PRESCRIPTION ONLY MEDICINES (POM) Flashcards
What prescriber details must be included for an Rx in EEA to be valid? (5)
- Full first name
- Professional qualifications
- Email address
- Telophone number (with international prefix)
- Work address (including the country they work in)
What are the types of prescriptions?
- Health Rx (NHS)
- Private Rx
Which UK registered practitioners can prescribe ALL POMs? (5)
- Doctor
- Dentist
- Supplementary Prescriber
- Nurse Independent Prescriber
- Pharmacist Independent Prescriber.
- must be UK registered
How to check registration of EEA/ Swiss health professional (4)?
- Check GMC (doctors)
- GDC (dentists)
- Nurse and Midwifery Council (nurses)
- Use professional judgement
What does supplementary prescribing mean (4 main points)?
it is a voluntary partnership1 between independent and supplementary rx-er2 to implement an agreed patient specific clinical management plan3 with the patient’s agreement4
Are EEA/ Swiss Rx written in a foreign language valid?
Yes, provided the pharmacist has enough information to enable safe supply and the Rx is compliant with legal requirements
What are the three legal classifications for medicinal products?
- General Sale medicines
- Pharmacy Medicines
- Prescription Only Medicines
Give 10 examples of Supplementary Rx-ers?
- Pharmacists
- Registered midwife
- Registered nurse
- Chiropodist
- Podiatrist
- Paramedic
- Physiotherapist
- Radiographer
- Registered Optometrist
- Registered Dietician
What must a clinical management plan contain (8)?
- name of patient
- illnesses or conditions which may be treated by SP
- date on which plan takes effect & when to be reviewed by the doctor or dentist
- class/ description of medicinal product which may be prescribed or administered
- any restrictions or limitations for medicinal product: (strength/dose/period of administration)
- sensitivities/ known difficulties of patient
- What to do if there’s suspected or known ADRs
- circumstances in which SP should seek the advice of IP
Which UK registered practitioners are restricted/limited to what POMs they can prescribe (6)?
- Optometrist Independent rx-ers
- Paramedic Independent rx-ers
- Physiotherapist Independent rx-er
- Podiatrist (chiropodist) Independent rx-er
- Therapeutic Radiographer Independent rx-er
- Community Practitioner Nurse rx-ers .
What’s the criteria for lawful supplementary prescribing (5)?
- Independent Rx must be a doctor or a dentist
- Independent rx-ers and supplementary rx-ers must be involved
- it must involve a written clinical management plan
- agreement to the plan must be recorded by the patient, IP and SP
- IP and SP must use the same common patient record
What prescribed medicine details must be included for an Rx in EEA to be valid (5)?
- Name of medicine
- Pharmaceutical form
- Quantity
- Strength
- Dosage
What is a Prescription Only Medicine?
A medicinal product which may only be sold or supplied by retail in accordance with a prescription given by an appropriate practitioner
What can medicines can a supplementary rx-er prescribe (4)?
- All GSL and P, appliances and devices, foods and other borderline substances
- All POMs, incl. parenteral, CDs
- Medicines for use outside of their licensed indications (i.e. ‘off label’ prescribing, ‘black triangle’ drugs, and drugs marked ‘less suitable for prescribing’ in the BNF
- Unlicensed drugs as part of a recognised clinical trial
What can Physiotherapist Independent rx-ers prescribe, what are the exemptions (7)?
Any POM, but not CDs, other than:
- codeine
- fentanyl
- midazolam
- morphine
- oxycodone
- temazepam
- tramadol
Are EEA health professionals classed as an appropriate practitioner?
Yes they are and so are Swiss Prescribers
What costs are incurred on a private Rx?
The patient pays for the drug and dispensing fee (however, the patient may be reimbursed if they have private medical insurance)
What can Paramedic Independent rx-ers prescribe?
Any POM but not CDs, other than:
- codeine
- fentanyl
- midazolam
- morphine
What must a valid UK prescription contain (7)?
- Signature (in ink or indelible – the signature can be an advanced electronic signature)
- Address of prescriber
- Date
- Particulars of prescriber (e.g. how to identify the Rx-er e.g. professional registration number)
- Name of patient
- Address of patient
- Age of patient (if under 12 years)
What can Community Practitioner Nurse rx-ers prescribe?
Only dressing, appliances, and licenced medicines listed in the NPF
What can Chiropodist/ Podiatrists Independent rx-ers prescribe, what are the exceptions (4)?
Any POM, but not CDs, other than:
- Diazepam (oral)
- Dihydrocodeine (oral)
- Lorazepam (oral)
- Temazepam (oral)
What’s an EEA health professional (2)?
- an individual in a relevant European state, who is a doctor, nurse responsible for general care, dental practitioner, midwife, pharmacist
- who is registered to practise in an EEA country or Switzerland
What are the Rx requirements for Rx’s issued in EEA or Switzerland (5)?
- Patient details (full name and DOB)
- Prescriber details
- Prescriber medicine details
- Prescriber signature
- Date of issue (same as UK, 6 months for POM and 28 days for Schedule 4 CD’s)
What is a repeatable prescription?
A Rx that contains a direction that it may be dispensed more than once, this is only permitted under private Rx’s
What does independent prescribing mean (3)?
- The practitioner is responsible and accountable
- for the assessment of patients with undiagnosed or diagnosed conditions
- and for decisions about the clinical management, including prescribing
If a repeatable Rx doesn’t specify how many times it needs to dispensed, what is the procedure (2)?
The Rx should only be dispense TWICE (1 repeat)
Unless the rx is for oral contraceptive, then it may be dispensed 6 times before the end of the 6-month period (5 repeats)
What can EEA health professionals not prescribe?
CD schedule 1,2,3
What’s the time limit for the remaining repeats of a repeatable Rx?
- There’s no time limit for the remaining repeats
- But the pharmacist should use professional judgement and clinical factors to determine whether re-dispensing the x is appropriate
What can Optometrist Independent rx-ers prescribe?
Any POM, but not CDs or parenterals
What does ETP stand for?
Electronic transfer of prescriptions
How long are prescriptions valid for (3)?
- 6 months from appropriate date (date on which signed)
- Or date indicated by rx-er – this is only for health rx’s
- Schedule 2,3,4 CD are only valid for 28 days
When does a repeatable Rx have to be dispensed for it to be valid (dispensed for the first time)?
Must be dispensed for the first time within 6 months from when it was signed (28 days for Schedule 4 CDs)
What medicinal products are usually designated a POM (4)?
- If medical supervision is required
- if the medicinal product is frequently misused
- is a new active substance
- is for parenteral administration
