache if used continuously for more than three days

PIL:
- Indication
- Medicine can cause addiction or headache if used continuously for more than three days
- Warning signs of addiction

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6
Q

Prescription legal requirements

A
  • Signature of the prescriber
  • Address of the prescriber
  • Particulars of the prescriber
  • Date of prescription
  • Patient name
  • Patient address
  • Age (if under 12 years)
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7
Q

On an NHS prescription, the date was signed on the 1st May but written ‘supply on 10th May’. What date can you legally supply this prescription from?

A

10th May.

*Note: For NHS prescriptions, the appropriate date is the later of either the date on which the prescription was signed or a date indicated by the appropriate prescriber as the date before which it should not be dispensed.

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8
Q

On a private prescription, the date was signed on the 1st May but written ‘supply on 10th May’. What date can you legally supply this prescription from?

A

1st May.

*Note: For private prescriptions, the appropriate date will always be the date on which it was signed.

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9
Q

Can you supply prescriptions in the Welsh language?

A

Yes, provided that you can understand the prescription in the Welsh language. If not, put patient safety first and find alternatives through translation services or informal networks (e.g., LanguageLine).

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10
Q

Can you supply prescriptions from the Crown Dependencies (Jersey, Guernsey, Isle of Man)?

A

Yes, provided they meet all the prescription requirements.

*Note: For Schedule 2/3 CDs, the prescriber’s address must be within the United Kingdom. Crown Dependencies are not part of the UK.

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11
Q

How many times can you repeat an NHS FP10 prescription which states ‘repeat x 4’?

A

0; you cannot repeat dispense NHS FP10 prescriptions.

*Note: repeatable prescriptions are private prescriptions.

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12
Q

How many times can you DISPENSE a private prescription that states ‘repeat x2’?

A

3

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13
Q

How many times can you DISPENSE a private prescription that states ‘repeat’?

A

2

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14
Q

How many times can you REPEAT a private prescription that states ‘repeat x3’?

A

3

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15
Q

How many times can you repeat and dispense a prescription for an oral contraceptive prescription?

A

Repeat 5 times (dispensed 6 times).

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16
Q

Is there a time limit for dispensing the remaining repeats after the first dispense has been done?

A

*Note: the first dispensing has to be within 6 months for POM and CD-5 (28 days for Schedule 4 CDs) from the appropriate date, but the remaining repeats have no legal time limit.

CD-2 and 3 can’t be repeated!!!

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17
Q

Prison prescriptions are still considered NHS prescriptions. True or False?

A

True.

*Note: They use a different form generated by the clinical IT system (FP10s used only to access urgent medicines such as during out of hours).

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18
Q

How long is the validity of owings for P and GSL medications?

A

6 months.

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19
Q

How long is the validity of owings for POMs and Schedule 5 CDs?

A

6 months.

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20
Q

How long is the validity of owings for Schedule 2, 3 and 4 CDs?

A

28 days.

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21
Q

How long do you have to keep private prescriptions for a POM?

A

2 years.

*Note: from the date of sale or supply or for repeatable prescriptions, from the date of last sale or supply.

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22
Q

How long should you keep a record in the POM register?

A

2 years.

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23
Q

What should you record in the POM register?

A
  • Supply date
  • Prescription date
  • Medicine details (name, quantity, formulation, strength)
  • Prescriber’s name and address
  • Patient’s name and address
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24
Q

You need to record oral contraceptives into the POM register. True or False?

A

False, prescriptions for oral contraceptives are exempt from record keeping.

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25
Q

Dentists can legally write prescriptions from any POM. True or False?

A

True.

*Note: However, when prescribing on an NHS dental prescription, dentists are restricted to the medicines listed in the Dental Prescriber’s Formulary.

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26
Q

Is a faxed prescription legally valid?

A

No, because it is not written in indelible ink and has not been signed in ink by an appropriate prescriber.

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27
Q

Can you supply against a faxed prescription?

A

Use your informed decision and take steps to safeguard patient safety and where possible, mitigate the risks. Consider making a record of the decision-making process and reasons leading to a particular course of action.

*Note: supplying Schedule 2/3 CDs without a lawful prescription could be prosecuted as a criminal offense.

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28
Q

What are the legal requirements for prescriptions from EEA and Swiss healthcare professionals?

A
  • Patient’s full first name, surname and date of birth
  • Prescriber’s full first name, surname, professional qualifications, direct contact details, work address
  • Name of medicine, form, quantity, strength and dosage details
  • Prescriber signature
  • Date of issue
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29
Q

Prescriptions from EEA and Swiss healthcare professionals have to be written in English language if you were to supply. True or False?

A

False.

*Note: prescriptions in a foreign language is still legally acceptable but you will need to have enough information to enable the safe supply of medicines considering patient care and wellbeing.

You can confirm the registration status of the prescribers through the GMC, GDC, or European Commission website

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30
Q

You cannot supply if you are unable to confirm the registration status of the prescriber. True or False?

A

False.

*Note: you may still supply in the interests of patient care provided that you record details of any interventions and steps taken (use professional judgement).

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31
Q

Items not under the marketing authorisation valid in the UK are not permitted. True or False?

A

True.

*Note: Consider referral to an appropriate UK-registered prescriber if such items are required.

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32
Q

Can you supply Schedule 1, 2 and 3 CDs (including phenobarbital) or unlicensed products in an emergency to a patient of an approved EEA/Swiss health professional?

A

Nope!

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33
Q

On what forms are military prescriptions written on?

A

FMed 296.

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34
Q

Where would the invoice of military prescriptions be sent to if the pharmacy has a contract with the Ministry of Defence (MOD)?

A

To the MOD directly.

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35
Q

Can FMed 296 (military) prescriptions be presented and supplied in non-contracted pharmacies?

A

Yes, treat as a private prescription and charge the patient the appropriate fee.

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36
Q

On what forms do you prescribe Schedule 2 and 3 CDs?

A

Pink FP10PCD forms

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37
Q

Can you legally dispense Schedule 2 and 3 CDs on FMed 296 (military) prescriptions?

A

No, they should be on the usual pink FP10PCD form.

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38
Q

What are the legal requirements for labelling of dispensed medicinal products?

A
  • Name of patient
  • Name and address of supplying pharmacy
  • Date of dispensing
  • Name of the medicine
  • Directions for use
  • Precautions relating to the use of medicines
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39
Q

What are the legal requirements for labelling of dispensed medicinal products broken down from bulk containers?

A

Usual labelling requirements plus
- Name of medicine
- Quantity of the medicine in the container
- Quantitative particulars of the medicine
- Handling and storage requirements where appropriate
- Expiry date
- Batch number

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40
Q

Anyone can administer adrenaline for anaphylaxis in emergency situations. True or False?

A

True!

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41
Q

What is a patient-specific direction (PSD)?

A

Written instruction from a doctor, dentist or non-medical prescriber for a medicine to be supplied or administered to a named patient after the prescriber has assess that patient on an individual basis.

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42
Q

Can the directions for the purpose of administration be through verbal or telephone call (i.e., not written)?

A

Yes.

*Note: double-check with your own local hospital formulated policies as well.

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43
Q

In which situation(s) can you sell and supply without a prescription?

A
  • Patient Group Directions (PGD)
  • Patient-Specific Directions (PSD)
  • Emergency Supply
  • Optometrist/Podiatrist Signed Patient Orders
  • Supply of salbutamol inhalers to schools
  • Supply of adrenaline autoinjectors to schools
  • Supply of naloxone by individuals providing recognised drug treatment services
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44
Q

What is a Patient Group Direction (PGD)?

A

Written direction that allows the supply and/or administration of a specified medicine(s), by a named authorised health professional, to a well-defined group of patients requiring treatment for a specific condition.

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45
Q

Can you supply, offer to supply or administer morphine and diamorphine under a PGD?

A

Yes, for the immediate, necessary treatment of sick or injured persons.

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46
Q

What requirements must be satisfied for an emergency supply at the request of the prescriber?

A
  • Relevant prescriber
  • Emergency
  • Prescription within 72 hours
  • Directions
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47
Q

Can you supply Schedule 1, 2 and 3 CDs (excluding phenobarbital) or unlicensed products in an emergency to a patient of an approved UK health professional?

A

No

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48
Q

Can you supply Phenobarbital (Schedule 3) under an emergency supply in the request of the prescriber?

A

Yes, in an emergency for the treatment of epilepsy for 5 days.

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49
Q

Should emergency supplies be kept in the POM register?

A

Yes, if it’s a POM

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50
Q

What requirements must be satisfied for an emergency supply at the request of the patient?

A
  • Interview the patient
  • Immediate need satisfied
  • Previously prescribed
  • Dose
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51
Q

What is the maximum length of emergency supply for a Phenobarbital/Schedule 4/5 CDs?

A

5 days

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52
Q

What is the maximum length of emergency supply for any other POM? Are there any other products with exceptions to this length of supply?

A

No more than 30 days except insulin, creams, ointment, inhaler for asthma (smallest pack available to be supplied), and for antibiotics or an oral contraceptive, the full treatment cycle should be supplied.

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53
Q

For emergency supplies in the request of the patient, what should be recorded in the POM register?

A
  • Date of supply
  • Name and quantity of medicine
  • Patient’s name and address
  • Nature of emergency
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54
Q

For emergency supplies in the request of the prescriber, what should be recorded in the POM register?

A
  • Date of supply
  • Name and quantity of medicine
  • Prescriber’s name and address
  • Patient’s name and address
  • Date on the prescription (when received)
  • Date on which the prescription is received
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55
Q

A school has requested a supply of adrenaline auto-injectors via a signed order. Can you make this supply?

A

Yep

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56
Q

A school has requested a supply of salbutamol inhalers via a signed order. Can you make this supply?

A

Yep

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57
Q

If a school requests a supply via a signed order for adrenaline auto-injectors/salbutamol inhalers, what are the requirements in the signed order?

A
  • Name of school
  • Product details (including spacer if relevant)
  • Strength (if relevant)
  • Purpose of product
  • Total quantity
  • Signature of the principal or head teacher
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58
Q

How many adrenaline auto-injectors/salbutamol inhalers can a school order via a signed order?

A

Not specified.

*Note: provided it is for small quantities on an occasional basis and not for profit. Use professional judgement by considering school size, number of students known to be affected, etc.

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59
Q

How long do signed orders need to be retained for?

A

2 years

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60
Q

Anyone can administer naloxone during an emergency. True or False?

A

True

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61
Q

Which medications are under the pregnancy prevention programmes (PPP) scheme?

A
  • Oral retinoids
  • Valproate
  • Thalidomide
  • Lenalidomide
  • Pomalidomide
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62
Q

How long is the prescription under the PPP valid for?

A

7 days

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63
Q

What is the maximum length of supply for patients who are under the PPP?

A

30 days

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64
Q

Biosimilars are generic medicines. True or False?

A

False

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65
Q

Biologics should be prescribed by brand name. True or False?

A

True

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66
Q

What is a biologic?

A

Medicine made from a variety of natural resources (e.g., vaccines, DNA, therapeutic proteins, etc.).

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67
Q

What is a biosimilar?

A

A biologic medicine that is similar to an already licensed biologic medicine in terms of quality, safety and efficacy.

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68
Q

What kind of license would you need to prescribe Schedule 1 CDs?

A

Home Office Licence

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69
Q

A prescriber’s address must be within the UK if they were to prescribe Schedule 2/3 CDs. True or False?

A

True.

70
Q

Who is allowed to prescribe Schedule 2/3 CDs (including cocaine, diamorphine or dipipanone for treating addiction)?

A
  • Doctor
  • Dentist
  • Veterinary surgeon (technically can prescribe any Schedule 2/3 CDs)
71
Q

Who is allowed to prescribe Schedule 2/3 CDs with exceptions?

A
  • Nurse/midwife/pharmacist independent prescribers (except cocaine, diamorphine or dipipanone for treating addiction)
  • Physiotherapist independent prescribers (only oral: diazepam, dihydrocodeine, lorazepam, morphine, oxycodone and temazepam; injection: morphine; transdermal: fentanyl)
  • Podiatrist/chiropodist independent prescriber (only oral: diazepam, dihydrocodeine, lorazepam and temazepam)
  • Supplementary prescribers (except cocaine, diamorphine or dipipanone for treating addiction)
72
Q

These type of prescribers are restricted to areas of clinical competence and included within an agreed clinical management plan.

A

Supplementary prescribers

73
Q

Can a community practitioner nurse prescriber prescribe Nystatin off-label (the management of thrush) for neonates?

A

Yes.

*Note: that is the only exception as they cannot prescriber other unlicensed and/or off-label medicines. In addition, they can only prescribe restricted to dressings, appliances and licensed medicines listed in the Nurse Prescribers’ Formulary.

74
Q

Who can prescribe both unlicensed and/or off-label medicines?

A
  • Doctor
  • Dentist
  • Veterinary surgeons (for treatment of animals only)
  • Nurse/midwife/pharmacist independent prescribers
  • Supplementary prescribers
75
Q

Can therapeutic radiographer independent prescribers prescribe an unlicensed/off-label medicine?

A

Only off-label medicines.

76
Q

Can podiatrist/chiropodist independent prescribers prescribe an unlicensed/off-label medicine?

A

Only off-label medicines.

77
Q

Can physiotherapist independent prescribers prescribe an unlicensed/off-label medicine?

A

Only off-label medicines.

78
Q

Can paramedic independent prescribers prescribe an unlicensed/off-label medicine?

A

Only off-label medicines.

79
Q

Can optometrist independent prescribers prescribe an unlicensed/off-label medicine?

A

Only off-label medicines.

*Note: for treating conditions affecting the eye and surrounding tissue only; not parenteral preparations.

80
Q

It is illegal to dispense self-prescribed prescriptions and prescriptions for close friends and family. True or False?

A

False.

*Note: it is poor practice to self-prescribe or to prescribe for persons for whom there is a close personal relationship. Use professional judgement and make sure that it is in the best interest of the patient.

81
Q

What is ‘Off-Label’ use of medication?

A

Off-label’ use means that the medicine has a license for treating some conditions, but that the manufacturer of the medicine has not applied for a license for it to be used to treat your condition. In other words, the medicine may not have undergone clinical trials to see if it is effective and safe in treating your condition.

82
Q

Unlicensed medications

A

An unlicensed medicine is one that does not have a product license in the UK.

83
Q

Would you need a wholesaler license if your pharmacy supplies to another pharmacy within the same legal entity?

A

No.

*Note: the pharmacy supplying would need to have their name on the wholesaler license of the legal entity.

84
Q

Do registered pharmacies or hospitals supplying small quantities of medicines to healthcare professionals for onward treatment or onward supply to patients require a wholesaler license?

A

No.

*Note: as long as they meet the below requirements:
- Transaction takes place on an occasional basis
- Quantity of medicines supplied is small
- Supply is made on a not for profit basis
- The supply is not for onward wholesale distribution

85
Q

How long would you have to keep an invoice for a POM?

A

2 years

86
Q

When signed orders/invoices for POMs are retained in the pharmacy, would you have to make a record in the POM register?

A

No.

*Note: for signed orders, you either keep the signed order/invoice or you make a record in the POM register.

87
Q

What are the different categories under veterinary medicines?

A
  • POM-V
  • POM-VPS
  • NFA-VPS
  • AVM-GSL
  • SAEs
  • Unauthorised veterinary medicine
88
Q

What is a POM-V?

A

Medicines only prescribed by vet and supplied by vet or pharmacist with written prescription.

89
Q

What is a POM-VPS?

A

Medicines only prescribed and supplied by vet, pharmacist, or suitably qualified person on an oral or written prescription.

90
Q

What is a NFA-VPS?

A

Medicines for non-food animals that can be supplied by vet, pharmacist or suitably qualified person.

91
Q

What is a AVM-GSL?

A

Authorised vet medicine available on general sale.

92
Q

What is a SAEs?

A

Unlicensed vet medicine that does not require marketing authorisation because it meets criteria laid out in Schedule 6 of the Veterinary Medicines Regulations - exemptions for small pet animals.

93
Q

What is an unauthorised veterinary medicine?

A

Unlicensed medicine that has no marketing authorisation and is not eligible for exemption through SAEs. Only can be prescribed by a vet under the veterinary cascade.

94
Q

What are the prescription requirements for POM-V, POM-VPS and medicines supplied under the veterinary cascade?

A
  • Name, address, telephone number, qualification and signature of the prescriber
  • Name and address of the owner
  • Date
  • Identification and species of the animal and its address
  • Name, quantity, dose and administration instructions of the required medicine
  • Any necessary warnings and if relevant, the withdrawal period
  • Where appropriate, statement: medicine prescribed under the veterinary cascade
  • If repeatable, number of repeats
95
Q

Do veterinary prescriptions require standardised forms?

A

No.

*Note: statement that medicines are ‘prescribed for the treatment of an animal or herd under my care’ is required for Schedule 2/3 CDs.

STANDARDISED FORMS ARE REQUIRED FOR HUMAN PRIVATE SCRIPTS FOR CD-2 AND 3’S

96
Q

How long should veterinary prescriptions be retained for?

A

5 years

97
Q

Veterinary prescriptions are required to submit their prescriptions to the relevant NHS agency. True or False?

A

False.

*Note: should be retained for 5 years.

98
Q

It is a legal requirement for CDs under vet prescriptions to be not more than 28 days’ worth of treatment. True or False?

A

False.

*Note: it is good practice only. However, human prescriptions for Schedule 2, 3 or 4 CDs should (not must) not exceed 30 days.

99
Q

Veterinary prescriptions for Schedule 2 and 3 CDs must include the RCVS registration number of the prescriber. True or False?

A

True

100
Q

Veterinary prescriptions for CDs are only valid for 28 days from the appropriate date. True or False?

A

True.

*Note: do not get confused with the length of treatment that can be given. There is no legal requirement for veterinary prescriptions containing CDs in the length of treatment but the prescription itself is only valid for 28 days from the appropriate date.

101
Q

When can you prescribe under the veterinary cascade?

A

Only when the licensed veterinary product is not available so other medicines, in a strict order of preference can be considered (including human medicines).

*Note: the following order is as follows:
- Vet medicine with a GB or UK-wide marketing authorisation for the species and condition indicated
- Vet medicine with a NI marketing authorisation for the species and condition indicated
- GB, NI or UK-wide vet medicine licensed for another species or different condition
- GB, NI or UK-wide licensed human medicine or vet medicine authorised outside the UK
- Extemporaneous or specially manufactured medicine

102
Q

If products are not authorised in the GB or UK-wide for veterinary medicines, you could use those licensed in NI. But what type of certificate would you need?

A

Special Import Certificate.

103
Q

A veterinary prescription requires a medication that is licensed for another species. Can you supply this and what are the considerations to allow this supply?

A

Only can be supplied if the vet prescription has the relevant wording ‘for administration under the cascade’.

104
Q

A person comes into the pharmacy asking for an OTC medicine for their pet as suggested by their vet. Can you sell this product?

A

No.

*Note: it is unlawful to sell or supply unauthorised vet medicines including human medicines for an animal unless it is under the veterinary cascade.

105
Q

It is a legal requirement to generate a dispensing label for veterinary prescriptions. True or False?

A

False.

*Note: it is ONLY a legal requirement for medicine prescribed under the VETERINARY CASCADE.

106
Q

It is a legal requirement to add the wording ‘keep out of reach and sight of children’ in dispensing labels for all prescriptions. True or False?

A

False.

*Note: it is only a recommendation, except for prescriptions under the veterinary cascade, the dispensing label is a legal requirement and the words: ‘keep out of reach of children’ is required.

107
Q

How long should you keep a POM record for POM-V and POM-VPS prescriptions?

A

5 years

108
Q

Schedule 4 and 5 CDs need to meet the legal CD prescription requirements. True or False?

A

False.

*Note: only Schedule 2 and 3 CDs.

109
Q

How long are Schedule 5 CD prescriptions valid for?

A

6 months

110
Q

How long are Schedule 4 CD prescriptions valid for?

A

28 days

111
Q

Only Schedule 4 and 5 CDs are repeatable. True or False?

A

True

112
Q

Invoices for Schedule 5 CDs need to be retained for 2 years. True or False?

A

True

113
Q

Invoices for Schedule 2 CDs need to be retained for 2 years. True or False?

A

False.

6 complete tax years! Alongside ALL of Schedule 4

114
Q

Invoices for Schedule 3 CDs need to be retained for 2 years. True or False?

A

True

Alongside Schedule 5.

115
Q

All CDs require a license to import or export. True or False?

A

False.

*Note: Schedule 5 CDs do not need a license to import or export.

116
Q

Who can possess, supply and procure Schedule 2, 3, 4 and 5 CDs (2001 Regulations)?

A
  • Pharmacists
  • Doctors
  • Dentists

*Note: Others that can lawfully possess CDs include:
- Those with a Home Office License
- Home Office group authority
Legislation: class of person (e.g., midwife)
- Legislation: class of drug
- Patients prescribed a CD

117
Q

What are the legal requirements for a CD requisition?

A
  • Signature of the recipient
  • Name of the recipient
  • Address of the recipient
  • Profession or occupation
  • Total quantity of drug
  • Purpose of the requisition
118
Q

Which type of form do you use for requisition of CDs?

A

FP10CDF (England).

119
Q

Requisition is only necessary for Schedule 2 and 3 CDs. True or False?

A

True.

120
Q

You are working in a hospital pharmacy and have receive a requisition request for a Schedule 2 CD by a department not within the same legal entity. Can you supply this?

A

Yes, if the approved requisition form is used (unless the request is from a hospice or prison).

*Note: prisons have different requisition forms and specific processes for handling of CDs.

121
Q

You are working in a community pharmacy and you get a request from a local hospital for a requisition of a Schedule 3 CD. Can you supply this?

A

Yes, if the approved form is used (unless the request is from a hospice or prison).

*Note: prisons have different requisition forms and specific processes for handling of CDs.

122
Q

You receive a faxed requisition request for a Schedule 3 CD. Can you supply this?

A

No.

*Note: legislation requires that a requisition in writing must be obtained by the supplier before delivery of any Schedule 2/3 CDs (except GPhC registered pharmacies).

123
Q

Fill in the blank.

During an emergency, the doctor or dentist can be supplied a Schedule 2 CDs in the circumstance that the requisition is supplied within the next ‘….’ hours.

A

24h

124
Q

What would you do with a requisition form for Schedule 1, 2, 3 CDs during and after supply?

A
  • Mark indelibly with supplier’s (i.e., pharmacy) name and address
  • Send to NHSBSA
125
Q

It is a legal requirement to retain a copy of the requisition of a scheduled CD for two years from the date of supply. True or False?

A

False.

*Note: only for good practice. Don’t get confused with invoices for Schedule 3 and 5 CDs which need to be kept for 2 years.

126
Q

A registered midwife uses a midwife supply order to obtain diamorphine. Can you supply this?

A

Yes

127
Q

What CDs can a registered midwife request using a midwife supply order?

A
  • Diamorphine
  • Morphine
  • Pethidine
128
Q

What are the legal requirements for obtaining CDs under a midwife supply order?

A
  • Name of midwife
  • Occupation of midwife
  • Name of person to whom the CD is to be supplied
  • Purpose for which CD is required
  • Total quantity of drug to be obtained
  • Signature of an appropriate medical officer (or doctor authorised in writing by supervising authority)
129
Q

What are the prescription requirements for Schedule 2/3 CDs?

A
  • Signature of prescriber
  • Date
  • Address of prescriber
  • Name of CD
  • Form of CD
  • Strength (if more than one strength available)
  • Dose
  • Total quantity in both words and figures
  • Quantity prescribed
  • Name of patient
  • Address of patient
  • Statement in dental prescriptions, ‘for dental treatment only’
  • Instalment direction (if appropriate)
130
Q

It is a legal requirement for Schedule 2, 3 and 4 CDs to not be prescribed more than 30 days. True or False?

A

False.

*Note: it is not a legal restriction but only a strong recommendation.

131
Q

What are the additional legal requirements when CDs are supplied?

A

Mark the CD prescription with the date of supply at the time the supply is made.

In indelible ink and can be computer-generated.

132
Q

What should an instalment direction consist of?

A
  • Amount of medicine to be supplied per instalment (in addition to the dose)
  • Interval between each time the medicine can be supplied
133
Q

Within how many days must the first instalment be dispensed?

A

28 days

134
Q

What would you do if the patient has missed three or more consecutive days of their instalment prescription drug?

A

Consult prescriber

135
Q

A patient will miss a dose as the pharmacy is closed on the day they are due their dose. Can this be supplied earlier?

A

Yes, if the approved Home Office wording is used on the instalment prescription (i.e., ‘Please dispense instalments due on a pharmacy closed days on a prior suitable day’).

136
Q

A prescription for a Schedule 2 CD is missing the words but not figures of the total quantity. What would you do as the pharmacist?

A

Amend the prescription yourself.

*Note: this can be done if only either the word or figure is missing but not both.

137
Q

A prescription for a Schedule 2 CD is missing both the words and figures of the total quantity. What would you do as the pharmacist?

A

Contact the prescriber to amend.

138
Q

If you amend a minor technical error on a Schedule 2/3 CD as the pharmacist, what must you also mark on the prescription?

A
  • Name
  • Date
  • Signature
  • GPhC registration number
139
Q

Which forms do private prescriptions need to be for prescribing Schedule 2/3 CDs?

A

FP10 PCD.

140
Q

What should you do with original private prescriptions for Schedule 2/3 CDs?

A

Send to NHSBSA.

*Note: other POMs should not be prescribed together on this CD form because non-CD POM prescriptions need to be kept in the pharmacy for 2 years.

141
Q

Where do you keep Tramadol in the pharmacy?

A

On the shelves in the dispensary.

*Note: there are exemptions for some Schedule 2/3 drugs.

Others exempt:
- gabapentin
- Mazindol
- Meprobamate
- Midazolam
- Pentazocine
- Phentermine
- Phenobarbital
- Pregabalin

142
Q

Where do you keep Temazepam in the pharmacy?

A

CD cupboard

143
Q

Where do you keep buprenorphine in the pharmacy?

A

CD cupboard

144
Q

You obtain a returned CD by a patient that’s now expired. What should you do?

A

Denature and dispose!

145
Q

A witness by an authorised person is required for the destruction of patient-returned CDs (CD 2, 3, or 4 Part 1). True or False?

A

False.

*Note: only for pharmacy stock of Schedule 2 CDs

146
Q

Can an accountable officer be an authorised witness for the destruction of CDs?

A

No (2001 regulations).

*Note: however, an accountable officer can authorise other persons to witness the destruction of CDs.

147
Q

What is the method of destruction involving CDs for solid dosage forms?

A
  • Grind/crush and add a bit of water before adding to CD denaturing kit
  • Alternative: grind/crush and place into a small amount of warm, soapy water until dissolved/dispersed. Then poured onto a suitable product and added to an appropriate waste disposal bin
148
Q

What is the method of destruction involving CDs for liquid containing ampoules and vials?

A

Open ampoule and empty into CD denaturing kid. Then, dispose ampoule as sharps pharmaceutical waste.

149
Q

What is the method of destruction involving CDs for powder containing ampoules and vials?

A

Open ampoule and add water to dissolve the powder inside. Pour this into the CD denaturing kit and ampoule disposed as sharps pharmaceutical waste.

150
Q

What is the method of destruction involving CDs for patches?

A

Remove the backing and fold the patch over on itself. Place into a waste disposal bin or a CD denaturing kit.

151
Q

What is the method of destruction involving CDs for aerosol formulations?

A

Expel into water and dispose the liquid as written on the liquid destroying guidance for CDs.

152
Q

What scheduled controlled drugs should be recorded on the CD register?

A

Schedule 1/2 CDs.

153
Q

What should you record when receiving Controlled Drugs?

A
  • Date supply received
  • Name and address from whom received
  • Quantity received
154
Q

What should you record when supplying Controlled Drugs?

A
  • Date supplied
  • Name and address of recipient
  • Details of authority to possess
  • Quantity supplied
  • Details of person collecting Schedule 2 CD
  • Whether proof of identity was requested upon person collecting
  • Whether proof of identity was provided
155
Q

What schedule under Controlled Drugs are cannabis-based products for medicinal use (CBPM)?

A

Schedule 2 CD.

156
Q

What is Sativex used for and what schedule of CD is it under?

A

It is used for moderate-severe spasticity in multiple sclerosis and is Schedule 4 Part 1 CD.

157
Q

Where a product states ‘use by 07/22’, when is the last date it can be used?

A

30th June 2022.

158
Q

Where a product with an expiry date of 07/22, when is the last date it can be used?

A

31st July 2022

159
Q

Where should waste medicines be stored?

A

In a secure waste container at a designated area away from medicines that are fit for use.

160
Q

Where should waste medicines containing sharps be stored?

A

In a sharps container at a designated area away from medicines that are fit for use.

161
Q

Does the MHRA require homeopathic products to demonstrate efficacy?

A

No

*Note: only quality and safety.

162
Q

What are the licensing requirements for herbal remedies to?

*Hint: there are 2 types of licence they can have.

A

Either one of these:
- Full marketing authorisation based upon safety, quality and efficacy
- Traditional herbal registration (THR) based upon safety, quality and evidence of traditional use

163
Q

For medical devices, what markings do they need to carry to denote compliance with the medical devices regulations?

A

CE or UKCA mark.

164
Q

Which benzodiazepines have a legal driving limit?

A
  • Clonazepam
  • Oxazepam
  • Lorazepam
  • Diazepam
  • Flunitrazepam
  • Temazepam
165
Q

How long should the responsible pharmacist records be kept for?

A

5 years

166
Q

What does a responsible pharmacist need to do?

A
  • Secure the safe and effective running of the pharmacy
  • Display a notice
  • Complete pharmacy record
  • Establish, maintain and review pharmacy procedures
167
Q

What is the maximum period the responsible pharmacist can be absent for?

A

2 hours.

*Note: this total includes if there is more than one responsible pharmacist during business hours.

168
Q

What activities can take place when the responsible pharmacist is absent?

A

With suitable trained staff:
- Ordering stock
- Receiving stock (excluding CDs)
- Putting stock away onto shelves (excluding CDs)
- Date checking (excluding CDs)
- Stocking pharmacy with consumables
- Cleaning
- Responding to enquiries
- Accessing PMR
- Receive prescriptions from EPS, patients or collecting from surgery
- Processing prescriptions that have been dispensed
- Delivery person conveying medicines to patient
- Receiving patient returned medicines (excluding CDs)

169
Q

GSL medicines can be sold without the supervision of the responsible pharmacist. True or False?

A

True.

*Note: but the responsible pharmacist will still need to be in charge of the pharmacy i.e. have opened up for the day, if not present and not signed in, it can’t go ahead!

170
Q

What does P of 0.05 mean?

A

A statistically significant test result (P ≤ 0.05) means that the test hypothesis is false or should be rejected.

A P value > 0.05 means that no effect was observed.

171
Q

Clinical Audit

A

Approval:

You don’t need ethics approval to conduct a clinical audit!!!

No breach of patient confidentiality occurs if the use of data is carried out by healthcare professionals who already have access to the information in their role of providing care.

Patient consent will not be required if you are collecting data which you already provide as part of your care to the patient, and which does not identify the patient.

Paeds, MEP, OTC & Misc. (28 decks)

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