Professional and Legal issues Flashcards
What are legal requirements on a general prescription
Signed by prescriber
address of prescriber
valid date
type of practitioner/prescriber
name of the patient
address of the patient
age of the patient if under 12
can electronic prescriptions electronically signed meet prescription requirements
no
what are repeatable prescriptions?
How many times can it be dispensed if a number is not specified
when should it be dispensed for: POM and schd 5 CDs
schd 4
prescriptions containing directions saying they can be dispensed more than once
twice unless for oral contraception where it can be dispensed six times in total
First dispensing must be made within 6 months then following the there is no time limit for remaining repeats
Within first 28 days following which there is no legal limit
What are the legal requirements on a label of a dispensed product
Name of the patient
Name and address of the supplying pharmacy
name of medicine
Date of dispensing
Directions for use
Precautions relating to the use of the med
What is patient specific directions (PSD) ?
A number of exemptions to the restrictions on the sale, supply, and administration of medicines made by the human medicines regulation.
generally an instruction to administer a medicine to a list of individually named patients where each patient on the list has been individually assessed by that prescriber.
What are the lists of exemptions where sale and supply of medicine can be made without prescription
Patient Group directions
Patient specific directions
Emergency supply
Optometrist or podiatrist signed patient orders
Supply of salbutamol inhalers to schools
Supply of adrenaline auto injectors to schools
Supply of naloxone by individuals providing recognised drug treatment services
What is a PGD?
A written direction that allows the supply and or administration of a specified medicine(s) by named authorised health professionals to a well defined group of patients requiring treatment for a specific condition
mainly reserved for those limited situations where this offers an advantage for patient care, without compromising patient safety
Give examples of PGD
Pharmacists can supply or offer to supply diamorphine or morphine under PGD for immediate and necessary treatment to injured or sick patient
Morning after pill to women who have had unprotected sex in last 72 hours for prevention of pregnancy
what is an emergency supply
a registered pharmacist can supply a POM to a patient without a prescription at the request of a relevant prescriber or a patient
e.g community practitioner nurse prescriber
an EEA or Swiss health professional
what are the conditions that need to be met to make an emergency supply at the request of a prescriber
from a Relevant prescriber
emergency
Prescription cannot be provided immediately due to emergency
Prescriber agrees to provide written prescription within 72 hours of emergency supply
supplied in accordance with the directions given by the prescriber
NO CDs (2 or 3) except for Phenobarbital
record kept
what should the record kept for EMS at ‘PRESCRIBER REQUEST’ say
The date the POM was supplied
the name and quantity of medicine supplied
the name and address of the prescriber requesting the emergency supply
the name and address of the patient for whom the POM was needed
date on prescription
the date on which the prescription is received
State “emergency supply at request of prescriber”
What are the conditions needed to be met for EMS at request of patient
Interview by pharmacist
Immediate need
Patient has been legally prescribed the medication before
Provide appropriate dose based on PMH
NO schd 2 or 3 medication (except phenobarbital max for 5 days)
Length of treatment must not exceed 30 days except for abs, oral contraception and insulin, an ointment, cream, or an inhaler for asthma
record must be kept
What must the record say about EMS at patient request
The date the POM was supplied
The name and quantity of medicine supplied
Information on the nature of the emergency
labelling must include ‘emergency supply’
Conditions needed for optometrist or podiatrist
Must be in accordance with a signed patient order
Must be a medication that can be legally sold or supplied by optometrist or podiatrist
they have provided enough advice to enable patient to use the medicine safely and effectively
Labelled as medicinal product
(it is not prescription)
recorded in POM register
SUPPLY OF MEDICINES TO SCHOOLS:
What is this for?
for use of emergency meds administered to student by trained persons to pupils previously prescribed such medication and where parental consent is received
SUPPLY OF MEDICINES TO SCHOOLS
how is it obtained?
By a signed order which should include:
Name of the school
Product details
Strength
Purpose for med
Total quantity
Signature of the principal or head teacher
SUPPLY OF MEDICINES TO SCHOOLS
how many can be ordered?
No legal limit
Can purchase salbutamol inhalers and or AAI from pharmacies provided it is for small quantities on occasional basis and not for profit.
SUPPLY OF MEDICINES TO SCHOOLS
What records need to be kept in pharmacy?
-signed order retained for 2yrs
-make record in POM register (good practice)
Includes; date supplied,
name, quantity, formulation, strength
name and address, trade business or
profession to the person supplied
purpose of purchase
SUPPLY OF MEDICINES TO SCHOOLS
What type of schools can be supplied?
All primary and secondary schools
SUPPLY OF MEDICINES TO SCHOOLS
what additional advice should be given to the schools?
how to store, care and how to dispose and administer properly
advice on most appropriate spacer to use
advice on important of record keeping, regular date checking and when to replace
SUPPLY OF NALOXONE
who can be supplied ?
Who can/should be trained to administer naloxone?
Individuals employed or engaged in the provision of recognised drug treatment services
; NHS body, a local authority, Public health England or public health agency
anyone for life saving purposes, people who are likely to witness opioid overdose
PREGNANCY PREVENTION PROGRAMMES
What meds have a high risk of causing foetal malformations and or can increase the risk of spontaneous abortions?
What is the PPP?
Oral retinoids, valproate, thalidomide, lenalidomide and pomalidomide
Protect females of childbearing potential and minimise risk of them becoming pregnant.
PREGNANCY PREVENTION PROGRAMMES
When can oral retinoids be given to women of childbearing potential?
On the PP programme and initiated by GP with extended role in dermatology , dermtoligts and nurse dermatologists
Patient must comply, understand and acknowledges reasons for PPP and MUST have MONTHLY follow up
PREGNANCY PREVENTION PROGRAMMES
How long are prescriptions with a PPP valid for?
What is maximum quantity that can be supplied?
7 days
after which it is expired and may need to reconfirm not pregnant
(repeat prescriptions are not valid)
30 days
PREGNANCY PREVENTION PROGRAMMES-valproate
what is valproate used to treat?
epilepsy, bipolar disorder
PATIENT GROUP DIRECTION
What should HCP when carrying out PGD?
Assess the patients suitability for a specific drug without reference of independent prescriber
PGD
When are they useful?
Patient seeks unscheduled care
medicines use follows predictable pattern
Supplying or administering a medicine for a discrete treatment episode
Homogenous patient group
PGD
What legislation includes PGDs?
Human Medicines Regulations 2012
