PAMS Flashcards
What are the types of ‘Emergency Supply’?
(1) Patient
(2) Prescriber
(PATIENT REQUESTED EMERGENCY SUPPLY)
Does the medication have to have been previously prescribed?
Yes. The medication must have been prescribed before.
(PATIENT REQUESTED EMERGENCY SUPPLY)
What is the maximum treatment duration?
30 days.
(PATIENT REQUESTED EMERGENCY SUPPLY)
Which controlled drugs can be dispensed?
CD4 and CD5 only.
Phenobarbital (CD3) can be dispensed ONLY for the indication of epilepsy.
(PATIENT REQUESTED EMERGENCY SUPPLY)
What is the maximum duration of treatment for a CD4 or CD5?
5 days treatment for CD4 and CD5.
CD2 and CD3 cannot be prescribed at patient’s request. (UNLESS PHENOBARBITAL FOR EPILEPSY)
(PATIENT REQUESTED EMERGENCY SUPPLY)
Is a POM register required? If so, when must it be completed by?
Yes.
POM register must be completed on the same or following day.
(LEGAL REQUIREMENT)
(PATIENT REQUESTED EMERGENCY SUPPLY)
What words must be written on the label?
“EMERGENCY SUPPLY”
When should a reference number be included on the label?
When a POM Register is required - Should also be included with the price.
(UNLESS NHS + EXEMPT)
(PRESCRIBER REQUESTED EMERGENCY SUPPLY)
What does the pharmacist need to confirm with the prescriber?
That the prescriber will provide a prescription within 72hrs (LEGAL REQUIREMENT)
(PRESCRIBER REQUESTED EMERGENCY SUPPLY)
What are considered ‘relevant prescribers’?
(1) Doctors
(2) Dentists
(3) Supplementary prescribers
(4) Community Nurse Prescriber
(5) Independent Nurse Prescriber
(PRESCRIBER REQUESTED EMERGENCY SUPPLY)
What must the prescriber do within 72 hours of the emergency request?
Prescriber must supply a prescription within 72 hours of emergency request.
(LEGAL REQUIREMENT)
(PRESCRIBER REQUESTED EMERGENCY SUPPLY)
What controlled drugs are able to be dispensed following an emergency request?
CD4 and CD5 only.
Phenobarbital (CD3) can be dispensed, ONLY if to treat epilepsy.
(PRESCRIBER REQUESTED EMERGENCY SUPPLY)
Is a POM Register required?
Yes.
LEGAL REQUIREMENT
(PRESCRIBER REQUESTED EMERGENCY SUPPLY)
Does the pharmacist need to check if the emergency supply is NHS/ private?
Yes.
Pharmacist needs to know if patient is exempt (NHS ONLY)
(1) How many types of prescription forms are there?
(2) What colours are they?
(1) 5 different prescription forms.
(2) Green, yellow, lilac, grey, and pink
What does the phrase ‘RD’ mean?
‘RD’ indicates a repeat dispensing form. This is NOT a prescription.
What does the phrase ‘RA’ mean?
‘RA’ is a repeat authorisation form.
What is the code for a green Rx form?
FP10SS
What is the code for a yellow Rx form?
FP10D
What can be prescribed on a yellow Rx form and who can prescribe using this form?
Only items that are in the Dentists’ Formulary.
Dentists.
Can dentist’s prescribe branded products?
Yes, they can prescribe any branded equivalent.
But they are advised to prescribe generically.
Can pharmacists dispense blacklisted drugs?
No.
Where can blacklisted drugs be found?
In section XVIIIa in the Drug Tariff.
Who can prescribe on a lilac Rx form?
Independent nurse prescribers and supplementary prescribers.
What can independent nurses and supplementary prescribers prescribe?
Any drug from the BNF.
What can a community nurse prescribe?
Only drugs in the Nurses’ Formulary.
What are FP10P-REC Rx forms?
Out of hours prescriptions. These items are supplied directly to the patients.
What is the layout of a private prescription and what are the requirements?
There is no standardised layout for a private Rx.
The requirements are the same as those for an FP10SS Rx.
How much does the pharmacist charge a patient for a private prescription?
The pharmacy can charge any amount for a private Rx.
Is a FP10SS form sent or retained after the item has been dispensed?
Sent to NHSBSA services at the end of the month.
Is a FP10D form sent or retained after the item has been dispensed?
Sent to NHSBSA services at the end of the month.
Is a FP10PN form sent or retained after the item has been dispensed?
Sent to NHSBSA services at the end of the month.
Is a private Rx form sent or retained after the item (POMs only) has been dispensed?
Script should be retained for 2 years.
When should a pink form be used?
For a private prescription for CD2 and CD3 drugs.
What should happen to a pink Rx form after the item has been dispensed?
Sent to NHSBSA at the end of the month.
Where should a reference number be found, when it applies?
(1) On POM/ CD register
(2) On Rx, by pharmacy stamp - with price
(3) On drug label
(ONLY APPLIES WHEN A POM REG IS LEGALLY REQUIRED)
What are the FP10 Rx legal requirements?
(1) Age (+DOB if <12yrs)
(2) Patient name + address
(3) Prescriber signature
(4) Date of prescription
(5) Prescriber address and type of prescriber
(6) CDID number if a private CD
What are the FP10 Rx contractual requirements?
(1) Pharmacy stamp
(2) Ref. number + price (if POM or CD)
(3) Number of items on Rx
(4) Endorsements
(5) FP10D - only dental formulary
(6) FP10PN - only nurses formulary
When do you endorse?
(1) If item is branded
(2) If >1 pack size available
(3) If quantity is not clearly stated
(4) If item is a CD
What medicine details are required on a FP10 Rx?
(1) Drug name
(2) Dose
(3) Strength
(4) Form
(5) Quantity - in words + figures for CD
How many times can a ‘repeat x3’ form be dispensed in total?
4 times.
Once for original script and 3 repeats.
If number of repeats is not stated, how many times can it be dispensed in total? What is the exception to this?
Twice. Once for original script and once for a repeat.
Oral contraceptives can be dispensed 6 times in total.
How soon must POM Register entries be made?
On the same/ following day.
How long must a POM Register be kept?
POM Registers must be retained for 2 years.
What are the register requirements for CD2 drugs on an FP10?
CD Register - Legal
POM REG NOT REQUIRED FOR NHS CD2
What are the register requirements for CD3 drugs on an FP10?
No register requirements.
NO REG REQUIREMENTS FOR NHS EXCEPT CD2
What are the 3 POM Register headings?
(1) Date supplied
(2) Date dispensed
(3) Details
What details are required on a POM Register?
(1) Patient name + address
(2) Prescriber name + address
(3) Drug name, dose, strength, quantity, form
(4) Reference number - also on label and Rx
(5) Price - also on Rx
Why are CD1 drugs rarely prescribed?
They are recognised as having no therapeutic value.
What register requirements do CD2 drugs have on a private prescription?
CD Register - Legal
POM Register - Good practice for private CD2 drugs
How long is a CD2 Rx valid for?
28 days - maximum 30 days supply.
What types of supply are not permitted for CD2?
(1) Emergency supply
(2) Repeat prescribing
What register requirements do CD3 drugs have for (1) NHS forms and (2) private forms?
(1) No register requirements for FP10
1) POM Reg for private (LEGAL REQUIREMENT
Is emergency supply allowed for a CD3?
No. Unless for the treatment of epilepsy with phenobarbital (CD3).
What types of supply are not permitted for CD3?
(1) Emergency supply only permitted for phenobarbital for epilepsy.
(2) Repeat prescribing.
Are CD3 scripts sent or retained for (1) NHS, (2) private, and (3) veterinary?
(1) NHS are sent to NHSBSA services at end of month.
(2) Private are sent to NHSBSA services at end of month.
(3) Veterinary CD3 are retained for 5 years - as with all vet scripts.
How many types of CD4 drugs are there?
2 types.
(1) Benzodiazepines - CD4-1
(2) Androgenic + anabolic steroids - CD4-2
Which controlled drugs have to be kept in the CD cabinet?
CD1, CD2, and CD3.
CD4 and CD5 are not required to be kept in CD cabinet.
Do CD4 drugs require a CD register entry?
No.
What types of supply are not permitted for CD4?
None.
Repeat prescription is allowed.
Emergency supply is allowed - Max. 5 days supply
(1) Which CD schedule are lowered doses of CD2 drugs?
(2) Name some examples
(1) CD5.
(2) Such as codeine/ morphine.
Which type of CDs are available OTC?
Some CD5 only.
How long are the scripts of each of the CD schedules valid for?
(1) CD2
(2) CD3
(3) CD4
(4) CD5
(1-3) CD2, CD3, CD4 - 28 days only.
(4) CD5 - 6 months.
What extra information is required on the prescription from the prescriber for private controlled drugs?
(1) Quantity in words and figures (LEGAL REQUIREMENT)
(2) CDID number of the prescriber for private CD (LEGAL REQUIREMENT).
This must also be stated on the CD/ POM register.
What different categories of Veterinary prescriptions are there?
(1) POM-V
(2) POM-VPS
(3) NFS-VPS
(4) AVM-GSL
(5) SAES
What must the Rx for a POM-V CD state?
Prescribed for an ‘an animal/ herd under his/ her care’
Who can prescribe a POM-V?
Veterinary surgeon or pharmacist
What type of Rx is required for a POM-VPS?
(1) Written/ oral prescription
(2) Written is ONLY required if prescriber is not the supplier.
What is an NFA-VPS?
Medicines for a non-food animal.
What type of Rx is required for a NFA-VPS?
Written Rx is not required, oral ONLY.
What are the register requirements for POM-V, POM-VPS, and CD3?
POM Register - LEGAL
Are POM-V, POM-VPS, and CD3 prescriptions sent or retained after being dispensed?
Scripts should be retained for 5 years.
Applies for all veterinary prescriptions
Where can AVM-GSL drugs be obtained?
Petshops, supermarkets, or online.
There is no restriction/ advice for AVM-GSL drugs.
What are SAES?
SAES are exempt medicines for specific species.
Species include: Ferrets, aquarium animals, cage birds, rabbits, etc
(1) What is an unauthorised veterinary medicine? (2) What is the exception?
(1) The prescription of a human drug against a veterinary Rx
(2) Exceptions include endorsing ‘FOR USE UNDER THE CASCADE’
How long should veterinary prescriptions be retained for following dispensing?
The Rx should be retained for 5 years.
(1) When is the RCVS Registration number of the prescriber required?
(2) What should be stated on the prescription when the RCVS number is required?
(1) For the prescription of CD2 and CD3 drugs.
(2) ‘For an animal/ herd under his/ her care’ should also be stated.
What extra requirements do CD2 and CD3 veterinary prescription scripts have?
(1) Prescriber’s RCVS Registration number
(2) ‘For an animal/ herd under his/ her care’
What Rx form should veterinary prescriptions be on?
There is no standardised Rx form for veterinary medicines.
What duration of treatment can be prescribed for a controlled drug in a veterinary prescription?
28 days - Good practice
Longer durations of treatment should be well justified.
What type of prescription does not LEGALLY require a dispensing label?
Veterinary medicines - unless under the cascade.
It is still GOOD PRACTICE to make dispensing labels.
What extra requirements are needed for the dispensing label of veterinary medicines?
‘FOR ANIMAL TREATMENT ONLY’ or equivalent.
What records are needed for a medicine prescribed under the cascade?
(1) Treat as if a private script - POM REG LEGAL REQUIREMENT
(2) Include the batch number of the drug
(3) Include reference number and price
What are the register requirements for private POM prescriptions?
POM Register - LEGAL
What are the register requirements for private CD2?
POM Register - GOOD PRACTICE
CD Register - LEGAL
What are the register requirements for private CD3?
POM Register - LEGAL
What are the register requirements for veterinary CD2 prescriptions?
POM Register - GOOD PRACTICE
CD Register - LEGAL
(SAME AS PRIVATE CD2)
What are the register requirements for veterinary POM-V, POM-VPS, and CD3 prescriptions?
POM Register - LEGAL
What are the register requirements for NHS POM, P, and GSL prescriptions?
No register requirements
What are the register requirements for NHS CD1/ CD2?
CD Register - Legal
What are the register requirements for NHS CD3?
No register requirements
What are the register requirements for NHS FP10D (Dentists)?
No register requirements
What are the register requirements for emergency supply at the request of a patient?
POM Register - LEGAL
What are the register requirements for emergency supply at the request of a prescriber?
POM Register - LEGAL
Are private POM prescriptions sent/ retained?
Retain for 2 years
Are private CD2 prescriptions sent/ retained?
Sent to NHSBSA at month end.
Are private CD3 prescriptions sent/ retained?
Sent to NHSBSA at month end
Are all veterinary prescriptions sent/ retained?
Retained for 5 years
Are all NHS prescriptions sent/ retained?
Sent to NHSBSA at month end.
What is the action to be taken for emergency supply at the request of a prescriber?
It is not a prescription.
Request a prescription to be received within 72hrs.
This prescription will then be sent to NHSBSA at month end when received.
What is the action to be taken for emergency supply at request of a patient?
It is not a prescription.
Charge the patient for the medication.
When is the quantity required in both words and figures?
CD2 prescriptions.
QUANTITY SHOULD BE CONFIRMED WITH PRESCRIBER BEFORE AMENDING
Is the prescriber number required on a CD Register?
Yes.
Under ‘Details of authority to possess’
What should be written in the ‘BALANCE’ column of a CD Register?
Top line - Initial/ current stock
Below - How much is being dispensed
(1) When can a pharmacist amend the script clinically?
(2) What additions are required?
(1) When the prescriber has not written the quantity in words and figures.
(2) The quantity in words/ figures, pharmacist signature, pharmacist name, date, pharmacist GPhC number
When does ‘human’ need to be written on supply type?
When the prescription is private.
What type of error is prescribing a drug which is not permitted, e.g. Dentist prescribing outside of formulary?.
Contractual error
What units are required for prescription endorsements?
Units are only required when the item being endorsed has a quantity in ‘mL’
e.g. 250mL/250mL
In regards to the prescription of liquids, what administration instructions are required (unless specified otherwise on the Rx, e.g. syringe)?
Take ONE 5mL “SPOONFUL”
Unless stated otherwise, the measurement of a spoonful following the quantity is required.
How should the remaining balance be written on the CD register when the prescription information says only “3 bottles remaining”, but you know their quantity (e.g. 250mL)?
The remaining balance should be written in mL or other such unit, NOT in number of remaining bottles.
What is the price of a single NHS prescription?
£9.15
What is the significance of the price £9.15?
£9.15 is the price of a single NHS prescription, unless the patient is exempt.
When should the dispensing label state “EMERGENCY SUPPLY”?
For emergency supply at the request of a patient ONLY.
What extra POM Register requirements are there for emergency supply at the request of a prescriber?
(1) Date on prescription
(2) Date prescription received
Remember also: Date supplied/ dispensed.
For emergency supply at the request of a prescriber, what happens to the prescription once it is received?
The prescription should be sent to NHSBSA at the end of the month.
“Not applicable - no prescription” applies only to ES at patient request.
What addition to the POM Register is required for E/S at the request of a patient?
The reason for emergency supply.
(1) When is the batch number required?
(2) Where is it required?
(1) For veterinary prescriptions
(2) On the POM register
(1) When is the expiry date required?
(2) Where is the expiry date required?
(1) For veterinary prescriptions
(2) On the label for veterinary prescriptions
What are 2 alternative names for phenobarbital?
(1) Phenobarbitone
(2) Phenobarbitone sodium
What is a requirement for E/S at request of the patient, with specific regard to the requested treatment?
The medication must have previously been prescribed by a suitable prescriber.
(1) What is the maximum length of treatment prescribed for a CD at request of the patient?
(2) What CDs cannot be prescribed?
(1) 5 days emergency supply
(2) CD2 or CD3 - unless phenobarbital for epilepsy
When is the RCVS number required?
When a CD2 or CD3 has been prescribed on a veterinary prescription.
When is the animal’s address required on a veterinary prescription, in addition to the owner?
When the address of the animal is different to that of the owner.
Which prescriptions are valid for 28 days only?
CD1, CD2, CD3 and CD4.
Which CD categories are not eligible for emergency supply?
(1) CD2
(2) CD3 - unless phenobarbital for epilepsy.
Which prescribers are unable to prescribe CD2 and CD3 due to their geographical location?
EEA and Swiss prescribers.
If you have to calculate the quantity (usually from the duration of treatment), what do you need to do on the prescription?
Endorse, e.g. 28/28.
Do you have to endorse if the medication is branded?
Yes
(1) What does the endorsement ‘PC’ mean? (2) When is it required?
(1) Prescriber contacted
(2) When the quantity has been amended by the prescriber - i.e. to be written in words and figures.
For oral solutions, when is the amount in mg also required?
When the oral solution is being administered using a syringe.
The dose in mg should be written in brackets, e.g. 5mL (10mg)
(1) When should the reference number be written on the label? (2) How should it be written?
(1) When a POM Register is required - required on the POM Register, dispensing label, and by the pharmacy stamp.
(2) It should be typed onto the label.
How much should a pharmacy charge for E/S at prescriber’s request?
NHS - £9.15/ Exempt
Private - Any amount
How much should a pharmacy charge for E/S at patient’s request?
Any amount, for handling and medication fee - as no prescription will be received.
