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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
What is found in the monograph
``` Description Identification tests Physical constants Min purity Ingredients Limit tests Storage conditions ```
26
How is public protection achieved
Restricting public access to poisons and potent drugs/medicines Prevent use for criminal purposes, self medication and gratification of addiction
27
What is the CHM
Commission on Human Medicines Committee of MHRA - advise ministers Advisory non-departmental public body Membership - clinicians, pharmacists, lay members, expert advisory groups
28
What is a medicinal product
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
29
What is a authorised medicinal product
Medicine - marketing authorisation Homeopathic's - Certificate of registration Herbals - Traditional herbal registration
30
What is a relevant medicinal product
A medicinal product with a marketing authorisation
31
What is a medicinal purpose
Treating/preventing disease Diagnosing or ascertaining existence/degree/extent Contraception Anesthesia Preventing or interfering with the normal operation of physiological function
32
When are medicinal products usually designated POM
Medical supervision require to prevent (in)direct damage to human health Misused and danger New active substance For parenteral admin
33
Who can prescribe all POM's
``` Doctor Dentist Pharmacist IP Nurse IP Supplementary prescriber ```
34
Who can supply restricted POM's
``` Optomestrist IP Paramedic IP Physiotherapist IP Podiastrist IP Therapeutic Radiographer IP Community practitioner nurse prescriber ```
35
What can Optometrist IP's prescribe
Any POM | No CD's or parenterals
36
What can Chiropodist IP's prescribe
``` Any POM Diazepam Dihydrocodeine Lorazepam Temazepam ```
37
What can Physiotherapist IP's prescribe
``` Any POM Diazepam Dihydrocodeine Lorazepam Temazepam Fentanyl Oxycodone Morphine ```
38
What can Therapeutic radiographer IP's prescribe
``` Any POM Codeine Fentanyl Morphine Oxycodone Tramadol Midazolam Temazepam ```
39
What can Paramedic IP's prescribe
``` Any POM Codeine Fentanyl Midazolam Morphine ```
40
Community practitioner nurse prescriber can prescribe
``` 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 ```
41
What is supplementary prescribing
Voluntary partnership between doctor or dentist and a supp prescriber to implement an agreed PATIENT SPECIFIC clinical plan with patients agreement
42
Who can be a supplementary precriber
``` Pharmacist Registered midwife Registered nurse Chiropodist/Podiatrist Paramedic Physio Radiograoher Registered optom Registered dietician ```
43
What should a clinical management plan include
``` 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 ```
44
Which drugs can be prescribed by supplementary prescribing?
``` 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 ```
45
Is an EEA/Switzerland prescription valid in the UK?
Yes except CD 1-3 | Must be a doctor, nurse (gen care), dentist, midwife, pharmacist, registered in the EEA or Switzerland
46
A valid UK rx must contain...
``` Patient name Patient address Patient age if under 12 Prescriber signature Prescriber particulars Prescriber address Appropriate date (7) ```
47
What is a repeatable prescription?
Contains direction that it may be dispensed more than once | Only PRIVATE
48
When must the first repeat of a POM repeatable prescription be done by?
Within 6 months of appropriate date | CD4=28 days
49
How many repeats of a repeatable prescription can be done if not specified?
One (so original then another) | For oral contraceptives = 5 times (so 6 altogether)
50
After the first repeat of a repeatable prescription, how long is it valid for?
There is no time limit unless specified
51
What are the requirements for EEA/Switzerland prescriptions?
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
52
Green prescriptions
``` FP10NC GP Community practitioner nurse prescriber SP Hospital unit ```
53
Blue precription
``` FP10MDA (Installment) GP IP SP Hospital unit ```
54
Lilac Prescription
FP10P Community practitioner Nurse Precriber Nurse IP/SP
55
Yellow Prescription
FP10D | Dentists in primary care - only DPF list
56
Why is a fax not legally valid?
Not written in indelible ink | Not signed by appropriate practitioner
57
Can medicines be dispensed of a fax/ when can they be?
No - supply can only be made legally when original Rx has been received and checked
58
Steps to take when suspecting forged prescription
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
59
When is an Electronic prescription valid?
Created in electronic form Electronic signature - uniquely linked, identifies, can maintain, change is detectable Sent to the person dispensing as an electronic communication
60
What are the laws around SUPPLY of POMs in hospitals ?
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
61
What are the laws around ADMIN of POMs in hospitals ?
Directions do not need to be in writing (Good practice) Some have policies Emergency requires 2 nurses checking each other Carefully consider and agree
62
When does a POM record not need to be made?
NHS Oral contraceptives Already in CD register Sale by wholesale dealing with order/invoice retained for 2 years
63
When must a POM record be made within? | How long should it be kept for?
That day or the following day | 2 years
64
What should be in the POM record?
``` 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) ```
65
What is the fate of POM prescriptions?
Retain for 2 years Unless: NHS - sent off Private CD 2/3 - Sent off
66
When can a pharmacist make changes to a prescription?
Name or common name of product Directions for use Precautions Dose/duration (keep within cieling/timeframe)
67
What must be on a label of a broken bulk medicine?
``` Name of med Quantity in container Quantitative particulars of medicine Handling and storage requirements Expiry date Batch ref no. ```
68
What does a 'use by' or 'use before' date mean?
Product should be used before end of previous month
69
What does an expiry date mean?
Product should not be used by the end of that month
70
What conditions are needed in order to sell P meds?
GPhC registered pharmacy Responsible pharmacist Person selling/supplying = pharmacist or under pharmacist supervision
71
What criteria can make a P medicine?
POM below a strength/dose GSL above certain quantities MA Exemptions from licensing for pharmacists (counter prescribed)
72
What makes a POM under Schedule 1 part 1 of HMR 12?
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
Which controlled drugs can be P if following laws?
``` Codeine Dihydrocodeine Ethylmorphine Morphine Pholcodeine Their salts and medicinal opium ```
74
What is counter prescribing?
Pharmacist required to make up a medicinal product Patient present Use judgement as to treatment required Always P if all contents are GSL
75
What are the regulations with pseudoephedrine and ephedrine P meds?
Cannot sell together 720mg pseudoephedrine salts or 180mg ephedrine
76
What are the P and POM regulations on EHC?
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
What are the P and POM regulations on codeine and dyhydrocodeine?
Short term use - max 3 days P=32 max POM = 32+ Must say short term use and have signs of addiction
78
What are unsuitable ingredients for cough and cold medicines for children?
Antitussives Expectorants Nasal decongestants Antihistamines
79
Should codeine linctus BP be used for children?
No-over 18's only | Use:Pulmo bailly, Galcodeine linctus
80
What is GSL product?
Not P or POM but is covered by a MA stating it is to be available on general sale
81
What are the conditions for a GSL sale in a retail pharmacy?
RP in charge of premises RP accountable RP does not need to be physically present or supervising
82
What are the conditions for a GSL sale in a retail?
Premised can exclude public Made up elsewhere in immediate and outer packaging Not been opened and bulk not broken
83
What are the conditions for Viagra POM to P?
``` Oral 50mg sildenafil citrate Erectile dysfunction 50mg tab prn with water about an hour before sex MD 50mg MDD 50mg MP 8 tabs ```
84
How many Esomeprazole can you purchase and what MD?
14 tablets MD=20mg MDD=20mg
85
Can GSL be put on prescriptions?
Yes | Legal requirements
86
Will GSL prescriptions be reimbursed by the NHS?
Yes unless blacklisted
87
Is PO a HMR 12 legal classification?
No
88
What is a PO medicine?
Product licensed as a GSL but restricted to sales through pharmacies only by license or manufacturers decisions Does not need to be supervised
89
Under what conditions can an emergency supply from a prescriber be made?
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
What needs to be in a record for emergency supply at prescribers request?
``` Date of supply/sale Date on prescription Medicine detail - name, quantity, form, strength Prescriber name and address Patient name and address ```
91
What conditions must be met for an emergency supply from a patient?
Immediate need and impracticable to get Rx Previously prescribed Dose appropriate
92
What core and additional data is on the summary care record?
Core - allergies, adverse reactions, medication Additional - Significant diagnosis, care plan info, any other relevant info they want (preferences ect)
93
Which drugs cannot be supplied for an emergency request from a patient
``` CD 1,2,3 except phenobarbital for epilepsy Anything containing: Bromide salts Hexobarbitone/Na Methohexitone/Na Thiopentone/Na Strychinine HCl ```
94
How many days supply can be made for an emergency?
``` 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
What needs to be on the label of an emergency supply?
All usual | 'EMERGENCY SUPPLY'
96
What are pandemic exemptions to emergency supply?
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
Which injectables can be administered to save a life?
``` Adrenaline Atropine Sulfate Chlorphenamine Dicobalt edetate Glucagon Glucose 50% Hydrocortisone Naldoxone Pradidoxime HCl Snake venom antiserum Sodium nitrate Sodium thiosulfate ```
98
What is a PGD?
Written instructions for the sale/supply/administration of medicines to specific patient groups who may not be identified before presentation for treatment
99
Who must sign a PGD?
Doctor OR dentist AND a pharmacist anyone who may be required to sign in circumstances specified for its use
100
Requirement for wholesale dealers license
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
In what circumstances do pharmacists NOT need a wholesale dealers license
Small quantities Occasional basis Supply not for profit Not for onward wholesale distribution
102
What can doctors, dentists and vets supply?
POM, P, GSL to: a patient of his/her, or a person under whose care such a patient is
103
What can midwives sell and supply?
``` All GSL, P POM containing: Diclofenac Hydrocortison acetate Miconazole Nystatin Phytomenadione ```
104
What can midwives administer?
``` 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
What can registered optometrists sell or supply? (Not IP ones)
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
Which POM meds can optometrists use in their practise?
``` Containing: Amethocaine HCl Lignocaine HCl Oxybuprocaine HCl Proxymetacaine HCl ```
107
What can additional supply optometrists supply?
Diclofenac Na | Polymixin B/bacitracin
108
Which P meds can a chriopodist supply?
``` 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
Which POMs can chiropodists with the annotation supply?
``` 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
Which can chiropodists with the local anaesthetic annotation supply?
``` Adrenaline (Epinephrine) Bupivacaine HCl Lignocaine (Lidocaine) HCl – and with adrenaline 1mg in 200ml Mepivacaine HCl Prilocaine HCl Methylprednisolone NOT DIRECTLY TO PATIENT ```
111
What can paramedics administer?
``` Diazepam 5mg/ml emulsion for injection Succinylated gelatin 4% iv infusion Adrenaline (HCl & acid tartrate) Amiodarone Anhydrous glucose Ergometrine maleate Frusemide Heparin Na (for cannula flushing only) Lignocaine HCl Adrenaline (HCl & acid tartrate) Amiodarone Anhydrous glucose Ergometrine maleate Frusemide Heparin Na (for cannula flushing only) Lignocaine HCl ```
112
What does a written order from the principle for inhalers need on it?
Name of school Purpose for which medicinal product is required Total quantity required
113
What has to be on a signed order?
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
What does the Misuse of drugs act 1971 control?
Export, import, production, supply and possession or dangerous or other harmful drugs (CD's) Treatment of addicts
115
What are the 5 schedules of drugs?
``` 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
Who can manufacture or compound CD sch 2
License holder Practitioner Pharmacist Person conducting retail pharmacy business
117
Which drugs are in Schedule 1?
Hallocinogens (e.g. LSD), ecstasy-type drugs, raw opium, cannabis
118
Which drugs are in Schedule 2?
Opiates: Cocaine, diamorphine, ketamine, morphine, methadone, oxycodone, pethidine, secobarbital Major stimulants: Amfetamines Quinalbarbitone Cannabis-based products for medicinal use in humans
119
Which drugs are in Schedule 3?
``` Minor stimulants and other drugs Barbiturates, e.g. phenobarbital (except quinalbarbitone/secobarbital) Buprenorphine Temazepam, flunitrazepam, midazolam Tramadol ```
120
Which schedule 3 drugs do safe custody requirements apply to?
Diethylpropion Buprenorphine Flunitrazepam Temazepam
121
Which drugs are in Schedule 4 Part 1?
Most benzodiazepines | Sativex
122
Which drugs are in Schedule 4 Part 2?
Most anabolic and androgenic steroids, clenbuterol and growth hormones
123
Which drugs are in Schedule 5?
codeine, pholcodeine, morphine | when present in medicinal products of low strength
124
Who can possess, supply and procure CD's with/without a license?
Without - doctors, dentist, pharmacists | With - Wholesalers, importers, exporters
125
Classes of persons allowed to possess and supply CD sch 2-4
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
Directions for CD admin can be given by:
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
Which schedules require a licence for import and export?
1,2,3,4(part 1)
128
How many months supply of CD's can a traveler take?
3 Months
129
What would you advise a traveller with CD;s to do?
``` Obtain covering letter from Rx-er that confirms: Pt name travel plans, name of Rx-ed CD, total quantities & 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
What are the two ways of obtaining CD's?
Patients -prescription | Others - requisition order
131
What needs to be on a requisition form?
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
Are faxed or photocopied requisitions acceptable?
No
133
Authorised purchasers via requisition
``` 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
If a messanger is sent for requisition pick up, what is required?
Written authorisation to recieve on behalf
135
If CD required urgently and unable to supply a written requisition before delivery:
Doctor or dentist can be supplied schedule 2 or 3 | Must be supplied withing 24 hours otherwise offence on their side
136
What does the supplier of a requisition need to do?
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
Where are requisitions submitted to?
NHSBSA using FP34PCD
138
Requirements to mark and send to NHS agency do not apply to:
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
What can midwives obtain on a midwife supply order?
Diamorphine Morphine Pethidine For practice of their profession
140
What must a midwifes supply order include?
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
What records of a midwifes supply order must be kept?
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
Which CD's can NIP/PIP NOT supply?
Diamorphine, cocaine, dipipanone for addiction
143
What additional controls are needed for cannabis based products?
'special' - none licensed Special medical practitioner on GMC register Discuss with peer clinician on same register and agreed by multi dis team
144
What is a cannabis based product
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
CD prescription requirements
``` 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
What can a pharmacist amend of a CD prescription?
Minor typographical error | Missed words OR figures
147
What form must private CD 2 and 3 be on?
FP10PCD
148
Do private CD's Rx's issued and dispensed in a hospital need to be on FP10PCD?
No - same legal entity
149
What is the fate of private CD 2 and 3 scripts?
Sent to NHSBSA using FP34PCD
150
Do veterinary CD's need to be on standard forms and sent off?
No and not sent off - keep for 5 years
151
Can repeatable Rx's be issued for CD 2 and 3?
No
152
What time limit is on the first dispensing of CD 4 and 5 scripts?
4 - 28 days | 5 - 6 months
153
What records should be made for private CD 2 and 3?
2 - CDR | 3 -POM reg as private
154
Can a supply and admin of CD be made against a kardex?
Yes Supply - all prescription requirements Admin - not all prescription requirements
155
How many days instalment can be prescribed?
14
156
What is recommended if more than 3 days of installment is missed?
Do not supply
157
Which prescriptions for addiction can only be prescribed by specially authorised doctors?
Cocaine Diamorphine Dipipanone
158
What must a pharmacist do if a HCP is picking up a patients CD2?
Obtain name and address | Request ID proof (unless known)
159
What must a pharmacist do if a representative of a drug misuse patient comes to collect?
Obtain letter from misuser that authorises - separate one each time If supervised - contact prescriber
160
What must a pharmacist do if a representative is picking up a patients CD2?
Professional judgement | MAY request evidence
161
When can nurses and pharmacists supply diamorphine?
Acting in there capacity | Where admin is needed for immediate, necessary treatment of sick or injured persons (excluding addiction)
162
Which controlled drugs can a nurse, pharmacist or other HCP supply or admin via PGD?
Schedule 5 | Part 1 Schedule 4 or midazolam
163
Which CD's can an emergency supply be made for?
Schedule 4 and 5 | Phenobarbitone/Na - for treatment of epilepsy at request of doctor, dentist, or supplementary prescriber
164
How many days of emergency supply for a CD can be given?
5 days
165
Where is safe custody of CD's required?
Retail dealer Care and residential homes Mental care homes/private hospitals
166
Which schedules do safe custody requirements apply to?
1 Most 2 (except some liquid preps and quinalbarbitone) Some schedule 3 - temazepam, flunitrazepam, buprenorphine, diethylpropion
167
How must a CD preparation be marked?
Amount of CD in each dosage unit AND number of dosage units OR Total amount of prep and percentage of each CD component
168
What schedule is Sativex and does it need recording?
Schedule 4 part 1 | HO strongly recommends recording - extracts of a schedule 1 CD (Cannabis sativa)
169
What must be in the CDR for received drugs?
Date supply received Name and address from whom received Quantity received
170
What must be in the CDR for supplied drugs?
``` Date Name and address of recipient Quantity supplied Person collecting Was ID requested Was ID provoded ```
171
Is a CDR running balance legal?
No, good practice
172
When is there a requirement for a destruction witness for a CD?
If there is a requirement to make a CDR So not for patient returns But need for expired stock
173
What does a CDAO do?
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
Who can be an authorised witness?
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
The CDR for destruction of CD's must contain:
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
Can pharmacies accept care home returns?
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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