OptoP: Ocular prescriptions - Week 5

Question 1

What are the roles of optometrists? (4)

Answer 1

Optometrists are an arm of primary care that can:
Refract the eye
Test vision
Detect eye, brain and systemic disease
use medical substances (s4) to treat eye disease

Question 2

What financial scheme is optometry a part of? (2)

Answer 2

Medicare (MBS) and Pharmaceutical Benefits Scheme (PBS)

Question 3

What are the medicare obligations of optometrists (5)

Answer 3

provide refractive and BV service + correction
screen and diagnose eye disease (e.g. glaucoma)
detect ocular manifestations of systemic disease (e.g. diabetes)
detect brain disorders with eye/vision involvement
treat disease with meds (PBS) as appropriate or refer for surgical intervention

Question 4

What act in Victoria governs all dealings with drugs and poisons? (e.g. their manufacture, possession, prescription, supply, storage, use, etc.)

Answer 4

Drugs, Poisons and Controlled Substances (DPCS) Act 1981

Question 5

What does Drugs, Poisons and Controlled Substances Regulations 2017 specify?

Answer 5

schedules of drugs and poisons (schedules 2-9) that categorise ALL pharmaceutical agents

Question 6

What are S2 drugs?

Answer 6

Drugs for shelf preparations (e.g. can find in supermarket, pharmacy on the shelves)

Question 7

What are S3 drugs?

Answer 7

OTC (over-the-counter) preparations at a chemist (restrictions enforced by chemist)

Question 8

What are S4 drugs?

Answer 8

therapeutic drugs that MUST BE PRESCRIBED (toxicity basis to prescribing)

Question 9

What are S8 drugs?

Answer 9

drugs of addiction (special procedures)

Question 10

Can drugs move between schedules?

Answer 10

Yes. Given a proper reason they can

Question 11

What specifies the list of S4 drugs optometrists can use?

Answer 11

Optometry Board of Australia (OBA)

Question 12

How long are prescriptions valid?

Answer 12

12 months

Question 13

What 9 features should an optometry prescription contain?

Answer 13

1. Prescriber details: name, address, telephone
2. Therapeutic endorsement number
3. Name+Address of Px
4. Date when written
5. Handwritten prescriber signature
6. The particulars of the drug being supplied
7. Instructions for use
8. Number of repeats
9. Get authority for restricted or authority ONLY Meds (PBS)

Question 14

What particulars of the drug being supplied should be included in an optometry prescription? (4)

Answer 14

Name, formulation (e.g. drops or ointment) and conc.
Sometimes good idea to write generic name
Pharmacist can supply cheapest option for Px
Must specify brand if wish specific brand

Question 15

What does RPBS stand for?

Answer 15

Repatriation Pharmaceutical Benefits Scheme

Question 16

As a prescriber, what happens if you run out of forms? (2)

Answer 16

A prescriber may telephone a pharmacist and ask that a PBS prescription be supplied. He/she must forward a written PBS prescription and duplicate to the pharmacist within 7 days of the date of supply

Question 17

Explain the following abbreviations:
- BE
- Gutt (or gtt)
- Oc
- Collyr (or Coll)

Answer 17

BE = both eyes
Gutt = eye drops
Oc = eye ointment
Collyr = eyewash

Question 18

Explain the following abbreviations:
- ad (or mdu)
- m (or mane)
- n (or noct)
- h

Answer 18

ad = as directed
m = in the morning
n = at night
h = an hour

Question 19

Explain the following abbreviations:
- stat
- qd
- qod
- qqh (or q4h)

Answer 19

stat = immediately
qd = every day
qod = every other day
qqh (or q4h) = every 4 hours

Question 20

Explain the following abbreviations:
- bid
- tid
- qid

Answer 20

bid = 2x a day
tid = 3x a day
qid = 4x a day

Question 21

Explain the following abbreviations:
- Rpt 2
- PRN
- q
- po

Answer 21

Rpt 2 = supply 2 repeats
PRN = when necessary
q = every
po = by mouth

Question 22

Explain the following abbreviations:
- sig
- sol
- susp
- ung

Answer 22

sig = label (directions)
sol = solution
susp = suspension
ung = ointment

Question 23

Explain the following abbreviations:
- qhs
- qpm
- qam

Answer 23

qhs = at bedtime nightly
qpm = at night
qam = every morning

Question 24

How are the generic names of drugs created?

Answer 24

They are the name of the active pharmaceutical compound

Question 25

What does compounding of medicines mean?

Answer 25

Compounding means making up a medicine from raw ingredients

Question 26

Why might pharmacists “compound” medicines? What can this achieve? (7)

Answer 26

Unique medicine strength/dosage
An experimental drug that may be needed for research purposes
Different drug form (i.e. change administration method)
For unavailable medications
Remove medicine taste (some px’s don’t like the taste)
Allergy (removing allergic additives)
Veterinary compounding: dose variation based on pet size

Question 27

Why should we care about patient’s finding their medication tastes bad?

Answer 27

Issues with compliance, and general dissatisfaction of patient, particularly for chronic medication use.

Question 28

Are optometrists permitted to sell or dispense S4 drugs?

Answer 28

NO!!! (we can only use them)

Question 29

How should drugs be stored?

Answer 29

in accordance with DPCS act 1991 (in a locked cabinet)

Question 30

How long should records of drug stock be kept?

Answer 30

records should be retained for 3 years

Question 31

What 3 broad categories do pharmaceutical benefits in the schedule fall under?

Answer 31

Unrestricted benefits: have no restriction on their therapeutic uses
Restricted benefits: can only be prescribed for specific therapeutic uses
Authority required benefits: are restricted benefits that require prior approval from the department of Human Services or the DVA

Question 32

Is PBS always cheap?

Answer 32

No