Prescriptions

Question 1

Why do we need prescriptions (2)

Answer 1

1) human medicines regulations 2012

2) a POM may only be supplied/ sold in accordance with a prescription given by an appropriate practitioner

Question 2

List the different types of prescribers (7)

Answer 2

1) doctor
2) dentist
3) nurse
4) physiotherapist
5) podiatrist
6) pharmacist
7) optometrist

Question 3

Can community nurse practitioners prescribe anything?

Answer 3

No - only a limited range of products as listed in the BNF/drug tariff (Nurse Prescribers’ Formulary)

Question 4

What are independent prescribers? (2)

Answer 4

1) completed an extra qualification

2) can prescribe any POM within area of competence ( optometrists cannot prescribe CDs or parenteral medicines)

Question 5

What are supplementary prescribers? (3)

Answer 5

1) have completed an extra qualification
2) can prescribe in accordance with a clinical management plan agreed by an independent prescriber
3) pharmacist, midwife, nurse, chiropodist, podiatrist, physiotherapist, radiographer, optometrist

Question 6

What is the difference between supplementary and independent prescribing? (2)

Answer 6

1) Independent prescribers are responsible for the assessment of patients with undiagnosed or diagnosed conditions, and for decisions about the clinical management required and drawing up a treatment plan. The independent prescriber also has the authority to prescribe the medicines required as part of the plan.
2) Supplementary prescribers are authorised to prescribe for patients whose condition had been diagnosed or assessed by an independent prescriber, within the parameters of an agreed treatment plan

Question 7

Outline the legal requirements of a prescription (6)

Answer 7

1) age and/or DOB - the age or date of birth is legally required if the patient is under 12 years old.
2) patients name and address
3) date (must be dispensed within 6 months)
4) signed in Ink by prescriber
5) type of prescriber (doctor, dentist etc)
6) prescribers address- ( name is not legally required)

• written indelibly.
• drug name, form, strength, quantity not legally required.

Question 8

Discuss faxed prescriptions (5)

Answer 8

1) not legally valid prescription
2) may not be clear
3) may never receive original script
4) original script may never be amended after supply
5) consider alternative methods

Question 9

Outline what prescribers from the EEA/ Switzerland can and cannot do (5)

Answer 9

1) EEA prescribers (Dr,dentist, prescribing pharmacist/nurse) can not issue NHS prescriptions
2) can issue private prescriptions
3) can not prescribe unlicensed medicines or certain CDs
4) do not legally need patients address on script
5) do not legally need patients age on script

Question 10

Describe what you would look out for in a forged prescription (5)

Answer 10

1) drug liable to misuse
2) large/ excessive quantity
3) amendments
4) Dr in signature
5) patients appearance- agitated, nervous, aggressive

Question 11

What type of prescription is a FP10SS and FP10NC (2)

Answer 11

1) FP10SS
- printed
- all prescribers except dentists

2) FP10NC
- handwritten
- FP10NC - GP
- FP10HNC - hospital

Question 12

What type of prescription is a FP10D (4)

Answer 12

• dentist (yellow)
• handwritten prescription
• can only prescribe items listed in dental practitioners formulary
• can legally prescribe any POM on private prescription

Question 13

What type of prescription is an FP10P , FP10SP and FP10P-REC (3)

Answer 13

1) FP10P
- handwritten
- FP10PN & FP10CN - nurse independent prescribers & community nurse practitioners
- NB community nurse practitioners must follow nurse prescribers formulary

2) FP10SP
- other independent & supplementary prescribers

3) FP10P-REC
- out of hours centres

Question 14

What are electronic prescription service tokens (7)

Answer 14

• paper copy of the electronic prescription
• green= prescribing token
• White = dispensing token
• similar format to normal prescriptions
• barcode to allow matching to electronic prescription
• token is not signed by prescriber so it’s not a legal prescription
• electronic prescription has special electronic signature

Question 15

Discuss where you could find information about the patient (6)

Answer 15

1) prescription, including the back (exemptions)
2) the patient
3) the patients representative/ carer
4) the GP or other health care professionals
5) community- patient medication record system - prescribing intervals, changes in regimen, interactions
6) patient treatment cards

Question 16

List some Co-morbidities (5)

Answer 16

1) heart disease
2) asthma
3) epilepsy
4) renal failure
5) liver failure