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MEP 2021/22 > 3.3 Professional And Legal Issues: POM > Flashcards

3.3 Professional And Legal Issues: POM Flashcards

1
Q

General Prescription requirements [7]

A
  1. Patient Name
  2. Patient Address
  3. Age if under 12 (DOB not legal req)
  4. Prescriber signature
  5. Prescriber address
  6. Date (valid 6 months, if CD 28 days)
  7. Particular - that indicate the type of appropriate practitioner
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2
Q

Discuss repeatable prescriptions [4]

A
  • Repeated IF indicated by the prescriber
  • Number is not stated - can only be repeated once (dispensed twice)
  • UNLESS prescription is for an oral contraceptive - can be repeated five times (dispensed six times in total)
  • CD 2 and 3 are not repeatable
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3
Q

What is NHS repeat dispensing service

A

A specified number of ‘batch’ issues that may be dispensed at specified intervals from a pharmacy (England and Wales only).

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4
Q

Private Prescriptions POM Entry requirements

A
  1. Supply date
  2. Prescription date
  3. Drug name, strength, formulation and quantity
  4. Prescriber name and address
  5. Patient name and address
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5
Q

Private POM Prescriptions Record Keeping

A
  • Retain private POM for 2 years from date of supply (last supply of repeat)
  • Retain POM register 2 years from last date
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6
Q

Why is a faxed prescription NOT ‘legal’ [1]

A

Because it’s not written in indelible ink

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7
Q

What are the risk of supply medicine against fax [7]

A
  1. Uncertain supply made in accordance of a legally valid prescription
  2. Risk of poor reproduction
  3. Risks of non-receipt, inability to demonstrate a supply was made in accordance of prescription
  4. Risks that the original prescription is subsequently amended by the prescriber
  5. Risk it’s sent to multiple pharmacies/duplicate made
  6. Risk it’s not genuine
  7. Risk of faxing is not secure - GDPR

The supply of Schedule 2 and 3 CDs without possession of a lawful prescription could be prosecuted as a criminal offence.

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8
Q

What questions help detect

Forged prescriptions [6]

A
  1. Large or excess quantity for the condition?
  2. Known prescriber?
  3. Is the patient known?
  4. Title ‘DR’ before the signature?
  5. Patients behaviour - nervous, agitated, aggressive etc
  6. Is the medicine commonly used
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9
Q

Further investigations for a forged prescription [3]

A

1 Scrutinise the signature carefully –
possibly checking against a known genuine prescription from the same prescriber

2 Confirm details with the prescriber
(e.g. whether or not a prescription has been issued, the original intention of the prescriber and whether or not there has been an alteration)

3 Use contact details for the prescriber that are obtained from a source other than the suspicious prescription (e.g. directory enquiries)

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10
Q

Approved EEA Countries and Switzerland

A

Austria, Belgium, Bulgaria, Croatia, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Republic
of Ireland, Italy, Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, The Netherlands, Norway, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden, Switzerland.

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11
Q

APPROVED HEALTH PROFESSIONAL

A

Doctors and Dentist
Other professions with prescribing rights i.e. chiropodists or podiatrists, nurses (including community nurses), optometrists, paramedics, pharmacists, physiotherapists and therapeutic radiographers

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12
Q

PRESCRIPTIONS FROM THE EEA OR SWITZERLAND

A
  • legally recognised by the UK
  • Prescription
  • Repeatable prescriptions
  • Emergency supply
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13
Q

What do if prescription isn’t by an approved EEA country/ Switzerland or an approved health professional

A

Refer them to local GP, walk-in, 111

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14
Q

PRESCRIPTIONS REQUIREMENTS FROM THE EEA OR SWITZERLAND

A
  • Patient full first name(s), surname, DOB
  • Prescriber’s full first name(s), surname, professional qualifications, direct contact details including, email address and telephone or fax number (with international prefix), work address (including the country they work in)
  • Name of the medicine (brand name where appropriate), pharmaceutical form, quantity, strength and dosage details
  • Prescriber signature
  • Prescriber signature
  • Date of issue - Valid 6 months 28 days if Sch 4
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15
Q

CHECKING THE REGISTRATION STATUS OF APPROVED HEALTH PROFESSIONALS

A
  1. Doctors - General Medical Council (GMC) www.gmc-uk.org
  2. Dentists - General Dental Council (GDC) www.gdc-uk.org
  3. Search for ‘List of EEA competent authorities regulated professions and competent authorities - on the European Commission website (ec.europa.eu/info/index_en).
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16
Q

Medicine not allowed on eea / Switzerland prescriptions

A
  • CD Sch 1, 2, 3
17
Q

Legal requirement of a label

A
  • Name of the patient
  • Name and address of the supplying pharmacy • Date of dispensing
  • Name of the medicine
  • Directions for use
  • Precautions relating to the use of the medicine.
  • The RPS recommends the following also appears on the dispensing label•

‘Keep out of the reach and sight of children’
‘Use this medicine only on your skin’ where applicable.

18
Q

DEFINE COVERT ADMINISTRATION OF MEDICINE

A
  • Medicine are administered in a disguised/without the knowledge /consent of the person receiving them, for example, in food or in a drink.
  • People who actively refuse their medication and who are considered to lack mental capacity
  • NEWT guidelines
19
Q

ADRENALINE IN AN EMERGENCY

A
  • CHILD 5 OR UNDER: 100-150mcg
  • CHILD 6-11: 300mcg
  • 12+: 500mcg
    • 300 micrograms (0.3 mL) if child is small or prepubertal
    • Anterolateral area of mid thigh - injection site
    • If no improvement repeat dose after 5 mins
20
Q

Brands of adrenaline intramuscular injections in your pharmacy

A

Epipen®, Emerade® and Jext®

21
Q

Who is exempt to the restrictions on the sale, supply and administration of medicines IN HOSPITALS AND OTHER SETTINGS

A

patient specific directions (PSDs).

22
Q

EXEMPTIONS: SALE AND SUPPLY WITHOUT A PRESCRIPTION

A
  • Patient group directions (PGDs)
  • Patient specific directions (PSDs)
  • Emergency supplies
  • Optometrist or podiatrist signed patient orders
  • Supply of salbutamol inhalers to schools
  • Supply of adrenaline autoinjectors to schools
  • Supply of naloxone by individuals providing recognised drug treatment services
23
Q

Label of PGD

A

Same as a normal label
Must state
‘supplied under a PGD’

24
Q

EMERGENCY SUPPLY AT THE REQUEST OF A PRESCRIBER

A
  1. Must be a relevant prescriber
  2. EMERGENCY i.e. Pt can collect prescriptions, prescriber unable to drop off prescriptions
  3. Follow up prescriptions must be given with 72hrs
  4. Directions
  5. NO CD’s
  6. Record keeping: date supplied; name, strength, formulation and quantity supplied; name and address of prescriber; date on prescription (added when received); date prescription was received
25
Q

EMERGENCY SUPPLY AT THE REQUEST OF A PATIENT

A
  1. Interview the pt
  2. Immediately needed - not of surgery is open
  3. Must have used in previous (recent-ish) treatment
  4. Dose
  5. No CD’s
  6. CD Exception = 5 days max. Others = no more than 30 days. Give full course of COC. Antibiotics = smallest quantity to fulfil scripts
  7. Record keeping - include why pt needs it and why script can’t be obtained
  8. Label must include Emergency supply
26
Q

Refuse the supply of an emergency supply

A 
Advised pt on how to obtain a prescription
E.g. 
-a doctor, 
NHS 111, 
NHS walk-in centre 
Accident and Emergency department.

A record could be made of why request was refused for audit purposes.

27
Q

OPTOMETRIST OR PODIATRIST SIGNED PATIENT ORDERS

A

Optometrists and podiatrists can
authorise supplies of POMs IF they are
additionally qualified as independent or
supplementary prescribers

28
Q

Supplying medicine to schools

A
  • Adrenaline auto- injectors (AAIs)

* and/or Salbutamol inhalers

29
Q

What does a school signed order require

A
  • Name of the school
  • Product details (including spacer if relevant)
  • Strength (if relevant)
  • Purpose for which the product is required
  • Total quantity required
  • Signature of the principal or head teacher

Ideally, appropriately headed paper should be used; however, this is not a legislative requirement.
Gov.uk

30
Q

What is the maximum amount schools can order

A

Quantity not specified
Pharmacist to use professional judgement
Factors:

  • School size and number of sites it is comprised of
  • Number of children known to be affected
  • Past experiences e.g. of children not having access to an AAI or inhaler
31
Q

School signed order: record keeping

A
  • Retain for 2 years

* from supply or POM entry

32
Q

Addition advice for a school signed order

A
  • How to use and store correctly
  • Advise on appropriate spacer device for the different age groups and how to use them correctly
  • Advise on correct storage, care and disposal
  • Advise importance of record keeping, regular date checking and when to replace
33
Q

Supply of Naloxone: law amendments

A

Human Medicines (Amendment) (No.3) Regulations 2015 allow staff engaged or employed in “lawful drug treatment services”

A pharmacy may be commissioned to participate in a local take home naloxone scheme - can continue in the absence of a pharmacist

34
Q

Define ‘staff engaged or employed in “lawful drug treatment services” ‘

A

(a) an NHS body
(b) a local authority
(c) Public Health England,
or (d) Public Health Agency

extends to commissioned services providing needle and syringe programmes AND substance dependence services

35
Q

Administration of Naloxone

A
  • Anyone can administer it
  • anyone = people likely to witness an overdose and includes family members, peers and staff in regular contact with drug users
36
Q

PPP - PREGNANCY PREVENTION PROGRAMME

A

• Protects females of childbearing potential by minimising the risk of becoming pregnant while taking these medicines

37
Q

What medicine require PPP

A 
• Oral retinoids, 
• Valproate, 
• Thalidomide, 
• Lenalidomide 
and Pomalidomide

carry a high risk of causing foetal malformations and terminating pregnancy

38
Q

VALPROATE PPP

A
39
Q

ORAL RETINOIDS PPP

A

DRUG USED TO TREAT SEVERE SKIN CONDITIONS E.g. acitretin, alitretinoin and isotretinoin

Programme: education, pregnancy test and distribution control
Prescription: check pt compliance, understanding and acknowledgement of PPP
Patient: monthly follow up and pregnancy test

MEP 2021/22 (3 decks)

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