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MPharm2 SL22109 > Pharmacy practice > Flashcards

Pharmacy practice Flashcards

1
Q

What are the 2 visions of the veterinary medicines directorate?

A
  • To ensure the responsible, safe and effective use of VMPs
  • To protect public health, animal health, the environment and promote animal welfare by assuring the safety, quality and efficacy of veterinary medicines
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2
Q

What are the 4 responsibilities of the veterinary medicines directorate?

A
  • To authorise veterinary medicines (equivalent to MA)
  • To monitor safety and efficacy following authorisation
  • To develop, update and enforce legislation controlling
  • To monitor foodstuffs derived from animals for residues
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3
Q

What is a veterinary medicinal product?

A

Any substance presented as having properties that may be used to restore, correct or modify physiological functions of animals

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4
Q

What are the 4 different legal classifications of VMPs?

A

POM-V (POM-Veterinarian)

POM-VPS (Vet, Pharmacist & Suitably Qualified Person - SQP)

NFA-VPS for Non Food-producing Animals

AVM-GSL (Authorised Veterinary Medicine-General Sales List)

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5
Q

What are POM-Vs?

A

Must be prescribed by a vet after a clinical assessment of an animal under their care

If not supplied by the prescribing vet, a written Rx is required

Record of receipt and supply must be kept for 5 years (including batch numbers)

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6
Q

What are the 4 reasons why medicines are categorised as POM-V?

A
  • Contains narcotic or psychotropic substances
  • Diagnosis and clinical assessment is required by a vet before use
  • Requires a strict limitation on its use for safety reasons
  • Has a narrow safety margin requiring above average care in its use
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7
Q

What are POM-VPSs?

A
  • May be prescribed by any Registered Qualified Person
  • Clinical assessment not required
  • Client may request written Rx
  • RQP may supply a POM-VPS medicine against Rx from another RQP
  • Record of supply kept for 5 years (including batch numbers)
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8
Q

What are the 3 reasons why medicines are classified as POM-VPS?

A
  • It is used to prevent routine disease in herds, flocks or individual animals
  • Use implies risks for user, animal, consumer safety or the environment but users can be made aware of precautions to take
  • Professional user can be given adequate training in its safe use
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9
Q

What are NFA-VPSs?

A

Non food-producing animal
- May be supplied without a prescription
- Indicated for use only in non food-producing animals
- Used routinely to prevent or limit effects of disease
- Supplied by RPQ

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10
Q

What are AVM-GSLs?

A

Authorised Vet Med - GSL
- No restrictions apply
- Its use has a wide margin of safety
- It is used to alleviate or prevent the signs of disease or support the treatment of common ailments
- Special advice is not required to permit safe/effective use

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11
Q

What are schedule 6 products?

A

Exemptions for small animals
Schedule 6 permits certain medicines to be marketed without an MA

Vet medicines labelled exclusively for use in specified animals

May be sold by any retailer

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12
Q

Which 5 legislations are Vet CDs still required to adhere to?

A
  • Prescriptions
  • Supply
  • Record keeping (CD Register (schedule 2) + Vet Record (all))
  • Storage requirements (most Sch 2 and some 3)
  • Destruction and disposal (witnessed for Schedule 2)
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13
Q

How does the cascade of a VMP outside of its MA work?

A

The first treatment choice considered by a vet must always be a UK AVM, for that condition in that species.

If there is no such product, the vet surgeon responsible for that animal may, in particular to avoid unacceptable suffering, treat the animal with the following ‘the cascade’ in the following order:
- The same condition in a different species or
- A different condition in the same species

If no veterinary licensed product available, the vet may consider a product licensed for:
- Humans in the UK and then…
- Vet product licensed in EU (SIC needed)

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14
Q

What is required of a vet prescription?

A

May be oral or written

A written prescription is required when the product is to be supplied elsewhere

Name, address & telephone number of prescriber
Qualifications of prescriber - MRVCS or SQP (only legal if a CD)
Name & address of owner
Species of animal, identification & number of animals
Premises where kept if different from owner’s address
Date of the Rx
Signature of prescriber
Name & quantity of product
Explicit osage & administration instructions
Necessary warnings
Withdrawal period if relevant
If prescribed under the cascade, a statement to that effect
Number of repeats, if necessary
Validity remains the same as human Rx

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15
Q

What must also be included in a vet prescription if sc2,3,4?

A

Address of prescriber (must be in UK)
RCVS Registration number
Form of the preparation
Strength where more than one available
Total quantity in words and figures
Declaration that the CD is prescribed for an animal or herd under the vet’s care
Name & address of the person to whom the CD is to be delivered
If to be dispensed in instalments – amount of instalment and intervals of supply
S1 to 4 CD Rx are valid for 28 days
Repeats of S2 and 3 CDs not allowed
Repeats are allowed for S4 but all repeats must be supplied within the 28 days

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16
Q

What are the 4 laws surrounding retail supply for vet meds?

A
  • May only be from a Registered premises
  • Supply only to the final user (except emergency)
  • Pharmacists must supply a licensed vet product if one is available
  • Is offence to supply a medicine licensed for humans for administration to animals unless it is in accordance with a prescription from a vet for administration under the ‘cascade’
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17
Q

What are the pharmacist requirements for supply of vet meds?

A

A pharmacist may only supply a veterinary medicinal product classified as POM-V, POM-VPS or NFA-VPS from
- premises registered as a pharmacy with the GPhC or with the PSNI;
- premises from which a veterinary surgeon supplies veterinary medicinal products; or
- premises from which a suitably qualified person supplies veterinary medicinal products

A pharmacist supplying a veterinary medicinal product (other than AVM-GSL) must be present when it is handed over unless the pharmacist
- authorises each transaction individually before the product is supplied; and
- is satisfied that the person handing it over is competent to do so.

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18
Q

What are the duties of a pharmacist during supply of vet meds?

A
  • Must be satisfied that the person who will use the product is competent to do so safely
  • Must advise on safe administration and on any warnings or contra-indications on the label or package leaflet
  • Must not supply more than the minimum amount required for treatment as far as possible
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19
Q

What are the 4 laws surrounding advertisement of vet meds?

A

A VMP may be advertised provided that the advertisement is not misleading
Any advertising for POM-V and POM-VPS medicines must be aimed at ‘professionals’
Antimicrobials must not be advertised to professional keepers of animals
It is an offence to advertise to public
- POM-V and POM-VPS medicines
- Any human medicine for administration to an animal
- Any ‘off-label’ use of a product

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20
Q

Who is in control of medics?

A

GMC
Consists of :
i) 6 appointed medical members
ii) 6 lay members

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21
Q

What are the required qualifications for doctors?

A

Primary degree from UK or European Economic Area (EEA)/Swiss university
MB ChB (BM BS), Bachelor of Medicine, Bachelor of Surgery

22
Q

What are doctors prescribing rights?

A
  • May prescribe any POM & requisition POM stock (use of signed order) under the Human Medicines Regulations 2012
  • Can prescribe & requisition S2, S3, S4, S5 CDs under the Misuse of Drugs Act 1971
  • Can request emergency supplies of a POM under the Human Medicines Regulations 2012
23
Q

What are the 2 different required qualifications for dentists?

A

BDS (Bachelor of Dental Surgery)
LDS (Licentiate of Dental Surgery)

24
Q

Who controls dentists?

A

General dental council

25
Q

What are dentists prescribing rights?

A
  • Any POM under the Human Medicines Regulations 2012
  • Any S2, S3, S4 or S5 CD under Misuse of Drugs Act 1971
  • FP10D prescribing of Dental Practitioners’ Formulary items only
  • Unethical for dentists to prescribe outside their sphere of expertise
  • May request emergency supplies
26
Q

What are the prescribing rights of doctors and dentists from of the EEA or switzerland?

A
  • Prescriptions valid in UK since 2008
  • EEA/Swiss Rx requirements the same as UK, except age and address of the patient not legal requirements
  • Need not be written in English BUT pharmacist must be able to understand language
  • S1, S2, S3 CDs NOT prescribable
  • Products prescribed must have UK Marketing Authorisation
27
Q

Who controls nurses and midwives?

A

Nursing & Midwifery Council
Consists of 14 members, 7 lay members, 7 registrants

28
Q

What are nurses prescribing rights?

A
  • Trained nurses may prescribe limited range of GSL, P & a few POMs
  • Drug Tariff Part XVIIB(i) - Nurse Prescribers’ Formulary for Community Practitioners
  • Nurse and Pharmacist Independent Prescribers are able to prescribe any medicine for any medical condition within their competence, including any controlled drug listed in S2-5, except diamorphine, cocaine and dipipanone for the treatment of addiction
29
Q

Can midwives prescribe controlled drugs?

A
  • Registered midwife may possess diamorphine, morphine, pethidine and pentazocine for the practice of her profession
  • Supplies of diamorphine, morphine, pethidine and pentazocine may only be made to her on the authority of a patient-specific midwife’s supply order signed by the “appropriate medical officer” who is a doctor
30
Q

What are midwife supply orders?

A

Used to obtain diamorphine, morphine or pethidine
The order must contain the following:
- 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 to exercise supervision over midwives within the area

31
Q

Who controls optometrists?

A

GOC
Promote high standards of professional education training and conduct
Maintain registers of:
- Dispensing opticians
- Optometrists (ophthalmic opticians)
- Bodies corporate carrying on businesses as ophthalmic or dispensing opticians
- Student optometrists and dispensing opticians

32
Q

What are optometrists drug supply rules?

A

All GSL medicines
All P medicines
POM eye drops or eye ointments that are prescription-only medicines by reason only that they contain:
- No more than 0.5% chloramphenicol as drops, or
- No more than 1% chloramphenicol as ointments
- Cyclopentolate hydrochloride
- Fusidic acid
- Tropicamide

May obtain the following POMs as wholesale, for use in the course of their profession (but not supply).
- Amethocaine hydrochloride
- Lignocaine hydrochloride
- Oxybuprocaine hydrochloride
- Proxymetacaine hydrochloride

33
Q

What can optometrists IPs prescribe?

A
  • Optometrist Independent Prescribers can prescribe any licensed medicine for ocular conditions affecting the eye and surrounding tissue, but cannot prescribe any controlled drug independently
  • Can also request emergency supplies
34
Q

What are the 2 normal qualifications for vets?

A

BVetSci (Bachelor of Veterinary Science)

MRCVS (Member of Royal College of Veterinary Surgeons)

35
Q

What are the 7 common reasons why a persons fitness to practise may be impaired?

A
  • Misconduct
  • Deficient professional performance (lack of competence)
  • Adverse physical or mental health
  • Not having the necessary knowledge of English
  • Failure to comply with a reasonable requirement imposed by an assessor
  • Conviction of a criminal offence or receipt of a caution
  • Determination by another health or social care regulator that the registrant’s fitness to practise is impaired.
36
Q

What are the 4 roles of fitness to practise committees?

A
  • Must act to protect the public
  • Maintain public confidence in the profession
  • Uphold proper standards of conduct & behaviour
  • Register disapproval of unprofessional conduct
37
Q

What is the investigating committee?

A
  • Screening committee required to consider all cases referred to it, and to decide whether or not to refer the case to the - Fitness to Practise Committee, or whether the GPhC should bring a criminal prosecution.
  • May order further inquiries to be made, including obtaining medical reports.
  • Where the allegation is admitted, the Investigating Committee may decide, instead of referring a case, to accept written undertakings from a registrant or to issue a warning or advice.
  • May decide to take no further action
  • Sits in private and does not hear oral evidence
38
Q

What 5 things can be done if it is decided that a persons ftp is impaired?

A
  • Give a warning to the registrant and decide that details of this warning should be recorded in the Register
  • Give advice to any other person or organisation involved in the investigation
  • Remove the registrant from the Register
    suspend the registrant from the Register for up to 12 months
    place conditions on the registrant’s registration for up to three years.
  • Recommend that the GPhC Council to initiate criminal proceedings
  • Require a registrant to undergo a medical examination (in a health case)
39
Q

What things can be used as evidence by an ftp committee?

A
  • Criminal convictions
  • Cautions, bind-overs, conditional discharges, admonishments or reports to a procurator fiscal
  • Findings by a body responsible for the regulation of a health or social care profession
  • Allegations, complaints or information about the applicant which have been brought to the attention of the Registrar
  • Testimonials and character references about the applicant
40
Q

What gets considered during an ftp trial?

A
  • Seriousness of the conduct or behaviour
  • Relevance of behaviour to the practice of pharmacy
  • Relevance of the behaviour to the honour of the profession
  • Recency of the conduct or behaviour
  • Age at the time of behaviour was committed
  • Personal mitigation in respect to the conduct or behaviour committed
  • Efforts to rehabilitate themselves since the conduct or behaviour was committed
  • Insight in relation to the conduct or behaviour committed;
  • Extent to which the conduct or behaviour is counterbalanced by recent testimonials and character references
  • Extent to which the conduct or behaviour is characteristic of the applicant, or indicative of a propensity by the applicant to commit such conduct or behaviour
  • Extent to which the applicant disclosed the existence of the conduct or behaviour, during the application process;
  • Extent of co-operation by the applicant with any inquiries into the conduct or behaviour made by the GPhC
41
Q

Which acts are automatically considered to be serious?

A
  • Dishonesty, fraud or misrepresentation
  • Drug or alcohol dependency
  • A criminal conviction or finding of misconduct/unfitness to practice by any body responsible for the regulation of a health or social care profession
  • Violence exhibiting intentional or deliberate disregard of human life
  • Non-consensual sexual acts
  • Conduct or behaviour involving any sexual acts with children
  • Trafficking in, or illegally manufacturing, any controlled drug
  • Conduct or behaviour that poses a threat to public health, safety or welfare
  • Discrimination on the grounds of race/colour/religion
  • A blatant disregard for the law or the system of registration
42
Q

What are deontological ethics?

A

Duty based - everything is predetermined right or wrong

43
Q

What are consequentialist ethics?

A

The main consideration is favouring action that will achieve the best possible consequence or result.
It is not the nature of the action but its outcome that is most relevant

44
Q

What are virtue ethics?

A

The concept is referred to as being aretetic (goodness, excellence or virtue)

Principle focus is the moral uprightness or goodness of the individual

Virtues tend to be being trustworthy, loyal, generous or helpful so nature of any action is secondary to individual’s disposition to behave morally

45
Q

What is an ad hominem argument?

A

Literally it means ‘an argument against the man’. It is normally an attack on a particular person and is intended to discredit what he or she says or does

46
Q

What is a tu quoque argument?

A

Literally this means ‘you too’ and this method is used to reduce or deflect the force of an argument that a person is making

47
Q

What is duty based morality?

A

Patients who consult a pharmacist do so with the expectation that that they have the right to good quality, current information and decisions made are safe and up to date

The GPhC publish Standards for Pharmacy Professionals that lay down how pharmacists must act in the form of 9 standards

48
Q

What is goal based morality?

A

Internal motivations to use one’s knowledge and skills to better the lives of as many people as possible

49
Q

What is virtue based morality?

A

Joining a profession implies a commitment to values such as:

Honour Integrity Humanity Confidentiality Empathy Compassion

It is expected these values will be internalised (adopted as one’s own personal values)

50
Q

What are the essential services in pharmacies?

A

Dispensing Medicines
2. Repeat Dispensing
3. Dispensing Appliances
4. Disposal of unwanted medicines
5. Public Health – Promotion of healthy lifestyles
6. Signposting
7. Support for Self-Care
8. Clinical Governance (PQS)

51
Q

What are the 4 steps of decision making?

A

Information gathering
Making judgements
Making decisions
Evaluating outcomes

52
Q

What are the advanced services available in pharmacies?

A

Community Pharmacist Consultation Service (CPCS)
Flu Vaccination Service
Hypertension Case Finding
New Medicine Service (NMS)
Smoking Cessation Service
Pharmacy Contraception Service (PCS) - started 24/04/23
Appliance Use Review (AUR)
Stoma Appliance Customisation (SAC)

MPharm2 SL22109 (5 decks)

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