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Pre-Reg November Exam '24 > MEP > Flashcards

MEP Flashcards

1
Q

Restrictions around GSL medication

A
  • Can be sold in registered pharmacy, and any retail outlets
  • Can only be sold when pharmacist assumes responsibility, but can when pharmacist not present
  • Due to EU or UK marketing authorisation
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2
Q

Restrictions surrounding P medication

A
  • Can only be sold in registered pharmacies
  • Can be sold by pharmacist or person acting under supervision of pharmacist
  • Can only be sold when pharmacist assumes responsibility, but can when pharmacist not present
  • Self-selection of P meds are prohibited
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3
Q

Restrictions surrounding POM medication

A
  • Prescription only medication
  • Subject to restriction of requiring a Rx written by appropriate prescriber
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4
Q

Restrictions surrounding pseudoephedrine and ephedrine

A
  • Sale of a product containing more than 720mg pseudoephedrine OR 180mf ephedrine at any time without a Rx
  • Must not sell both products at the same time without Rx
  • Meaning you can sell more than one pack of each but as long as combined strengths do not exceed those stated above
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5
Q

Why are the restrictions on pseudoephedrine and ephedrine in place?

A

Due to potential misuse in illicit production of Methylamphetamine (crystal meth)

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6
Q

Restrictions in place on sale of codeine and dihydrocodeine and packaging

A
  • Only sell up to 32 dose units as a P medication, any higher is POM
  • Each pack MUST have the warning, ‘Can cause addiction. For three days use only’
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7
Q

What are the 4 phases that constitute a CPD

A
  • Reflection
  • Planning
  • Action
  • Evaluation
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8
Q

What is the minimum number of CPDs required to be submitted per year

A

9 CPDs

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9
Q

How many annual CPDs must start at reflection stage?

A

3 reflection CPDs

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10
Q

What are the regulation on relevance of CPDs submitted

A

Entries must be relevant to the safe and effective use of practice of pharmacy and your own scope of practice

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11
Q

Restrictions on sale of EHC

A

MUST NOT be sold to patients representative, due to possible abuse (forced sexual activity)

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12
Q

Which EHC are licenced for sale OTC?

A
  • Levonorgestrel 1500mcg tablets
  • Ulipristal acetate 30mg tablets
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13
Q

At what age and time period after unprotected sex can levonorgestrel be sold?

A
  • 16 years and over
  • Within 72 hours (3 days) of unprotected sex
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14
Q

At what age and time period after unprotected sex can ulipristal be sold?

A
  • No age limit
  • Within 120 hours (5 days) of unprotected sex
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15
Q

Thoughts relevant to a child under 13 requiring sale of EHC

A
  • 13 is too young to consent to sexual activity
  • Instance should be treated as serious event and reported to social services (Frasers guidelines)
  • Pharmacist can provide contraception or sexual health advice to children under 13 years old
  • Can sell Ulipristal
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16
Q

Can an advanced supply of EHC be sold?

A
  • Pharmacists can provide an advanced supply of oral EHC (professional judgement)
  • Patient should be assessed to ensure that they are competent, they intend to use properly and its clinically appropriate
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17
Q

Can a pharmacist refuse supply of EHC on religious or moral beliefs?

A

Yes

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18
Q

by which other services can patients acquire EHC?

A
  • Family planning clinics
  • GPs
  • Providers of PGDs for EHC and genitourinary medicine (GUD) clinics
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19
Q

Which medications interact with EHC tablets?

A
  • Barbiturates e.g. phenobarbital
  • Primidone
  • Phenytoin
  • Carbamazepine
  • Rifampicin
  • Rifabutin
  • Ritonavir
  • Griseofulvin
  • Ciclosporin
  • St. John’s Wort

All reduce effectiveness of OTC EHC- referral to GP

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20
Q

Other reasons for pharmacist’s refusal to sell EHC, and refer

A
  • Signs of abuse
  • Unprotected sex outside of licence
  • Pregnancy
  • Feel sick
  • Vaginal bleeding
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21
Q

Can Levonorgestrel and Ulipristal be used again in the same menstruation cycle?

A
  • Levonorgestrel- YES
  • Ulipristal- NO
22
Q

Regulations surrounding the responsible pharmacist (RP)

A
  • In order to conduct business, registered RP must be in charge
  • Pharmacist must be physically present to accept responsibility
  • Can only be the RP in charge of ONE PREMESIS at any given time
23
Q

Legal requirements for the RP notice board

A

Must be displayed conspicuously in the registered pharmacy, and include:
* Your name
* Your GPhC number (NOT RPS membership number)
* That you are the responsible pharmacist in charge of that premises

24
Q

Regulations surrounding RP register

A
  • Can be paper or electronic
  • Pharmacist must sign the register (must be physically present at pharmacy for this)

Register must include:
* Date and time when the RP became the RP
* Date and time when RP ceased to be the RP
* Date and time at which absence of RP commenced and returned to premises

Register must be kept in pharmacy for 2 years ready for inspection by GPhC

25
Q

Regulations surrounding RP absence

A
  • RP can be absent for up to 2 hours in each 24 hours (between midnight and midnight)
  • Where there are 2 RPs assigned, total absence between them must not exceed 2 hours
  • Sale and supply of GSL medicines can take place during absence
  • Sale of P medicines, and handing out of POMs can NOT take place
26
Q

Regulations surrounding private human prescriptions

A
  • Private Rx itself must be retained for 2 years
  • Record made in paper or electronic register and retains for 2 years
  • Record should be made on the day of sale, or if impractical, the following day
  • Rx for oral contraception and Sch 2 meds are exempt from record keeping
27
Q

What information must a private Rx record contain?

A
  • Supply date
  • Prescription date
  • Medicine details (name, quantity, form, strength)
  • Prescriber details
  • Patient details
28
Q

What are the legal requirements for emergency supply requested by prescriber?

A
  • Appropriate practitioner
  • Immediate need- satisfied it is emergency and Rx can’t be obtained
  • Promised an obtained Rx within 72 hours (3 days)
  • Directions- medicine is supplied in accordance with directions from prescriber
  • Not CD 1,2 or 3, except phenobarbital for epilepsy
  • Record kept- entry in POM register (retained for 2 years)
29
Q

What are the legal requirements for emergency supply requested by a patient?

A
  • Interview and satisfied the need is immediate- establish Rx can’t be obtained
  • Previous treatment- check PMR or contact prescriber directly
  • Dose- appropriate and safe
  • Not CD 1, 2 or 3, except phenobarbital for epilepsy
  • Length of treatment- if supply is CD (phenobarbital or Sch 4&5) MAX 5 days treatment. POM- MAX 30 days supplied (professional judgement- can give less)
30
Q

Are there any exceptions to the length of POM supplied under emergency supply?

A
  • If an insulin, ointment, cream or inhaler (i.e. packs can’t be broken), supply smallest pack
  • If POM is oral contraceptive, supply full treatment cycle
  • If POM is a liquid antibiotic, supply the smallest quantity to complete course of treatment
31
Q

Record requirements for ES by request of prescriber

A
  • Date POM supplied
  • Name, form, quantity and strength of medication
  • Name and address of prescriber requesting medication
  • Name and address of patient for whom the medication was requested for
  • Date on prescription (can be added once Rx is obtained- up to 3 days after)
32
Q

Record requirements for ES by request of prescriber

A
  • Date of POM supplied
  • Name, form, quantity and strength of medication
  • Name and address of patient requesting medication
  • Nature of emergency
33
Q

Any label requirements for emergency supplied mediation?

A

MUST have the words, “Emergency supply” on label

34
Q

Prescription requirements for vet Rx (POM-V, POM-VPS only)

A

Prescriber details

  • Name and address
  • Telephone number
  • Qualification
  • Signature
  • Name and address of owner
  • Identification of species of animal
  • Address of animal (if different to owner)
  • Date of Rx
  • Medication name, quantity, dose and strength
  • Clear administration instructions (‘AS DIRECTED’- not acceptable)
  • ‘UNDER THE VETERINARY CASCADE’
  • For Sch 2, 3, must contain ‘THE ITEM HAS BEEN PRESCRIBED FOR AN ANIMAL OR HERD UNDER THE CARE OF VET’
  • if repeatable, number of times it can be repeated must be present
  • Any necessary warnings or withdrawal
35
Q

How long as POM-V and POM-VPS valid for?

A
  • Regular valid for 6 months
  • Sch 2, 3 and 4 are valid for 28 days
36
Q

Legal requirements surrounding vet Rx label on medication

A
  • Name of prescribing veterinary surgeon
  • Name and address of animal owner
  • Name and address of pharmacy
  • Identification of species of animal
  • Date of supply
  • Expiry date of product
  • Medication details
  • Dosage and admin. instructions (asd- not acceptable)
  • Any warnings or withdrawal info
  • The words ‘FOR ANIMAL USE ONLY’ and ‘KEEP OUT OF REACH OF CHILDREN’
37
Q

What records must be made for POM-V and POM-VPS Rx

A
  • Paper or electronic records
  • Must be kept for 5 years
  • Pharmacists that supply POM-V and POM-VPS MUST take an annual audit

Record must include:

  • Name of medicine
  • Date of receipt or supply
  • Batch number
  • Quantity
  • Name and address of the supplier or recipient
  • Name and address of prescriber
38
Q

What might a signed order be used for?

A
  • Optometrist and podiatrist because they can’t write a Rx
  • Also used for school head office to request salbutamol for school
39
Q

Legal requirements for signed orders record making

A

Record must be made in POM register

  • Date POM was supplied
  • Name, quantity, form and strength of POM
  • Name and address, trade, business or profession of the person to whom the POM was supplied
  • The purpose for which it was sold or supplied
40
Q

Can schools request supply of Adrenaline Auto-Injectors (AAIs) without Rx?

A

Yes- since legislation change in March 2017

Provided it is for individual emergency use, and not for profit

41
Q

What information should be present on signed order from a school for an AAI?

A

Order must be signed by the principle or head teacher at the school concerned and state”:

  • Name of the school for which the AAI is required
  • The purpose for which the AAI is required
  • Total quantity required
42
Q

Which medications require entry into CD register?

A

Any Sch 1+2

43
Q

What must be recorded in CD register when a pharmacy premises receives a CD i.e. through order from distributer

A
  • Date supply received
  • Name and address from whom received
  • Quantity received
44
Q

What must be recorded in CD register when a CD is supplied to a patient

A
  • Date supplied
  • Name and address of recipient
  • Prescriber or licence holders details (address not required)
  • Details of person collecting (if not patient, record their name and address)
  • Whether proof of identity was requested
  • Whether proof of identity was provided
45
Q

Legal regulations surrounding CD requisition

A
  • Only for Sch 2+3
  • MUST use standard CD requisition form
  • Faxed requisition is not acceptable
  • Requisitions of Sch 2+3 are not required for transfer of CD from one pharmacy to another
  • Emergency supply can be made to doctor or dentist, providing requisition will be provided within 24 hours (failure to provide will be an offence to the doctor or dentist)
46
Q

Legal requirements for CD requisition form information

A
  • Signature of recipient
  • Name of recipient
  • Address of recipient
  • Profession or occupation
  • Total quantity for drug
  • Purpose of requisition
46
Q

Legal requirements for processing of CD requisition form

A
  • Mark form indelibly with suppliers name and address (pharmacy’s)
  • Retain a copy for 2 years from date of supply
  • Send the original to relevant NHS agency (‘MARK AND SEND’)
46
Q

When is ‘mark and send’ of CD requisition form not necessary

A

When requisition made by:

  • Hospital or care home
  • Pharmaceutical manufacturers or wholesalers
  • Prison pharmacy
  • Against midwife supply order
  • Against veterinary requisition (original requisition retained for 5 years)
47
Q

Which medication can a midwife request to obtain using a midwife supply order

A
  • Diamorphine
  • Morphine
  • Pethidine
48
Q

What information must a midwife supply order contain?

A
  • Name of midwife
  • Name of person the medicine is for
  • Purpose to which medicine is required
  • Total quantity of drug
  • Signature of appropriate medical officer
49
Q
A

Pre-Reg November Exam '24 (10 decks)

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