Emergency Supply of Prescription Medications Quiz

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Questions and Answers

Under what circumstances can a pharmacist supply Prescription Only Medications (POMs) in an emergency without a prescription?

  • Only when a patient has a prior documented history with the pharmacy.
  • Only when the medication is not available at a hospital.
  • When requested by any healthcare professional.
  • When requested by a 'relevant prescriber' or the patient directly. (correct)

According to the Human Medicines Regulations 2012, what is the primary legislation that covers emergency supply of medicines?

  • Part 15, Regulation 250
  • Part 12, Regulations 224 & 225 (correct)
  • Part 1, Regulations 1 & 2
  • Part 10, Regulation 200

Which of the following is NOT a recognized way a prescriber can initially contact a pharmacy to request an emergency supply?

  • Through a phone call
  • By fax or emailing a prescription
  • By personal visit
  • Via a text message (correct)

What is a key difference in the conditions for emergency supply when a request comes from a prescriber versus from a patient?

<p>Different chapters of the Human Medicines Regulations 2012 apply to each. (B)</p> Signup and view all the answers

What is the specific term in a national PGD in Scotland that allows pharmacists to provide a supply for current repeat medicines?

<p>Urgent provision (B)</p> Signup and view all the answers

What action should a pharmacist take if they are unable to supply a medicine requested under emergency supply?

<p>Make a record in the POM register on the same day or next day (B)</p> Signup and view all the answers

Which of the following controlled drugs (CDs) can NOT be supplied to an EEA/Swiss patient, even if they have a prescription from an EEA/Swiss health professional?

<p>Phenobarbital (D)</p> Signup and view all the answers

According to the provided list, which substance is NOT permitted for supply under emergency supply at a patient's request?

<p>Ammonium bromide (B)</p> Signup and view all the answers

During a pandemic, what is one key requirement for a pharmacist when supplying an emergency supply of medicine?

<p>The pharmacist must check that the treatment has been previously prescribed by an appropriate practitioner, and the dose is appropriate (B)</p> Signup and view all the answers

Under what condition might a pharmacist supply Schedule 2 or 3 controlled drugs (CDs) during a pandemic as an emergency supply?

<p>If the Secretary of State makes a statement specifying the area and circumstances allowing it. (C)</p> Signup and view all the answers

Which piece of information is a legal requirement when recording an emergency supply of a prescription-only medicine (POM) in the POM register?

<p>The nature of the emergency that warrants the supply. (B)</p> Signup and view all the answers

According to the provided information, what is a mandatory entry when an emergency supply of a POM is provided?

<p>The date the POM was supplied. (D)</p> Signup and view all the answers

In the provided scenario, what does 'HMR 2012 (Schedule 23)' refer to?

<p>The specific regulations governing emergency supply of prescription medicines. (A)</p> Signup and view all the answers

What is the significance of the 'POM register reference number' in the context of emergency supply?

<p>It is a good practice record-keeping for audit and tracking purposes. (A)</p> Signup and view all the answers

Which of the following is not legally required to be recorded in a POM register when an emergency supply is dispensed?

<p>The dispensing pharmacist's registration number. (B)</p> Signup and view all the answers

When recording an emergency supply at a prescriber's request in the POM register, which of the following is NOT a mandatory legal requirement?

<p>Dosage of the medication (C)</p> Signup and view all the answers

Regarding emergency supplies at a prescriber's request, what is the latest time for recording specific details in the POM register?

<p>Same day or next day of the supply (B)</p> Signup and view all the answers

Which of the following details is NOT explicitly stated as a legal requirement for a POM register entry regarding an emergency supply at a prescriber's request according to the content provided?

<p>The date the prescription was received (D)</p> Signup and view all the answers

A doctor requests an emergency supply of medication over the phone. According to the good practice guidelines, which of these details would be recorded in the POM register?

<p>The dosage of the medication (B)</p> Signup and view all the answers

According to the provided content, which detail is good practice to include in the POM register but is not a legal requirement when documenting an emergency supply at a prescriber's request?

<p>The POM register reference number (D)</p> Signup and view all the answers

A pharmacist receives a faxed prescription from an out-of-hours doctor for oxycodone for a patient in severe pain at the weekend. Based on the information provided, is it legal to supply?

<p>Yes, as long as it meets professional guidelines and it is in the patient’s best interest (B)</p> Signup and view all the answers

A dentist telephones requesting a supply of tramadol 50mg capsules for a patient on a Saturday. How should this request be treated?

<p>This is acceptable as an emergency supply request from a prescriber (B)</p> Signup and view all the answers

A doctor requests an emergency supply of phenobarbital 60mg tablets over the phone, promising to send the prescription later. In this situation, how should this request be handled?

<p>It can be supplied as an emergency but with caution and good documentation (C)</p> Signup and view all the answers

A patient requests an emergency supply of medication. What is a mandatory label requirement?

<p>The words ‘EMERGENCY SUPPLY’ (D)</p> Signup and view all the answers

A patient needs an emergency supply of flucloxacillin for a rash, having had the same rash previously. What is the MOST important factor to consider before supplying?

<p>Whether the patient has had flucloxacillin before for the same issue (A)</p> Signup and view all the answers

A patient requests a supply of sildenafil, stating they have run out. What is MOST relevant to the decision to supply?

<p>Whether the patient has a valid prescription for it (A)</p> Signup and view all the answers

A regular patient needs a few simvastatin tablets until Monday. The prescription wasn't collected from the surgery. What is the MOST important consideration?

<p>Whether the patient has a valid prescription from before (B)</p> Signup and view all the answers

A patient on supervised methadone consumption needs an emergency supply because the clinic is closed and their prescription wasn't collected. What question is crucial?

<p>Whether the patient has a history of missed collections (A)</p> Signup and view all the answers

A patient visiting relatives forgot to bring their aspirin 75mg tablets. What should a pharmacist assess before an emergency supply?

<p>Whether they have a history of aspirin allergies (D)</p> Signup and view all the answers

A patient requests codeine tablets, having received an emergency supply last month. What should a pharmacist consider before supplying?

<p>Whether emergency supplies are being frequently requested (C)</p> Signup and view all the answers

A patient with an allergy is having an anaphylactic reaction from a wasp sting. They usually carry an Epipen. What is the most urgent action?

<p>Immediately administer adrenaline (A)</p> Signup and view all the answers

A patient requests an emergency supply of warfarin as they've forgotten it while on holiday. Which action MUST a pharmacist take before supplying the medication?

<p>Personally interview the patient, except in a pandemic. (A)</p> Signup and view all the answers

What is the maximum duration of an emergency supply that can be provided for a non-controlled Prescription Only Medicine (POM), such as an antibiotic, upon a patient's request?

<p>30 days (A)</p> Signup and view all the answers

According to the regulations, under what circumstance would a pharmacist be permitted to supply a Schedule 3 Controlled Drug (CD) as an emergency supply to a patient?

<p>If it is phenobarbital for epilepsy. (B)</p> Signup and view all the answers

A patient with a prescription from a Swiss doctor requires an emergency supply of medication. What is the pharmacist’s legal restriction regarding Controlled Drugs?

<p>No CDs from Schedule 1, 2, or 3 can be supplied at all for such patients. (C)</p> Signup and view all the answers

In addition to standard dispensing label requirements, what additional wording is MANDATORY on the label of an emergency supply medication?

<p>&quot;Emergency Supply&quot; (D)</p> Signup and view all the answers

A patient contacts a pharmacy via the Community Pharmacist Consultation Service (CPCS) for an emergency supply. How should the pharmacist treat the payment for the medication?

<p>The patient pays as if it were an NHS prescription (with normal exemptions). (A)</p> Signup and view all the answers

According to the process of emergency supplies, what record-keeping procedure MUST be followed after providing a supply in an emergency?

<p>Document the supply in the POM Register. (C)</p> Signup and view all the answers

A patient requests a one-month emergency supply of a POM, but the pharmacist cannot determine their previous dose. What would be the pharmacists's best course of action?

<p>Refuse supply, due to lack of information. (B)</p> Signup and view all the answers

Flashcards

Emergency Supply

A situation where a pharmacist can provide prescription-only medication (POMs) to a patient without a written prescription.

Legal Framework for Emergency Supply

Pharmacists can provide POMs in an emergency situation by following specific legal guidelines.

HMR 2012 (Part 12)

The Human Medicines Regulations (HMR) 2012 outlines the legal basis for emergency supply.

Community Pharmacist Consultation Service (CPCS)

A service offered by pharmacists where they provide advice and supply medications on behalf of a prescriber.

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Emergency Supply - Request from Prescriber

A prescriber, such as a doctor, can request an emergency supply from a pharmacist by phone, in person, or through electronic means.

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Emergency Supply at Patient's Request

A pharmacy is allowed to dispense drugs without a prior prescription in case of an emergency as long as the treatment has been prescribed by a doctor and the dose is appropriate.

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EEA Or Swiss Health Professional

Patients from the European Economic Area or Switzerland CANNOT get controlled drugs (Schedule 1, 2 or 3) or medications without a UK Marketing Authorisation.

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Substances Not Permitted

There are certain drugs that pharmacies cannot supply as emergency supplies even for existing patients. The list is defined in the Human Medicines Regulations 2012 (HMR 2012) Schedule 18.

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Emergency Supply During Pandemic

During a pandemic, pharmacists can supply Schedule 2 and 3 controlled drugs as an emergency supply if the Secretary of State declares it's necessary. This declaration defines the particular circumstances and area of coverage.

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Pharmacist's Role During Pandemic

In a pandemic context, pharmacists do not need to interview the patient directly when supplying an emergency supply. However, they still need to ensure the treatment has been previously prescribed and the dose is appropriate.

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Emergency Supply Prescription

A prescription that is issued by a doctor for a patient who needs medication urgently, but cannot wait for a regular prescription.

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POM Register

A record kept by pharmacists to track all medicines dispensed. It contains information about the medication, the patient, and the prescriber.

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Emergency Supply at Prescriber’s Request

When a doctor asks for a medication to be supplied to a patient in an emergency situation. The dispensing pharmacist must also keep a record of the request.

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Documentation Required for an Emergency Supply Prescription

When a doctor prescribes a medication to a patient who requires it immediately, the dispensing pharmacist must document the request. This record includes details of the medicine, the patient, and the prescriber.

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Independent Nurse Prescriber and Controlled Drugs

A prescription for a controlled drug (Schedule 4) cannot be given by an independent nurse prescriber. Instead, the patient should be advised to contact their doctor to get the medication.

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Labeling of Emergency Supply Medicines

It is good practice, but not a legal requirement, to mark a dispensing label with 'Emergency Supply'. The pharmacy has a responsibility to ensure the supply is appropriate by assessing the situation and considering potential risks to the patient.

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Dosage of Medication in Emergency Supply Records

It is a good practice to include the dosage of medication in your documentation, though it is not legally required.

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Questioning a Request for an Emergency Supply Prescription

If a pharmacist is unsure about the validity of a request for an emergency supply, they should question the doctor or contact the relevant authorities to verify the request. They should ask if they should contact the patient for further confirmation.

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POM Register: Recording Emergency Supplies

The pharmacist must record the details of the emergency supply in a specific register. This includes the date of supply, the drug details, the patient's information, the prescriber's details, and the reason for the emergency.

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Timeframe for Emergency Supply

The pharmacist can supply a POM for a short period in an emergency, allowing time for the formal prescription to be obtained.

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Request for Emergency Supply

The pharmacist can supply a POM in an emergency only with the express request of the patient or the prescriber. The patient can request it directly, or the prescriber can make the request on their behalf. In either case, the pharmacy needs to record the request for the purpose of accountability.

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Emergency Supply Label

A label indicating that the medication is an emergency supply, including specific details like the date of supply, patient's name, and the words "EMERGENCY SUPPLY".

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Human Medicines Regulations (HMR) 2012 (Part 12)

The legal framework governing the provision of emergency supplies, outlining the conditions and requirements for pharmacists.

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Legal and Ethical Considerations for Emergency Supply

Assessing if a patient's request for an emergency supply meets the legal criteria and if it is in the patient's best interest.

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Questions to Ask Before Supplying an Emergency Supply

Asking specific questions to determine if the patient's situation justifies an emergency supply, ensuring accuracy and appropriate action.

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Emergency Supply - Case Study: Flucloxacillin

A situation where a healthcare professional can provide a patient with an emergency supply of medication without a valid prescription because of a genuine urgent need.

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Emergency Supply - Case Study: Simvastatin

A situation where a patient needs a regular medication but has forgotten to collect their prescription, suggesting a possible emergency supply scenario.

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Emergency Supply - Case Study: Methadone

A situation where a patient needs medication but cannot obtain it because their usual source of supply, such as a clinic, is closed, potentially justifying an emergency supply.

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Pharmacist Interview

The pharmacist must directly interview the patient themselves to confirm their identity and the validity of the emergency supply request, unless in a pandemic situation.

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Prior Prescription

The medication requested for emergency supply must have been previously prescribed by a qualified medical professional.

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Emergency Supply Limits

For schedule 3 controlled drugs (like phenobarbital), the pharmacist can only supply a maximum of 5 days' worth of medication in an emergency situation.

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CPCS Referral

Community Pharmacist Consultation Service (CPCS) refers minor ailments and emergency medication requests from NHS 111 to a nearby pharmacy

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NHS 111 Referral

Patients with minor ailments or emergency medication needs can contact NHS 111. NHS 111 will then refer the patient to a pharmacy.

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Supply Appropriateness

The pharmacist can only supply the medication if it is deemed safe and appropriate for the patient. Incorrect dose, contraindications, or potential interactions are important considerations.

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Study Notes

Emergency Supply

  • Pharmacists can supply prescription-only medicines (POMs) to patients in emergency situations without a prescription.
  • The request must be made by a relevant prescriber or patient.
  • Each request is considered on a case-by-case basis, using professional judgment in the best interests of the patient.
  • The supply must meet legal requirements and follow proper recording procedures.

Aim

  • To detail the legal framework for pharmacist emergency supplies of prescription-only medications (POMs).

Learning Outcomes

  • Define types of emergency supplies.
  • Describe legal requirements and necessary records.
  • Evaluate ethical issues.

Underpinning Legislation

  • Human Medicines Regulations (HMR) 2012 (Part 12 Regulations 224 & 225).
  • Community Pharmacist Consultation Service (CPCS) (effective 29/10/2019 onwards).
  • Included in the new NHS Community Pharmacy Contractual Framework 2019-24 (CPCF) as part of Advanced services.
  • Scottish national Patient Group Directions (PGDs) allow supply for urgent provision of current repeat medicines.

Emergency Supply - Request Made by Prescriber

  • Prescriber can contact via phone, personal visit, or fax/email.
  • Pharmacist should be clear on what is required.
  • Provide details and requirements if needed.
  • Prescribers must be registered in the UK or EEA/Switzerland and their qualifications must be confirmed before supplying the medication.

Prescribers who can Request Emergency Supply

  • Doctor
  • Dentist
  • Supplementary prescriber
  • Community practitioner nurse prescriber
  • Independent prescriber (e.g. nurse, pharmacist, optometrist, podiatrist, physiotherapist)
  • EEA or Swiss health professional (defined in EU Directive 2005/36/EC)

Emergency Supply at Prescriber's Request - Request

  • Prescriber must be registered and their qualifications must be confirmed.
  • The request must be made for a reason that the usual procedures cannot be followed.
  • The prescriber will need to provide enough details to complete the clinical check, label, dispense, supply and inform the customer regarding the required procedures. Ensure that the appropriate POM register documentation is completed.

Emergency Supply at Prescriber's Request - Records

  • The POM register will need to include the date of sale or supply, details about the medicine, the customer's name and address, the prescriber's name and address, the prescription date and any fees.
  • Include the emergency supply request details, NHS payment or exemption details, and medication dosage.
  • Record the POM register reference number on the dispensing label.

Emergency Supply at Patient's Request

  • Typically involves a patient visit to the pharmacy.
  • The pharmacist needs to interview the patient.
  • Immediate need must be shown.
  • The medication must have been previously prescribed by a UK registered professional (or EEA-Swiss).
  • It must be an appropriate dose.

Emergency Supply at Patient's Request - Labelling Requirements

  • The container or packaging must include normal labelling and include the words "EMERGENCY SUPPLY".
  • The label will need details about the medicine and the customer's information, including the name, form, strength, quantity, date of supply, and pharmacy details.

Emergency Supply at Patient's Request - Record

  • Record in the POM register information on date of sale/supply, name, form, strength, the quantity, customer's name and address, and details about the emergency situation.
  • Include the patient's GP name and address, the dosage of medication, if any payment/exemption was made, and reference number of POM for dispensing.

Emergency Supply at Patient's Request - Substance Restrictions

  • A list of substances that cannot be supplied in an emergency is available.

Emergency Supply at Patient's Request - (Pandemic)

  • During a pandemic, pharmacists don't need to interview patients unless the treatment is not previously prescribed.
  • The treatment should've been prescribed by an appropriate practitioner, and the dose has to be appropriate.
  • The government secretary makes declarations of what regions are affected by a pandemic. Specific timeframes can be included in the declarations.

Community Pharmacist Consultation Service (CPCS)

  • 111 services refer requests to pharmacies.
  • Patients can contact pharmacies directly.
  • Patients can visit pharmacies and pharmacists supply depending on the appropriate HMR 2012 regulation.
  • Fees are applicable for dispensing as usual and may vary depending on the circumstances.

References/Further Reading

  • Includes the medicines, ethics and practice guide from July 2019.
  • Details about relevant pharmacy law and ethics texts.
  • Details of relevant legislation and services.

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