MEP 3.3 Professional and legal issues: prescription‑only medicines Flashcards

(161 cards)

1
Q

what is required for rx

A

Patients:
- age if under 12
- name
- address

prescribers:
- signature
- name
- address
- particulars

date of rx

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2
Q

what are repeatable rx

A

private prescriptions that can be dispensed more than once.

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3
Q

how many times are repeatable rx repeated

A

The number stated by the prescriber.

If no number is stated, they can only be repeated once (dispensed twice) , unless the rx is for an oral contraceptive which can be repeated 5 times (dispensed 6 times)

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4
Q

which control drug schedule can be repeated

A

CD 4 & 5, not cd 2 & 3

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5
Q

what is the time limit for POM or CD 5 repeat

A

there is not, but the first dispensing must be made within 6 months of the appropriate date

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6
Q

what is the time limit for CD 4 repeat

A

If the prescription is for a Schedule 4 CD, the first
dispensing must be made within 28 days of the
appropriate date, following which there is no
time limit for remaining repeats

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7
Q

What is the record keeping for a Private prescription POM

A

Private prescriptions for a POM must be retained for 2 years from the date of the sale or supply or for
repeatable prescriptions from the date of the last
sale or supply

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8
Q

where are private POM recorded?

A

POM register

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9
Q

What are the requirements for a record keeping

A

> supply date
prescription date
medicine details: name, quantity, formulation, strength
prescriber name and address
patient name and address

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10
Q

when should a record take place

A

> on the day of sale

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11
Q

Where are CD 2 and 3 Recorded

A

> A CD register

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12
Q

what do dental rx look like

A

> FP10D
YELO

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13
Q

what can dentists prescribe

A

the medicines listed in the
Dental Prescribers’ Formulary

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14
Q

what are the legal requirements for the dispensing of EEA rx

A
  1. Patient’s details: full first names and surname, date of birth
  2. prescribers details: full first names, surnames, professional qualifications, direct contact details including email address, telephone number or fax number, work address
  3. prescribed medicine details: name of medicine, pharmaceutical form, quantity, strength , dosage
  4. prescriber signature
  5. date of issue - rx valid up to 6 months, scheduke 4 CD 28 days
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15
Q

Are faxed rx valid?

A

NO, because it is not written in indelible ink and has not been signed in ink by an appropriate practitioner

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16
Q

what are the risks of faxed rx

A
  1. uncertainty that the supply has been made in accordance with legally valid prescription
  2. risks of poor reproduction
  3. risks of non receipt of the original rx and therefore inability to demonstrate that a supply has been made in accordance
  4. risk that the original rx is subsequently amended by prescriber
  5. risks that the fax is sent to multiple pharmacies and mutilple supplies made
  6. risk that the rx is not genuine
  7. risk of insecure faxing system
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17
Q

what are the check list for forged prescriptions

A
  • Is a large or excessive quantity prescribed and is this appropriate for the medicine and condition being treated?
  • Is the prescriber known?
  • Is the patient known?
  • Has the title ‘Dr’ been inserted before the signature?
  • Is the behaviour of the patient indicative? e.g. nervous, agitated, aggressive, etc.)
  • Is the medicine known to be commonly
    misused?
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18
Q

who do you report concerns about a rx to

A

Use judgement to determine the severity of the matter :

  • discussions with patient and prescriber
  • NHS counter fraud services for nhs rx only
  • police
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19
Q

which countries abroad can prescriptions be approved in the uk

A
  • EEA (European Economic Area) countries and switzerland
  • 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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20
Q

which EEA prescriptions can you supply

A
  • POM
  • CD 4
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21
Q

what are the legal requirements for the dispensing of EEA rx

A
  1. Patient’s details: full first names and surname, date of birth
  2. prescribers details: full first names, surnames, professional qualifications, direct contact details including email address, telephone number or fax number, work address
  3. prescribed medicine details: name of medicine, pharmaceutical form, quantity, strength , dosage
  4. prescriber signature
  5. date of issue - rx valid up to 6 months, scheduke 4 CD 28 days
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22
Q

which professions from abroad are approved ?

A

doctors and dentists as well as 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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23
Q

EEA emergency supply

A
  • emergency supplies at the request of patient of hcp is legally possible
  • 1, 2, 3 CD or unlicensed products cannot be supplied in an emergency to a patient of an approved hcp
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24
Q

what happens if the rx is not from an approved country

A

prescription is not valid and you should use your
professional judgement (e.g. refer to local GP), in
finding the best way to help the patient.

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25
what happens if the rx is written in a foreign language
legally acceptable. However, you will need to have enough information to enable the safe supply of medicines considering patient care and wellbeing.
26
what can you use to check the registration status of approved health care professions of international prescribers
- there is no international database and not all of the approved countries have a register of practitioners or online registers in english - however you can use the general medical council or general dental cvouncil
27
what happens if youre not able to obtain registration status of the international medical professional
- you can make safe and legal supply in the interest of patient care - beneficial to keep record of interventions and ste[s taken
28
which medicines can you not supply for EEA
Schedule 1, 2 and 3 CDs and medicinal products without a marketing authorisation valid in the UK are not permitted. Consider referral to an appropriate UK-registered prescriber if such items are required.
29
what is military rx
- FMed 296
30
who deals with Military rx
- military primary healthcare medical centres - designated pharmacies under the ministry of defence (MO) contract - community pharmacies not covered by the contract will boot routinely handle military prescriptions
31
what happens when military rx is presented to a non contracted pharmacy
- the rx should be treated as a private rx - charge the patient the appropriate fee , it is up to the patient to recover any costs incurred from their military unit
32
what happens when a military personnel presents an NHS or other private rx
- pay appropriate fee and request a receipt to reclaim any costs, if eligible UNLESS they are exempt and present an exemption certificate
33
what happens when a military personnel presents a CD 2 or 3 rx
- should be written on a pink FP10PCD form. - if written on MOD FMed 296, it cannot be legally dispensed,
34
when should you pay attention to a military rex
- handwritten FMed 296 : majority of FMed are computer generated, so unlikely to see handwritten ones, especially for MOD accoutable drugs - British forces post office (BFPO) address stamp
35
when should you pay attention to a military rx
- handwritten FMed 296 : majority of FMed are computer generated, so unlikely to see handwritten ones, especially for MOD accoutable drugs - British forces post office (BFPO) address stamp: these rx have been generated abroad and are not nromally seen in the uk
36
what are MOD accountable drugs
CD 3, 4, 5, codeine, sedatives and medicine for erectile dysfunction
37
what are the label requirements for dispensing
*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: "(e.g. For external use only)". 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. NB: In secure environments it is strongly recommended that the prisoner number is also included on the label as a definitive patient identifier. Additional information can be added to the dispensing label if the pharmacist considers it to be necessary
38
where do you place labels
- - the actual container e.g the inhaler or tube of cream as the outer container can be lost
39
how and when is labelling optimised ?
if pharmacist is of the opinion that the the directions for use, name or common name of the medicine, or precautions, relating to the use of the medicine, are not appropriate on the prescription, they can substitute these with appropriate particulars of a similar kind when producing the dispensing label without contacting the prescriber. >> it's good to make a record
40
how is medicines broken down from bulk containers labelled
* Name of the medicine * Quantity of the medicine in the container * Quantitative particulars of the medicine (i.e. the ingredients) * Handling and storage requirements where appropriate * Expiry date * Batch reference number (e.g. LOT number or BN).
41
what is assembly and pre packing medicines
The assembly or pre-packing of medicines by the pharmacy to be supplied to a separate legal entity > (e.g. for a NHS Trust to supply a different NHS Trust or an out of hours medical practice)
42
what does assembly and prepacking medicines require
> requires the appropriate licence from the MHRA (medicines and healthcare products regulatory agency, > i.e. Manufacturer’s/importer’s licence (MIA) or Manufacturer ‘specials’ licence (MS)).
43
how is assembly and prepacking medicines labelled
> The MHRA can be contacted for further details on the licence and any labelling requirements
44
where can repeat prescriptions be dispensed
the patient can choose to have repeats dispensed from different pharmacies
45
what is done to repeatable rx
to maintain an audit trail mark on the rx, the name and address of the pharmacy from where supply has been made and the date of supply
46
what sort of forms do prisons and other residential custodial secure environments use
- FP10 form not used for routine prescribing - a customised rx form generated by the clinical it system, is used instead
47
when are fp10 forms used for prisons and custodial settings
- to access urgent medicines (out of hours) - to a released person to access medicines that couldn't be supplied to them on release
48
can prisoners have repeat dispensing scheme
- no as they dont use FP10s or EPS but customised forms
49
what are repeat slips
they are not prescriptions themselves but a list of medications which patient can use to reorder their regular medication
50
are repeatable prescriptions and repeat slips
NO, they are 2 separate things
51
what are instalment rx
they provide for a single rx for a CD to be dispensed in several installments
52
what is the NHS repeat dispensing service
Where the prescriber authorises a prescription with a specified number of 'batch' issues that may be dispensed at specified intervals from a pharmacy
53
what is the NHS repeat dispensing service
Where the prescriber authorises a prescription with a specified number of 'batch' issues that may be dispensed at specified intervals from a pharmacy
54
what is the validity of owings on POM
6 months from the date
55
what is the validity of owings on CD sch 5
6 months from the date
56
what is the validity of owings on P and GSL medicines
6 months from the approprate date
57
what is the validity of owings on sch 2,3 and 4 CDs
28 days after the approprate date
58
which type rx are recorded
Private POM rx
59
who is responsible for self administration
patients , unless risk assessment indicates otherwise
60
who else can administer medicine
registered healthcare professionals can administer of delegate the administration of medicines non registered hcp who are appropriately trained, assessed as competent and meet relevant organisational guidance
61
what are hcp / non hcp who administer medicines help accountable for
their actions, non actions and omissions
62
what should the administerer of medicine know
- understanding of the medicines being administered - awareness that they can seek adice from a prescriber or pharmacy professional
63
when can parental POMs be administered
can be administered to another person in accordance with the directions of an appropriate practioner or by the
64
when is administeration exempted
to save a life in an emergency and a list of parenteral medicines can be found in schedule 19 of the human medicines regulations 2012
65
name 3 example of administering a parenteral medicine for emergency
naloxone as an emergency first aid for a drug related overdose adrenaline for emergency treatment of anaphylaxis small pox vaccine
66
which classes of persons can also administer POM under certain conditions
Midwives, paramedics , first aid personells , life support provider , podiatrists, nhs body or local authority operating an occupational health shceme, commander of an aircraft
67
what is covert administration of medicines
when medicines are administered in a disguised format without the knowledge or consent of the person recieving them, for example in food or drink
68
why are medicines administered covertly
patients who actively refused medication patients who lack mental capacity in accordance with an agreed management plan
69
what should be followed for covert administration
organisational policies and procedures
70
what should pharmacist who are asked to sign covert administration documentation check
what they are being asked to sign off as this may indicate : - they have to perform a clinical medicaion review and - provided advice on how medicines should be administered - what to do if a patient consumes only part of their food or drink
71
what is adrenaline
A POM given intramuscularly for anaphylaxis
72
give an example where a pharmacist expected to recognise and treat an anaphylactic reaction
offering a vaccination service
73
what should pharmacist have access to incase of anaphylactic administration
an anaphylaxis pack, and must have received the training in the recognition of anaphylaxis and administration for adrenaline
74
what doesa anaphylaxis pack include
ampoules of adrenaline and syringes and needles or prefilled syringes
75
who can administer adrenaline
anyone for the purpose of saving life in an emergency - by the regulations 238 of human medicines regulations 2012
76
what should a pharmacist do after administering adrenaline
call am ambulance
77
when is adrenaline administered
an anaphylactic emergency
78
what exemptions allow POMs to be sold or supplied with a rx
* Patient group directions (PGDs) * Patient specific directions (PSDs) (see section 3.3.9) * 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
79
what are patient group direction (PGDs)
- a written direction that allows the supply and/or administration - of a specified medicine or medicines, by named authorised health professionals, - to a well defined group of patients requiring treatment for a specific conditon
80
when is supply and administration of medicines under a PGD used
for those in limited situations where this offers an advantage for patient care without comprimising patient safety
81
which sch 2 drug can pharmacists supply / administer under a PGD and which situation
MORPHINE OR DIAMORPHINE For the immediate ,necessary treatment of sick or injured persons
82
when is a PGD developed
only be developed after careful consideration of all the potential methods of supply and/or administration of medicines, including prescribing, by medical or nonmedical prescribers.
83
how is pgd labelled
POM supplied under PGD are labeled the same way as rx
84
what is patient specific directions
a written instruction from a doctor, dentist or non-medical prescriber for a medicine to be supplied or administered to a named patient after the prescriber has assessed that patient on an individual basis.
85
what do PSD relate to
a specific named patient but do not need to comply with the requirements specified for a rx
86
where are PSD encountered on hospital ward
on in patient charts as directions to administer
87
what is an emergency supply
a pharmacist working in a registered pharmacy can supply POMs to a patient without a rx on the request of a 'relevant prescriber' or a patient
88
what are the 'relevant prescribers'
A doctor * A dentist * A supplementary prescriber * A nurse independent prescriber * A pharmacist independent prescriber * A community practitioner nurse prescriber * A physiotherapist independent prescriber * A podiatrist independent prescriber * A therapeutic radiographer independent prescriber * An optometrist independent prescriber * An EEA or Swiss health professional (see section 3.3.5) * A paramedic independent prescriber
89
which 'relevant prescriber' is not accepted for emergency supply in the uk
hcp from countries outside of the EEA or switzerland
90
what are the conditions for emergency supply at the request of a prescriber
- a relevant prescriber - Pharmacist is satisfied that the rx can't be provided due to an emergency - the prescriber agrees to provide a written rx within 3 days - the medicine is supplied in accordance with the prescriber's directions
91
can cds be supplied through emergency supply
NOT CD 1 2 OR 3
92
which CD can be supplied in am emergency supply
sch 3 phenobarbital
93
who can authorise the supply of the cd in emergency supply
UK prescribers - doctors nurses pharmacist, independent
94
should you record emergency supply?
yes
95
where and when do you make an emergency supply record
POM register on the day of supply (if impractical the day after)
96
what should an emergency supply entry include
* The date the POM was supplied * The name (including strength and form where appropriate) and quantity of medicine supplied * The name and address of the prescriber requesting the emergency supply * The name and address of the patient for whom the POM was required * The date on the prescription (this can be added to the entry when the prescription is received by the pharmacy) * The date on which the prescription is received (this should be added to the entry when the prescription is received in the pharmacy)
97
what happens when a patient requests an emergency suppy
- interview of patient - ensure that theres an immediate need for the POM - ensure that the POM has been used as previous treatment as prescribed by a uK, EEA or swiss - Pharmacist must be satisfied with the dose patient needs to take - ensure its not a cd except phenobarbital - length of treatment >> max for Cd: 5 days, POM : 30 days (except insulin, cream,inhaler or oral contraceptive - an entry must be made
98
what record is made for patient request emergency sipply
The date the POM was supplied * The name (including strength and form where appropriate) and quantity of medicine supplied * The name and address of the patient for whom the POM was supplied * Information on the nature of the emergency, such as why the patient needs the POM and why a prescription cannot be obtained, etc.
99
when is emergency supply denied
records shows multiple requests
100
if denied emergency supply , what should pharmacist advice
- how to obtain a prescription or appropriate medical care -- referral to doctor etc
101
what CPCS
Community pharmacy consultation service
102
what does CPCS allow
enables NHS 111, urgent care settings and 999 providers to refer patients to a community pharmacy for an emergency supply of regular medicines under the NHS.
103
can optometrist or podiatrist authorise supply of POM by writing a rx
No except theyre qualified as independent or supplementary prescribers however Pharmacists can supply certain POMs directly to patients in accordance with a signed patient order from any registered optometrist or podiatrist - must be one that's on their formulary
104
is signed patient order a rx
no so does not require usual rx requirements
105
what medicines can schools obtain
adrenaline auto injections and or salbutamol inhalers on a signed order
106
when can these medicines be administered
emergency by a trained individual
107
what information must be on a school's signed order
* 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 teache
108
how many medicines can schools obtain
not specified in legislation as is dependent on school size, number of children affected, past experience etc
109
how long is the school signed order retained for in the pharmacy
2 years from the date of supply or an entry made into the POM register
110
what type of schools
all primary and secondary
111
can naloxone be obtained wihtout a rx, PGD or PSD
yes because of the high amts of deaths
112
who can administer naloxone
anyone for the purpose of saving a life
113
which medicines can increase risk of foetal malformations or spontaneous abortion
oral retinoids valporate thalidomide lenalidomide pomalidomie
114
what does the PPP do
prevent pregnacy
115
what is the pregnancy prevention programme (PPP)
protects females of child bearing potential by minimising the risk of becoming pregnant while taking these medicine
116
how do pharmacy ensure PPP
- ensure risky medicines not dispensed for females that may be pregnant or considering becoming pregnant unless they follow the manufacturer's PPP or the prescriber agrees
117
Provide examples of oral retinoids
acitretin, alitretinoin, isotretinoin
118
what are oral retinoids described as in their SPC
- powerful human teratogen inducing a high frequency of severe and life threatening birth defects
119
what are the distribution controls of oral retinoids for females at risk of pregnancy
1. rx validity : under PPP, rx valid for 7 days 2. quantity: max supply is 30 days, more can be dispensed if patient is confirmed by prescriber as not being under PPP 3. no repeat rx, free sample distribution or faxed rx. telephone rx accepted if emergency
120
what are the distribution controls of oral retinoids for females at risk of pregnancy
1. rx validity : under PPP, rx valid for 7 days 2. quantity: max supply is 30 days, more can be dispensed if patient is confirmed by prescriber as not being under PPP 3. no repeat rx, free sample distribution or faxed rx. telephone rx accepted if emergency supply at the request of a PPP specialist prescriber together with confirmation that pregnancy status has been established as negative within the preceding seven days.
121
who is oral retinoids containdicated in
pregnant women and women of potential child bearing unless all the conditions of PPP are met
122
what is valproate PPP
valproate is used to treat epilepsy and bipolar disorder. It can cause harm to an unborn child when taken during pregnancy
123
when is valproate given
- when nothing works - patient is part of pPP
124
what should pharmacists do when a patient when dispensing valproate to female patients of child bearing age
- ask patients if theyre on a PPP, have had a review with their doctor and are aware of risks - those planning pregnancy should be advice to speak to their prescriber for a review - if unplanned pregnancy, patient should be advised to not stop taking valproate and arrange to see their prescriber for a review - emphasize the need for annual specialist review - report any suspected side effects via the yellow card scheme
125
what should pharmacist give patient when valproate is dispensed
patient card
126
how should valproate be dispensed
in original packs if dispensed in while boxes ensure PIL is provided and a warning label /sticker is added in the box ensure dispensing label does not cover warning label/ sticker
127
what is biologic
medicine made from a variety of natural source that may be human animal or microorganism
128
what are some examples of biologic
vaccine blood blood products somatic cells dna human cells
129
what is a biosimilar
a biological medicine that is similar to an already licensed biologic medicine in terms of quality, safety and efficacy. it treats the same condition as the original
130
when is biosimilar marketed
after the patent protecting the originator product and any period of marketing exclusivity have expired
131
why are biosimilars not a generic medicine
. - biosimilars are complex in strucutre and bigger molecules and result from complex production methods - It is not possible to characterise a biologic to the same extent as a small molecule drug, where an identical copy can be produced, known as a generic medicine
132
can you switch between original biologic and biosimilar
yes but only made by prescriber following discussion with patient
133
how is biosimilar prescribed
by brand to avoid automatic substitution
134
how are biosimilar ADR reported
- both brand name and brand number are provided
135
when can sch 1 cd be prescribed
only under the home office license
136
what can doctors and dentists prescribe
> sch 2 - 5 ; home office license for cocaine, diamorphine or dipipanone >unlicensed of off label med > emergency supply including phenobarbital but no other sch 1 2 3 > dentists limited to dental ocnditions
137
what can vet med prescribe
>unlicensed and off label but needs cascade > sch 2 - 5 , but must include RCVS reg number > no emergency supply > only for animals
138
what can nurse / midwife / independent prescriber prescribe
> sch 2 - 5 but not cocaine , diamorphine or dipipanone > unlicensed med & off label but unlicensed meds are exluded from nurse formulary > emergency supply include phenobarbital but no other sch 123 Cd
139
what can Optometrist independent prescriber prescribe
>> NO sch 2 -5 cd >> only off label medicines >> emergency supply >> no parenteral preparations
140
difference between off label and unlicensed
off label : licensed medicine outside of its approved use unlicensed: not officially approved for treating condition as not undergone clinical trials for effectiveness
141
Paramedic IP prescribe
>> no sch 2 - 5 >> only off label >> emergency supply but not sch 1 2 3 including phenobarbital
142
Pharmacist IP prescribe
>> sch 2 - 5 but not cocaine diamoprhine or dipipanone >>unlicensed and off label >> emergency supply incl phenobarbital but no other sch 1 2 3
143
Physiotherapist IP prescribe
>> only certain sch 2 - 5 cd : For oral administration - diazepam, dihydrocodeine, lorazepam, morphine, oxycodone and temazepam For injection – morphine For transdermal administration - fentanyl >> only off label >> emergency supply but not sch 1 2 3 incl phenobarbital
143
Physiotherapist IP prescribe
>> only certain sch 2 - 5 cd : For oral administration - diazepam, dihydrocodeine, lorazepam, morphine, oxycodone and temazepam For injection – morphine For transdermal administration - fentanyl >> only off label >> emergency supply but not sch 1 2 3 incl phenobarbital
144
Podiatrist/chiropodist independent prescriber
>> only these CDs for oral administration - diazepam, dihydrocodeine, lorazepam and temazepam >> only off label >> emergency supply but not sch 1 2 3 incl phenobarbital
145
Therapeutic radiographer independent prescriber
>> no sch 2 - 5 >>only off label >> emergency supply but not sch 1 2 3 incl phenobarbital
146
Supplementary prescriber: dietician, midwife, nurse, optometrist, paramedic, pharmacist, physiotherapist, podiatrist/chiropodist, radiographer (diagnostic/therapeutic)
>> sch 2 - 5 not cocaine, diamorphine or dipipanone for treating addiction >> unlicensed and off label >> emergency - includes phenobarbital for epilepsy but no other Schedule 1, 2 or 3 CDs >> prescribing restricted to areas of clinical competence
147
community practitioner nurse prescriber
>> no sch 2 - 5 >> no unlicensed other than nystatin for neonates >> emergency supply
148
What can EEA or swiss registered hcp
>> only sch 4 and 5 >> off label >> emergency
149
which hcp are covered by human medicines regulations exemptions
* Midwives * Opthoptists * Optometrists (see also section * Paramedics * Podiatrists/chiropodists
150
should the same person prescribe and dispense ?
no to ensure patient safety
151
what is the exception for prescribing and dispensing by THE SAME PERSON
pharmacist prescriber but its good practice to ensure processes are in place to limit errors
152
what should pharmacists do when dispensing a prescribers self prescribed rx or rx for close family and familiy
pharmacist should consider that: > it's poor practice to self rx or for close personal relationship > the professional judgement of the prescriber may be impaired or influenced > regulatory bodies advise against it > the abuse potential of drug being requested > CD only supplied in exceptional circumstances and details documented
153
whats the most appropriate action when dispensing a prescribers self prescribed rx or rx for close family and family
to refuse
154
what is the labelling requirements to appear on dispensed medicinal products
* 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: "(e.g. For external use only)". 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.
155
Patient specific directions PSD
a written instruction from a doctor, dentist or non-medical prescriber for a medicine to be supplied or administered to a named patient after the prescriber has assessed that patient on an individual basis.
156
what should PSD include
A PSD, signed by a qualified, registered prescriber, at a minimum should specify:  Name of patient and/or other individual patient identifiers  Name, form and strength of medicine (generic or brand name where appropriate)  Route of administration  Dose  Frequency  Start and finish dates.  Signature of prescriber.
157
Example of patient group directions
vaccine for over 65
158
when is home office license required
schedule 1 , cocaine , diamoprhine or dipipanone
159
which rx do dischargered prisoners use
FP10
160
do discharged prisoners have to pay if the FP10 form have the name and address of the prison
no