unit 1 - Sale & Supply lesson 3&4

Question 1

Why is a faxed prescription not legal?

Answer 1

It is not written in indelible ink and has NOT been signed by an appropriate practitioner

Question 2

What are the risks associated with supplying medicines against a faxed prescription?

Answer 2

Misinterpretation
Fraud
Deception
Duplicate dispensing

Question 3

Why is supplying medicines against a faxed prescription risky?

Answer 3

Uncertainty that legally valid prescription exists
Risks of poor reproduction leading to errors
Risks of non-receipt of the original prescription
Risks that the original prescription is subsequently amended by the prescriber
Risks the fax is sent to multiple pharmacies
Risks that the prescription is not genuine
Risks that the fax system is not secure

Question 4

How can the integrity of the original prescription be checked?

Answer 4

Telephone surgery before dispensing the prescription to confirm the details

Make arrangements to get original prescription ASAP (ideally collect original from surgery at next visit)

Question 5

What are the penalties of supplying Schedule 2 or 3 Controlled Drugs without possession of a lawful prescription?

Answer 5

Could be prosecuted as a criminal offence

Question 6

What does the Misuse of Drugs Regulations 2001 allow for?

Answer 6

The lawful possession and supply of controlled (illegal) drug for legitimate purposes. They cover prescribing, administering, safe custody, dispensing, record keeping, destruction and disposal of controlled drugs to prevent diversion for misuse

Question 7

What are Controlled Drugs used for?

Answer 7

Pain relief
Palliative care
Epilepsy treatment
Alcohol and drug withdrawl
Methadone substitution etc

Question 8

Which schedule of Controlled Drugs is under the strictest control?

Answer 8

Schedule 1

Question 9

Where must records of the supply of Schedule 2 Controlled Drugs be kept?

Answer 9

Controlled Drugs register

Question 10

Which drugs are subject to Safe Custody Requirements?

Answer 10

All Schedule 2 Drugs (except quinalbarbitone)

Some Schedule 3 Drugs (temazepam, diethylpropion, buprenorphine, flunitrazepam)

Question 11

How long is a Schedule 1, 2, 3 or 4 Controlled Drug prescription valid for?

Answer 11

28 days

Question 12

How long is a Schedule 5 Controlled Drug prescription valid for?

Answer 12

6 months (pholcodine, codeine)

Question 13

What is a Veterinary Medicinal Product?

Answer 13

Any substance presented as having properties for treating or preventing disease in animals, or that may be used with a view to either restoring, correcting or modifying physiological functions by exerting a pharmacological, immunological or metabolic action or to making a medical diagnosis

Question 14

What are the classes of Veterinary Medicine?

Answer 14

POM-V
POM-VPS
NFA-VPS
AVM-GSL

Question 15

What is a POM-V?

Answer 15

Prescription only medicine that can only be prescribed by a veterinary surgeon and supplied by a veterinary surgeon or a pharmacist with a written prescription

Question 16

What is a POM-VPS?

Answer 16

Prescription only medicine that can be prescribed and supplied by a veterinary surgeon, a pharmacist or suitably qualified person on an oral or written prescription

A written prescription is only required if the supplier is not the prescriber

Question 17

What is a NFA-VPS?

Answer 17

A category of medicine for non-food animals that can be supplied by a veterinary surgeon, a pharmacist or a suitably qualified person

A written prescription is not required

Question 18

What is an AVM-GSL?

Answer 18

An authorised veterinary medicine that is available on general sale

Question 19

When can a POM-V medicine be supplied?

Answer 19

A Veterinary Medicinal Product (VMP) that has been classified as a POM-V may only be supplied if it has been prescribed by a veterinary surgeon following a clinical assessment of an animal, or group of animals, under the veterinary surgeon’s care

Question 20

When can a POM-VPS medicine be supplied?

Answer 20

A veterinary medicine classified as POM-VPS may be prescribed by any Registered Qualified Person (RQP - a veterinarian, a pharmacist or other Suitably Qualified Person under DEFRA guidelines). A clinical assessment of the animal(s) is not required when prescribing this category of veterinary medicine and the animal does not have to be seen by the prescriber

Question 21

What are the requirements for the prescribing, or making a supply of a NFA-VPS?

Answer 21

Advise of the safe administration of the product
Advise of any warnings or contraindications on the label package/leaflet
Be satisfied that the person administering it is competent and intends to use it for authorised use
Not prescribe or supply more than the minimum amount needed for treatment

Question 22

Who can supply a NFA-VPS?

Answer 22

A veterinary medicine classified as NFA-VPS may be supplied by an RQP (a veterinarian, a pharmacist or an appropriately qualified SQP) provided the requirements for supply are met

Question 23

Who can supply an AVM-GSL?

Answer 23

There are no legal restrictions in the VMR for the retail supply of veterinary medicines classified as AVM-GSL (over the counter medicine) but a responsible approach to the supply of these medicines is still expected

Question 24

When should a veterinary medicine with a UK MA be prescribed or supplied?

Answer 24

Where one exists and is clinically appropriate

Question 25

What allows for the supply of human medicines that are not otherwise licensed for use in animals?

Answer 25

The Cascade Exemption within the Veterinary Medicines Regulations It is unlawful to supply a human medicine against a Veterinary prescription unless it is prescribed by a vet and specifically states "for administration under the Cascade" (or words to this effect)

Question 26

What are the three types of collection and/or delivery service?

Answer 26

Standard Prescription Collection Service Managed Prescription Collection Service Delivery Service

Question 27

What are collection and delivery services governed by?

Answer 27

GPhC standards

Question 28

What is the Standard Prescription Collection Service?

Answer 28

An arrangement whereby a Pharmacy receives a prescription other than directly from the patient or their representative (e.g. collected by pharmacy staff or driver)

Question 29

How is the Standard Prescription Collection Service managed?

Answer 29

The Pharmacy MUST: obtain consent to receive the patient's prescriptions explain to patients/careers what the service involves including when to collect the medication prescriptions must be collected by individuals acting in accordance with the Pharmacist's directions have procedures in place to safeguard confidentiality and security

Question 30

How is the Standard Prescription Collection Service organised?

Answer 30

Any request for an ONGOING service must come directly from the patient or career, ideally in writing On receipt of any prescriptions, the Pharmacist must ensure that they are authorised to receive and dispense them Any prescription received without consent should be returned to the pharmacy

Question 31

What is the difference between the Standard and Managed Prescription Collection Service?

Answer 31

The patient doesn't prompt the Pharmacy to order their repeat prescription with the Managed Prescription Collection Service

Question 32

How does a Managed Prescription Collection Service work?

Answer 32

The Pharmacy will prompt the patient in order to establish what medications are needed and will inform the patient when the medication will be ready to collect

Question 33

Why was a Managed Prescription Collection Service set up?

Answer 33

Began in order to manage increasing workloads - allows the Pharmacy 7 days to order and dispense the prescription Reduces wastage, increases compliance and secures the patient's repeat custom

Question 34

What is the Prescription Delivery Service?

Answer 34

A service whereby medicines are handed to the patient/career someplace other than in the registered Pharmacy e.g. their home or place of work

Question 35

How is the Prescription Delivery Service managed?

Answer 35

Pharmacist still has a professional responsibility to ensure that the patient knows how to use the medication safely and is not experiencing side effects or compliance issues. This is especially important for medications such as Warfarin that require careful and frequent monitoring of blood levels

Question 36

Why must appropriate records be kept for the Prescription Delivery Service?

Answer 36

Audit purposes

Question 37

What are the responsibilities of the Pharmacist with the Prescription Delivery Service?

Answer 37

Must ensure that the delivery mechanisms: are safe ensure prompt delivery with instructions for use medicines are handed to the patient/carer unless alternative arrangements have been made confirm the correct name and address of recipient cater for special storage requirements (e.g. refrigerated lines) have a clear audit trail and safeguards confidentiality obtain a signature to verify safe delivery (good practice)