restrictions

Question 1

ampicillin/ sulbactam

Answer 1

• only for infections by Acinetobacter baumannii (gram-ve)
• HAP/ VAP (SG: klebsiella, pseudo, Enterobacter spp, Acinetobacter spp)

Question 2

mupirocin

Answer 2

• cream: HD/ PD catheter site infections with positive culture MRSA
• nasal oint: infecion control team/ PACE (decolonisation package)

deviation insisted –> Infection control nurse/ ASP –> summary, pt particulars –> outcome

Question 3

antibiotic samples

Answer 3

NO

Question 4

antimicrobial containing dermatologicals

Answer 4

• formal dermatology consults
• otherwise BOTH ASP approval + IPDR needed
• clindamycin gel, lotion, BPO gel
• fusidic cream, TCS cream/ oint
• terbinafine tab, cream

Question 5

abx review

Answer 5

• correct indication
• dose (adj renal)
• TDM (vanco, AG)
• duration
  *no unnecessary abx combi – overlapping spectrum

Question 6

rx legal requirements (HSA)

Answer 6

pt name, IC, contact details

prescriber name, address, signature

date of rx (1yr)

drug (name, route, dose, freq, DF, duration/ qty)

• only ORG, no DUP/ reprint etc
• only supply from avail balance

Question 7

CD rx legal requirements (HSA)

Answer 7

pt name, IC, contact details

prescriber signature

drug (name, route, dose, freq, STRENGTH, DF, duration/ qty)

• total qty of prep or dosage units in BOTH WORDS AND FIGURES
  (——-handwritten above—–)

prescriber name, address - stamp

date of rx (30d) - stamp

Question 8

acitretin (psoriasis)

Answer 8

• HSA
• prescriber LOU

Question 9

clozapine

Answer 9

• HSA
• prescriber LOU

Question 10

entecavir (hep B)

Answer 10

• HSA & TTSH
• initiation: specialist in GE, ID, IM. Oncologists (Medical, oncology, haem: for urgent chemo.) TCU GE 2wks
• continuation: no restriction, supply till next GE/ID TCU

Question 11

lamivudine (HIV)

Answer 11

• HSA & TTSH
• initiation: specialist in GE, ID, IM. Oncologists (Medical, oncology, haem: for urgent chemo.) TCU GE 2wks
• continuation: no restriction, supply till next GE/ID TCU

Question 12

methadone (opioid)

Answer 12

• HSA & TTSH
• Specialist pain and palliative care

Question 13

avanafil; sildenafil; tadafil

Answer 13

• for ED px
• urology and endocrinology (MO & above)
• other disciplines consultants

Question 14

codipront (Codeine + Phenyltoloxamine – antihistamine)

Answer 14

• TTSH – max 5d duration per px 1tab BD
• HSA – max 11 tab 7d, no repeat px

Question 15

oxycodone (oxyNORM)

Answer 15

• TTSH
• pain and palliative care specialists (no restrictions)
• allow use for IP discharges and day surgery cases only
  (max 5mg 6H for 5d for discharge) – higher dose/ longer duration require PCS

Question 16

oxycodone + naloxone PR (TARGIN)

Answer 16

• TTSH
• pain and palliative care specialists (no restrictions)
• allow use for IP discharges and TKR/ UKA day surgery cases only
  (1 tab 12H for 3d) – higher dose/ longer duration require PCS

Question 17

oxycodone (oxycontin) 10mg, 20g

Answer 17

• TTSH
• pain and palliative care specialists (no restrictions)

Question 18

estradiol TD/ tab

Answer 18

• endocrinology (TTSH). no supply to ext rx

Question 19

TAF, TDF

Answer 19

• TTSH
• initiation: specialist in GE, ID, IM. Oncologists (Medical, oncology, haem: for urgent chemo.) TCU GE 2wks
• continuation: no restriction, supply till next GE/ID TCU

Question 20

zanamivir inj (influenza A & B)

Answer 20

• NCID clinical director for use within TTSH/ NCID/ NN I
• loans/ sales to external institutions (critical drugs with infreq use)

Question 21

phentermine hcl (retard) – weight loss

Answer 21

• endocrinology and sports med physician
• no supply to external rx