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Exam 2019 > MEP42 2 > Flashcards

MEP42 2 Flashcards

1
Q

Do emergency supplies need to be entered into the POM register?

If it is a the request of a patient, what information should be documented?

A

Yes

If a patient request, should include information and nature of emergency - why the patient needs the POM and why a prescription cannot be obtained

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2
Q

For emergency supplies, what is the max quantity that can be supplied for:

  1. CD 4 and 5s
  2. Any other POMs

What are the exceptions to this?

A
  1. 5 day supply max
  2. 30 day supply max

Exceptions include insulin, creams, inhaler where a pack cannot be broken down. The smallest pack available should be given.

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3
Q

How much of an oral contraceptive should you give in an emergency supply?

A

If an oral contraceptive, a full treatment cycle should be provided

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4
Q

How much of a liquid antibiotic should you give in an emergency supply?

A

If an antibiotic in liquid form, smallest quantity that will provide full course should be supplied

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5
Q

In addition to standard labelling requirements, what else needs to be included on the dispensing label in an emergency supply?

A

The words “Emergency supply”

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6
Q

Is it possible to do an emergency supply during GP opening hours?

A

Yes, need to use professional judgement to see if the patient cannot get a prescription that day

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7
Q

What are the 7 exemptions of supplying a medicine without a prescriptions?

A
  1. Patient group directions
  2. Emergency supply (by prescriber or patient)
  3. Pandemic exemptions
  4. Optometrist or podiatrist signed orders for patients
  5. Supply of salbutamol inhalers to schools
  6. Supply of adrenaline autoinjectors to schools
  7. Supply of naloxone by individuals providing recognised drug treatment services
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8
Q

Can schools stock hold salbutamol inhalers and epi pens?

A

Yes

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9
Q

Who can provide a signed order for salbutamol inhalers and epi pens for a school?

A

Principal/head teacher

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10
Q

What is needed on a signed order for salbutamol inhalers and epi pens for a school?

A

(i) the name of the school for which the medicinal product is required
(ii) the purpose for which that product is required
(iii) the total quantity required (there is no limit but should relate to school size, number of kids with asthma)

Ideally, appropriately headed paper should be used; however, this is not a legislative requirement. You need to ensure it is not for profit as well.

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11
Q

How long does a record of salbutamol and epi pen supply for a school need to be kept for?

A

Signed record needs to be retained for 2 years or an entry in the POM register. You need to include the purpose of supply in this record

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12
Q

What programme is in place for females on isotretinoin and how long should the patient be under this programme for?

Is this compulsory?

A

Pregnancy prevention programme. During treatment and for at least one month after stopping

Patient should be under PPP unless the prescriber agrees that there
are compelling reasons that indicate there is no risk of pregnancy.

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13
Q

How long are isotretinoin prescriptions under the pregnancy prevention programme valid for?

A

7 days

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14
Q

What is the max quantity that can be supplied for an isotretinoin prescription under the pregnancy prevention programme?

A

30 days max

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15
Q

Can you issue repeat prescriptions of oral isotretinoin?

A

No

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16
Q

Can you issue faxed prescriptions for oral isotretinoin?

A

No

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17
Q

Can you issue an emergency supply for isotretinoin?

A

Should only be accepted if this is an emergency supply at the request of a PPP specialist prescriber together with confirmation that pregnancy status has been established as negative within the preceding seven days.

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18
Q

If there is an unplanned pregnancy and patient is on sodium valproate what should you advise the patient?

A

Do not stop your treatment and arrange to see prescriber ASAP

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19
Q

Why is a biosimilar medicine not a generic medicine?

A

Due to the complexity of structure and greater size of biologics as well as their inherent heterogeneity resulting from their production methods, it is not possible to make an identical copy of the originator biologic.

All biosimilars need to be prescribed by brand as per MHRA advice

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20
Q

What sort of license is required to prescribe cocaine, dipipanone or diamorphine?

Who can prescribe these?

A

Home Office License

Doctors

Pharmacist/nurse independent prescribers may for organic disease/injury, not for addiction

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21
Q

When a POM is supplied from a registered pharmacy to healthcare professionals, what needs to be kept and how long for?

A

Signed order/invoice for 2 years

Alternatively, a register in the POM register

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22
Q

What is a POM-V?

A

Prescription-only medicines that can only

be prescribed by a veterinary surgeon and supplied by a veterinary surgeon or a pharmacist with a written prescription

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23
Q

What is a POM-VPS?

A

Prescription-only medicines that can be prescribed and supplied by a veterinary surgeon, a pharmacist or a suitably qualified person on an oral or written prescription. A written prescription is only required
if the supplier is not the prescriber

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24
Q

What is a NFA-VPS?

A

A category of medicine for non-food animals that can be supplied by a veterinary surgeon, a pharmacist or a suitably qualified person.
A written prescription is not required

e.g. Frontlin

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25
Q

What is an AVM-GSL?

A

An authorised veterinary medicine that is available on general sale e.g. Dentastix

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26
Q

What are exempt medicines under schedule 6 of the veterinary medicines regulations – exemptions for small pet animals? (SAEs)

A

An unlicensed veterinary medicine that does not require a marketing authorisation because it meets criteria laid out in Schedule 6 of the Veterinary Medicines Regulations - Exemptions for small pet animals

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27
Q

What is an unauthorised veterinary medicine?

A

An unlicensed medicine that does not have
a marketing authorisation and is not eligible
for exemption through the SAES. It can only be prescribed by a veterinary surgeon under the Cascade (see Diagram 10). This includes any human medicine used for animals

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28
Q

What 8 pieces of information must be present for a veterinary prescription to be valid?

A

1 Name, address, telephone number, qualification and signature of the prescriber. Where Schedule 2 or 3 Controlled Drugs have been prescribed, the Royal College of Veterinary Surgeons (RCVS) registration number of the prescriber must also be included.

2 Name and address of the owner.

3 Identification and species of the animal and its
address (if different from the owner’s address).

4 Date. prescriptions are valid for six months
or shorter if indicated by the prescriber
(the Veterinary Medicines Directorate
has confirmed in the case of repeatable prescriptions all supplies must be made within 6 months or shorter if indicated by prescriber). Prescriptions for Schedule 2, 3 and 4 Controlled Drugs are valid for 28 days.

5 Name, quantity, dose and administration instructions of the required medicine
NB: The Veterinary Medicines Directorate advises that ‘as directed’ is not an acceptable administration instruction.

6 Any necessary warnings and if relevant the withdrawal period (i.e. the time that must elapse between when an animal receives a medicine and when it can be used for food).

7 Where appropriate, a statement highlighting that the medicine is prescribed under the veterinary Cascade (e.g. ‘prescribed under the Cascade’ or other wording to the same effect).

8 Where Schedule 2 or 3 Controlled Drugs have been prescribed, a declaration that ‘the item has been prescribed for an animal or herd under the care of the veterinarian’ – usual Controlled Drugs prescription requirements apply

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29
Q

Is there a standardised form for vet prescriptions?

A

No

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30
Q

How long should vet prescriptions be retained for?

A

5 years
Entry into POM register required

They do not need to be submitted to an NHS agency, but pharmacies that supply veterinary medicines must undertake an annual audit

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31
Q

What information about the prescriber must be present on a vet prescription for a CD 2 and 3 drug?

A

Registration number

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32
Q

What is the veterinary cascade?

A

Allows the supply of medicines that are not licensed for animals (e.g. if there is no licensed alternative)

It is unlawful to supply a human medicine (including GSL and P) against a veterinary prescription unless it is prescribed by a veterinary surgeon and specifically states that it is ‘for administration under the Cascade’, or other wording to this effect.

Need a written prescription (verbal request will not suffice)

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33
Q

Does a pharmacist have to be physically present during the sale of a POM-V/POM-VPS/NFA-VPS medicine?

A

Yes unless the transaction has been individually authorised in advance

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34
Q

When a medicine is being dispensed under the veterinary cascade, what should be on the label?

A
  • Name of the prescribing veterinary surgeon
  • Name and address of the animal owner
  • Name and address of the pharmacy
  • Identification and species of the animal
  • Date of supply
  • Expiry date of the product
  • The name or description of the product or its active ingredients and content quantity
  • Dosage and administration instructions
  • If appropriate, special storage instructions
  • Any necessary warnings for the user (e.g. relating to administration, disposal, target species, etc)
  • Any applicable withdrawal period (i.e. The time between when an animal receives a medicine and when it can safely be used for food)
  • The words: ‘For animal treatment only’
  • The words: ‘Keep out of reach of children’.
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35
Q

What do accountable officers do?

A

Responsibility for supervising and managing the use of Controlled Drugs in their organisation or setting.

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36
Q

What are the two sub-classes of CD 4s?

A

Part 1- mostly benzos

Part 2- anabolic and androgenic steroids

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37
Q

With regards to CDs, what classes require a license to import and export?

A

1 , 2, 3

4 (unless for self-administration)

5 - no

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38
Q

With regards to CDs, what classes require invoices to be retained for 2 years?

A

2- No (has CD register)

3- Yes

4- No

5- Yes

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39
Q

When the MEP states repeatable prescriptions, what is it referring to?

A

Where the prescriber adds an instruction on the main prescription for the prescribed item to be repeated,e.g. repeat x 3. This does not refer to the prescription counterpart which is sometimes used as a patient repeat request to the prescriber.

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40
Q

Can a prescriber on an NHS prescription indicate “repeat x times”?

A

No- usually used on private prescriptions

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41
Q

Who supplies the licenses to possess and supply controlled drugs?

A

Home Office

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42
Q

What are the two exemptions of pharmacists possessing Schedule 1 drugs?

A
  1. For the purpose of destruction (if the patient does not agree, contact police)
  2. For the purpose of handing over to a police officer

The patient’s confidentiality should be maintained unless the quantity is so large it cannot just be for personal use

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43
Q

What is the advice if a patient on controlled drugs and is travelling?

A

Personal license not required by the Home Office if they are carrying less than 3 months worth
It is advised they carry a covering letter signed by prescriber including travel plans, name, quantity, dose

They should also check they are complying with the countries’ regulations that they are going to

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44
Q

What are the requisition requirements for CD 2 and 3 drugs and what places are exempt from this?

A

Need to use approved forms

Requisitions should be in writing (not faxed/photocopied) before delivery

Hospices and prisons are exempt from this requirement

If the request is within a hospital setting for a ward/department within the same legal entity, an approved form is not required

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45
Q

What are the legal requirements for a controlled drug requisition?

A 
1.  Signature of the recipient
2 Name of the recipient
3 Address of the recipient
4 Profession or occupation
5 Total quantity of drug
6 Purpose of the requisition
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46
Q

CD requisitions:

In an emergency, can a doctor/dentist be supplied with a CD 2 or 3 drug without a CD requisition?

What must be supplied and within what time frame?

A

Yes but the requisition needs to be supplied within 24 hours (failure to do so is an offence on behalf of doctor/dentist)

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47
Q

What is an FP10CDF form?

A

Requisition form for CD 2 and 3 for private supplies

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48
Q

What is an FP10GP10A form?

A

Requisition form for CD 2 and 3 for NHS supplies

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49
Q
  1. When you receive a CD 2 or 3 requisition, what should you legally do?
  2. What are the exceptions to this?
A
  1. Mark the requisition indelibly with name and address of supplier e.g. name of pharmacy

Send the original requisition to the relevant NHS agency

Good practice- retain a copy for 2 years

  1. Exceptions- if the supply is made by a person dispensing at a hospital, care home, hospice, prison
    - By pharmaceutical manufacturers or wholesalers
    - Veterinary requisitions
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50
Q

A midwife may use a midwife supply order to obtain what 3 controlled drugs?

A
  1. Diamorphine
  2. Morphine
  3. Pethidine
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51
Q

Can advanced electronic signatures be accepted for CD 2 and 3 drugs?

A

Yes where the electronic prescribing service (EPS) is used

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52
Q

Does the strength of a medicine always need to be on a prescription?

A

If there is more than one strength available, yes

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53
Q

What does the quantity on a CD 2 and 3 prescription need to be written as?

A

Words and figures

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54
Q

What does the DOH recommend that the maximum prescribed quantity of Schedule 2, 3 and 4 drugs on one prescription (in terms of days)?

Is this a legal restriction?

A

30 days

Not a legal restriction but prescribers should be able to justify the quantity requested

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55
Q

If a patient is homeless, what should you put in the address section on a prescription?

A

No fixed abode

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56
Q

When a controlled drug prescription is written by a dentist, what phrase must be present?

A

“For dental treatment only”

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57
Q

When a controlled drug is supplied, it is a requirement to mark the prescription with what?

A

Date and time of supply

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58
Q

True or false:

Sugar free products have a greater potential for abuse, so the RPS advises that these are only supplied when specifically prescribed

A

True

Page 97 of MEP

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59
Q

Would the instructions “as directed” be acceptable on a controlled drug prescription?

A

No

“One as directed” would be acceptable however

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60
Q

If a woman of child bearing age is on valproate, do they have to be on the pregnancy prevention programme?

A

Yes- Government warning came in April 2018 stating they should not be prescribed it unless on PPP

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61
Q

True or False:

For instalment prescriptions, there is approved wording set out by the Home Office

A

True

1 Please dispense instalments due on pharmacy
closed days on a prior suitable day.
2 If an instalment’s collection day has been
missed, please still dispense the amount due for
any remaining day(s) of that instalment.
3 Consult the prescriber if three or more
consecutive days of a prescription have been
missed.
4 Supervise consumption on collection days.
5 Dispense daily doses in separate containers

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62
Q

For CD 2 and 3 prescription, if either the words or figures (but not both) of the quantity has been omitted, can a pharmacist amend this?

A

Yes- should mark the prescription to show amendment has been made

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63
Q

If there is a minor typographical error/spelling mistake on a CD 2/3 prescription, can a pharmacist amend this?

A

Yes- should mark the prescription to show amendment has been made

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64
Q

For CD 2/3 prescriptions, can a pharmacist amend a date, dose, form or strength?

A

No

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65
Q

True or false:

Private CD 2/3 prescriptions must be written on standardised forms

A

True

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66
Q

If a hospital is dispensing a private CD 2/3 prescription within the same legal entity, is a standardised form required?

A

No

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67
Q

What must you have on a private CD prescription to identify the prescriber and what is it?

A

A prescriber identification number must be
included on standardised private prescriptions.
This number is not the prescriber’s professional registration number (i.e. the GMC number).
It is a number issued by the relevant NHS agency and the prescriber can obtain it from their local primary care organisation

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68
Q

Do vet CD prescriptions need to be written on a standardised private CD form?

A

No

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69
Q

If a healthcare professional is picking up a CD2 on behalf of a patient, what is required?

A

Name of HCP
Address of HCP
Identity required - if they do not have identity, it is up to discretion of pharmacist

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70
Q

If a drug misuser wants a representative to collect a CD on their behalf, what are pharmacists advised to do?

A

Obtain a letter
from the drug misuser that authorises and names the representative. (This includes those detained
in police custody who should supply a letter of authorisation to a police custody officer to present to the pharmacist)

A separate letter should be obtained each time and the record of supply should be included about the representative in the CD register

71
Q

If a CD script is meant to be supervised but a representative with a consent letter from the patient turns up to the pharmacy, what should you do?

A

You should contact the prescriber before the medicine is supplied to
the representative – since supervision will not be possible. It is legally acceptable to confirm verbally with the prescriber that they are happy with this arrangement since supervision, while important, is not a legal requirement under the 2001 Regulations.

It would not be necessary to contact
the prescriber if the person has been detained in police custody and the representative collecting the dose is a police custody officer

72
Q

Does phenobarbital require safe custody?

A

No

73
Q

Does tramadol require safe custody?

A

No

74
Q

What drugs need to be kept under safe custody?

A

Schedule 1
Schedule 2
Schedule 3
There are some exemptions e.g. tramadol

75
Q

Does safe custody apply to returned CDs from patients?

A

Yes until destroyed

76
Q

What controlled drug schedules need to be denatured before disposal?

A

Schedules 1, 2, 3 and 4 (part 1)

77
Q

What is the difference between destroying CDs that are pharmacy stock, and that are returned POMs?

A

Pharmacy stock needs a witness by authorised person for CD2 whereas returned POMs do not - however it is preferable for denaturing to be witnessed by another staff member

78
Q

For patient returned CDs, should a record be made when destroying them?

A

A record should not be made in the Controlled Drugs register but records of patient- returned Schedule 2 Controlled Drugs and their subsequent destruction should be recorded in a separate record for this purpose

79
Q

Do you need an authorised witness when destroying CD unwanted stock/patient returned expired stock?

A

Yes if schedule 2

Good practice for schedule 3

80
Q

Do you need to make a record when destroying CD unwanted stock/patient returned expired stock?

A

Yes in the CD register for CD2 drugs

81
Q

In community pharmacy, only CD2s are entered into the register. How does this advice differ in prisons?

A

It is recommended to maintain a robust audit trail of Schedule 3 and 4 drugs

82
Q

True or false:

An accountable officer has the power to authorise other persons to witness the destruction of Controlled Drugs.

A

True

83
Q

Can an accountable officer be an authorised witness person?

A

No

84
Q

What is the advice regarding capsules and tablets before adding them to a CD denaturing kit?

A

Grind or crush them

85
Q

What is the advice regarding CD liquids, ampoules and vials when denaturing them?

If the ampoules contain powder, what should you do?

A

Pour into CD denaturing kit

Add water to the powder to dissolve it and then pour into CD denaturing kit

86
Q

What is the advice regarding CD patches when destroying them?

A

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

87
Q

What is the advice regarding CD aerosols when destroying them?

A

Expel into water and dispose of the resulting liquid into CD denaturing kit

88
Q

Pharmacists are required to keep a register for CD 2 drugs. What additional drug needs to have a record?

(Hint- schedule 4 part 1)

A

Sativex (cannabis-based medicine)

89
Q

How long should a CD register be kept for?

A

2 years from date of last entry

90
Q

Can you have an electronic CD register?

A

Yes

91
Q

How often should CD stock be checked?

A

At least once a week (could be less frequent based on risk assessment)

92
Q

If a product says “Use by 6/2019” what does this mean?

A

The product should not be used after 31st May 2019

93
Q

If a product has an expiry date of 6/2019, when should the product be used?

A

Should not be used after 30th June 2019

94
Q

When would there be exceptions to not dispensing a medicine in child-resistant packaging?

A

Patient request e.g. if they have difficulty opening it

Original pack is not child resistant and it is not possible to change it

95
Q

Can a child collect a prescription on someone else’s behalf?

What about a CD2 drug?

A

Yes but need to use professional judgement regarding maturity of child, reason for collection, understanding counselling points

Should get identification for CD2 drugs but a child may not have this. Use professional judgement

96
Q

Children under what age are legally too young to consent to any sexual activity?

A

Under 13 years

97
Q

In terms of driving, when can a statutory medical defence be raised?

A

When the driver has been taking a prescribed drug on the list of specified drugs (e.g. morphine, diazepam) but driving is not impaired

If driving is impaired, it can lead to an offence

98
Q

What is the Pharmacy record and what do you record in it?

A

Legal document to show who is the responsible pharmacist at any one time
(including GPhC number, date and time)
Also includes absence details

99
Q

How long must you keep the Pharmacy record for (records responsible pharmacist info)?

A

5 years

100
Q

How long can the responsible pharmacist be absent for?

A

Max of 2 hours in 24 hour period

101
Q

If there is more than one responsible pharmacist in 24 hours, what can the total hours absent be?

A

2 hours

102
Q

What are the required arrangements if the responsible pharmacist is absent?

A

They must remain contactable

If they cannot, then they must arrange for another pharmacist to be contactable and available for advice

Needs to record absence in Pharmacy record

103
Q

Can a pharmacy receive patient returned medicines if there is no RP and what is the exception?

A

Yes apart from CDs

104
Q

How do you dispose of used methadone bottles?

A

Once a methadone bottle is emptied as far
as possible, bottles can be rinsed and the liquid added to a denaturing kit and treated
as pharmaceutical waste.

Empty container is then disposed of into the recycling or general waste

105
Q

How would you destroy solid dosage form CDs?

A

Grind or crush the solid dose formulation before adding to the CD denaturing kit to ensure that whole tablets or capsules are not retrievable

The resulting mixture may then be poured onto an appropriate amount of suitable product and added to an appropriate waste disposal bin

If a CD denaturing kit is not available - mix it with warm soapy water

106
Q

How would you destroy liquid dosage form CDs?

A

Pour into a CD denaturing kit e.g. DOOP kit

If this is not available, pour into a suitable product then add to an appropriate waste disposal bin

107
Q

How would you destroy ampoules and vials if they contain CDs?

i) Liquid containing vials
ii) Powder containing vials

A

i) For liquid containing ampoules, open the ampoule and empty the contents into a CD denaturing kit
Dispose of ampoules into sharps bin

ii) For powder containing ampoules, open the ampoule and add water to dissolve the powder inside. The resulting mixture can be poured into the CD denaturing kit and the ampoule disposed of as sharps pharmaceutical waste

108
Q

How would you destroy patches that are CDs?

A

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

109
Q

How would you destroy aerosol products containing CDs?

A

Expel into water and dispose of the resulting liquid in accordance with the guidance on destroying liquid formulations

110
Q

For MDA (methadone) scripts, what is the maximum number of days you can prescribe on one script?

A

14 days

111
Q

If a patient came into the pharmacy with a prescription for:

Levothyroxine 25 mcg
Levothyroxine 50 mcg

How many charges would this be?

A

1 charge as same drug and formulation

112
Q

If a patient came into the pharmacy with a prescription for:

Amoxicillin 500mg caps
Amoxicillin 250/5mL solution

How many charges would this be?

A

2 charges as different formulations

113
Q

True or false:

The duty of confidentiality still applies after the person has died

A

True

114
Q

In what situations would you not need the person’s consent to share their information?

A

• Disclosure is required by law, or
• the disclosure can be justified in the
public interest1, or
• To do so is impracticable, would put the pharmacy professional or others (including the person receiving treatment or care) at risk of serious harm, or would prejudice the purpose of the disclosure, for example to prevent a crime

However, only disclose the necessary information required

Make a record about the details of the disclosure

115
Q

When gaining consent from a patient about disclosing confidential information, what 4 things should you ensure the patient understands?

A
  • What information will be disclosed
  • Why it will be disclosed
  • Who it will disclosed to
  • Consequences of disclosing and not disclosing information
116
Q

What organisation can provide advice regarding guidance on data protection legislation?

A

ICO

117
Q

What are the two types of consent?

A

Explicit/express

Implied

Pharmacists should use their professional judgement to decide what kind of consent to get

118
Q

True or false:

People with capacity can withdraw their consent at any time

A

True

119
Q

For a patient to have capacity and to be able to make an informed decision, what 4 things must they be able to do?

A
  • Understand the information provided
  • Remember the information provided
  • Use and weigh up the information provided
  • Communicate their decision to the pharmacy professional (by any means).
120
Q

True or false:

If a person lacks capacity to make a certain decision, it is assumed they do not have capacity to make any decisions

A

False

Pharmacy professionals must not assume that because a person lacks capacity on one occasion, or in relation to one type of service, that they lack capacity to make all decisions

121
Q

What is the target number of MURs each year in community pharmacy?

A

400

122
Q

How many CPD entries do you have to do a year to revalidate?

A

4

2 must be planned learning activities

123
Q

What do you have to submit each year to revalidate as a pharmacist from end of 2019 onwards?

A

4 CPD records (2 must be planned learning activities), a peer discussion record and a reflective account record.

in 2018, was 4 CPDs

124
Q

What is the recommended number of days to be prescribed for a CD script on a vet prescription vs a human prescription?

A

Good practice to prescribe 28 days worth of treatment vet prescriptions for all CDs- unless in situations of long term treatment e.g. epilepsy

For human prescriptions- recommended max of 30 days for CD 2,3,4 (over this amount must be justified by the prescriber)

125
Q

What are the 4 steps of the veterinary cascade when choosing a medicine to dispense?

A
  1. SUPPLY A LICENSED VETERINARY MEDICINE

if not possible

  1. AN EXISTING LICENSED VETERINARY MEDICINE FOR ANOTHER SPECIES OR DIFFERENT CONDITION CAN BE CONSIDERED

if not possible

  1. A LICENSED HUMAN MEDICINE OR AN EU-LICENSED VETERINARY MEDICINE CAN BE CONSIDERED

if not possible

  1. EXTEMPORANEOUS OR SPECIALLY MANUFACTURED MEDICINES CAN BE CONSIDERED
126
Q

If a veterinary surgeon has told the animal owner to purchase a human medicine for their pet, would you be able to do sell this?

A

No- it has to be prescribed under the veterinary cascade

127
Q

What must be present on a midwife supply order for CDs?

A

• Name of the midwife
• Occupation of the midwife
• Name of the person to whom the Controlled Drug is to be administered or supplied
• Purpose for which the Controlled Drug is required
• Total quantity of the drug to be obtained
• Signature of an appropriate medical officer
– a doctor authorised (in writing) by the local supervising authority or the person appointed
by the supervising authority to exercise supervision over midwives within the area

128
Q

What are the MHRA checkpoints for accuracy checking a prescription?

A 
Right medicine
Right patient
Right dose
Right route
Right time
129
Q

A mother approaches you and asks for a spacer for her five year old son because his has broken. What would be the most appropriate course of action?

A

Sell the mother a spacer

A spacer is a medical device not a medicine. Therefore there are no restrictions on the sale of the spacer.

130
Q

How long should the responsible pharmacist record be kept for?

A

5 years

131
Q

How long should the CD register be kept for?

A

2 years

132
Q

How long should you keep a signed order?

A

2 years

133
Q

How long should you keep private prescriptions?

A

2 years

134
Q

If the responsible pharmacist absence exceeds 2 hours, can the pharmacy still be open?

A

No- after the 2 hours in 24 hours, the pharmacy must close if the pharmacist needs to be absent

135
Q

You are stuck in traffic on the bus on the way to work and will be late. Your pharmacy has an electronic responsible pharmacist register that allows you to log in remotely.

Are you allowed to do this so the pharmacy can open?

A

Yes if you feel confident in doing so

136
Q

Is the quantity on a prescription a legal requirement for non CD scripts?

A

No

137
Q

A patient brings in a script during GP opening hours to community pharmacy

What should you do if a non-CD script does not have a quantity on it?

A

Contact the prescriber for guidance and add a ‘PC’ endorsement to the prescription

138
Q

A patient brings in a script (GP is closed) to community pharmacy

What should you do if a non-CD script does not have a quantity on it?

A

If cannot contact prescriber, supply enough for 5 days of treatment only and endorse “PNC”

139
Q

What is the maximum interval your responsible pharmacist should leave for reviewing pharmacy procedures?

A

2 years

140
Q

Can CD2 drugs be repeated on a prescription?

A

No

141
Q

Can CD3 drugs be repeated on a prescription?

A

No

142
Q

Can CD4 drugs be repeated on a prescription?

A

Yes

143
Q

How long should the following be retained:

An invoice for a Schedule 3 CD taking account of tax.

A

6 years

Although the law relating to CDs requires the invoices to be retained for 2 years (as per the BNF advice), the law relating to tax requires the invoices to be kept for 6 years (as per SPS advice).

144
Q

What is the first date you could supply the following prescription?

An NHS prescription for amoxicillin capsules 250 mg signed 1 May 2019, with the words “supply on 10 May” in the body of the prescription

A

10th May

For an NHS prescription, the appropriate date is the LATER of either the date on which the prescription was signed or a date indicated by the appropriate practitioner as the date before which it should not be dispensed.

145
Q

What is the first date you could supply the following prescription?

A private prescription for amoxicillin capsules 250 mg signed 1 May 2019, with the words “supply on 10 May” in the body of the prescription.

A

1st May

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

146
Q

A prescription which is hand written by a German doctor registered in Germany as he stands in your pharmacy for amoxicillin. Can you dispense this?

A

Do NOT dispense the prescription, the prescriber is not allowed to prescribe whilst in the UK
EEA and Swiss prescribers can only prescribe whilst in the country they are registered in. They can not prescribe in the UK unless also registered with the GMC.

147
Q

You receive an NHS prescription for a Schedule 2 controlled drug. The prescription is signed on 6 March 2019. The prescriber has written in the body of the prescription “Supply on 10 April”.

What is the last date you can dispense this prescription?

A

28 days from 10th April

The appropriate date of a NHS CD prescription is either the signature date or the date indicated by the prescriber as a date before which the medicine should not be supplied, whichever is the later. The 28 day validity of a CD prescription runs from the appropriate date.

148
Q

Out of the 4 CPDs you have to do to revalidate, how many of them should be planned learning?

A

2

149
Q

Does midazolam require safe custody?

A

No

150
Q

Does temazepam require safe custody requirements?

A

Yes

151
Q

Does buprenorphine require safe custody requirements?

A

Yes

152
Q

What are the two types of conflict of interest?

A

Actual and potential

153
Q

What gender is finasteride contraindicated in?

A

Women

154
Q

True or false:

A no culture blame is encouraged in Pharmacy

A

False

A “right or just culture” is needed - based on fairness, transparency, learning from mistakes

155
Q

Who do you report safety incidents to?

A

NRLS - National reporting and learning system

156
Q

OTC is a collective term for what categories of medicines?

A

P and GSL

157
Q

On prescriptions, if it states “repeat x times”, when must the first dispensing be done?

What about controlled drugs?

A

Within 6 months (following this no time limit)

CD2 and 3 are not repeatable

CD4 within 28 days (following this no time limit)

158
Q

Supplementary prescribers can prescribe what?

A

Items under a clinical management plan

In partnership with an independent prescriber - doctor or dentist

159
Q

Can optometrist independent prescribers prescribe CDs?

A

No

160
Q

Can optometrist independent prescribers authorise emergency supplies?

A

Yes

161
Q

Can EEA prescriptions have unlicensed meds?

A

No

And can only prescribe medicines that have a MA in the UK

162
Q

On vet prescriptions, is “as directed” suitable directions?

A

No

163
Q

What must it state on CD2 and 3 vet prescriptions?

A

“The item has been prescribed for an animal or herd under the care of a vet”

164
Q

Are vet prescriptions repeatable?

A

Yes

165
Q

Do CD2 and 3 vet prescriptions need to be written on a standardised form?

A

No

166
Q

Do CD2 and 3 vet prescriptions need to be submitted to the relevant NHS agency?

A

No - but prescription should be retained for 5 years

167
Q

True or false:

Pharmacies that supply POM-V and POM-VPS must undertake an annual audit

A

True

168
Q

Approved CD requisition forms must be used for CD2 and 3 drugs except if the request is from what two places?

A

Hospice

Prison

169
Q

Does a controlled drug requisition need to have the patient’s name on?

How does this differ from a midwife supply order for CD (morphine, pethidine, diamorphine)?

A

No

Midwife supply order needs to have the patient name

170
Q

On CD scripts, is it recommended that multiple strengths of the same medicine are prescribed separately?

A

Yes

171
Q

Do “in house” pharmacy prisons need to be registered with the GPhC?

A

No

172
Q

What logo is compulsory if selling medicines online via internet pharmacy?

What logo is voluntary?

A

EU internet logo is compulsory - apply to the MHRA for it

GPhC logo is voluntary

173
Q

Can an emergency supply be made at the request of an EEA patient?

A

Yes

174
Q

A Scottish lady asking for a emergency dutasteride for her husband who has taken his last tablet this morning.

What should you do?

A

Need to speak to the patient

Emergency supply at the request of a patient requires interviewing the patient

Exam 2019 (21 decks)

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