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Sem 1 Year 2 > The Pharmacist > Flashcards

The Pharmacist Flashcards

1
Q

P medicine and examples

A 
Covered by authorization that it has to be available only from a pharmacy: 
Night nurse
Contact capsules 
Tyrozets
Chloramphenicol eye drops
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2
Q

Products only available from a pharmacy

A

Anthelmintics - for worms
Parenterals
Enemas
For irrigation or wounds, bladder, vagina or rectum
Aloxiprin or aspirin(>16) from admin to children

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3
Q

Examples of exemptions to POM that are P

A 
Budesonide 
  200mg per nostril/ 10mg in pack
  Nasal admin only
  Prevention/treatment of hayfever
  Adults and children >12

Econazole
Vaginal candidiasis - vaginal use

Chlorine phosphate
Prophylaxis of malaria

Some controlled drugs if:
One
Specified max strength
in form specified
labelled to show dose
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4
Q

Liquid paraffin GSL and P differences

A 
GSL = all
P = nasal drops, sprays, inhalation’s, oral laxatives
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5
Q

Quinine classes POM ,GSL and P differences

A

POM
P = MD 100mg and MDD 300mg
GSL = MD 35mg

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6
Q

Cetrizine Hydrochloride GSL and P differences

A

P =MDD 10 mg

GSL = 30 tabs or 70ml of 1mg/ml (still 10mg MDD)

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7
Q

Beclometasone classes POM, GSL and P differences

A

POM=nasal spray
P=allergy nasal spray
GSL=Hayfever nasal spray

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8
Q

Aspirin GSL pack sizes

A

0-325mg 30 tablets
Up to 500mg 20 tablets

Non effervescent
Up to 75mg e/c, ONLY aspirin 28 tablets
Others 16 tablets

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9
Q

Paracetamol GSL pack sizes

A

Capsules 16
Powder or granules 10 sachets
Liquids for over 12’s is 160ml
Liquids for under 12’s is 100ml

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10
Q

Ibuprofen GSL pack sizes

A

16 tablets
16 capsules
12 sachets
100ml

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11
Q

What is criminal law

A

Between the individual and state

Regulation of human behaviour

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12
Q

What is penal law

A

Bodies of rules with the potential for severe impositions as punishment for failure to comply

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13
Q

What is civil law

A

Relationships between individuals (or a large organisation)

Compensation
Private disputes
Protects and enforces rights of an individual

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14
Q

Do pharmacists need professional indemnity insurance?

A

Yes - required by GPhC

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15
Q

What is a Primary Legislation?

A

Acts or parliment
Lay down general principles
No great detail

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16
Q

Examples of primary legislation?

A

Medicines act 1968
Misuse of drugs act 1971
Poisons act 1972

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17
Q

What is a secondary legislation?

A

Subsidiary to an act
Normally in the form of statutory instruments
Include regulations and orders

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18
Q

Who initiates a statutory instrument?

A

A government minister

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19
Q

When does a statutory instrument become law?

A

After laying on the table for 3 days

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20
Q

What do an act and a statutory instrument form?

A

Statutory law

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21
Q

What is Judicial Precedent?

A

Case law/common law/judge-made law
When no legislation on issue
Legislation is unclear
Statement of the legal position in a case based on previous courts decisions/similar cases

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22
Q

Who is the European union made up of and what are their roles?

A

European commission - initiates
Council of EU - makes ultimate decisions
European Parliament - directly elected chamber
European court of justice - Decisions by them must be accepted by courts in member states and there is no right of appeal

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23
Q

What are specified publications under HMR 2012

A

European Pharmacopoeia
British Pharmacopoeia
Cumulative list of recommended INN’s

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24
Q

What do the MHRA do

A

set standards for the quality of medicines
Ensure medical substances meet standards of safety, quality and efficacy
Ensure medicines and medical devices work and are acceptably safe

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25
Q

What is found in the monograph

A 
Description 
Identification tests
Physical constants
Min purity
Ingredients
Limit tests
Storage conditions
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26
Q

How is public protection achieved

A

Restricting public access to poisons and potent drugs/medicines
Prevent use for criminal purposes, self medication and gratification of addiction

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27
Q

What is the CHM

A

Commission on Human Medicines
Committee of MHRA - advise ministers
Advisory non-departmental public body
Membership - clinicians, pharmacists, lay members, expert advisory groups

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28
Q

What is a medicinal product

A

A substance or combination that has properties of preventing or treating disease in humans
Administered to:
Restore/correct/modify a physiological function by exerting a pharmacological/immunological/metabolic action
Make diagnosis

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29
Q

What is a authorised medicinal product

A

Medicine - marketing authorisation
Homeopathic’s - Certificate of registration
Herbals - Traditional herbal registration

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30
Q

What is a relevant medicinal product

A

A medicinal product with a marketing authorisation

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31
Q

What is a medicinal purpose

A

Treating/preventing disease
Diagnosing or ascertaining existence/degree/extent
Contraception
Anesthesia
Preventing or interfering with the normal operation of physiological function

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32
Q

When are medicinal products usually designated POM

A

Medical supervision require to prevent (in)direct damage to human health
Misused and danger
New active substance
For parenteral admin

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33
Q

Who can prescribe all POM’s

A 
Doctor 
Dentist
Pharmacist IP
Nurse IP
Supplementary prescriber
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34
Q

Who can supply restricted POM’s

A 
Optomestrist IP
Paramedic IP
Physiotherapist IP
Podiastrist IP
Therapeutic Radiographer IP
Community practitioner nurse prescriber
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35
Q

What can Optometrist IP’s prescribe

A

Any POM

No CD’s or parenterals

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36
Q

What can Chiropodist IP’s prescribe

A 
Any POM 
Diazepam 
Dihydrocodeine
Lorazepam
Temazepam
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37
Q

What can Physiotherapist IP’s prescribe

A 
Any POM
Diazepam 
Dihydrocodeine 
Lorazepam
Temazepam
Fentanyl
Oxycodone
Morphine
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38
Q

What can Therapeutic radiographer IP’s prescribe

A 
Any POM
Codeine
Fentanyl 
Morphine 
Oxycodone
Tramadol 
Midazolam 
Temazepam
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39
Q

What can Paramedic IP’s prescribe

A 
Any POM 
Codeine 
Fentanyl
Midazolam
Morphine
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40
Q

Community practitioner nurse prescriber can prescribe

A 
Certain POM's - licensed  with marketing authorisation
Co-danthramer (caps, oral)
Co-danthrusate
Mebendazole
Miconazole
Nystatin
Streptokinase and streptodornase topical powder
Water for injections
Dressing/appliances
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41
Q

What is supplementary prescribing

A

Voluntary partnership between doctor or dentist and a supp prescriber to implement an agreed PATIENT SPECIFIC clinical plan with patients agreement

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42
Q

Who can be a supplementary precriber

A 
Pharmacist
Registered midwife
Registered nurse 
Chiropodist/Podiatrist
Paramedic
Physio
Radiograoher
Registered optom
Registered dietician
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43
Q

What should a clinical management plan include

A 
Name of patient
Illnesses/conditions to be treated by SP
Date of effect and review by IP
Class of description of medicinal product
Restrictions/limitations - strengths, doses, period of use
Relevant warnings/patient difficulties
Reporting or suspected/known ADR's
When SP should seek IP help
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44
Q

Which drugs can be prescribed by supplementary prescribing?

A 
Meds referred to in clinical management plan:
GSL and P
Appliances/devices
Foods
Borderlines
All POM inc parenteral CD's
Off license 
Unlicensed drugs as part of clinical trial
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45
Q

Is an EEA/Switzerland prescription valid in the UK?

A

Yes except CD 1-3

Must be a doctor, nurse (gen care), dentist, midwife, pharmacist, registered in the EEA or Switzerland

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46
Q

A valid UK rx must contain…

A 
Patient name
Patient address 
Patient age if under 12 
Prescriber signature 
Prescriber particulars
Prescriber address
Appropriate date 
(7)
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47
Q

What is a repeatable prescription?

A

Contains direction that it may be dispensed more than once

Only PRIVATE

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48
Q

When must the first repeat of a POM repeatable prescription be done by?

A

Within 6 months of appropriate date

CD4=28 days

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49
Q

How many repeats of a repeatable prescription can be done if not specified?

A

One (so original then another)

For oral contraceptives = 5 times (so 6 altogether)

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50
Q

After the first repeat of a repeatable prescription, how long is it valid for?

A

There is no time limit unless specified

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51
Q

What are the requirements for EEA/Switzerland prescriptions?

A

Patients name, nurname, DOB (no address)

Prescriber name, surname, qualifications
Direct contact details - email, phone/fax (with international prefix), work address and country

Medicine details - name/brand, form, quantity, strength, dosage

Prescriber signiture
Date of issue - valid for 6 months

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52
Q

Green prescriptions

A 
FP10NC
GP
Community practitioner nurse prescriber
SP
Hospital unit
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53
Q

Blue precription

A 
FP10MDA (Installment)
GP
IP
SP
Hospital unit
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54
Q

Lilac Prescription

A

FP10P
Community practitioner Nurse Precriber
Nurse IP/SP

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55
Q

Yellow Prescription

A

FP10D

Dentists in primary care - only DPF list

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56
Q

Why is a fax not legally valid?

A

Not written in indelible ink

Not signed by appropriate practitioner

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57
Q

Can medicines be dispensed of a fax/ when can they be?

A

No - supply can only be made legally when original Rx has been received and checked

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58
Q

Steps to take when suspecting forged prescription

A

Scrutinise signature - check against known if possoble
Confirm details with prescriber (that this was what they intended)
Use contact details from directory ect , NOT prescription

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59
Q

When is an Electronic prescription valid?

A

Created in electronic form
Electronic signature - uniquely linked, identifies, can maintain, change is detectable
Sent to the person dispensing as an electronic communication

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60
Q

What are the laws around SUPPLY of POMs in hospitals ?

A

May be supplied against a written direction (PSD) of an appropriate prescriber
Prescription requirements not required - must be pateint specific
Permits sale/supply against a bedcard and patient notes

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61
Q

What are the laws around ADMIN of POMs in hospitals ?

A

Directions do not need to be in writing (Good practice)
Some have policies
Emergency requires 2 nurses checking each other
Carefully consider and agree

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62
Q

When does a POM record not need to be made?

A

NHS
Oral contraceptives
Already in CD register
Sale by wholesale dealing with order/invoice retained for 2 years

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63
Q

When must a POM record be made within?

How long should it be kept for?

A

That day or the following day

2 years

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64
Q

What should be in the POM record?

A 
Patient name and address
Prescriber name and address
Date on prescription 
Date of supply
Medicine details - name and quantity
(form and strength if not apparent from name)
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65
Q

What is the fate of POM prescriptions?

A

Retain for 2 years
Unless:
NHS - sent off
Private CD 2/3 - Sent off

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66
Q

When can a pharmacist make changes to a prescription?

A

Name or common name of product
Directions for use
Precautions
Dose/duration (keep within cieling/timeframe)

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67
Q

What must be on a label of a broken bulk medicine?

A 
Name of med
Quantity in container
Quantitative particulars of medicine 
Handling and storage requirements
Expiry date
Batch ref no.
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68
Q

What does a ‘use by’ or ‘use before’ date mean?

A

Product should be used before end of previous month

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69
Q

What does an expiry date mean?

A

Product should not be used by the end of that month

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70
Q

What conditions are needed in order to sell P meds?

A

GPhC registered pharmacy
Responsible pharmacist
Person selling/supplying = pharmacist or under pharmacist supervision

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71
Q

What criteria can make a P medicine?

A

POM below a strength/dose
GSL above certain quantities
MA
Exemptions from licensing for pharmacists (counter prescribed)

72
Q

What makes a POM under Schedule 1 part 1 of HMR 12?

A

For parenteral admin
CD
Cyanogenic substance (other than for external)
Emit or generates radiation and are used for this
Contain - aspirin, aloxiprin, paracetamol (non-eff tabs pr capsules)
Pseudoephedrine salts or ephedrine base or salts
Not covered by MA but is a POM by POM Order 1997 and amendments

73
Q

Which controlled drugs can be P if following laws?

A 
Codeine 
Dihydrocodeine
Ethylmorphine
Morphine
Pholcodeine
Their salts and medicinal opium
74
Q

What is counter prescribing?

A

Pharmacist required to make up a medicinal product
Patient present
Use judgement as to treatment required
Always P if all contents are GSL

75
Q

What are the regulations with pseudoephedrine and ephedrine P meds?

A

Cannot sell together
720mg pseudoephedrine salts
or
180mg ephedrine

76
Q

What are the P and POM regulations on EHC?

A

Levonorgestrel Levonelle 1500 = POM
Levonelle One-step = P
Women 16+
Within 72 hours

Upristal acetate 30mg = POM
EllaOne 30mg tablet = P
within 5 days

77
Q

What are the P and POM regulations on codeine and dyhydrocodeine?

A

Short term use - max 3 days
P=32 max
POM = 32+
Must say short term use and have signs of addiction

78
Q

What are unsuitable ingredients for cough and cold medicines for children?

A

Antitussives
Expectorants
Nasal decongestants
Antihistamines

79
Q

Should codeine linctus BP be used for children?

A

No-over 18’s only

Use:Pulmo bailly, Galcodeine linctus

80
Q

What is GSL product?

A

Not P or POM but is covered by a MA stating it is to be available on general sale

81
Q

What are the conditions for a GSL sale in a retail pharmacy?

A

RP in charge of premises
RP accountable
RP does not need to be physically present or supervising

82
Q

What are the conditions for a GSL sale in a retail?

A

Premised can exclude public
Made up elsewhere in immediate and outer packaging
Not been opened and bulk not broken

83
Q

What are the conditions for Viagra POM to P?

A 
Oral
50mg sildenafil citrate
Erectile dysfunction
50mg tab prn with water about an hour before sex
MD 50mg
MDD 50mg
MP 8 tabs
84
Q

How many Esomeprazole can you purchase and what MD?

A

14 tablets
MD=20mg
MDD=20mg

85
Q

Can GSL be put on prescriptions?

A

Yes

Legal requirements

86
Q

Will GSL prescriptions be reimbursed by the NHS?

A

Yes unless blacklisted

87
Q

Is PO a HMR 12 legal classification?

A

No

88
Q

What is a PO medicine?

A

Product licensed as a GSL but restricted to sales through pharmacies only by license or manufacturers decisions
Does not need to be supervised

89
Q

Under what conditions can an emergency supply from a prescriber be made?

A

Appropriate prescriber
Cannot be provided immediately
Agrees to provide Rx within 72 hours
Sold/Supplied in accordance with directions of prescriber
NOT CD 1,2,3 unless phenbarbital/Na for epilepsy

90
Q

What needs to be in a record for emergency supply at prescribers request?

A 
Date of supply/sale
Date on prescription
Medicine detail - name, quantity, form, strength
Prescriber name and address
Patient name and address
91
Q

What conditions must be met for an emergency supply from a patient?

A

Immediate need and impracticable to get Rx
Previously prescribed
Dose appropriate

92
Q

What core and additional data is on the summary care record?

A

Core - allergies, adverse reactions, medication

Additional - Significant diagnosis, care plan info, any other relevant info they want (preferences ect)

93
Q

Which drugs cannot be supplied for an emergency request from a patient

A 
CD 1,2,3 except phenobarbital for epilepsy 
Anything containing:
Bromide salts 
Hexobarbitone/Na
Methohexitone/Na
Thiopentone/Na
Strychinine HCl
94
Q

How many days supply can be made for an emergency?

A 
Prescriber - any
Patient -
30 days
5 days if CD
1 cycle of oral contraceptive
smallest pack size if cant break bulk or if certain preperations
Antibiotic liquid full course
95
Q

What needs to be on the label of an emergency supply?

A

All usual

‘EMERGENCY SUPPLY’

96
Q

What are pandemic exemptions to emergency supply?

A

Do not have to interview patient
Just be satisfied it has previously been prescribed and dose is appropriate
Provisions to allow supply from designated collection points - do not have to be registered pharmacies
Supplies do not have to be supervised by a pharmacist

97
Q

Which injectables can be administered to save a life?

A 
Adrenaline
Atropine Sulfate 
Chlorphenamine
Dicobalt edetate
Glucagon
Glucose 50%
Hydrocortisone
Naldoxone
Pradidoxime HCl
Snake venom antiserum
Sodium nitrate
Sodium thiosulfate
98
Q

What is a PGD?

A

Written instructions for the sale/supply/administration of medicines to specific patient groups who may not be identified before presentation for treatment

99
Q

Who must sign a PGD?

A

Doctor OR dentist
AND
a pharmacist
anyone who may be required to sign in circumstances specified for its use

100
Q

Requirement for wholesale dealers license

A

Have to hold license
Apply good distribution practice standards
Have a suitably experienced Responsible person named on the license to ensure meds are procured, stored and distributed appropriately
Can only supply to - other wholesale dealers, pharmacists, other authorised persons entitled to supply to the public

101
Q

In what circumstances do pharmacists NOT need a wholesale dealers license

A

Small quantities
Occasional basis
Supply not for profit
Not for onward wholesale distribution

102
Q

What can doctors, dentists and vets supply?

A

POM, P, GSL to:
a patient of his/her, or
a person under whose care such a patient is

103
Q

What can midwives sell and supply?

A 
All GSL, P
POM containing:
Diclofenac
Hydrocortison acetate
Miconazole
Nystatin
Phytomenadione
104
Q

What can midwives administer?

A 
Adrenaline 
Anti-D Immunoglobulin
Cyclizine lactate
Diamorphine
Ergometrine
Hep B vaccine
Lignocaine/HCl
Morphine
Naloxone HCl 
Oxytocins
Pethidine
Phytomenadione
Prochloperazine
Sodium Chloride 0.9%
WHEN ATTENDING WOMEN IN CHILDBIRTH
105
Q

What can registered optometrists sell or supply? (Not IP ones)

A

All GSL
Certain P
Certain POM - non parenteral - in emergency:
Drops - <0.5% chloramphenicol
Ointments - <1.0% chloramphenicol
Containing cyclopentolate HCl, Fusidic acid or Tropicamide

106
Q

Which POM meds can optometrists use in their practise?

A 
Containing: 
Amethocaine HCl
Lignocaine HCl
Oxybuprocaine HCl
Proxymetacaine HCl
107
Q

What can additional supply optometrists supply?

A

Diclofenac Na

Polymixin B/bacitracin

108
Q

Which P meds can a chriopodist supply?

A 
Potassium permanganate crystals or solution 
Ointments of heparinoid and hyaluronidase 9.0% borotanic complex
Ibuprofen
Medicines containing, as their only ingredient, not more than:
Clotrimazole 1.0%
Crotamiton 10.0%
Econazole 1.0%
Griseofulvin 1.0%
Miconazole nitrate 2.0%
Pyrogallol 70.0%
Salicylic acid 70.0%
Terbinafine 1.0%
109
Q

Which POMs can chiropodists with the annotation supply?

A 
Amoxicillin, erythromycin, flucloxacillin
Co-codamol
Co-dydramol 10/500 tabs
Codeine phosphate
Amorolfine HCl cream – max strength 0.25%
Amorolfine HCl lacquer – max strength 5%
Tioconazole 28%
Silver Sulfadiazine
Topical hydrocortisone – max strength 1%
110
Q

Which can chiropodists with the local anaesthetic annotation supply?

A 
Adrenaline (Epinephrine)
Bupivacaine HCl 
Lignocaine (Lidocaine) HCl – and with adrenaline 1mg in 200ml
Mepivacaine HCl
Prilocaine HCl
Methylprednisolone
NOT DIRECTLY TO PATIENT
111
Q

What can paramedics administer?

A 
Diazepam 5mg/ml emulsion for injection
Succinylated gelatin 4% iv infusion
Adrenaline (HCl &amp; acid tartrate)
Amiodarone
Anhydrous glucose
Ergometrine maleate
Frusemide
Heparin Na (for cannula flushing only)
Lignocaine HCl
Adrenaline (HCl &amp; acid tartrate)
Amiodarone
Anhydrous glucose
Ergometrine maleate
Frusemide
Heparin Na (for cannula flushing only)
Lignocaine HCl
112
Q

What does a written order from the principle for inhalers need on it?

A

Name of school
Purpose for which medicinal product is required
Total quantity required

113
Q

What has to be on a signed order?

A

No legislation to specify
Advisable that details for a POM reg entry are on:
Date POM supplied
Name, quantity, and formulation & strength (where not apparent) of POM supplied
Name and address, trade/ business/ profession of person to whom medicine supplied
Purpose for which sold or supplied – has to be in record

114
Q

What does the Misuse of drugs act 1971 control?

A

Export, import, production, supply and possession or dangerous or other harmful drugs (CD’s)
Treatment of addicts

115
Q

What are the 5 schedules of drugs?

A 
Schedule 1 – CD Lic POM
Schedule 2 – CD POM
Schedule 3 – CD No Register POM
Schedule 4 
Part I – CD Benz POM
Part II – CD Anab POM
Schedule 5 – CD Inv P or CD Inv POM
116
Q

Who can manufacture or compound CD sch 2

A

License holder
Practitioner
Pharmacist
Person conducting retail pharmacy business

117
Q

Which drugs are in Schedule 1?

A

Hallocinogens (e.g. LSD), ecstasy-type drugs, raw opium, cannabis

118
Q

Which drugs are in Schedule 2?

A

Opiates:
Cocaine, diamorphine, ketamine, morphine, methadone, oxycodone, pethidine, secobarbital

Major stimulants:
Amfetamines

Quinalbarbitone

Cannabis-based products for medicinal use in humans

119
Q

Which drugs are in Schedule 3?

A 
Minor stimulants and other drugs
Barbiturates, e.g. phenobarbital (except quinalbarbitone/secobarbital)
Buprenorphine
Temazepam, flunitrazepam, midazolam
Tramadol
120
Q

Which schedule 3 drugs do safe custody requirements apply to?

A

Diethylpropion
Buprenorphine
Flunitrazepam
Temazepam

121
Q

Which drugs are in Schedule 4 Part 1?

A

Most benzodiazepines

Sativex

122
Q

Which drugs are in Schedule 4 Part 2?

A

Most anabolic and androgenic steroids, clenbuterol and growth hormones

123
Q

Which drugs are in Schedule 5?

A

codeine, pholcodeine, morphine

when present in medicinal products of low strength

124
Q

Who can possess, supply and procure CD’s with/without a license?

A

Without - doctors, dentist, pharmacists

With - Wholesalers, importers, exporters

125
Q

Classes of persons allowed to possess and supply CD sch 2-4

A

Doctor
Dentist
Pharmacist
Nurse independent prescriber (NIP)
Paramedic independent prescriber (limited)
Podiatrist (chiropodist) independent Rx-er (limited)
Physiotherapist independent Rx-er (limited)
Therapeutic radiographer independent Rx-er (limited)

126
Q

Directions for CD admin can be given by:

A

Doctor
Dentist
Nurse independent Rx-er
Paramedic independent prescriber (limited)
Pharmacist independent Rx-er
Podiatrist independent Rx-er (limited)
Physiotherapist independent Rx-er (limited)
Therapeutic radiographer independent Rx-er (limited)

127
Q

Which schedules require a licence for import and export?

A

1,2,3,4(part 1)

128
Q

How many months supply of CD’s can a traveler take?

A

3 Months

129
Q

What would you advise a traveller with CD;s to do?

A 
Obtain covering letter from Rx-er that confirms:
Pt name
travel plans, 
name of Rx-ed CD,
total quantities &amp; dose

Check with embassies or high commissions for countries they will travel through to ensure that import and export regulations in those countries are complied with
Check any additional requirements that travel operator may impose

130
Q

What are the two ways of obtaining CD’s?

A

Patients -prescription

Others - requisition order

131
Q

What needs to be on a requisition form?

A

Write CD (including strength, form, quantity & unit of measure)
Indicate purpose
Write their name, individual/ organisation code*, occupation/ professional qualification (e.g. GP, pharmacist, Vet), address of work premises
Sign their name (handwritten in ink)
Date

132
Q

Are faxed or photocopied requisitions acceptable?

A

No

133
Q

Authorised purchasers via requisition

A 
Practitioners
Hospitals
Ambulance trusts
Care homes
Ship and offshore installation personnel (without Dr)
Supplementary prescribers
Senior registered nurses in charge of wards, theatres and other hospital departments
GP = PHARMACIES
134
Q

If a messanger is sent for requisition pick up, what is required?

A

Written authorisation to recieve on behalf

135
Q

If CD required urgently and unable to supply a written requisition before delivery:

A

Doctor or dentist can be supplied schedule 2 or 3

Must be supplied withing 24 hours otherwise offence on their side

136
Q

What does the supplier of a requisition need to do?

A

rite their account submission code, name of organisation, and address in part A
OR
Include legible stamp in the top left section of Part A, confirming their details*
Ensure that customer has completed their relevant sections with correct data

137
Q

Where are requisitions submitted to?

A

NHSBSA using FP34PCD

138
Q

Requirements to mark and send to NHS agency do not apply to:

A

hospital or care home - Retain original requisition for 2 years
pharmaceutical manufacturer or wholesaler
prison pharmacy to wings within prison
Against midwife supply order (next*)
Against veterinary requisitions
Original requisition retained for 5 years

139
Q

What can midwives obtain on a midwife supply order?

A

Diamorphine
Morphine
Pethidine
For practice of their profession

140
Q

What must a midwifes supply order include?

A

Midwife’s name & occupation
Name of person to whom CD is to be administered or supplied
Purpose for which CD required
Total quantity to be obtained
Signature of the “appropriate medical officer”
= a doctor authorised (in writing) by local supervising authority

141
Q

What records of a midwifes supply order must be kept?

A

Retain for 2 years
CDR
Midwife must keep record in a book soley for that purpose
Not destroy stock- surrender to appropriate medical officer

142
Q

Which CD’s can NIP/PIP NOT supply?

A

Diamorphine, cocaine, dipipanone for addiction

143
Q

What additional controls are needed for cannabis based products?

A

‘special’ - none licensed
Special medical practitioner on GMC register
Discuss with peer clinician on same register and agreed by multi dis team

144
Q

What is a cannabis based product

A

Is or contains cannabis, cannabis resin, cannabinol or a cannabinol derivative
For medicinal use in humans
a medicinal product or a substance or preparation for use as an ingredient of, or in the production of an ingredient of, a medicinal product;”

145
Q

CD prescription requirements

A 
Indeligible
Signed
Dated
Prescriber address in UK
Specify dose
Formulation
Strength (if more than one)
Total quantity WORDS AND FIGURES
No more than 30 days (reccommended)

‘Dental treatment only’
Instalment directions

146
Q

What can a pharmacist amend of a CD prescription?

A

Minor typographical error

Missed words OR figures

147
Q

What form must private CD 2 and 3 be on?

A

FP10PCD

148
Q

Do private CD’s Rx’s issued and dispensed in a hospital need to be on FP10PCD?

A

No - same legal entity

149
Q

What is the fate of private CD 2 and 3 scripts?

A

Sent to NHSBSA using FP34PCD

150
Q

Do veterinary CD’s need to be on standard forms and sent off?

A

No and not sent off - keep for 5 years

151
Q

Can repeatable Rx’s be issued for CD 2 and 3?

A

No

152
Q

What time limit is on the first dispensing of CD 4 and 5 scripts?

A

4 - 28 days

5 - 6 months

153
Q

What records should be made for private CD 2 and 3?

A

2 - CDR

3 -POM reg as private

154
Q

Can a supply and admin of CD be made against a kardex?

A

Yes
Supply - all prescription requirements
Admin - not all prescription requirements

155
Q

How many days instalment can be prescribed?

A

14

156
Q

What is recommended if more than 3 days of installment is missed?

A

Do not supply

157
Q

Which prescriptions for addiction can only be prescribed by specially authorised doctors?

A

Cocaine
Diamorphine
Dipipanone

158
Q

What must a pharmacist do if a HCP is picking up a patients CD2?

A

Obtain name and address

Request ID proof (unless known)

159
Q

What must a pharmacist do if a representative of a drug misuse patient comes to collect?

A

Obtain letter from misuser that authorises - separate one each time
If supervised - contact prescriber

160
Q

What must a pharmacist do if a representative is picking up a patients CD2?

A

Professional judgement

MAY request evidence

161
Q

When can nurses and pharmacists supply diamorphine?

A

Acting in there capacity

Where admin is needed for immediate, necessary treatment of sick or injured persons (excluding addiction)

162
Q

Which controlled drugs can a nurse, pharmacist or other HCP supply or admin via PGD?

A

Schedule 5

Part 1 Schedule 4 or midazolam

163
Q

Which CD’s can an emergency supply be made for?

A

Schedule 4 and 5

Phenobarbitone/Na - for treatment of epilepsy at request of doctor, dentist, or supplementary prescriber

164
Q

How many days of emergency supply for a CD can be given?

A

5 days

165
Q

Where is safe custody of CD’s required?

A

Retail dealer
Care and residential homes
Mental care homes/private hospitals

166
Q

Which schedules do safe custody requirements apply to?

A

1
Most 2 (except some liquid preps and quinalbarbitone)
Some schedule 3 - temazepam, flunitrazepam, buprenorphine, diethylpropion

167
Q

How must a CD preparation be marked?

A

Amount of CD in each dosage unit AND number of dosage units
OR
Total amount of prep and percentage of each CD component

168
Q

What schedule is Sativex and does it need recording?

A

Schedule 4 part 1

HO strongly recommends recording - extracts of a schedule 1 CD (Cannabis sativa)

169
Q

What must be in the CDR for received drugs?

A

Date supply received
Name and address from whom received
Quantity received

170
Q

What must be in the CDR for supplied drugs?

A 
Date 
Name and address of recipient
Quantity supplied
Person collecting
Was ID requested
Was ID provoded
171
Q

Is a CDR running balance legal?

A

No, good practice

172
Q

When is there a requirement for a destruction witness for a CD?

A

If there is a requirement to make a CDR
So not for patient returns
But need for expired stock

173
Q

What does a CDAO do?

A

Ensure that each provider body establishes and operates appropriate arrangements for securing the safe management and use of CDs within organisations subject to their oversight
Can be authorised witnesses

174
Q

Who can be an authorised witness?

A

Police and GPhC inspectors

Any NHS England CDAO may designate (authorise) an individual and/or class of persons 
Senior members of staff not involved in day to day management or use of CDs

Multiples (5+) - Superintendent Pharmacist accountable for governance arrangements around witnessed destruction of CDs in their premises

Independents (<5) - CDAO authorises appropriate people or groups of people

175
Q

The CDR for destruction of CD’s must contain:

A

Drug name, form & strength
Quantity destroyed
Date of destruction
Signature of authorised witness present

Good practice:
Person carrying out destruction to sign (usually pharmacist)
Identify authority of witness

176
Q

Can pharmacies accept care home returns?

A

No - industrial waste not household waste

Need a waste carriers licence for storage and treatment

Sem 1 Year 2 (4 decks)

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