PPP Week 21 Flashcards
(100 cards)
1
Q
define requisition
A
a formal request for a stock of medicines
2
Q
Since 2015, what has been needed to get a requisition for Sch 2 and 3 CDs in the COMMUNITY?
A
an approval form
3
Q
When do hospitals not need an approval form for a requisition?
A
if the request is from a ward or department within that hospital - ‘same legal entity’
4
Q
Where are requisitions forms sent off to?
A
the NHSBSA
5
Q
What must be written legally on a Sch 2 or 3 CD requisition?
A
- name of recipient
- signature of recipient
- address of recipient
- their profession or occupation
- total quantity of drug
- purpose of the requisition
6
Q
How do you know if a request is genuine?
A
- check person’s ID
- look their name up on a professional system - registration
- you would most likely know them professionally
7
Q
What type of requisitions are NOT legal?
A
faxed or photocopied - you MUST have a physical piece of paper
8
Q
When must the requisition be received?
A
BEFORE the supply is made - except in an emergency, but the requisition must be given within the next 24 hours
9
Q
What does the supplier (you) need to mark the requisition with?
A
the supplier’s (pharmacy) name and address - can use stamp
10
Q
Where is the original requisition sent to?
A
NHSBSA
11
Q
How long does a copy of the requisition have to be kept for?
A
2 years from supply date - for good practice
12
Q
Who are the only people exempt from having to keep requisitions?
A
pharmaceutical manufacturers and wholesalers
13
Q
For veterinary requisitions, how long must you keep the original requisition?
A
5 years
14
Q
Which CD drugs can midwives order?
A
diamorphine, morphine and pethidine
15
Q
What must a midwife have to obtain these drugs?
A
a Midwife Supply Order (MSO)
16
Q
What information must an MSO state?
A
- name of midwife
- their occupation
- name of person who will receive the CD
- purpose for which CD is supplied
- total quantity to be supplied
- signature of ‘appropriate medical officer’ doctor or supervisor authorised by the NHS trust
17
Q
What are the prescription requirements for Sch 2 and 3 CDs?
A
- name of patient
- address of patient
- name, formulation, strength and dose of CD drug
- total quantity of drugs
- quantity prescribed
- prescriber’s signature and address
- date of signing
18
Q
How long is a Sch 2, 3, 4 CD prescription valid for after signing?
A
28 days after the appropriate date
19
Q
What could be the ‘appropriate date’?
A
either:
1. the signature date
2. any other date indicated on prescription as a date before which supply should not be made
20
Q
Where must the prescriber’s address be?
A
in the UK
21
Q
What type of dose indications are NOT legal?
A
‘when required’, ‘rpm’, ‘weekly’
22
Q
How must the total quantity be written?
A
in BOTH words and figures e.g. dispense twenty-eight, 28)
23
Q
What is the recommendation of the maximum quantity of Sch 2, 3, and 4 CDs that should be supplied at one time?
A
30 days
24
Q
What is the difference between total quantity and quantity prescribed?
A
total quantity - the total quantity prescriber for the entire course of treatment
quantity prescribed - the amount the pharmacy can dispense and should dispense at a given time
25
What is a pharmacist legally required to do when someone is collecting a CD?
determine who the collecting person is (patient, patient's representative etc)
26
If a healthcare professional is collecting a CD, what must you ask?
1. name
2. address (work)
3. evidence of identity
27
What must you get the collector for Sch 2 and 3 CDs to do?
sign the back of the prescription in the CD collector box
28
Which Schedules of CDs must be recorded in the CD register?
Schedules 1 and 2 - ALSO Sativex (Schedule 4, part 1)
29
Which 3 things does the law require to be at the top of a CD register?
1. class
2. form
3. strength
30
Are electronic CD registers allowed by law?
yes - but entries must be attributable, capable of being audited and compliant with best practice
31
What information must be recorded in the CD register when CDs come into the pharmacy?
1. date received
2. name and address from who it was received - good practice to include invoice number
3. quantity received
32
What information is recorded when CDs are supplied from the pharmacy?
1. date of supply
2. name and address of recipient
3. details of authority to possess (prescriber or licence holder details)
4. quantity supplied
5. details of person collecting
6. whether ID proof was requested
7. whether ID proof was supplied and which type
33
What is the time frame in which CD register entries must be made after supply?
24 hours - LEGAL
34
What must you not do to CD entries?
alter them - crossing out - ILLEGAL
35
How must you make corrections in a CD register?
by dated notes in the margin or bottom of page - include name, signature, GPhC number
36
Why are 'running balances' carried out?
to help discrepancies and irregularities be spotted quickly
37
How often is a balance check usually done?
once a week, but may be more or less frequent
38
How must you check liquids?
by visual checks, measure volumes periodically and check the balance at the end of a bottle
39
What must the healthcare professional running the check do?
record, sign and date the check
40
Who legally has responsibility for running balance checks?
the pharmacist
41
What must you do if you find a discrepancy but can resolve it?
make a margin or footnote and correct the running balance
42
What must you do if you find a discrepancy and cannot resolve it?
fully investigate and notify CDAO
43
Where must Schedule 2 CD private prescriptions be recorded?
CD register AND POM book for good practice
44
What must you put on private Schedule 2 POM prescriptions?
reference number on prescription, label AND CD register
45
What are the 5 main stages of structured consultations?
1. initiating the session
2. gathering information
3. physical examination
4. explanation and planning
5. closing the session and safety netting
46
What does the upper respiratory tract consist of?
nasal cavity, pharynx and larynx
47
What are illnesses involving the upper respiratory tract?
sore throat, cold/flu, rhinitis
48
What does the lower respiratory tract consist of?
trachea, bronchi and lungs
49
What are illnesses involving the lower respiratory tract?
coughs, Covid-19
50
What causes coughing?
irritation of the respiratory mucosa as a response to infection or contamination
51
What are the main causes of coughs?
1. bacterial or viral infections
2. allergies
3. post-nasal drip
4. covid-19
52
What is the most important thing in differential diagnosis of a cough?
you MUST exclude a more serious condition or infections - there is higher risk for a patient if they have underlying pathology or an issue outside of your competency
53
What are the red flags for a cough?
1. wheezing, SOB
2. coloured sputum
3. lasted more than 3 weeks
4. chest pain
5. drug induced cough or wheeze
6. dry, night-time cough in children
54
What are 3 examples of OTC treatments for chesty coughs?
1. Robitussin Chesty Cough
2. Benylin Chesty Cough
3. Covonia Chesty Cough
55
What are 2 examples of OTC treatments for a dry cough?
1. Robitussin Dry Cough
2. Benylin Dry Cough
56
What are examples of other OTC treatments for coughs?
1. Linctus
2. Broncho Stop syrup
3. Broncho Stop Pastilles
57
When can you give antibiotics for a cough?
if patient is showing certain symptoms associated with a bacterial infection - coughing up lots of phlegm
58
What are the 7 main causes of a sore throat?
1. bacterial/viral infection
2. candida
3. glandular fever
4. quinsy
5. poor inhaler technique
6. cancer
7. tonsillitis
59
For which illness must you refer a patient to a GP?
candida, glandular fever, tonsillitis, quinsy, cancer concerns
60
What is candida?
an unusual illness only really seen in immunocompromised patients
61
What is the main sign of candida?
plaques extending down the throat and the underlying surface is raw and inflamed
62
What is glandular fever caused by?
the Epstein-Barr virus
63
How is glandular fever treated?
NOT using antibiotics - treated symptomatically
64
What is the main symptom of quinsy?
an abscess between the back of the tonsil and the wall of the throat
65
Why is quinsy so serious and must result in going to A&E?
infection spread from the tonsils to the area around them
66
Which clinical score is used to make differential diagnoses for a sore throat?
FeverPain score
67
What is the 1st line treatment option for a sore throat?
analgesics- then a lozenge, spray or mouthwash if needed
68
What are 3 examples of analgesics?
1. paracetamol
2. aspirin
3. ibuprofen
69
What are 3 examples of other products for sore throat relief?
1. Ultra Chloraseptic Spray
2. Strepsils Honey and Lemon
3. Olbas Pastilles
70
What must you advice patients on when giving sore throat products?
1. gargles have a shorter duration of action than lozenges
2. diabetics should take ONLY sugar-free lozenges
3. check for contraindications
4. do NOT swallow mouthwashes
71
What is the most important thing when treating people with colds?
make sure it isn't flu - as some patient groups may get very unwell
72
What are the main differences between a cold and influenza?
colds:
develop over a few days, with a sore throat, then runny nose, coughing, congestion etc
influenza:
sudden onset of symptoms including shivers, chills, aching, non-productive cough and loss of appetite
73
What are red flags for colds?
1. symptoms of flu
2. persistent uncontrollable fever
3. chest infection signs
4. chest pain
74
What conditions could chest pain indicate?
pneumonia, heart issues, secondary infections
75
How should you decide what to give a patient with a common cold?
ask them about their most problematic symptoms - or would they like an all-in-one treatment?
76
What are examples of analgesics you can offer to patients with a cold?
paracetamol, ibuprofen, aspirin
77
What are other combination cold treatment you can offer?
1. Lemsip Max sachets
2. Benylin Day and Night
3. Beechams all-in-one tablet
78
Why must you be careful with giving both Lemsip Max sachets and Beechams all-in-one?
they both contain Phenylephrine which has contraindications for diseases such as CVD, angina, hypertension
79
How do decongestants work?
by constricting the dilated blood vessels in the nasal mucosa
80
What are 3 examples of OTC decongestants?
1. Otrivine nasal spray
2. Sudafed
3. Sinutab
4. Vicks Vaporub
81
Which drugs, since 2009, should no longer be given to children under 6 for coughs and colds?
brompheniramine, chlorphenamine, diphenhydramine, dextromethorphan, guaifenesin, ipecacuanha, phenylephrine, pseudorephedrine, ephedrine, oxymetazoline and xylometazoline
82
What are examples of different pollens and when they affect patients?
tree pollen - early spring
grass pollen - peaks in June and July
fungal spores - autumn
perennial - dust mites, cats, dogs
83
What is the main way you can differentiate between allergic rhinitis and a cold?
the patient won't be particularly unwell, and will mainly be suffering from nasal and eye symptoms
84
What are the referral signs for allergic rhinitis?
1. wheezing or SOB - exacerbation of asthma
2. treatment failure
3. earache, facial pain, eye problems
4. unilateral discharge - could suggest some form of blockage e.g. nasal polyps or deviated nasal septum
85
What is the first line of treatment for allergic rhinitis?
allergen avoidance, if possible
86
What advice can you give to patients with allergic rhinitis?
1. identify cause and avoid
2. stay indoors/close windows
3. avoid hanging washing on high pollen days
4. avoid smoking
5. avoid grassy areas
6. modify house to remove dust etc
87
What is the main issue with antihistamines?
most are sedating
88
What must you advise patients on when giving antihistamines?
driving and using heavy machinery
89
Which generation of antihistamines are sedating?
1st generation
90
Why are 1st generation antihistamines sedating?
they are lipophilic and can cross the blood-brain barrier, so cause drowsiness
91
What is an example of a 1st generation antihistamine?
Piriton (chlorphenamine)
92
Why are 2nd generation antihistamine non-sedating?
the cross the blood-brain barrier to a much lower extent
93
Which is the only true non-sedating antihistamine?
loratadine
94
What are 3 examples of non-sedating antihistamines?
1. loratadine
2. certirizine
3. Benadryl Plus
95
What do corticosteroids do for allergic rhinitis?
reduce the underlying inflammatory response
96
What is the main issue in using corticosteroids for allergic rhinitis?
they do not have an immediate effect and may take several weeks for a full response to be seen
97
What is the minimum age for corticosteroids?
18
98
What are 2 examples of corticosteroids used to treat allergic rhinitis?
1. Beclometasone (Beconase)
2. Flucticasone (flixonase)
99
What is the issue with using mast cell stabilisers for eye symptoms?
there are compliance issues due to frequent administration - may limit efficacy
100
What is an example of a mast cell stabiliser used to help eye symptoms caused by allergic rhinitis?
Opticdrom Allergy eye drops (sodium cromoglycate)
