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PHAM01 > repeat dispensing > Flashcards

repeat dispensing Flashcards

1
Q

T/F: Paracetamol, to be taken ‘when required’, is not suitable to be included on a repeat dispensing prescription?

A

FALSE

paracetamol can be on repeat Rx, no reason it can’t

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2
Q

T/F: A repeat dispensing prescription for atenolol tablets must be dispensed for the first time within 6 months of the date on the Rx?

A

TRUE

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3
Q

T/F: Morphine solution 10mg/5ml can be prescribed using repeat dispensing?

A

TRUE

Schedule 5

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4
Q

T/F: The patient can decline to have any items dispensed on a batch prescription?

A

TRUE

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5
Q

T/F: The max Tx period that can be issued on a batch of repeat dispensing prescriptions is 6 months?

A

FALSE

period is 1yr

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6
Q

T/F: A repeatable prescription for nitrazepam should be dispensed for the first time within 30 days of the date of issue?

A

FALSE

it is Sch 4, period is 28 days

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7
Q

T/F: All batches should be dispensed within a 1 year period from the first date of dispensing?

A

FALSE

1yr period from the date on the Rx

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8
Q

T/F: It is good practice to ask certain questions of the patient prior to dispensing a repeat dispensing prescription?

A

FALSE

not good practice, LEGAL REQUIREMENT to ask certain Qs

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9
Q

T/F: Gabapentin capsules cannot be prescribed using repeat dispensing?

A

TRUE

Schedule 3

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10
Q

T/F: ABX should not be prescribed on repeat dispensing?

A

FALSE

  • tetracycline for acne
  • azithromycin for prophylaxis of respiratory conditions
  • trimethoprim for UTI prophylaxis
  • can be used for LT conditions
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11
Q

What type of service is repeat dispensing?

A

essential service in community pharmacy contract

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12
Q

max supply for repeat dispensing

A

12 months

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13
Q

how often need to order Rx

A

every 1 or 2 months

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14
Q

benefits of repeat dispensing?

A
  • convenient for pt
  • flexibility and easier access to meds for pts
  • reduces workload and time for the prescriber and staff
  • single repeatable Rx for review and signature
  • enhances the role of the pharmacist (more than dispensing)
  • compliance check with pt
  • pharmacist ‘manages’ repeat Rx
  • reduce waste of medicines
  • drug safety - encourage regular reviews at surgery (monitoring & safe prescribing)
  • uses std FP10s (no new Rx forms needed, but printed in 2 diff formats)
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15
Q

2 types of paper Rxs for repeat dispensing

A
  1. Repeatable prescription
  2. Batch prescription
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16
Q

repeatable prescription

A
  • legal authority and clinical authority to supply med
  • 1 needed per batch
  • letters ‘RA’ on the Rx (repeat authorisation)
  • ‘master’ Rx
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17
Q

batch prescription

A
  • dispensing Rx
  • usually more than one
  • letters ‘RD’ on the Rx (repeat dispensing)
  • ‘invoice for payment’
18
Q

Which Rx is the dispensing Rx?

A

batch prescription

19
Q

forms the RA and RD are printed on

A

FP10

20
Q

how must repeat Rx be generated

A

computer generated

21
Q

hand amendments of Rx by prescriber

A

can’t be amended by hand by the prescriber

22
Q

Patients suitable for repeat dispensing?

A
  • LT conditions who are stabilised on medication
  • pts who use one regular pharmacy
23
Q

Patients NOT suitable for repeat dispensing?

A
  • newly diagnosed patients
  • on acute meds for ST Tx
  • pts with unstable medical conditions
24
Q

Who has final decision for suitability of repeat dispensing?

A

GP

25
Q

patient consent for repeat dispensing

A
  • patient must give consent for sharing of info between GP and pharmacist
  • if unwilling to do this they cannot use this service
26
Q

meds that CAN’T be on repeat dispensing

A

CD Sch 2 & 3

27
Q

PRN and non-oral meds and repeat dispensing

A
  • PRN meds and non-oral medication (inhalers, creams, drops) CAN be included
  • but should be issued on separate RD Rx
  • because more difficult to ‘fit in’ with the ‘regular’ items
28
Q

How does repeat dispensing work in GP practice?

A
  • surgery generates ‘batch’ of repeat Rxs for pt
  • up to 12 mths of meds can be issued
  • all issues dated with date when the Rx generated
  • 1 RA (repeatable Rx) issued and signed by the GP
  • batch Rxs (RD) produced next
  • RD don’t have to be signed by the GP
29
Q

How does repeat dispensing work in pharmacy?

A
  • repeatable Rx must be dispensed for 1st time in 6 mths from date on Rx (except CD Sch 4: 28 days)
  • repeatable Rx left at the pharmacy
  • to dispense batch Rx, repeatable Rx must be seen
  • pts encouraged to leave the batch Rx at pharmacy
  • batches only dispensed at the pharmacy holding the repeatable Rx (if paper Rx)
  • all Rx must be dispensed within 12 months of the date on the RA
30
Q

legality of the repeatable Rx

A

still need to check legality of repeatable Rx

31
Q

What questions must the patient be asked before each batch is dispensed?

A
  • taking/using the med appropriately (any problems)?
  • any s/e from med?
  • change in their condition?
  • taking any new meds (OTC or Rx)?
  • anything don’t need?
  • need PRN meds?
  • inform of the date should collect next supply
32
Q

What should happen when the last batch is dispensed?

A
  • usual questions
  • inform that this is last issue
  • pt will need to contact surgery
  • might need clinical check
  • good practice to give written reminder that this is last batch
  • if Rx is only for 1 mth supply, inform them of 2nd last issue to allow time to arrange review
33
Q

PRN meds

A
  • can be issued on an acute Rx (as a ‘one off’)
  • can be issued on a separate batch Rx
  • should not be added to the regular RD Rx as this limits
    flexibility when dispensing
34
Q

new meds with repeat dispensing

A

will need to be fit in to the current batches

35
Q

discontinued medicines with repeat dispensing

A

if discontinued mid batch pharmacy should be notified

36
Q

common problems with with repeat dispensing

A
  • PRN meds
  • new meds
  • discontinued meds
  • changes in meds
37
Q

good communication between surgery and pharmacy…

A
  • when prescriber starts/stops med
  • when strength of med changes
  • when pt in hospital or med changed by secondary care
  • when pt not collecting meds regularly
  • when pt does not request item/refuses item which should be used/taken regularly
38
Q

records for repeat dispensing

A
  • date & quantity of each item dispensed recorded
  • records of interventions made by pharmacist, considered to be clinically significant, kept in the pt’s record
39
Q

prescription charges

A
  • apply to batch Rx like any FP10
  • pts exempt must sign each batch Rx
  • no charge for the repeatable Rx (RA) because it’s not actually ‘dispensed’
40
Q

time limit for all of RD to be dispensed

A

within 12 months of the date on RA

PHAM01 (22 decks)

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