POM EXEMPTIONS: SALE & SUPPLY WITHOUT RX - PGDS, LIFE-SAVING Flashcards
What are the instances when a POM can be supplied without a prescription? (5)
- Parenterals when saving a life
- Patient Group Directions (PGDs)
- Signed orders for patients
- Serious shortage protocols
- Emergency supply (at request of prescriber or patient)
- Pandemic
Who can legally administer a parenteral POMs and what is an exemption? (4)
- The person to themselves
- An appropriate practitioner
- Someone who’s doing it with directions from the practitioner
- Exemption - certain injectables can be administered if LIFE SAVING
Where is the complete list of parenterals which may be administered by ‘others’ when saving a life in an emergency?
Human Medicines Regulations 2012, schedule 19
What pararental POMS are allowed to be administered legally for life saving emergencies (12)?
- Adrenaline
- Atropine sulfate (bradycardia)
- Chlorphenamine (antihistamine)
- Dicobalt edetate (cyanide antidote)
- Glucagon (diabetes - raises glucose)
- Glucose 50%
- Hydrocortisone (posion ivy, insect bites)
- Naloxone (opoid overdose)
- Pralidoxime (organophosphate posioning)
- Promethazine HCL (antihistamine)
- Snake venom antiserum
- Sodium nitrite (cyanide)
- Sodium thiosulfate (cyanide)
What are patient group directions?
Allow supply or administration of a POM without a prescription IF the patient fits within a specific patient group
Usually relates to specific POM
What are the benefits of PGDs? (4)
- Effective patient care
- Improved medicines access
- Safe and legal framework for patient care
- Reduced treatment times
Who signs a PGD? (3)
- Doctor/dentist AND a pharmacist
- Anyone who may act under the PGD e.g.
- Multi-disciplinary group
- NHS, clinical governance lead etc.
- individual health professionals working under PGD
What is included in a PGD? (13)
- Name of business who owns PGD
- Start and end date of PGD
- Description of medicine
- Class of HCP who can supply/administer
- Signature of doctor/dentist and pharmacist
- Signature of appropriate organisation
- Clinical condition PGD is for
- Patients who are excluded from the PGD
- Advice on when patients should get advice from doctor and details for referral
- Appropriate dose etc etc
- Warnings/ ADRs
- Any necessary follow ups
- Statement of records to be kept for audit purposes
Which health professionals can supply/administer POMs under a PGD? (15)
- Pharmacist
- Chiropodist/podiatrists
- Dental hygienists/therapists
- Dieticians
- Midwives
- Nurses
- Occupational therapists
- Optometrists
- Orthoptists
- Orthotists and prosthetists
- Paramedics
- Physiotherapists
- Radiographers
- Speech and language therapists
What medicines can be included in a PGD with care?
- Antimicrobials - prevents antimicrobial resistance
- Black triangle (under intense survelliance)
- Products out of their SPC (the PGD must describe what the status if of the product (i.e. it is used out of SPC)
What medicines cannot be included in a PGD?
Unlicensed medicines
Which CDs can be included in a PGD?
- All Sch 5
- All Sch 4 (except anabolic steroids)
- Midazolam (CD3)
- Diamorphine and morphine (CD2)
Diamorphine and morphine from schedule 2 can be supplied under a PGD, but by who and under which instances?
- By nurses and pharmacist
- They must be acting in their capacity (in their competence)
- The instance must be that the administration is required for immediate treatment necessarily for a sick or injured person.
Diamorphine and morphine from schedule 2 can be supplied under a PGD, but under which instance is this NOT allowed?
Treatment of addiction
Regarding PGD, how must the medicines be supplied?
As pre-packs made up by the pharmacist
