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A - Pre-reg Exam COPY > MEP > Flashcards

MEP Flashcards

1
Q

What are the four principles of medicines optimisation

A

safety
patient experience
evidence based
part of routine practice

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2
Q

What are the new CPD (or revalidation) requirements?

A
  • 4 entries a year
  • minimum 2 planned learning
  • maximum 2 unplanned learning
  • 2 additional records must be submitted from end of 2019: one peer discussion and one reflective account.
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3
Q

what is the hierarchy of research?

A 
meta analysis
systematic reviews
RCTs
cohort studies
case studies
expert opinion
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4
Q

What are the 9 GPHC standards for pharmacy professionals?

A
  1. professionalism
  2. professional judgement
  3. maintain, develop, use professional knowledge
  4. leadership
  5. patient centered care
  6. communication
  7. working in partnership with others
  8. observe confidentiality
  9. speak up when things go wrong
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5
Q

What is a PO medicine?

A

A GSL medicine that the manufacturer wants to restrict sales to pharmacies only. e.g 30 sachet packs fybogel

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6
Q

Which wording must be prominent on codeine and dihydrocodeine?

A

Can cause addiction. For three days use only

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7
Q

Can cough and cold medicines (antitussives, expectorants, decongestants) be given to children under 12?

A

Not for children under 6

For children 6-12 years old they should be used second line and not for more than five days.

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8
Q

What is the age restriction for codeine linctus?

A

12 years- contraindicated

12-18 not recommended

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9
Q

What are the 7 prescription requirements?

A
  1. Signature
  2. Address of prescriber
  3. Date
  4. Particulars (type of prescriber)
  5. Patient name
  6. patient address
  7. age of patient (if under 12)
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10
Q

What is the law in regards to repeat prescriptions?

A
  • If a number of times to be repeated isn’t stated it can only be repeated once (twice in total). If it’s an oral contraceptive, it can be repeated 5 times.
  • CANNOT repeat schedule 2+3 but can for 4+5
  • First dispensing must be within 6 months, after that there is no legal time limit
  • For schedule 4, first dispensing must be within 28 days after which there is no time limit.
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11
Q

How long is an owing valid for?

A

6 months

28 days (from date on script/ start date on the script) for schedule 2,3,4

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12
Q

How long should a private prescription be retained?

A

2 years

Private scripts for CD 2 and 3 must be submitted to the relevant NHS agency.

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13
Q

Which prescriptions are exempt from record keeping?

A

Prescriptions for oral contraceptives

Prescriptions for schedule 2 CDs where a separate CD register entry has been made.

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14
Q

Are the details of a medicine a legal requirement on a prescription?

A

No

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15
Q

Are faxed prescriptions legally valid?

A

No

NOTE: Supplying a schedule 2/3 CD this way is a ciminal offence.

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16
Q

Can dentists prescribe any POM?

A

Yes- on a private script

No on an NHS dental prescription form.

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17
Q

What patient and prescriber details are required by law on an EEA prescription?

A

Patient: full name and DOB

Prescriber: full name, qualifications, contact details, work address (including country)

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18
Q

Which medicines are not available on EEA prescriptions?

A

CDs schedule 1,2,3

Medicines without a UK marketing authorisation

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19
Q

Can you supply phenobarbital for an emergency supply at the request of an EEA prescriber?

A

No

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20
Q

Can you supply CD schedule 4 and 5 for an emergency supply at the request of an EEA prescriber?

A

Yes

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21
Q

What are the exceptions to sale and supply of medicines without a prescription?

A
  1. Emergency supply
  2. PGDs/ PSDs
  3. Salbutamol inhalers for schools
  4. Naloxone for individuals providing drug services
  5. Pandemic exemptions
  6. Adrenaline auto injectors for schools
  7. Optometrist or podiatrist signed orders for patients
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22
Q

What is a PGD? What is an example of this?

A

Written direction that allows supply of specific medicine(s) by a named authorised HCP to a well-defined group of patients for a specific condition

e.g diamorphine/ morphine for immediate necessary treatment of sick or injured persons.

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23
Q

Within what timeframe must you receive a prescription after an emergency at the request of a prescriber?

A

72 hours

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24
Q

Which three dates must be recorded in the POM register after an emergency at the request of a prescriber?

A

Date of supply
Date on prescription
Date prescription is recieved

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25
Q

What is the exception to the no CD schedule 1,2,3 rule for emergency supplies?

A

Phenobarbital for epilepsy

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26
Q

What is the maximum length of treatment that can be supplied for an emergency supply at request of the patient?

A

30 days
5 days if its a CD
oral contraceptive- full course
Smallest pack available if inhaler or cream, insulin etc

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27
Q

Do you need to state the nature of the emergency in the POM register record for an emergency supply?

A

Yes- if its at the request of the patient

No if its the request of the prescriber

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28
Q

Must the wording ‘emergency supply’ be present on the label for an emergency supply?

A

Yes- if its at the request of the patient

No if its the request of the prescriber

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29
Q

What are the exceptions when it comes to a pandemic?

A

When the DOH relaxes legislation on emergency supplies so the pharmacist wouldn’t have to interview the patients.

Medicines may need to be collected from designated collection points that don’t need to be pharmacies or have a pharmacist present.

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30
Q

Should signed orders from optometrists or podiatrists be recorded in the POM register?

A

Yes

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31
Q

What is required for supply of salbutamol to schools?

A

A written order from the head teacher with:
name of the school, purpose and quantity required

Either retain the signed order for 2 years OR make an entry in the POM register.

Doesn’t have to be on headed paper.

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32
Q

What is required for supply of adrenaline auto-injectors to schools?

A

A written order from the head teacher with:
name of the school. purpose and quantity required

Either retain the signed order for 2 years OR make an entry in the POM register.

Doesn’t have to be on headed paper.

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33
Q

Who can be supplied naloxone for the purpose of saving a life in an emmergency?

What is the dose?

A

Anyone (family members, friends etc of adicts)- as long as members of staff engaged in drug treatment services give this supply.

IM- 400mg every 2-3 mins until ambulance arrives/ takes effect.

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34
Q

Is it illegal for a doctor to prescribe for himself?

A

No- poor practice

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35
Q

What are the rules surrounding isotretinoin prescriptions?

A

Women of childbearing potential must be on the PPP and must remain on PPP at least 1 month after stopping.

  • Prescription valid for 7 days only (neg pregnancy test must be specified)
  • Maximum 30 days supply if patient is on PPP
  • Can only supply as an emergency if its at the request of prescriber and they confirm pregnancy status within last 7 days is negative.
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36
Q

What is the latest information about valproate use in women of childbearing potential?

A

Contraindicated in women of childbearing age. Only to be used if conditions of PPP (pregnancy prevention programme) are met and ONLY for EPILEPSY when there are no other options

PPP

  • Given patient card + guide, review by specialist within last year, on highly effective contraception.
  • Annual review with specialist- complete and sign risk acknowledgement form
  • Pharmacists must dispense whole packs where possible, warning label (or sticker) on all containers, discuss risks each time a prescription is collected.

If pregnancy occurs, do not stop taking see Dr asap.

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37
Q

What should also be recorded when reporting an ADR for a biologic or biosimilar?

A

Proprietary name, brand name, batch number

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38
Q

What is the biosimilar of lantus (insulin glargine) ?

A

abasaglar

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39
Q

How should biologics be prescribed?

A

By brand

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40
Q

Which prescribers registered in the UK have the same rights as doctors from the UK except cocaine or diamorphine for treating addiction?

A

Pharmacists
Dentists
Nurse independent prescriber
Supplementary prescribers in all fields (only in an agreed clinical area)

NOTE: dentists and nurses limited to what they can prescribe on an NHS form but not on a private script.

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41
Q

Can vets prescribe for humans under any circumstances? Can they prescribe CDs?

A

No
Vets can prescribe CD 4+5 (for animals)
They can only prescribe CD 2+3 if they are surgeons and have their registration number on the prescription.

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42
Q

Can EEA prescribers prescribe CDs? Unlicensed meds?

A

Only CD 4+5
No to unlicensed meds
Only medicines with a UK MA can be prescribed.

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43
Q

What are community practitioner nurses allowed to prescribe?

A

Meds on the nurse prescriber’s formulary only

No CDs or unlicensed medicines.

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44
Q

What are optometrist independent prescriber’s allowed to prescribe?

A

Medicines for ocular conditions for the eye area only

No CDs and only off-label not unlicensed.

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45
Q

What are physio + podiatrist independent prescriber’s allowed to prescribe?

A

A set list of CDs, off label meds (not unlicensed)

Can request emergency supplies but not CDs

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46
Q

What records should be kept when wholesaling from a pharmacy (selling stock to another HCP)?

A

Entry in the POM register or keep the invoice for at least 2 years.

NOTE: a wholesale license is required

47
Q

What is a POM-V prescription?

A

POM that can only be prescribed by a veterinary surgeon and can be supplied by a pharmacist or vet surgeon with a written prescription.

48
Q

What is a POM-VPS prescription?

A

Can be prescribed and supplied by a suitably qualified person using an oral or written prescription. Written script only needed if the supplier is not the prescriber.

49
Q

What is a NFA-VPS prescription?

A

Medicines for non- food animals. A written prescription is not required.

50
Q

What is a AVM-GSL prescription?

A

Authorised vet med that is available for general sale

51
Q

How long are vet prescriptions valid for?

If repeatable when must all the repeats be issued?

A

6 months

Issue all repeats within 6 months (of date on script)

52
Q

What additional wording does a prescription for a schedule 2 or 3 CD for use in animals have?

A

‘Prescribed for treatment of an animal or herd under my care’

53
Q

Are standardised forms required for vet scripts?

What about vet CD 2+ 3 scripts?

A

No (including CDs 2+3)

54
Q

How long must you retain a vetinary CD script for?

Is it submitted to the relevant NHS agency like human CD prescriptions?

A

5 years

No

55
Q

What extra information is needed on a vetinary CD 2 and 3 prescription?

A

The prescriber’s RCVS registration number

56
Q

Do normal CD restrictions; valid for 28 days, quantity in words and figures apply to vet meds?

A

Yes

57
Q

What wording must be on a label produced for a vetinary medicine?

A

‘For animal use only’

58
Q

Does a pharmacist need to be present for supply of vetinary medicines?

A

Yes

Unless- authorised in advance by the pharmacist and the person handing out is judged to be competent.

59
Q

If a medicine is not prescribed under the cascade, does it require a dispensing label?

A

No

60
Q

Is it a requirement to keep records of receipt and supply of POM-V and POM-VPS meds?

A

Yes including batch number for at least 5 years.

61
Q

What are examples of schedule 1 (CD LIC POM) drugs?

A

LSD, opium, cannabis

Not used medicinally
Home office license needed for production, possession and supply.

62
Q

What are examples of schedule 2 (CD POM) drugs?

A

Opiates (morphine, methadone, pethidine oxycodone, diamorphine [heroin])
amphetamines
ketamine
quinalbarbitone/ secobarbital

63
Q

What are examples of schedule 3 (CD NO REGISTER POM) drugs?

A 
buprenorphine
tramadol
temazepam
midazolam
phenobarbital
barbiturates (except quinalbarb)
64
Q

What are examples of schedule 4 part 1 (CD BENZ POM) drugs?

A

Benzodiazepines (diazepam)
hypnotics (zopiclone)
Sativex (cannabinoid mouth spray)

65
Q

What are examples of schedule 4 part 2 (CD ANAB POM) drugs?

A

anabolic steroids and growth hormones (e.g clenbuterol)

66
Q

What are examples of schedule 5 (CD INV POM/ P) drugs?

A

codeine, pholcodeine, morphine liquid.

67
Q

Which CDs are subject to prescription requirements?

A

CD2 + 3

68
Q

What are the requirements for CD drugs?

A

Dose must be specified
Quantity in words and figures
Formulation must be stated without abbreviation
30 days max recommended (not legal requirement)

69
Q

After how many missed days of an instalment prescription should the prescriber be contacted?

A

3 days

70
Q

What are pharmacists allowed to amend on CD scripts? What cant they amend?

A

They can amend: typos and quantity if either words or figures missing but not when both are missing.

Cannot amend: missing date, wrong dose, form or strength. Can only be corrected by the prescriber

71
Q

How long is a CD valid for?

A

28 days?

6 months for CD 5

72
Q

Which CDs require the address of the prescriber to be in the UK?

A

CD 2+3

73
Q

Which CDs are repeatable?

A

CD 4 +5

74
Q

Which CDs are eligible for supply as an emergency?

A

CD 4 + 5

NOT 2 + 3 only exception is phenobarbital for epilepsy

75
Q

For which CDs is a requisition necessary?

A

CD 2 + 3

76
Q

Which CD invoices must be retained for 2 years?

A

CD 3 + 5

77
Q

After how long of travelling will a license be needed to carry CDs? What CDs does this affect?

A

3 months

Affects Schedule 1,2,3,4

78
Q

Does an approved form have to be used during requisitions of CD2 and CD3?

A

Yes

Exceptions for hospice and prisons, or if it is in hospital within the same department/ legal entity.

79
Q

Can a Schedule 2 or 3 CD be supplied to a doctor or dentist in an emergency?

A

Yes- if they agree a requisition will be provided within 24 hours. Failure to do this is an offence.

80
Q

What is the approved requisition form for CDs?

A

FP10CDF

81
Q

Who can access diamorphine, pethidine and morphine via signed order?

A

Midwives

must be signed by a supervising doctor

82
Q

Which controlled drugs require safe custody?

A

Schedule 1
Schedule 2 (except quinalbarbitone/ secobarbital and some liquids)
Schedule 3- buprenorphine and temazepam

83
Q

Which patient returned medicines must be denatured before disposal?
Is an authorised witness required?

A

CDs schedule 2, 3, 4 part 1.

No for AUTHORISED witness but they should show another member of staff especially if CD2.

84
Q

Must an entry be made in the CD register for patient returned CD drugs?

A

No. A SEPARATE record should however be kept for patient returned CD2s.

85
Q

Which expired/unwanted stock must be denatured before disposal?
Is an authorised witness required?

A

CDs schedule 2, 3, 4 part 1
Yes for authorised witness if CD2 only.
For other CDs they should just show a member of staff.

86
Q

Must an entry be made in the CD register for expired/ unwanted CD drugs?

A

Yes for CD2 only

87
Q

For which medicines should an entry be made in the CD register for receipt and supply?

A

CDs schedule 1+2

sativex (CD schedule 4 part 1)

88
Q

How long must CD registers be kept?

A

2 years from the date of the LAST entry

89
Q

How can a used methadone bottle be disposed off?

A

Rinse out remaining bits with water into denaturing kit.
Remove labels and patient identifiable info.
Bottle can be thrown into the normal bin.

90
Q

If a product is labelled as use by or use before 6/19, when is the last day it can be used?

A

31st May 2019

91
Q

If a product is labelled as expiry date 6/19 when is the last day it can be used?

A

30th June 2019

92
Q

Should tabs/caps be de-blistered when disposing of medicines?

A

No (except CDs that need de-blistering).

But you can remove the blister strips from the outer box.

93
Q

What is MCA and MDS?

A

Multi-compartment compliance aids

monitored dosage system

94
Q

When can a statuory medical defence be raised if caught driving with higher levels of the specified drugs in the road traffic act?

A

If there is evidence that the medicine has been taken in accordance with instructions from a HCP or the PIL

AND

Driving NOT impaired.
If driving is impaired it is still an offence even if its on prescription

95
Q

Can an entry in the RP record be made remotely if it is electronic?

A

Yes

96
Q

What is the maximum amount of time an RP can be absent for?

A

2 hours

97
Q

If there are more than one RP in a day in a pharmacy, what is the maximum total period of absence for all the RPs?

A

2 hours

98
Q

Which activities can occur if the RP is not physically present at the pharmacy?

A

The prescription assembly process (inc blister packs)

Accuracy checking

99
Q

Which activities can occur if the RP is phisically in the pharmacy premesis but not supervising (not in disp/ went out for whatever reason)

A

Sale of GSL

Processing waste medicines and patient returns (except CDs)

100
Q

Which activities can occur if there is no RP signed in?

A
  • Ordering, receiving and putting away stock (excluding CDs)
  • Processing scripts that have been dispensed + collected
  • receiving patient returns (not CDs)
  • Receiving scripts from eps or collecting from surgery
  • Responding to questions (including about medicine use)
101
Q

If a child (<16) has demonstrated competence wants to keep something confidential, are you allowed to tell their parents about their medicine?

A

No

102
Q

Can P medicines be sold on a website?

A

Yes- if the website is associated with a registered pharmacy.

103
Q

What are the 6 legal requirements of a CD requisition?

A 
Recipients signature
Name of recipient
Address of recipient
Profession/occupation
Total quantity of drug
Purpose of requisition
104
Q

What should be done if a bottle of methadone spills on the floor?

A

Clean it up with tissues and store the tissues in a bag in the CD cupboard.

Destruction of CDs need to be witnessed by an authorised person. This includes spillages.

105
Q

How should a private script for a schedule 2 drug be processed after it has been dispensed?

A

It should be submitted to the relevant NHS authority.

106
Q

How should a requisition for a schedule 2 drug be processed after it has been dispensed?

A

It should be submitted to the relevant NHS authority.

107
Q

How should a veterinary prescription for a schedule 2 drug be processed after it has been dispensed?

A

It should be retained for 5 years.

NOTE: it is not submitted like other CD scripts.

108
Q

How frequently should SOPs be reviewed minimum?

A

Every 2 years

109
Q

How long should the written RP log (pharmacy log) be kept?

A

5 years from the date of the LAST entry

110
Q

How long should the electronic pharmacy log (RP log) be kept?

A

5 years from the date of the FIRST electronic record

111
Q

If you have an NHS prescription dated on 1/1/19 but the script says supply from 15/1/19 Which date do you go off in terms of validity?

A

The later date- 15/1/19

112
Q

If you have a private prescription dated on 1/1/19 but the script says supply from 15/1/19 Which date do you go off in terms of prescription validity?

A

You always go off the date on the prescription 1/1/19.

113
Q

Can private prescriptions for Schedule 2 + 3 CDs be on any paper?

A

No - must be on special form FP10PCD

114
Q

If a veterinary prescription is for a product that is licensed in animals, must it say under the cascade on the prescription?

A

No

A - Pre-reg Exam COPY (15 decks)

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