Professional and legal issues: pharmacy medicines

Question 1

It is unlawful to supply a product or combination of products that contain more than ____mg of pseudoephedrine OR ___mg of ephedrine at any one time, without a prescription (Regulation 237 of HMR 2012).

Answer 1

720mg pseudoephedrine or 180mg ephedrine

Question 2

Can a product containg ephedrine be sold at the same time as a product containing pseudoephedrine?

Answer 2

No.

Question 3

What options are there that are licensed as pharmacy medicines for EHC?

Answer 3

1. Levonorgestrel 1500 microgram

2. Ulipristal acetate 30mg

Question 4

For who is levonorgestrel 1500 microgram licensed as EHC?

Answer 4

Those over 16 years of age for emergency contraception within 72 hours of unprotected sexual intercourse or failure of a contraceptive method.

Question 5

For who is Ulipristal acetate 30mg licensed as EHC?

Answer 5

Within 120 hours (five days) of unprotected sexual intercourse.

Question 6

Is it possible to provide an advance supply of oral EHC?

Answer 6

Yes - the patient should be assessed to ensure that they are competent, they intend to use the medicine appropriately and it is clinically appropriate.

Question 7

Can Ulpristal acetate be supplied as EHC to those below the age of 16?

Answer 7

The supply of ulpristal acetate to patients under the age of 16 years is not contraindicated by the manufacturer. However, pharmacists may wish to consider the following additional factors:
Children younger than 13 are legally to youn to consent.
Sexual activity with children under the age of 16 is also an offence but may be consensual.

Question 8

How many paracetamol tablets or capsules can be bought at any one time?

Answer 8

No more than 100 non-effervescent formulations.

Question 9

How many efferevescent paracetamol tablets can be bought over the counter?

Answer 9

There are no legal limits on the quantity of OTC effervescent tablets, powders, granules or liquids that can be bought at any one time.

Question 10

How many aspirin tablets or capsules can be sold at any one time?

Answer 10

No more than 100 non-effervescent formulations, same as paracetamol etc.

Question 11

Can someone buy more than one pack of 32 co-codamol tablets?

Answer 11

The RPS supports the purpose of the tighter controls around codeine and dihydrocodeine products (MHRA 2009) and recommends that only one pack of OTC medication containing codeine or dihydrocodeine should be sold, as sale of more than one pack would undermine the reduction in pack size and POM restriction on packs containing more than 32 dose units.

Question 12

Antitussives are unsuitable for those under 6 years of age, what are two examples?

Answer 12

Dextromethorphan and pholcodine

Question 13

Expectorants are unsuitable in those under 6 years of age. What are two examples?

Answer 13

Guaifenesin and ipecacuanha

Question 14

Nasal decongestants are now deemed unsuitable in children under 6 years of age, what are some examples of nasal decongestants?

Answer 14

Ephedrine
Oxymetazoline 
Phenylephrine 
Pseudoephedrine
Xylometazoline

Question 15

Antihistamines, such as what, are not unsuitable in children under the age of 6?

Answer 15

Brompheniramine, 
Chlorphenamine, 
Diphenydramine, 
Doxylamine, 
Promethazine and triprolidine.

Question 16

In which patient groups can codiene linctus be used?

Answer 16

18+ only, with no other condraindications.

Question 17

What drugs have recently been reclassfied from POM to P?

Answer 17

Omeprazole and pantoprazole.
Orlistat.
Sumatriptan 
Tamsulosin 
Tranxemic acid