Week 10: POMs Flashcards
What is a POM? (1)
A medicinal product that can only be sold/supplied in accordance with a prescription signed by an appropriate practitioner.
What does PSD mean? (1)
Patient specific direction e.g. Rx
Give e.g. of circumstances where POMs can be legally be supplied without a Rx. (3)
PGD
Emergency supplies
Patient specific direction in hospitals.
Give e.g. of products that are always POMs. (5)
Parenteral products
CDs unless the MA of product lists it as a P/GSL.
Cyanogenic substances unless for external use.
Medicinal substances that on administration emit radiation.
New chemical entities.
Give e.g. of products that can also be pharmacy medicines. (3)
Hydrocortisone 1% cream 15g
Naproxen 250mg - primary dysmenorrhoea
Codeine, dihydrocodeine and morphine (at low strengths)
What are the legal requirement for POM prescriptions? (10)
Must be issued by an appropriate practitioner
Be signed in ink by appropriate practitioner giving it.
Written in ink or indelible.
Address of appropriate practitioner.
The appropriate date
An indication of kind of appropriate practitioner.
Name and address of px.
If person < 12 yrs, px age.
Valid for 6 months from appropriate date.
Practitioner must be registered in the UK or be an approved health professional in approved country.
When should a repeatable prescription be dispensed? (1)
Should be dispensed for the first time within 6 months of the appropriate date and in acc. with directions contained on the Rx.
What does a repeatable Rx not always specify? (2)
The no. of repeats i.e. repeated only once.
Unless it’s a Rx for oral contraceptive which can be dispensed a total of 6 times (5 repeats) or not dispensed after end of the period of 6 months from the appropriate date.
What are ‘owings’? (2)
Px are given owing slips when the full quantity of medicines can’t be supplied at the time the px comes into the pharmacy. Supplied within the legal valid period of the Rx.
State the main features of a private Rx. (8)
Follows POM legal requirements.
Can be written on anything.
Can be written by any ‘appropriate practitioner’
Date on Rx is date when it was signed.
Rx must be satisfied it’s genuine.
No restrictions on what can be Rx (competence)
All rx written by approved health professional in approved country
Can be repeated.
State the main features of a repeatable Rx. (7)
Rx that can be repeated more than once.
No repeats allowed on FP10 unless part of NHS repeat dispensing scheme.
Repeat / repeat x?
No legal limit on no. of times a prescriber may request to be repeated.
No expiry of repeat Rx after it has been dispensed for the first time but prof. judgement should be used, considering clinical issues.
Px can retain Rx between repeats - pharmacy who dispenses the Rx for the final time must retain the Rx.
Repeatable Rx should be marked with name and address of the pharmacy and dispensing date to maintain an audit trail.
State the main features of prescribing by dentists. (6)
FP10(D) Rx (yellow) written by a dentist is valid only if the medicinal products are in the Dental Practitioner Formulary (DPF)
It’s against a dentists’ Terms of Service not to follow this.
It’s against a pharmacists’ Terms of Service to dispense such Rx.
DPT only has generic names but dentists can Rx a brand version of the generic product in the DPF.
A private Rx written by a dentist can legally be for any POM, P or GSL medicines (competence)
Dentists are required by the GDC to restrict their prescribing to areas in which they’re competent. Hence, dentists should only Rx medicines which have uses in dentistry.
State the main features of prescribing by community practitioner nurse prescribers. (5)
These include community nurses (District nurses + Health Visitors) who have under extra training.
Community nurse practitioners may prescribe a limited range medicines on a NHS Rx FP10P (lilac)
Medicines are listed in Nurse Prescriber’s Formulary (NPF) for community practitioners.
Similar Terms of Service issue to dental Rx.
Prescribers are recommended to Rx generically, except where it’s not clinically appropriate or no approved generic name.
What particulars is subject to ‘due diligence’? (5)
Address of appropriate practitioner.
Appropriate date.
Indication of kind of appropriate practitioner giving it.
Name and address of px.
If person is <12 yrs, person’s age.
What is the legal definition of due diligence? (1)
The sale/supply isn’t rendered unlawful if the person making the sale or supply, having exercised all due diligence, believes on reasonable grounds that the conditions has been met/Rx is genuine.
What is the working definition of due diligence? (1)
If any of the above particulars is missing (not incorrect) on a Rx, it’s not illegal to dispense as long as you have exercised due diligence.
State the main features of original pack dispensing (OPD). (6)
Starts on the 1st Jan 2025, allows pharmacists to supply a drug in its original pack even if the quantity dispensed is a different quantity to the Rx.
Quantity of drug dispensed must be within 10% (above or below) of the quantity on the Rx.
Only applicable to EPS NHS Rx + private Rx.
Not applicable to supplies under a SSP + non-Rx supplies, CDs Sch. 2-4 + specials.
Non-mandatory.
Pharmacist must believe that giving a different quantity to what’s Rx is reasonable and appropriate and will not cause px to fail to follow ‘the medication regimen as intended by Rx.’
What is the main benefit of the Original Pack Dispensing Law? (2)
May end blister cutting + repackaging of meds - saves time for pharmacy team.
What do you need to consider when dispensing valproate-containing medicines?
Only full packs of valproate-containing medicines can be supplied to px. (Closest to quantity of Rx)
Can’t be split or repackaged!
Applicable to all Rx (NHS + Private) for male/females.
What is the main benefit of dispensing valproate-containing medicines? (2)
Ensures px can see the warnings on the box.
Already contains a PIL/px card.
What would be the main exemption of not dispensing valproate-containing medicines in its original box? (1)
When supplied under MDS - risk assessment required and px to be given a PIL.
What do you need to consider when labelling a valproate-containing product? (1)
Ensure the label doesn’t cover the px safety warnings printed by the manufacturer on the pack.
Explain the main features of an electronic Rx. (3)
All POM legal requirements apply.
Must be signed with an advanced electronic signature and sent electronically to the person dispensing it.
All drugs (incl. CDs Sch. 2/3) can legally be sent as electronic Rx.
What does advanced electronic signature mean? (4)
Uniquely linked to person giving the Rx.
Capable of identifying signatory.
Signatory can maintain under their control.
Linked to the date to which it relates to in a way that any data changes is detectable.