PPM Flashcards
Pharmacy technician role :
prepare and dispense and place orders and make phone calls to doctors and healthcare providers to ask about pateint and their medication.
Accredited checking rechnician role:
Accurately makes orders, reduces error during dispensinng
Dispenseing assistant:
Assists in dispensing and stock control, re stocking dispensary and ordering
medicines counter assistant:
Help with prescriptions, talk to patients, order stock, load and unload delivery
Brand ambassador potentially
Give patients health advice
Community pharmacist role:
- Ensuring requiremetns for medicine storage and supply are met
- Ensuring prescriibed medcines are safe by:
Adivsing healthcare professionals how to select the best medicine fir the patient.
Monitoring patients oncertain medications
counselling patients on how to use their medication safely and providing advice on mangainging any side effects. - Offering health advice to patients through a range of clinical services
- Travel advice and vaccines and jabs
- Writing SOP’s for everyone
- educating and training collegaues and potentially managing staff if theres no “manager”
What does “medicines reconciliation” mean ?
Acccurately listing a persons mediccines (E.g. when treatment changes)
What does “medicines formulary” mean ?
Compounding and testing medication
What are radiopharmacaeutical products used for ?
used for diagnosis
What is the “ Duty of Candour” ?
Pharmacists have a professional duty to be “open and honest” with patients if things go wrong.
Whats a common fitness to practice problem ?
Criminal convictions
What was thalimode prescribed for ?
Tranquiliser, cold flu, nausea and morning sickness in pregnant women.
What is thalidomide prescribed for TODAY ?
AIDS
targeted cancer drug
Leproy
What are SmPCs ?
Summary of Product Characteristics
Key component of the marketing authorisations for drugs authorised in the EU.
What does the MHRA do ?
Medicines and Healthcare products Regulatory Agency
They regulate medicines and medicinal devices.
Trades description act 1968:
Offence to sell products/ service based on misinformation
What is English legal system made up of ?
Strucutre law and common law
What is structure law ?
Primary and Secondary legalisation
What is common law ?
Case law
based on principle of justice.
Primary legalisation:
Main laws passed by legal bodies in UK
E.g. medicines act 1968
parliament
Secondary legalisation:
Created by ministers and other bodies (council)
E.g. The medicines ( Pharmacies) (Responsible Pharmacist) Regulations 2008
- secondary legalisation can me made very quickly
To create a new law (parliament process) :
1) Green paper ( creating new law or change to existing law)
2) White paper (Test public opinion and gather feedback before presenting a “bill” to parliament)
3) Bill (Proposed new law presented to parliament)
What are the 4 different types of law ?
1) Criminal
2) Civil
3) Administrative
4) Professional
what is a tort ?
A civil wrong
most common one is negligencce
What is the Standard of proof required for criminal and civil law ?
Beyond reasonable doubt - criminal law
Balance of probabilities - Civil law
What does HMR stand for ?
Human Medicines Regulations 2012
HMR overview:
States that medicines can only be supplied to the public from pharmacies except OTC drugs.
- Also cover the labelling of medicines and containers and how drugs are advertised.
- 17 regulations
THR :
Traditional Herbal Registration
What is “pharmacovigilance” ?
monitoring and safety of drugs in clinical use and, taking appropriate actions to minimise risk.
How long are MA’s granted for ?
usually 5 years or less
off label drugs ?
licensed medicines, which are being used outside of the terms of it’s marketing authorisation.
Who sorts out classification for nutritional and dermatological products ?
ACBS
Advisory Committee on Borderline Substances
What is an “orphan drug” ?
A drug which treats rare diseases
What is “parallel import” ?
Importing something without permission from the owner of that product.
How is an eRD accessed ?
By smart cards and PINs
What a prescription type doesnt need a record ?
NHS prescription
What type of drug needs a record ? (CD)
Schedule 2 CD’s
- good practice to make a record for schedule 3’s too.
How to find out the legal classification of a medicine ?
By using SmPC which is found in the EMC ( electronic medicines compendium)
How long is the responsible pharmacist allowed to be absent for ?
Maximum of 2 hours
Best thing to do is get back up staff there
How often should SOP’s be reviewed ?
Every 2 years
What are SSPs ?
Serious Shortage Protocols
Basically where there is a shortage of medicines
and some medicines that would normally be “prescribed” no longer require prescription.
May involve alternative strengths, quantities or formulations.
E.g if tablet is in shortage , then capsules are used instead.
What are SSPs ?
Serious Shortage Protocols
Basically where there is a shortage of medicines
and some medicines that would normally be “prescribed” no longer require prescription.
May involve alternative strengths, quantities or formulations.
E.g. if tablet is in shortage , then capsules are used instead.
For an emergency supply, what is the maximum number of days for supply /
30 days max
Can emergency supplies be made for CD drugs ?
nah son
only phenobarbital and phenobarbital sodium
for a max supply of 5 days.
Do you always need patients permission to access PMR ?
99 % of the time
but sometimes there may be a language or communication barrier, or unconscious
in which case PMR can be accessed
What is an EPP and what does it stand for ?
Stands for “Explosives Precursors and Poisons” license.
Its a license required to buy poisons.
Public must hold this license for a pharmacist to supply them poisons.
Any transaction must be recorded onto the actual license.
Suspicious use must be reported to the “anti terrorism hot line”
What are regulated substances ?
Substances that may cause harm
Labelling of poisons (REACH) ?
REACH
Registration Evaluation Authorisation and Restriction of Chemical
labelling dealt by the manufacturer.
Also should be labelled with
“Acquisition, possession or use by the general public is restricted”
POM-V:
POM-V medicine can only be prescribed by a vet
Animal has to under go clinical assessment
POM-VPS:
Can be prescribed by any registered qualifed person (RQP)
Animal does not have to undergo clinical assessment when prescribing POM-VPS drugs.
NFA-VPS
Non- Food Animal
Dont require prescription but must be supplied by an RQP.
AVM-GSL:
vet medcines for GSL
No legal restrictions on the retail supply of these.
Exempt medicines for small pet animals (schedule 6)
Unlicensed drug that doesn’t require an MA
because requirements of schedule 6 VMR are met.
Exemptions for small pets and animals.
What is a “clinical audit” ?
Process of improving patient care through review of care.
Where indicated, changes may be implemented.
Stages of a clinical audit ?
1) Choose topic
2) agree review standards
3) Collect data on current practice methods
4) Compare data with standards
5) implement change if needed.
What does PIDA do ?
Public interest disclosure acts 1998
Protects people who leaks information for the better
What do caldicott principles do ?
Explain when confidential information can be used and accessed by RQp’s.
What are some other situations in which SCR might be accessed other than an emeergency /
- Private services
- Patient has queries regarding their current medication
- Accessing info on patient allergies
- Responding to symptoms over the counter where patients are taking multiple medicines
- Determine whether a prescription has been issued or to find lost prescriptions.
- Communication or language barriers.
What are the common causes of Dispensing errors :
1) poor hand-writing or poor interpretation of hand writing.
good practice to contact the prescriber to clarify what has been written.
2) LASA: reading a drug wrong and confusing drugs that sound similar with each other.
3) Unreasonable work loads for staff
4) Interrupting staff trying to carry out critical processes.
give one example of a LASA :
carbamazepine and carbimazole
How to reduce selection errors due to LASA ?
1) Physical separation of the LASA drugs
2) Sign asking staff to triple check the correct drug is selected
3) Prompts for the PMR to alert staff as to whether the correct drug is selected.
What is a “near miss” ?
An error that occurs in the pharmacy but does not reach the patient.
What are the different “Classes” of CD’s ?
Class A - cocaine
Class B- phenobarbital, canabis oil
Class C- diazepam
one benefit of methadone over heroin ?
methadone has a longer half life.
methadone vs Buprenorphine ?
buprenorphine comes in a sublingual tablet
- Some people prefer buprenorphine over methadone as it is less “sedating”.
- Withdrawal symptoms are milder.
What is Suboxone ?
A combination of buprenorphine and Naloxone.
What forms do Suboxone come in ?
Comes in a sublingual tablet and a sublingual film.
For which schedule CD drug must a record be made ?
Schedule 2 and schedule 1
E.g. methadone, Buprenorphine/naloxone, diazepam.
What colour is the FP10PCD ?
Pink
- Require the prescribers unique identification number.
What does a patient collecting a Schedule 2/3 CD have to do ?
They have to sign the back of a prescription.
What is a “requisition” ( to do with CD’s) :
Allows a pharmacist to buy CD’s from another pharmacist or
supply CD’s to other health care professionals
Except for schedule 1 and 2, what schedule 4 drug should a pharmacist keep a record for ?
Sativex
Schedule 4 part I CD
A licensed cannabis product
Schedule 5 CD’s ?
Preparations that include a small amount of CD drug
E.g. co-codamol tablets,
which is a mixture of paracetamol and codeine
- Invoices for these must be kept for 2 years.
What is “safe custody” ?
locking drugs in safes
Especially CD’s
What is “health physcology” ?
taking into consideration the phycology when treating health.
Understanding patients shoes more.
What does “disease aetiology” mean ?
Means “origin of disease”
