POM medicines Flashcards
What 7 things need to be present for a prescription to be legal?
1) Signature - In ink , you can use an advanced electronic signature.
2) Address of practitioner
3) Date - Rx is valid for up to 6 months from appropriate date.
For NHS Rx - the date signed or date to be dispensed - which ever is later.
For private POMs and Swiss/EEA POMs it is valid FROM DATE SIGNED.
4) Particulars for Rx’er
5) Name of patient
6) Address of patient
7) Age of patient if under 12
How long is NHS Rx valid for ? What is the appropriate date ?
6 months from the date it was signed or dispensed which ever is later.
What is the appropriate date for Private POM or Swiss/EEA ?
Valid for 6 months from the date it was signed
Can you accept a Rx in a different language?
Yes , you can
Which Swiss/ EEA prescriptions are NOT recognised which we can’t dispense ?
CD 1 , 2 , 3 and UK unlicensed meds
What colour are dentist prescriptions?
Yellow FP10D - Can only Rx from the dental prescribers formulary
Are faxed prescriptions legal ?
No they are not legally valid
Can you issue carbon copies of prescriptions ?
Yes as long as they are signed in ink
Can a prescription be signed electronically?
Yes it can be
Does a prescription need to be in English ?
No it does not
If a prescription is in another language what language should it be labelled in and why ?
Labelled in English to ensure that is a patient is seen by a non welsh speaker the instructions can be understood
Prescriptions from schedule 2 and 3 can the prescribers address be outside of the UK?
No for Sch 2 & 3 the prescribers address must be within the UK
What type of prescription do you usually find repeats ?
Private prescriptions - FP10 , WP10 and GP10 are not used in this way.
If a number is not stated for a repeat , how many should you repeat and dispense ?
Repeat once and dispense twice.
How many times can you repeat an oral contraceptive ?
Repeat x5 , Dispense 6 in total
Can you repeat schedule 2 and 3?
No you cannot
What CDs can you repeat ?
Schedule 4 and 5
For repeat when must the 1st dispensing be done? What about the rest ?
Within 6 month of the appropriate date for the first dispensing , then no legal time for the rest of the repeats
Can you get repeats from different pharmacies ?
Yes you can , to maintain audit trail the name and address of the pharmacy from where it was suppliers should be on Rx and date of supply.
What is a repeat slip?
Not an Rx but a list of medications which patients can use to reorder regular meds.
What is an instalment prescription?
A single Rx for a CD to be dispensed in several instalments
How long to keep private prescriptions on POM register ?
2 years from the date of last supply/sale.
Can be written or can be electronic
Private CD schedule 2 and 3 need to be submitted to the relevant NHS agency.
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What must the POM register include ?
Date of supply
The date on the prescription
Medicine details - The name , quantity , formulations and strength of medicine supplied.
Prescriber details - a name and address
Patient details - name and address
When should the POM register record be made?
On the day of sale or the next following day.
What RX’s are exempt form POM record keeping ?
Oral contraception
Schedule 2 - As in CD register
What part of the Rx is not a LEGAL requirement?
- name
- strength
- form
- quantity
- dose
They are important but not legal requirements
What are the time periods for validity of ownings ?
6 months - POM, SCHEDULE 5 , P and GSL
28 days - SCHEDULE 2 , 3 and 4 CDs
Prisons can be given an FP10 when they leave prison , does the patient have to pay?
-no they are exempt for because the prison address will be their address
Can a dentist prescribe any POM ?
Yes they can prescribe any POM.
But if prescribing on a yellow dentist prescription it must be from the formulary.
What prescriptions are recognised by EEA/Swiss prescribers ?
Emergency ? Repeats ?
- Prescriptions
- Repeat prescriptions
- Emergency supply
These are ALL PERMITED
Who can request emergency supplies ?
- patient
- EEA/Swiss prescriber
- UK prescriber
From emergency supply at what time does a Rx need to be supplied ?
Within 72hrs
What CD cannot be supplied as emergency ?
Schedule 1, 2 , 3 (EXCEPT phenobarbital) for epilepsy CANNOT be prescribed as emergency supplies
What CDs CAN be supplied as an emergency?
Schedule 4 and 5 CDs can be supplied as an emergency supply to a patient - even if of an EEA/Swiss prescriber
What type of prescription is military prescription written on?
FMed 296
Military prescriptions are I would by community pharmacies with a dispensing contract with the Ministry of defence otherwise treat as a private prescription.
Pharmacies with a contract with the MOD will usually invoice the MOD directly
If the military prescription is presented to a non-contracted pharmacy how should the pharmacy treat the prescription?
They should treat the prescription like a private prescription And they should charge the patient the appropriate fee and NOT charge MOD directly.
Can CD written on a MOD FMed be legally dispensed ?
No CD written on military prescription on PMed cannot be dispensed. Private CD prescriptions should be written on FP10 CD that is pink
Is it normal to see a FMed 296 handwritten ?
no , it is not normal military rx’s are usually computer generated.
Must be included legally on dispensing label?
- Name of patient
- Name and address of the supplying pharmacy
- Date of dispensing
- Name of the medicine
- Directions for use
- Precautions related to use of medicine
Is it a legal requirement to label the outer container?
No you don’t need to label outside container
If a patient is requesting an emergency supply it must be previously prescribed by practitioner.
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How many days of emergency supply can you give for CD’s ?
Only schedule 4 and 5 and phenobarbital can be given in emergency.
Only give 5 days worth
How many days max emergency supply for POM ?
30 days supply
Dispensing label for emergency supply must say what ?
“Emergency supply”
As a rule of thumb:
Vet and RP records - KEPT FOR 5 years
EVERYTHING else - kept for 2 years
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What is covert administration?
When medicines are administered in a disguise format without the knowledge or consent of the person receiving them for example food or drink
What is a patient specific direction?
A written instruction from a doctor dentist or other independent prescriber for a medicine to be supplied to the name is patient after the prescriber has assess that patient on an individual basis.
Give an example of a PSD
An inpatient charts on a hospital ward
What are examples when a POM Can be sold or supplied without a prescription?
Patient group direction
Patient specific directions
Emergency supplies
Pandemic exemptions
Optometrist or podiatrist signed patient orders
Supply of salbutamol to schools
Supply of adrenaline autoinjector to schools
Supply of naloxone by individuals providing recognised drug treatment services
What is a patient group direction?
Supply of a specific medicine by our names healthcare professional to well-defined group of patients requiring treatment for a specific condition
Pharmacists can supply , offer to supply and administer diamorphine and morphine under a PGD for the immediate , necessary treatment of a sick or injured person.
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Can an emergency supply be given for an animal?
No emergency supply cannot be given for an animal
If a prescriber is requesting an emergency supply when does the prescription have to be written in?
Within 72 hours, And the prescriber requesting has to agree to provide a prescription.
EA or Swiss prescribers can request emergency supply, As long as it is a schedule 4, 5 or phenobarbital for epilepsy.
If I emergency supplies made does a record need to be kept in the POM register ?
Yes a record needs to be kept in the POM register on the day of supply or the day after
If an emergency supply is requested by a patient they need to have had it before
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What are examples when a POM Can be sold or supplied without a prescription?
Patient group direction
Patient specific directions
Emergency supplies
Pandemic exemptions
Optometrist or podiatrist signed patient orders
Supply of salbutamol to schools
Supply of adrenaline autoinjector to schools
Supply of naloxone by individuals providing recognised drug treatment services
What is a patient group direction?
Supply of a specific medicine by our names healthcare professional to well-defined group of patients requiring treatment for a specific condition
Pharmacists can supply , offer to supply and administer diamorphine and morphine under a PGD for the immediate , necessary treatment of a sick or injured person.
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Can an emergency supply be given for an animal?
No emergency supply cannot be given for an animal
If a prescriber is requesting an emergency supply when does the prescription have to be written in?
Within 72 hours, And the prescriber requesting has to agree to provide a prescription.
EA or Swiss prescribers can request emergency supply, As long as it is a schedule 4, 5 or phenobarbital for epilepsy.
If I emergency supplies made does a record need to be kept in the POM register ?
Yes a record needs to be kept in the POM register on the day of supply or the day after
What are examples when a POM Can be sold or supplied without a prescription?
Patient group direction
Patient specific directions
Emergency supplies
Pandemic exemptions
Optometrist or podiatrist signed patient orders
Supply of salbutamol to schools
Supply of adrenaline autoinjector to schools
Supply of naloxone by individuals providing recognised drug treatment services
What is a patient group direction?
Supply of a specific medicine by our names healthcare professional to well-defined group of patients requiring treatment for a specific condition
Pharmacists can supply , offer to supply and administer diamorphine and morphine under a PGD for the immediate , necessary treatment of a sick or injured person.
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Can an emergency supply be given for an animal?
No emergency supply cannot be given for an animal
If a prescriber is requesting an emergency supply when does the prescription have to be written in?
Within 72 hours, And the prescriber requesting has to agree to provide a prescription.
EA or Swiss prescribers can request emergency supply, As long as it is a schedule 4, 5 or phenobarbital for epilepsy.
If I emergency supplies made does a record need to be kept in the POM register ?
Yes a record needs to be kept in the POM register on the day of supply or the day after
What are examples when a POM Can be sold or supplied without a prescription?
Patient group direction
Patient specific directions
Emergency supplies
Pandemic exemptions
Optometrist or podiatrist signed patient orders
Supply of salbutamol to schools
Supply of adrenaline autoinjector to schools
Supply of naloxone by individuals providing recognised drug treatment services
What is a patient group direction?
Supply of a specific medicine by our names healthcare professional to well-defined group of patients requiring treatment for a specific condition
Pharmacists can supply , offer to supply and administer diamorphine and morphine under a PGD for the immediate , necessary treatment of a sick or injured person.
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Can an emergency supply be given for an animal?
No emergency supply cannot be given for an animal
If a prescriber is requesting an emergency supply when does the prescription have to be written in?
Within 72 hours, And the prescriber requesting has to agree to provide a prescription.
EA or Swiss prescribers can request emergency supply, As long as it is a schedule 4, 5 or phenobarbital for epilepsy.
If I emergency supplies made does a record need to be kept in the POM register ?
Yes a record needs to be kept in the POM register on the day of supply or the day after
If insulin, ointment, cream or inhaler are given as emergency supply the pack cannot be broken so the smallest pack available should be supplied
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If an oral contraceptive is been given as emergency supply how much should be supplied ?
28 days should be supplied for oral contraceptive which is a full cycle.
If an antibiotic is being prescribed the smallest amount should be prescribed if it is an emergency supply
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If a pharmacist decided not to give an emergency supply then they can refer them to a doctor, walk in centre , A and E department.
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What are pandemic exemptions ?
This is when emergency supply requirements are relaxed during a pandemic.
This means that pharmacists do not need to interview the patient that requires a medicine through emergency supply.
Optometrists and podiatrists cannot authorise supplies of POMs by writing prescriptions unless they are an IP.
However pharmacists working in a registered pharmacy can supply certain POMs directly to patients from a signed patient order from any registered optometrist
Is a signed patient order a prescription ?
No a signed patient order is not a prescription so it doesn’t need prescription requirements.
Do you want put a supply from a signed patient order in the POM register ?
Yes you put it in the POM register.
Who can provide a signed order for salbutamol inhalers for a school?
A written order signed by the principal or head teacher at the school must be provided to enable a supply to be made to the school.
What information SHOULD be included in the signed order?l for school for salbutamol inhalers ?
1) the name of the school that medicinal product is required
2) the purpose the product is required
3) the total quantity required by
How many inhalers can a school obtain?
The is not legal amount specified it depends on factors such as school size and number of children in site.
What records are kept in the pharmacy for a signed order?
The signed order needs to be retained for 2 years from the date of supply.
Even when signed order is retained it is GOOD PRACTICE to make a record in POM register but not a LEGAL requirement
What other information could the pharmacist be asked to provide when giving salbutamol inhalers?
Explain how to use inhaler
Spacer devices
Schools can purchase adrenaline autoinjectors for emergencies
Must include:
- Name of the school
- Purpose needed
- Total quantity
Anyone can administer nalaxone for the purpose of saving a life. There has been effectiveness in training family member on how to administer.
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If a pharmacy is is commissioned to participate in local take home scheme, does the RP have to be present ?
No the RP does not have to be present it just been provided by trained staff.
A pregnancy prevention programme is in place to protect female patients at risk of pregnancy from becoming pregnant whilst using oral retinoids.
And at least one month after.
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For PPP how often do you have follow up meetings?
Once a month
Under the PPP how long are prescriptions valid?
7 days and should ideally be dispensed on the date it was written.
If after 7 days the prescription has expired and should be referred back to the prescriber for a new prescription.
Pregnancy status may need to be reconfirmed by a negative pregnancy test.
What is the maximum number of days supply that can be given under PPP?
30 days
Only can have more than 30 days if the prescriber can confirm the patient is bit under PPP
What PP Rxs cannot be accepted?
- repeats
- free sample distribution
- faxed prescription for oral retinoids
When is the only time a telephone request for PPP patient can be accepted?
-emergency supply at the request of a PPP specialist prescriber together with confirmation of pregnancy status in the last 7 days.
Valproate is teratogenic and should not be taken unless nothing else works or person is under PPP
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If unplanned pregnancy during valproate treatment what should be done? What advise should be given?
Advise the patient NOT TO STOP MEDICINE and arrange to see their GP.
Do you reports side effects due to valproate ?
Yes via the yellow card scheme
