POM, P+, P only, GSL

Question 1

What information must be included in a prescription to be legal? (Top 10) Where can you find this information?

Answer 1

1. Patient name
2. Patient NRIC
3. Patient Contact number
4. Patient Address
5. Dosing Instructions (Name, Strength, Frequency)
6. Total Quantity of Medication Supply
7. Doctor name
8. Doctor signature
9. Doctor’s clinic address
10. Date of supply

Medicines (Prescription Only) Order, Regulation 5

Question 2

Name 1 antiviral medication that is POM with exemption and state the limits

Answer 2

Acyclovir
- Max Strength: 5%
- Max Supply: 2g
- Indication: Cold sore
- Formulation: Topical

Question 3

Name 1 antimalarial drug that is POM with exemption and state the limits

Answer 3

Atovaquone Proguanil HCl
- Max Strength: 250/100 mg tablet per day
- Max supply: Duration of travel + 1 to 2 day before travel + 7 days after leaving
- Age: 18 y.o.
- Weight ≥ 40 kg

Question 4

Name the 2 cough with phlegm medications that are POM with exemption and state the limits.

Name the brands that are exceptions to this case

Answer 4

Ambroxol
- Max strength: 30mg/tablet OR 30mg/5mL liquid
- Indication: Chest congestion

Bromhexine
- Max strength: 8mg/tablet OR 4mg/5mL liquid
- Indication: Chest congestion

Exceptions:
- Mucosolvan (GSL)
- Mucolix Elixir (GSL)

Question 5

Name the 6 GERD medications that are POM with exemption and state the limits

Provide exceptions to the case

Answer 5

H2RAs: 2 wk supply
- Cimetidine (Max strength: 200 mg for short-term relief of heartburn; 100 mg for prophylaxis of nocturnal heartburn)
- Famotidine (Max strength: 20 mg/day for short-term relief of heartburn)
- Ranitidine (Max strength: 300 mg/day for short term relief of heartburn)

PPIs: 14 day supply to people ≥ 18 years old, max daily dose of 20 mg
- Omeprazole
- Esomeprazole
- Pantoprazole

Exceptions:
- Zenpro (P Only)

Question 6

Name 1 antifungal that is POM with exemption and state the limits

Answer 6

Fluconazole 150 mg tablet
- Max supply: 1 tab
- Formulation: Oral solid
- Age: 16 to 60 years
- Indication: Vaginal thrush

Question 7

Name 1 NSAID that is POM with exemption and state the limits

List down all exceptions in the retail

Answer 7

Ibuprofen 200 mg oral solid or 100 mg / 5 mL liquid
- Max daily: 1200 mg or 30 mg/kg
- Max supply: 10 days (solid) and 3 days (liquid)
- Age > 12 years old (solid) and > 6 months (liquid)

Examples: Apo-Ibuprofen tablets and all the other Ibuprofen injectibles

Exceptions: GSL
- Nurofen
- Nuromol
- Bifen
- Brufen
- Maxigesic

Question 8

Name 1 antiemetic / prokinetic that is POM with exemption and state the limits

Answer 8

Domperidone 10 mg solid or 1 mg / ml liquid
- Indication: Relieve postprandial nausea, bloating accompanied by heartburn
- Max daily: 30 mg
- Max supply: 14 days
- Age > 12 years old

Examples: Doridone, Motilium

Question 9

Name 2 antibiotics that are POM with exemption and state the limits

Answer 9

Clindamycin 1% (TOP)
- Indication: Acne
- Max daily: Twice daily
- Max supply: 30 g (Gel); 30 mL (Solution/Lotion)
- Age > 12 years old

Examples: Dalacin, T3 Mycin

Erythromycin 4% (TOP)
- Indication: Acne
- Max daily: Twice daily
- Max supply: 30 g (Gel); 30 mL (Solution/Lotion)
- Age > 12 years old

Question 10

Name 1 mast cell stabilizer eye drops that is POM with exemption and state the limits

Answer 10

Ketotifen 0.25 mg/mL
- Indication: Short term allergic conjunctivitis
- Max daily: 2 drops per affected eye
- Max supply: 10mL
- Minimum age: 3 years old

Question 11

Name 1 mast cell stabilizer oral preparation that is POM with exemption and state the limits

Answer 11

Ketotifen 2 mg solid or 1 mg / 5 mL liquid
- Indication: Allergic rhinitis and chronic urticaria
- Max daily: 2 mg
- Max supply: 10 days or 120 mL
- Age > 3 years

Question 12

Name the Antihistamine / Decongestant brand and name that is POM with exemption and state the limits

Answer 12

Aerius-D-12 Tablet
- Desloratadine 2.5 mg / Pseudoephedrine 120 mg
- Indication: Allergic rhinitis with blocked nose
- Max daily: 2 tabs
- Max supply: 10 tabs
- Age > 12 years

Question 13

List all corticosteroids with brand name examples that are POM with exemption (State limits in general)

Provide exceptions to the case

Answer 13

Nasal Sprays (Generally 3 month supply for ≥ 18 years old)
- Beclomethasone
- Budesonide
- Fluticasone FUROATE
- Mometasone Furoate
- Triamcinolone

Topical (Generally 0.1%, 15g OR 30mL supply, for ≥ 18 years old)
- Betamethasone
- Mometasone furoate
- Triamcinolone

Exceptions:
- Oracort E Paste (P Only)
- Flixonase (Fluticasone PROPIONATE) (P Only)

Question 14

Name 3 antihistamine eye drops that are POM with exemption

Answer 14

Alcaftadine, Emedastine, Olopatadine

Question 15

Name 2 acne topicals that are POM with exemption

Answer 15

Adapalene, Azelaic Acid

Question 16

Name the POM with exemption product that is used for oral candidiasis

Answer 16

Nystatin

Question 17

Name the three 2nd generation antihistamines that are POM with exemption, stating the limits and brand exceptions

Answer 17

Desloratadine 5 mg (solid) or 0.5 mg/mL (liquid)
- Indication: Allergic rhinitis and urticaria
- Max supply: 2 weeks
- Age ≥ 12 years old (solid) and ≥ 2 years old (liquid)

Fexofenadine 180 mg (solid) or 6 mg/mL (liquid)
- Indication: Allergic rhinitis and urticaria
- Max supply: 10 tabs or 150 mL
- Age ≥ 12 years old (tab) or ≥ 2 years old (liquid)

Levocetirizine 5 mg (solid) or 5 mg/mL (liquid)
- Indication: Allergic rhinitis and urticaria
- Max supply: 10 tab or 1 bottle
- Age ≥ 12 years old
- Example: Xyzal

Exceptions:
- Aerius (P Only)
- Telfast 120 mg (GSL)
- Telfast-D (P Only)

Question 18

In practical terms, state how it is to dispense a nasal corticosteroid that is POM with exemption

Answer 18

Avamys (Fluticasone Furoate)
- 3 month supply would mean either:
(1) Six boxes of 60 sprays (15 days/box)
(2) Three boxes of 120 sprays

Given that there is 27.5 mcg per actuation and the maximum daily dose is 110 mcg.