Psychiatry Flashcards

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1
Q

Who can prescribe clozapine?

MA23

A
  • Psychiatrist
  • Medical practitioner or nurse practitioner prescriber under supervision of a psychiatrist
  • Medical practitioner prescribing clozapine for patient whose illness is well-controlled by clozapine AND prescribing decision is taken in collaboration with a Community Mental Health Team
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2
Q

What are THREE other restrictions for clozapine prescribing?

A
  • Prescriber must comply with appropriate local treatment guidelines
  • Medicine must be dispensed in accordance with appropriate local dispensing guidelines
  • Sale/marketing may only occur if there is appropriate blood monitoring & patient recording
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3
Q

What classification is melatonin?

A

Prescription-only

Except when supplied in medicines for oral use containing 3mg or less per immediate release dose unit, or 2mg or less per modified-release dose unit, when sold in the manufacturer’s original pack that has received consent from the Minister of Health or the Director-General for the treatment of PRIMARY INSOMNIA for adults aged 55 YEARS OR OLDER for up to 13 weeks by a registered pharmacist.

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4
Q

SR3

A

Sale of needles & syringes by pharmacists & pharmacy employees

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5
Q

SR3 - Sale of needles & syringes by pharmacists & pharmacy employees

WHO can needles/syringes be sold to?

A
  • 16yo+

- Under 16yo with a prescription from a medical practitioner

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6
Q

SR3 - Sale of needles & syringes by pharmacists & pharmacy employees

WHO can sell needles/syringes?

A

Pharmacy employee from a registered pharmacy given there is a registered pharmacist there WHO IS ENTITLED TO SELL NEEDLES/SYRINGES

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7
Q

SR7

A

Further provisions relating to sale of needles & syringes

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8
Q

SR7 - Further provisions relating to sale of needles & syringes

WHEN can needles/syringes be sold?

A
  • If it is approved by the Director-General

- Contained in a container & labelled in a manner approved by the Director-General

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9
Q

LTA18 - Doctors & optometrists to give Agency medical reports of persons unfit to drive

In relation to psychiatry…?

A

Licence holder is only permitted to drive subject to limitations as may be warranted by the MENTAL OR PHYSICAL CONDITION of the licence holder

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10
Q

MDR29

A

General requirements in relation to prescriptions

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11
Q

MDR29 - General requirements in relation to prescriptions

A

Prescription for CDs must be:

  • On paper form, completed in handwriting of CD prescriber
  • On paper form electronically generated by CD prescriber from approved system

METHADONE

  • QUADRUPLICATE forms supplied by MoH/clinic prescriptions where Director-General has approved transfer to triplicate forms
  • Also need to record methadone mixture details, & record dispensing sheets
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12
Q

MDA24

A

Offence to prescribe, administer, or supply controlled drug in certain cases

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13
Q

MDA24 - Offence to prescribe, administer, or supply controlled drug in certain cases

THREE criteria that prescribers must meet to prescribe for patients clearly dependent on CDs

A
  • Gazetted practitioner
  • Working in gazetted agency
  • Has authority to prescribe for a particular patient

ie. not every practitioner can prescribe for patients dependent on CDs

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14
Q

MDA24A - Medical practitioners, nurse practitioners, designated prescriber nurses, and designated prescriber pharmacists may prescribe controlled drugs to people dependent on controlled drugs

A
  • Only those meeting MDA24 can prescribe for patients dependent on controlled drugs
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15
Q

What does “Restricted person” mean?

A

Restricted to certain prescribers or drugs –> only certain prescribers can prescribe certain drugs for patients

This is gazetted/published with names of all parties

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16
Q

MDA25

A

Restrictions on supply to particular persons

17
Q

MDA25 - Restrictions on supply to particular persons

When will a health professional have committed an offence against this law?

A

Knowing themselves to be restricted:
- (Attempts to) procure prescription drug/CD from someone who is prohibited from issuing/supplying said drug

When someone is restricted, it prohibits ‘normal’ medicinal practitioners from issuing prescriptions for supply

18
Q

Which THREE laws relate to prescriptions?

A

MA18 - Prescription medicines may only be sold or supplied pursuant to a prescription written by an authorised prescriber or a veterinarian

MR41 - Form of prescription (valid prescription requirements)

MR40 - Every authorised prescriber who issues a prescription must comply with requirements laid out in MR41

19
Q

Which TWO laws relate to CD prescriptions?

A

MDR29 - General requirements in relation to prescriptions [handwriting, triplicate]

MDR32 - Verification of prescriptions

  • -> Acquainted with prescriber signature, satisfied signature is genuine
  • -> No one can alter any CD prescription for supply
  • -> If pharmacist believes prescription is forged/altered, then the pharmacist keeps the prescription & notifies police/Medical Officer of Health
20
Q

MDR22 - Restrictions on prescribing

Which FOUR CDs have additional restrictions ie. needs to be gazetted?

A
  • Dexamphetamine
  • Ephedrine
  • Methylphenidate
  • Pseudoephedrine
21
Q

Who can prescribe dexamphetamine?

THREE points

A
  • Medical practitioners within in paediatrics or psychiatry for ADHD
  • Medical practitioners within in internal medicine for narcolepsy
  • Other medical practitioners/nurse practitioners when acting on written recommendation of specialists above
22
Q

Who can prescribe methylphenidate?

FOUR points

A
  • Medical practitioners within in paediatrics or psychiatry for ADHD
  • Medical practitioners within in internal medicine for narcolepsy
  • Medical practitioners within in palliative care
  • Other medical practitioners/nurse practitioners when acting on written recommendation of specialists above
23
Q

Who can prescribe ephedrine & pseudoephedrine?

A
  • Medical practitioners registered with NZMC

- As with normal prescribing