Flashcards in Professional and Legal Issues - P meds & Part 1 POM Deck (20):
What is the legislation on retail and supply of P meds?
Must be made by a person conducting a retail pharmacy business, at a registered pharmacy, and by or under the supervision of a pharmacist.
Under what circumstances does the conditions of P supply not apply to?
1. When there is a collection and delivery arrangement in place
2. Pandemic situation
What are the legal restrictions on the sale of pseudo-ephedrine and ephedrine?
Unlawful to supply a product or combination of products that contain more than:
720mg of pseudoephedrine
180mg of ephedrine
at any one time without a prescription.
Also illegal to supply any one at the same time as the other.
Describe the possible signs of misuse.
1. Nervous or guilty behaviour
2. Lack of symptoms
3. Rehearsed answers
4. Impatient or aggressive
6. Specific products containing those ingrediants
7. Paraphernalia - wishes to purchase other items used to manufacture e.g. lithium batteries, acetone
What are the two types of Oral emergency contraceptives? When is each best used?
1. Levonorgestrel 1500 microgram tab. - women 16 years and above and within 72 hours of unprotected sex or failed contraception.
2. Ulipristal acetate - within 120 hours/5 days
What are the OTC legal restrictions for Paracetamol and Aspirin?
No more than 100 non-effervescent tablets, capsules can be sold at any one time. 2 packs at a time (16 or 32 pack)
There is no legal limit on effervescent tabs, powders, granules or liquids that can be sold at any one time.
What are the indication restrictions for OTC codeine and dihydrocodeine?
From 2009 - Only to be used for short-term pain relief if paracetamol, ibuprofen or aspirin are not working alone.
All other previous indications such as cold and flu, coughing, sore throat and minor pain have been removed
Legal restrictions on pack sizes and packaging requirements for codeine and dihydrocodeine?
Max size - 32 packs. Any more = POM
Packages/Labels - "can cause addiction. For 3 days use only" must be clear and in prominent place.
A number of cough and cold medicines have been deemed unsuitable for children under 6. Which ones and why?
1. ANTITUSSIVES – dextromethorphan, pholcodine
2.EXPECTORANTS – guaifenesin, ipecacuanha
3. NASAL DECONGESTANTS – ephedrine, oxymetazoline,
phenylephrine, pseudoephedrine, xylometazoline
4.ANTIHISTAMINES – brompheniramine,
chlorphenamine, diphenhydramine, doxylamine,
Linked to s.e such as allergies, sleep disturbances and hallucinations
What is the best practice for treating children
with a cough and/or a cold
Most colds will resolve in 5 to 7 days- however can be given the following:
For all symptoms - drink plenty of fluids
Fever & Pain - paracetamol and ibuprofen (not at the same time for under 5)
Nasal Congestion - saline nasal drops, steam inhalation, vapour rubs
Cough - warm clear fluids, lemon and honey drinks if over 1 years. Simple linctus or glycerol.
Codeine linctus should NOT be used for under 18yrs
Name some examples of reclassified POM to P meds?
1. Amorolfine nail lacquer
2. Chloramphenicol eye drops and eye ointment
3. Levonorgestrel and ulipristal acetate
4.Omeprazole and pantoprazole
8. Tranexamic acid
What are the legal prescription requirements? For NHS and Private
1. Signature in indelible ink by appropriate practitioner
2. Address of prescriber
3. Date - valid for 6 months, 28 days for CDs
4. Particulars of prescriber
5. Name of Patient
6. Address of patient
7. Age of patient - if under 12
What are the legal record keeping requirements for private prescriptions for POM?
Records to be kept for 2 years from date of supply. Prescriptions for Sch 2 and 3 CDs must be submitted to relevant NHS agency.
1. Supply date
2. Prescription date
3. Med detail - name, quantity, formulation and strength
4. Prescriber details - name & address of practitioner
5. Patient details - name & address
Faxed prescriptions don't fall within the definition of a legally valid prescription within human legislation. Why?
Also what are the risks of supplying from a faxed prescription? (7)
Prescription not written in indelible ink and hasn't been signed in ink.
1. Uncertainty that the supply has been made in accordance with a legally valid prescription.
2. Risks of poor reproduction.
3. Risks of not receiving original prescription - and so can't show that a supply has been made in accordance to a prescription.
4. prescription may be amended by prescriber.
5. fax sent to multiple pharmacies = multiple supplies
6. Prescription is not genuine
7. system of sending and receiving of the fax is not secure
Which prescribers are acceptable from the EEA and switzerland? and is it still valid even though in a different language?
Yes - pharmacist needs enough info to enbale safe supply
Can emergency supply be made at the request of a PATIENT and EEA/Swit PRESCRIBER?
If so...what CAN'T be given?
Yes - prescription req within 72 hours.
Sch 1, 2, 3 (inc. phenobarbital) CANNOT be supplied at all regardless of who is requesting.
What are the legal requirements of a dispensing label?
1. Name of the patient
2. Name and address of the supplying pharmacy
3. Date of dispensing
4. Name of the medicine
5. Directions for use
6. Precautions relating to the use of the medicine.
The RPS recommends the following also appears on the dispensing label:
7. ‘Keep out of the reach and sight of children’
8. ‘Use this medicine only on your skin’ where applicable.
What must be labelled if a pack is split into another box or from bulk containers?
1. Name of med
2. Quantity of med
4. Hnadling and storage req where appropriate
5. Expiry date
6. Batch no.
What does covert administration mean?
‘Covert administration’ is the term used when medicines are administered in a disguised format without the knowledge or consent of the person receiving them, e.g., in food or in a drink.