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Pharmacy management > RAMAs, Storage And Disposal > Flashcards

RAMAs, Storage And Disposal Flashcards

1
Q

What are the 4 distribution categories of veterinary medicines

A

POM-V
POM-VPS
NFA-VPS
AVM-GSL

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2
Q

POM-V

A

Prescription Only Medicine

Only prescribed by a veterinary surgeon

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3
Q

POM-VPS

A

Prescription Only Medicine

Prescribed by veterinary surgeon, pharmacist or RAMA/SQP

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4
Q

NFA-VPS

A

Non-Food Animal

supplied by a veterinary surgeon, pharmacist or RAMA/SQP

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5
Q

AVM-GSL

A

Authorised Veterinary Medicine - General Sales List
Supplied by any retailer
Eg pets at home

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6
Q

Which controlled drugs CANT nurses/pharamacist/RAMAs prescribe

A

Diamorphine
Cocaine
Dipipanone for addiction treatment

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7
Q

What are the schedules of controlled drugs

A

Schedule l
Schedule ll
Schedule lll
Schedule lV
Schedule V

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8
Q

Schedule l drugs

A

Little or no therapeutic value
High potential for abuse/misuse
Only used for research purposes in vet practice
Illegal recreational drugs

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9
Q

Schedule ll drugs

A

High potential for abuse/misuse
highly addictive but with therapeutic value
Their use is strictly controlled
Opioids

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10
Q

Schedule l drug example

A

Cocaine and heroin

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11
Q

Schedule ll drug examples

A

Opioids such as methadone hydrochloride, fentanyl, morphine and ketamine

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12
Q

Schedule lll drugs

A

High potential for abuse/misuse but have therapeutic value
Their use is controlled

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13
Q

Schedule lll drug examples

A

Buprenorphine hydrochloride
Tramadol
Gabapentin
Phenobarbital

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14
Q

Schedule lV drugs

A

Some potential for abuse/misuse and has therapists value

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15
Q

Schedule IV drugs examples

A

Diazepam
Chronic gonadotropin
Clenbuterol hydrochloride

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16
Q

Schedule V drugs

A

Some potenitnal for abuse/misuse and has therapeutic value

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17
Q

Schedule V drug examples

A

Paracetamol and codeine phosphate

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18
Q

Controlled drugs requirements - lockable cupboard

A

All schedule 2 except Quinalbarbitone

Only burenorphine from schedule 3

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19
Q

Controlled drugs requirement - prescription validity

A

28 days for 2,3 and 4
6 months for 5

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20
Q

Controlled drugs repeat prescription

A

Only schedule 4 and 5

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21
Q

Controlled drugs register

A

Only for schedule 2 and buprenorphine from schedule 3

RCVS recommends all schedule 3 to be in CD cabinet

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22
Q

Controlled drugs witness destruction

A

Only for schedule 2 drugs

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23
Q

How long does the invoice get kept on controlled drugs

A

2 years

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24
Q

What is required on a prescription for schedule 2 and 3 drugs

A

Declaration that it is for an animal or herd under vet care
Full name and address of owner and animal
Name and form of drug
Amount prescribed in words and figures
Strength of preparation
Dose to be administered
RCVS number of prescribing vet

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25
Q

Sharps bin has what waste

A

Used needles
Syringes with fixed needles
Broken single use vials/ampules

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26
Q

Cytotoxic and cytostatic bin has what waste

A

Any cytotoxic or cytostatic medications (chemotherapy drugs) including syringes, needles and bottles/vials

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27
Q

Pharmaceutical waste bin has what waste

A

Multiuse medication bottles
Used syringes without fixed needles
Out of date medication
Returned medication from owners

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28
Q

Disposal of schedule 2 controlled drugs

A

Out of date or unused need to be denatured and disposed of in pharmaceutical waste bin in presence of either
A police officer (CD liaison officer)
Inspector appointed under VMR
vet from another practice (can’t be partners or friends - must provide RCVS number)
Drugs must be kept in cabinet and only removed from register once destroyed

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29
Q

Process of disposing schedule 2 drugs

A

Empty into a denaturing kit
Place on pharmaceutical waste bin
Record disposal in the CD register
Countersign from witness on register

Schedule 3,4,5 do not need to be witnessed

30
Q

How would you destroy transdermal fentanyl patch

A

Food and place into denaturing gel

31
Q

How would you destroy phenobarbital tablets

A

Crush and mix with water then add to denature gel

32
Q

What is significant about denaturing kit

A

Turns to gel so the drug can’t be extracted

33
Q

Waste vs stock on disposing of controlled drugs

A

If CD is waste then witnessed denaturing and destruction is NOT required

If CD is stock witnessed denaturing and destruction IS required

34
Q

What is stock

A

Any out of date controlled drugs
Any multiuse vial that is beyond 28 day broached life

35
Q

What is waste

A

Small out of medication left in single use vial after drawing up dose
If dose if drawn up but not administered
Unusable amount of medication left over in multiuser vial
Part used infusions

36
Q

Storage requirements of medicines in accordance to Summary of Product Characteristics (SPC)

A

pharmacy between 8 and 25
Pharmacy fridge between 2 and 8
Temp to be monitored and recorded daily incl min and max temps

37
Q

Can we accept medications back from clients and use them

A

No

38
Q

What is the formula for the order up to level regarding stock

A

OULT(order up to level) = D(daily demand) x L(lead time) which is how long it takes for drug to come.

39
Q

What is needed for stock storage

A

Set stock levels (min and max)
Named person responsible for stock level
Store products in original packaging
Supply a product leaflet with products dispensed
Dispense products with shortest expiry date first
Store products with different batch numbers together (in case of any recall they’ll have spares)

40
Q

What records should be kept in vet medicine

A

Dates of deliveries and items
Batch numbers for food producing animals
Record first usage on each box/bottle
Wholesaler to keep transaction records for 3 years
Vet practices to keep for 5years

41
Q

What are the reasons for stock loss

A

Products going OOD
broken/damaged
Items not charged
Theft
Items charged but not received
Wholesaler credit for goods returned/missing not received
Consumable wastage

42
Q

What is a stocktake

A

VMD requires all practices to do annually
Must include OOD products and broken/damaged stock aswell as the rest of the srock

43
Q

Controlled drugs record keeping

A

Register to be kept for all schedule 2 drugs for 2 years after the last entry
Chronological order
Separate page for each strength and form of that drug
Separated into each drug class
Be able to be audited
No corrections or alterations
Dated and signed
Recorded in a bound book

44
Q

What should every entry have in the register book for schedule 2 drugs

A

Date
Name and address of owner/animal/case number
Batch number
Amount dispensed and disposed of
Name or sig of prescriber
RCVS number
Amount remaining/ running balance

45
Q

Should we use CD returned by a client

A

No

46
Q

Should. Record any CD that are returned and destroyed

A

Yes

47
Q

CD cabinet requirements

A

Attached by bolts to wall of building
Multi point lock
Double lock
Kept locked when not in use
Different to any other lock
Keys to authorised members of staff
Key can be left in combination box but code must be changed monthly and should not be next to CD

48
Q

CD in vehicles

A

Lockable bag/box/glove compartment
Vehicle should not be left unattended
Separate register must be maintained

49
Q

Can CD be sent in the mails

A

Only in exceptional circumstances and must be recorded and signed fora

50
Q

Can CD be supplied by internet pharmacies

A

Yes but prescription must be received before the CDs are supplied

51
Q

Can CDs be advertised to clients

A

No but a VS can discuss the use of CDs during a consult

52
Q

What do SOPs cover

A

Order and receipts of CDs
Who has access to CD
Where are they stored
Dispensing of CD
Transportation of CD
Disposal and destruction of them
Who to alert if complications occur
Record keeping (what to do if discrepancies)

53
Q

28 days after opened stock of ketamine left in a bottle what should happen to it

A

Must be denatured and recorded in register and witnessed by independent vet surgeon

54
Q

What happens to remaining methadom in syringe from client

A

It is waste and is denatured ideally witnessed by another team member
Not recorded in register

55
Q

Tramadol drug RCVS recommendations

A

That it should be locked in CD cabinet even tho it’s schedule 3 drug and can be kept on dispensary shelf

56
Q

A discrepancy of methadone is noted at the end of the month what should be done

A

Consult the discrepancy policy SOP

57
Q

A - RAMA (AVM)

A

Birds

58
Q

L-RAMA (FAM)

A

Farm

59
Q

J-RAMA (EQM)

A

Horses

60
Q

C-RAMA (CAM)

A

Cats and dogs

61
Q

CA-RAMA

A

Companion and avian

62
Q

EA-RAMA

A

Companion equine and avian

63
Q

K-RAMA

A

Farm and companion

64
Q

G-RAMA

A

Farm and equine

65
Q

E-RAMA

A

Equine and companion

66
Q

JA-RAMA

A

Equine and avian

67
Q

RAMA training timeline

A

Register with AMTRA as a student RAMA/sit base module (VN don’t need to do this)
Sit modular exam in chosen species
Face to face exam
Register with AMTRA and maintain CPD

68
Q

Roles of a RAMA

A

Prescribe VMP within drug category POM-VPS
supply VMP within the drug categories POM-VPS, NFA-VPS, AVM-GSL
Identify infestations
Advise on prevention and control of disease
refer a client to vet if required
Ensure VMP are appropriate for client

69
Q

What info must be gathered before a RAMA can prescribe or supply

A

Species
Number to be treated
Clinical signs
Age, sex, weight, lifestyle, temperament
Current medical history
Repeat or not
When was Last clinical exam
If the owner knows how to use product

70
Q

What don’t RAMAs do

A

Diagnose disease
Treat disease
Don’t need to see the animal

Pharmacy management (9 decks)

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