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PHAM01 > POMs 1 > Flashcards

POMs 1 Flashcards

1
Q

What is a POM?

A

medicine listed in the POM Order
OR
a medicine where the MA lists the classification as POM
OR
medicinal product that can only be sold with a Rx and signed by appropriate practitioner

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2
Q

PSD - patient specific direction

A

a prescription

instruction from a prescriber for a medicine to be supplied to a named patient after assessment of patient

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3
Q

How to legally supply POM without Rx (only exceptions)?

A

PGD

emergency supply

patient spesific directions in hospitals

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4
Q

supply vs sale of POM

A

dispensing NHS Rx = supply

dispensing private Rx = sale

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5
Q

products that are always POMs

A
  • parenteral products
  • CDs (unless MA lists it as P/GSL)
  • cyanogenic substances (unless external use)
  • med substances that on admin emit radiation
  • new chemical entities
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6
Q

How can some products also be P or GSL?

A

depending on indication, pack size, strength, formulation, route of admin

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7
Q

example of POM that can be P based on strength, form, route of admin, pack size

A

hydrocortisone – 1% cream 15g [P]

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8
Q

example of POM that can be P based on specific indication

A

naproxen 250mg – primary dysmenorrhea in women aged between 15 and 50 years [P]

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9
Q

example of POM that can be P for CDs at low strengths

A

codeine, dihydrocodeine, morphine and pholcodine

  • exempt from POM status when in preparations containing only one of the controlled drugs below the stated strength
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10
Q

legal requirements for prescriptions for POMs

A

Issued by an appropriate practitioner and:
1. signed in ink by the appropriate practitioner

  1. written in ink or otherwise so it’s indelible
  2. contain the following particulars:
    - address of the appropriate practitioner
    - appropriate date
    - indication of the type of app. practitioner
    - name and address of the patient
    - if U12, pt’s age
  3. valid for 6 months from the appropriate date
  4. practitioner MUST be REGISTERED in the UK or be an approved health professional in an approved country
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11
Q

time for repeatable Rxs to be dispensed

A

first time within 6 months of appropriate date

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12
Q

Repeatable prescriptions that do not specify the number of repeats, how many times can they be dispensed?

A

can be repeated only once

** unless Rx for an oral contraceptive, then can be dispensed a total of six times (5 repeats)

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13
Q

can repeats be on normal NHS Rxs?

A

NO

** only on NHS repeat dispensing scheme

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14
Q

Who can issue POM Rxs?

A

appropriate practitioner

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15
Q

approved countries

A

EEA countries and Switzerland

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16
Q

other things needed to dispense POM that AREN’T legal, clinical about drug

A
  • name of drug
  • form
  • strength
  • dose
  • frequency
  • quantity
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17
Q

private Rxs

A
  • same legal requirements
  • can be written on anything (no specific template)
  • can be repeated
  • no restrictions on what can be prescribed (as long as prescriber is competent to do so)
  • can be written by any ‘appropriate practitioner’
  • date on private prescriptions is the date when it was signed
  • all prescriptions written by health professionals in an approved country are private prescriptions
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18
Q

colour and name of dentist Rx

A

yellow

FP10 D

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19
Q

FP10 D limitations

A

only valid if the medication is in the Dental Practitioners’ Formulary (DPF)

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20
Q

Can dentists prescribe generics or branded meds?

A

generic AND branded if in DPF

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21
Q

private dentist Rx

A

can legally be for any POM, P or GSL medicine

but

should be in area they’re competent, should prescribe medicine for use in dentistry

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22
Q

colour and name of Community Practitioner Nurse Prescribers Rx

A

lilac

FP10 P

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23
Q

meds Community Practitioner Nurse Prescribers can Rx on NHS Rx

A

a limited range of meds listed in the Nurse Prescribers’ Formulary for Community Practitioners (NPF)

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24
Q

Community Practitioner Nurse Prescribers and generics

A

recmmended to Rx generically except where no approved generic name

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25
Q

missing info on Rx (ONLY address, app date, name, age)

A

not illegal to dispense if exercised DUE DILIGENCE when dispensing

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26
Q

Are faxed Rx legal?

A

NO (not signed by prescriber)

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27
Q

if dispensing faxed Rx

A

MUST ensure the original Rx will be with pharmacist within a short time

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28
Q

ways to avoid faxed Rx if need POM in emergency

A

emergency supply

electronic prescriptions

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29
Q

faxed Rx and CD 2 & 3

A

criminal offence to dispense faxed Rx of CD 2 & 3 because Rx not present in the pharmacy

30
Q

photos of Rxs

A

not legally valid

31
Q

printing out photo/email of Rx

A

not the original copy

like faxed Rx

not legal Rx

32
Q

forged Rxs

A

dispensing forged = criminal offence

need to exercise all ‘due diligence and believe that the Rx is genuine’

33
Q

signature on electronic Rx

A

must be signed with ‘an advanced electronic signature’

34
Q

What drugs can be sent as electronic Rxs?

A

all drugs (incl CD2 & 3s)

35
Q

What does ‘advanced electronic signature’ mean?

A
  • uniquely linked to the person giving the Rx
  • can ID the prescriber
  • created using means that the prescriber can maintain under their control
  • linked to the data to which it relates in such a way that any subsequent change of the data is detectable
36
Q

What does pharmacy do with electronic Rxs?

A

sent from GP to pharmacy via NHS spine

printed out in pharmacy and known as ‘dispensing tokens’

printed in pharmacy on FP10 DT

37
Q

legal requirements for non-UK Rxs

A
  • patients full first name, surname and date of birth
  • prescriber’s full first name, surname, professional qualifications, direct contact details, including email address and PHONE NUMBER or fax number (with international prefix), work address (including the country they work in)
  • name of medicine (brand name where appropriate), form, quantity, strength and dosage details
  • prescriber’s signature
  • date of issue
38
Q

CDs and non-UK Rxs

A

CDs in Sch 1, 2 or 3 and products without UK MA can NOT be prescribed

39
Q

cautions with non-UK Rxs

A
  • likely written in foreign language (legally ok)
  • need to check registration status of the prescriber and there is no international database of prescribers
40
Q

If unable to confirm the registration status of non-UK Rx?

A

due diligence

41
Q

When do Rx records NOT need to be made for supply of a POM?

A
  • on a health Rx or a Rx for an oral contraceptive
  • a separate record is made in the CD register
  • wholesale dealing and the order or invoice (or a copy of it) is retained for two years
42
Q

where to keep records

A

POM register/Rx book

Electronically - need backups and facility for inspector to examine without disrupting the dispensing process

43
Q

hospital pharmacies and POM records

A

hospital pharmacies only need to make records if they are registered as a pharmacy with the GPhC

44
Q

When should entry be made in POM register?

A

on same day as the sale/supply

or if not reasonably practical, the next following day

45
Q

How long to keep POM records for?

A

2 years from date of the last entry in the book

46
Q

How long to keep POM PRESCRIPTIONS for?

A

for 2 years from date of last supply/sale

47
Q

details to be recorded in POM register

A
  • date of sale/supply
  • name, quantity and, except where it is apparent from the name, the form and strength of POM supplied
  • date on Rx
  • name and address of prescriber
  • name and address of patient
  • entry needs ref no., put this on Rx and onto dispensing label
48
Q

records for subsequent supplies of a repeat Rx

A

record date and original reference number of the first supply

49
Q

Where to send NHS Rxs?

A

send to NHSBSA (business services authority) prescription services division

at the end of the month

50
Q

Where to send private Rx (non-repeatable)?

A

keep at the pharmacy for 2 years

51
Q

Where to send private Rx (repeatable)?

A
  • if still repeats outstanding, give Rx back to patient or offer to retain at the pharmacy
  • if final repeat has been dispensed, keep at the
    pharmacy for 2 years from the date of the final dispensing
52
Q

hub and spokes

A
  1. Rx handed in at spoke, sent to hub, hub sends meds to spoke, spoke supplies pt
  2. Rx handed in at spoke, sent to hub, hub supplies Rx to patient (sent/delivered)

only chain pharmacies can use this (dispensing and supply to pt has to be done by same retail business - law)

hub registered with GPhC

but doesn’t need NHS contract to dispense NHS Rxs

** not dispensing from distance selling pharmacy

53
Q

avantages of dispensing from a hub

A
  • better efficiency
  • lower operating costs (but initial set up costs high)
  • free up pharmacists’ time at spoke for other activities
  • use of automation in the hub (reduced errors, safer dispensing, cheaper) – but hubs don’t have to use automated systems - dispensing robots
54
Q

disadvantages of dispensing from a hub

A
  • concerns about accountability and liability
  • legally, responsibility for the dispensing of the prescription is with pharmacist who supplies the med
  • clinical check is the responsibility of the spoke and
    the accuracy check is the responsibility of the hub?
  • operational failure in a hub could have consequences for patients
  • confidentiality and security of information is more complicated
  • could it affect the patient/pharmacy relationship (esp if the hub
    supplies the medicine to the patient directly)
  • not suitable if the patient needs medicine quickly/urgently
55
Q

Is supply from hub to spoke wholesale dealing?

A

NO

56
Q

questions about hub and spoke dispensing?

A

which address should go on dispensing label?

57
Q

concerns with online pharmacies

A
  • high risk med/repeat supply and no monitoring
  • Rx meds outside of prescribers’ scope of practice
  • high volumes of Rxs issued in short period of time
  • risk of meds liable to abuse/OD (CDs, Z drugs, weight loss meds)
58
Q

logo for online pharmacies

A

shows registered with GPhC

59
Q

SSPs

A

serious shortage protocols

60
Q

What are SSPs?

A

allow pharmacist to supply a different med to what’s on the Rx

61
Q

4 possible actions that can happen with SSPs

A
  • dispense a smaller quantity
  • dispense an alternative formulation or strength (of the same drug)
  • dispense a generic equivalent for a branded Rx
  • dispense an alternative drug with a similar therapeutic effect
62
Q

informing GP about SSP

A

patient’s GP must be informed if a SWITCH of medicine has occurred

  • but not if a different form or quantity has been dispensed
63
Q

When only can SSPs be used?

A
  • if prescription presented is legally valid
  • patient has to consent to receiving the medicine supplied under the SSP – if they do not, then they need to be referred back to prescriber
64
Q

original prescription and supply under SSP

A

if supply made under a SSP (even if lower quantity of the med supplied), the original Rx is no longer valid and no further supply can be dispensed from it

65
Q

the dispensing label and SSPs

A

the dispensing label needs to indicate that a supply was made
under a SSP and state the reference number of the SSP

66
Q

charge and SSPs

A

if pt usually pays Rx charge but receive a smaller quantity of the medicine, they’re exempt from a prescription charge payment

67
Q

drugs NOT elegible for SSPs

A

if brand prescribing is therapeutically important

certain drugs used for epilepsy

68
Q

admin of parenteral POM

A

unlawful to admin a parenteral POM other than to yourself unless you are an appropriate practitioner or you are acting in accordance with the directions of an appropriate practitioner

69
Q

parenteral products exempt from restriction

A
  1. if administered for the purpose of saving life in an emergency
  • adrenaline (epinephrine) injection
  • glucagon injection
  1. certain hc professionals can also admin meds in
    accordance with a PGDs
70
Q

legal restrictions when admin non-parenteral POMs

A

there are no LEGAL restrictions on the administration of non-parenteral POMs

(but organisations should have policies covering this)

PHAM01 (22 decks)

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