POM Flashcards
define emergency supply
means the emergency supply of a
POM without a valid Rx being present at the time of
dispensing
what are the two types of emergency supplies
1- emergency supply at the request of a patient
2- at request of prescriber
what are the conditions that must be met for the emergency supply at the request of a patient?
- That the pharmacist has interviewed the patient and is
satisfied: - That here is an ‘immediate need’ for the POM and it is
impractical to obtain a prescription without ‘undue delay’ - That the POM has on a previous occasion been prescribed
by a doctor, dentist, SP, community practitioner nurse
prescriber, nurse/pharmacist/ optometrist / podiatrist /
physiotherapist/ therapeutic radiographer / paramedic
independent prescriber, an approved country health
professional - As to the dose that it would be appropriate for the patient
to take
what CDs can be supplied for an emergency supply at the request of a patient?
- There is no provision for the emergency supply of schedule 2
or 3 CDs (except for phenobarbital or phenobarbital sodium
provided that it is for use in the treatment of epilepsy)
what is the max days which you can supply a CD for an emergency supply to a patient?
5 days
what is the max days you can supply for an emergency supply at request of a patient?
30
what are the exceptions to the 30 day max supply (emergency) at the request of a patient?
- Insulin, ointment / cream, inhaler for the relief of asthma –
the smallest pack available should be supplied - An oral contraceptive –supply a full treatment cycle
- An antibiotic in liquid form for oral administration –the
smallest quantity that will supply the full course of
treatment should be supplied
what records must be kept for an emergency supply at the request of a patient?
POM register
what details must be included in the POM register for an emergency supply at the request of a patient?
- The date on which the POM was supplied
- Name, quantity and, except where it is apparent from the
name, the pharmaceutical form and strength of the POM
supplied - The name and address of the person requiring the POM
- The nature of the emergency (i.e. why the person needs
the POM and the reason why a prescription cannot be
obtained)
what must the label show for an emergency supply at the request of a patient?
- The date of supply
- Name, quantity and, except where it is apparent from the
name, the pharmaceutical form and strength of the POM - The name of the person requesting the POM
- The name and address of the pharmacy
- The words ‘Emergency Supply’
- The words ‘Keep out of the reach of children’ (or similar
warnings)
can you emergency supply a CD at the request of a patient?
no CD 1/2
and no CD 3 except phenobarbital or phenobarbital sodium- epilepsy
what are your professional obligations when making an emergency supply
- Make the care of your patients your first concern
- You must consider the medical consequences, if any, of not making the
supply and be satisfied that your decision will not adversely affect the
patient - Consider any interval since when last prescribed
- Consider carefully the quantity you will supply
- If you consider an emergency supply not to be appropriate, you must
advise the patient on how to obtain essential medical care - The key is that you can justify your actions
- Consider adding extra information to the POM register record
what are the conditions for an emergency supply at the request of a prescriber?
- The pharmacist who is supplying the POM is satisfied that the supply has been requested by a doctor, dentist, SP, community practitioner nurse prescribers, nurse / pharmacist / optometrist / podiatrist / physiotherapist / therapeutic radiographer / paramedic independent prescriber, an approved country health professional
who by reason by some emergency is unable to furnish a
prescription immediately - That the appropriate prescriber has undertaken to provide the person lawfully conducting the retail pharmacy business with a
prescription within 72 hours - That the POM is sold or supplied in accordance with the directions of the appropriate practitioner
can a prescriber request an emergency supply of a CD?
not for CD 1/2
not for CD 3 except phenobarbital or phenobarbital sodium
are approved country health professionals allowed to request CD emergency supply?
no
what records should be made for an emergency supply at the request of a prescriber?
An entry should be made in the POM register on the day of supply or,
if impractical, the next day following, stating;
* The date on which the medicine was supplied
* Name, quantity and, except where it is apparent from the name, the pharmaceutical form and strength of the POM supplied
* The name and address of the practitioner requesting the
emergency supply
* The name and address of the patient
* The date on the prescription and the date when the prescription is received (these may be entered on the day the prescription is
received)
what happens to emergency supplies in a pandemic?
exemptions to medicines legislation
pandemic has to be officially announced by dep of health
conditions for emergency supply are relaxed
do you have to pay for an emergency supply?
yes- not part of the nhs
unless you go through NHS 111 and get referred
what is a PGD?
a written instruction for the sale, supply and/or administration of named medicines in an identified clinical situation. It applies to groups of patients who may not be individually identified before presenting for
treatment”
who may supply a PGD/
Only certain qualified professionals may supply or administer under a PGD nurses, midwives, health visitors, optometrists, pharmacists, chiropodists, radiographers, orthoptists, orthotists, prosthetists, physiotherapists, dental hygienists and dental therapists, dietitians, occupational therapists, podiatrists, speech and language therapists, paramedics but only as named
individuals
what details should a PGD contain?
- Name of organisation
- Date of PGD and date it expires
- Details of medicines to which it applies
- Class of professionals who may supply/administer
- Signature of doctor/dentist and pharmacist
- Signature from appropriate health organisation
- Clinical condition to which PGD applies
- Details of patients who are excluded
- When further advice/referral should be sought
- Dose, route, frequency, duration of treatment
- Warnings, including of potential side effects
- Details of any necessary follow-up action
- Details of records to be kept
what medicines can be included on a PGD?
- All POMs, Ps, GSLs
- Only certain CDs
- Sch 2, only diamorphine, morphine and ketamine (NB
only by certain persons) - Sch 3 only midazolam
- Any S4 part 1
- Any S5
what are PGDs suitable for?
- Best for single treatment episodes:* Nitrofurantoin for urinary tract infections
- Emergency hormonal contraception
- Topical antimicrobials for impetigo, conjunctivitis
- Analgesia (acute)
- Immunisation programmes
- Antiviral medicines for influenza