A couple of Q's i am stuck with.

[Raoul]

rank the options in line with what you feel is the best course of action to take first in the situation.

A customer comes in with a prescription for Klaricid for his child. The prescription is twice the recommended dose of that in the BNF for children. The GP's surgery has closed by this time.

a-Give him the recommended dose for the night and contact the doctor later.
b-Dispense the higher dose.
c-Refuse the prescription until you have spoken to the GP.
d-Refuse the prescription and recommend Calpol for the pain.

my opinion is: a, d,c then b. i am not sure i need some help pharmacists


Q 2: lady brings in her 8 year old child, whom she is convinced has conjunctivitis. She requests Chloramphenicol by name, as she has seen it on a TV programme. You examine the child, who tells you he is not in pain and seems unconcerned about his eyes.

a-Sell the medication as the mother requests.
b-Recommend an alternative such as Brolene.
c-Refer to her doctor.
d-Advise that it is not conjunctivitis and say they do not need to do anything.

Q3: A customer comes into the store with a prescription for 20 Ensure Plus nutritional drinks for their elderly mother. The script states 20 x vanilla flavour 220 mls tetra packs of Ensure Plus. The customer is unsure if their mother will like the vanilla flavour.

a-Give them 20 Vanilla 220mls Tetra Packs.
b-Ring the GP and ask them if they could re-write you a script for mixed flavours.
c-Ask the customer to go back to the GP and ask for the script to be changed to mixed flavours.
d-Dispense 20 mixed flavours 220mls, Ask the GP to provide a replacement script when they get a chance.


thanks

[Steve G]

Q1. a, without a doubt. I have had this situation several times, and have always taken this course of action and the GPs have agreed with me when I get in touch with them the next morning.

Q2. need more info really, but of the options, I would take d.

Q3. d

[lamzee]

With the first question, doesn't the BNF state that doses may be doubled in severe infections?

[the old merlin]

Agree with Steve for 1 & 2, but for 3 legally a is correct. The others are not. And, although it's not an option, flavourings can, I'm sure. be added to Ensure. And vanilla is, like, vanilla!

[Steve G]

Originally Posted by the old merlin

Agree with Steve for 1 & 2, but for 3 legally a is correct. The others are not. And, although it's not an option, flavourings can, I'm sure. be added to Ensure. And vanilla is, like, vanilla!

But the question is what is the best option, not what is legal, and I can't ever see anyone being prosecuted for supplying mixed flavours of ensure against a prescription for vanilla.

[pharmatron]

PSNC guidance on Substituting Flavours: (Reimbursement Arrangements for Medicines · Funding & Drug Tariff · PSNC)

The Royal Pharmaceutical Society have confirmed that it would not be a breach of the Code of Ethics if pharmacists substitute different flavours of the same product, for example of a nutritional drink, to meet patient preference. If an alternative flavour is dispensed, the prescription should be clearly endorsed with information on the dispensed product.

Payment will be based on the prescribed item. Pharmacists are reminded that if the prescription does not state mixed, assorted or various flavours, only one professional fee will be paid per prescribed flavour regardless of whether multiple flavours have been dispensed and endorsed. If the prescription orders mixed, assorted or various flavours and several flavours of the same preparation are supplied, the contractor will receive professional fees equivalent to the number of different flavours dispensed and endorsed on the prescription form.

Hope this helps!

[Raoul]

thank you all for your replies. yes it is helping me

[Pharmanaut]

Originally Posted by pharmatron

PSNC guidance on Substituting Flavours: (Reimbursement Arrangements for Medicines · Funding & Drug Tariff · PSNC)

The Royal Pharmaceutical Society have confirmed that it would not be a breach of the Code of Ethics if pharmacists substitute different flavours of the same product, for example of a nutritional drink, to meet patient preference. If an alternative flavour is dispensed, the prescription should be clearly endorsed with information on the dispensed product.

Payment will be based on the prescribed item. Pharmacists are reminded that if the prescription does not state mixed, assorted or various flavours, only one professional fee will be paid per prescribed flavour regardless of whether multiple flavours have been dispensed and endorsed. If the prescription orders mixed, assorted or various flavours and several flavours of the same preparation are supplied, the contractor will receive professional fees equivalent to the number of different flavours dispensed and endorsed on the prescription form.

Hope this helps!

Yes - with paper prescriptions this isn't hard to do.
Anyone heard of how it can work with EPS yet?
You will be giving something out of the correct VMP-AMP-AMPP link so the system will reject it. Hope someone is working on this?