Pharmacy medicines Flashcards
Is there a definitive list of pharmacy medicines?
No
Define P medicines
Medicinal products which are not POM or GSL or which are classified by manufacturers as P in their marketing authorisation
Outline the schedule 15 products
- Aspirin
- Ibuprofen
- Paracetamol
A pack of 16 paracetamol tablets 500mg (non-soluble) is considered which type of classification?
GSL
A pack of 32 paracetamol tablets 500mg (non-soluble) is considered which type of classification?
P
A pack of more than 32 paracetamol tablets 500mg (non-soluble) is considered which type of classification?
POM
Is it legal to sell a quantity of more than 100 paracetamol 500mg tablets over the counter?
No - it’s illegal
How many packs of paracetamol tablets 500mg can be sold in one transaction from non-pharmacies?
2 packs of 16
How many packs of paracetamol tablets 500mg can be sold in one transaction from pharmacies?
96
What is the legal maximum of paracetamol tablets 500mg (soluble)?
no legal maximum
Some POMS are classified as P when they are sold in..
- Smaller pack sizes
- Low strength
- Certain indications
- Certain forms
Give an example of a POM that is classified as a P due to the strength + pharmaceutical form
Hydrocortisone 1% cream 15g
Give an example of a POM that is classified as a P due to the indication
- Naproxen 250mg
- Indication: primary dysmenorrhea in women aged 15-50
Give examples of a POM that is classified as a P when given at a lower strength
- Codeine
- Dihydrocodeine
- Morphine
- Pholcodine
Ranitidine is a GSL when..
- Pack size max: 12
- 75mg tabs
Ranitidine is a P when..
- Pack size max 24
- 75mg tabs
Ranitidine is a POM when..
- 150mg + 300mgs
- Tabs, sol + effervescent tabs
What are the indications for ranitidine?
- Heartburn
- Dyspepsia
- Hyperacidity
- Prevention of symptoms when associated w/ consumption of food/drink
P medicines may not be sold by any person unless..
- They are lawfully conducting a pharmacy business
- Premises is registered pharmacy
- A pharmacists or acting under supervision of pharmacist
What is the legal definition of supervision?
Pharmacist must be aware of sale + in position to intervene
Can a sale/supply of a medicine be described as supervised if the pharmacist is absent from the pharmacy?
No
Is it good practice or a legal requirement that a P medicine should not be placed on self selection shelves?
Good practice
Give two alternatives for the location of P medicines in a pharmacy
- Empty box on self selection shelves so patient can read info on box
- P medicine in front of medicine counter behind glass lockable doors
Ephedrine and Pseudoephedrine are both P medicines. What are they used as?
Decongestant
What are the risks of selling ephedrine and pseudoephedrine?
Potential for misuse - manufacture of crystal meth
What is the legal maximum quantity of pseudoephedrine that can be sold in one transaction?
720mg
What is the legal maximum quantity of ephedrine that can be sold in one transaction?
180mg
What are the guidelines when selling pseudoephedrine and ephedrine?
- Unlawful to sell pseudoephedrine-containing products at same time as ephedrine-containing products
- RPS advice: sale made by pharmacists or trained staff under supervision
- Lawful request can be refused on grounds of misuse
- Suspicions reported to: local GPhC inspector, local CD liaison police officer or accountable officer
Codeine and dihydrocodeine are both P medicines. What are they used as?
Analgesics
What are the risks of selling codeine and dihydrocodeine?
- Overuse
- Addiction
What are the restrictions when selling codeine and dihydrocodeine?
- Short term acute, moderate pain not relieved by sched 15 prods
- Max 32 dose units
- Labels: ‘can cause addiction. For 3 days use only’, can cause addiction or overuse headache when used for more than 3 days continuously and warning signs of addiction
- RPS recommends max 1 pack per transaction
What are the signs of possible misuse?
- Lack of symptoms
- Rehearsed answers
- Impatient/aggressive
- Opportunistic
- Specific products
- Paraphernalia - buys other products that can be used to manufacture meth
- Large quantities
- Frequent requests
Outline what OTC stimulant laxatives contain
- Senna/sennosides
- Bisacodyl
- Sodium picosulfate
Outline what POM stimulant laxatives contain
- Danthramer
- Co-danthrusate
What are the changes to OTC stimulant laxatives in relation to the pack size?
- Smaller packs = GSL for short term constipation, adults only
- 20 standard strength tabs/10 max strength tabs/100ml sol
- Larger pack (100) = P
What are the changes to OTC stimulant laxatives in relation to the age restrictions?
- GSL: 18+
- No longer used in under 12
- 12-17 supplied under supervision of pharmacists
What are the changes to OTC stimulant laxatives in relation to warnings in patient leaflets?
- Overuse may be harmful due to risk of fluid + electrolyte disturbances + potential disruption of intestinal function
- Warning: doesn’t aid weight loss
- Include new age recommendations
