S2 and S3 Medicines and OTC Requests Flashcards
What are FOUR basic requirements of schedule 2 (pharmacy medicine) and schedule 3 (pharmacist only) medicines?
- Require appropriate recommendation and advice
- Requires monitoring by a pharmacist
- Pharmacists, pharmacy assistants, and student pharmacists are bound by a duty of care
- Are located out of reach of the public i.e. ‘behind the counter’
All requests relating to pharmacist only medicines (S3) must be referred to a?
Pharmacist
How many packs of Pharmacy Medicines and Pharmacist Only Medicines can be supplied at a time?
Only one proprietary pack
When may more than one pack of pharmacy medicines and pharmacist only medicines be supplied? Why should there be caution?
- More than one pack may be supplied if there are exceptional circumstances clearly demonstrable by the customer, additional documentation of which should be kept
- Caution should be exercised when considering requests for supply of multiple packages, particularly for drugs subject to abuse or misuse e.g. pseudoephedrine
What happens if the supply of S2 and S3 poisons have met a failure to comply with local jurisdiction regulations?
May be considered unprofessional conduct
Where should pharmacy only and pharmacist only medicines be located?
In a secure area that;
- Is within sight, hearing and supervision of the pharmacist
- Consumers do not have direct access to
- Consumers are unable to self-select from
> professional service area
> private consultation area
For Pharmacy medicines (S2);
A) Do they require medical diagnosis or management?
B) Does the pharmacist have to be involved?
C) When to refer to the pharmacist?
A)
Are for minor ailments and symptoms that do not require medical diagnosis or management
B)
You may provide these products without reference to the pharmacist
C)
Refer to pharmacist for advice
- Child or elderly
- Symptoms persistent
- Treatment failure
- Taking other medication(s) or other medical condition(s)
- Side effects from other medication(s)
- Pregnant or breastfeeding patient
For Pharmacist only medicines (S3);
A) Do they require counseling by a pharmacist?
B) Is a pharmacy student allow to provide this medicine without the pharmacist’s advice?
A)
YES, they are substantially safe in use but require professional advice or counselling by a pharmacist
B)
You may NOT provide this medicine without the pharmacist’s advice
For pseudoephedrine;
A) What information is required from the patient?
B) What identification is required
C) How is the recording done (can be done by pharmacist and other staff)?
A)
- Relay important information to the pharmacist who will determine if there is a genuine therapeutic need
B)
- Collect photo identification – drivers licence. Check photo matches person requesting the medicine
C)
- Log in to Projectstop™ using pharmacy’s log-in details
- Patient’s photo identification number
- Product requested
- Amount of product requested
- Whether the product was supplied or not (record sale, record non-sale, or sale under duress)
What current editions of information is required to supply S2 and S3 medicines?
PBA requires pharmacies to have current editions of the following
- APF, AMH, e-MIMs, AusDi, The Therapeutic Guidelines series, Don’t Rush to Crush, Herbs & Natural Supplements and the Merck Manual
Also optional resources such as Self-care cards and CMI print outs
What are the SEVEN steps of the pharmaceutical care quality system?
- Patient assesment and data collection
- Identify problems
- Set treatment goals
- Evaluate therapeutic alternatives
- Individualise therapy
- Implement therapeutic plan
- Monitor outcomes
What are the four steps for patient assessment (pharmaceutical care quality system)
- Gathering initial data and getting a general idea what the problem might be through
a) General observation of the patient
b) Considering the presenting complaint - Asking questions for further information (e.g. WWHAMMA)
- Confirming the facts
- Making a clinical decision and recommendations (subjective and objective findings)
What is the difference between subjective findings and objective findings? Provide examples of each
Subjective findings
- Obtained verbally from the patient or caregiver and so is not directly observed or measured by yourself
- E.g. the main complaint/symptom(s) presented; history of present illness; past medical history; social history; family history
Example: patient says “I have high blood pressure”
Objective findings
- details data that can be directly measured or observed by yourself or the pharmacist OR can be verified by you
- e.g. medication history from pharmacy’s records, physical observations of any symptoms
Example: pharmacist/pharmacy staff measures the patient’s blood pressure and notes that it is currently high
When to treat or refer to a doctor in general as every medical condition will have its own triggers for referral (step 4)?
- symptoms of long duration
- recurring or worsening problems
- severe pain
- treatment failure with appropriate medications
- suspected adverse drug reactions
For treating or referring to the pharmacist, provide examples of (step 4);
A) Consumer-based triggers?
B) Staff-based triggers
C) Product-based triggers
A)
- Age (under two years or elderly)
- Pregnant or breastfeeding
- Symptoms (not straightforward or persistent)
- Is taking other medication
- Has other medical conditions
- Appears to be under the influence of alcohol or drugs
- Looks unwell
- Unable to gather enough information
- Consumer requests pharmacist intervention
B)
- Do I know the best product to choose for this consumer? If not, refer
- For direct product request: Is the requested product the right one for this consumer or is there a better alternative?
- For symptom-based presentation: Do I know which product is right for this consumer’s symptoms?
- Do I have enough knowledge about this class of medicines or type of symptoms? If not, refer.
- Can I give the consumer the right advice on this product / their symptoms? If not, refer.
- Am I unsure whether to refer? If unsure, refer.
C)
- Pharmacist Only Medicine
- Suspect Inappropriate Use
- Specific request by pharmacist for referral with this product
