Stuck with Pre-reg NON Calculation Questions?

[emelianenko]

Questions 15 and 16 concern the following medicines:
A 1 pack of 100 Nu-Seals Aspirin (enteric coated aspirin tablets
300 mg)
B 4 packs of 30 Aspro Clear (aspirin effervescent 300 mg tablets)
C 2 packs of 32 paracetamol 500 mg tablets (non-effervescent)
D 1 bottle of 100 aspirin dispersible tablets 75 mg
E 3 packs of 32 Paramol (paracetamol 500 mg / dihydrocodeine
7.46 mg, non-effervescent tablets)
Select, from A to E, which one of the above:
15. can lawfully be sold from a non-pharmacy retail outlet
16. can only be sold or supplied lawfully from a registered pharmacy in
accordance with a prescription

[happy_bunny]

Hi,
All the exam papers I am doing seem to have at least one question about ES and the answer is nearly always of the "Thou shalt not supply without personally interviewing the patient" variety. Was just wondering how this works if the patient is a baby etc - is it reasonable to interview the parent? At what age does it become necessary to interview the child?

[johnep]

You would not normally make an ES for a baby, refer to OOH Dr.
johnep

[happy_bunny]

Good point, never thought of that - question came up coz i did an exam question where the mother of a 17-year old wants an ES of ventolin or something and I said I couldn't give it because I needed to interview the patient - then I thought what if the patient was much younger/autistic etc.
Basically if you cannot interview the patient yourself because of communication/understanding issues then would you just have to refuse and send them to OOH Dr?

[Fleegle]

This is a classic case of whether the pharmacist is brave enough to make the decision to supply given all the circumstances, or pass the buck, possibly wasting precious time. If the request was deemed to be genuine, I would supply.

What could be the possible consequence of refusing supply?

[Proteuspal]

Hi all
I came across a question which I found a bit tricky:

You are presented with a script for Tenormin LS 50mg OD. You find you have none in stock but you do have generic atenolol tablets. Which of these is/are appropriate courses of action?:

1. Contact the prescriber and ask for a new prescription written generically
2. order Tenormin LS tablets and inform the patient when they will be ready for collection
3. dispense generic atenolol and endorse the script to show a generic brand has been supplied

My instinct tells me the answer is number 2. Asking the Doctor for a new script just seems a bit of a waste of time. What I have seen to date is that this would be done as an owing. Number 3 would be incorrect for reasons discussed already in this thread, i.e. you would only be reimbursed for the generic price. However, number 1 I am just not certain about, so I hope someone can help!?

[Proteuspal]

Just struck another one...Sorry to post two at once guys, but this one is really bugging me.

To which of these patients is it appropriate to sell 1% hydrocortisone cream to:

1. A housewife with a first time episode of mild contact dermatitis (cause unknown)
2. a 5 month old with nappy rash
3. A lorry driver with badly chapped and broken skin on his hands due to garden work
4. a woman with a rash around the eyes which appears to be a form of contact dermatitis from mascara
5. a man with dermatitis on his lower arms which he has been treating with 1% cream for about 8 weeks

Ok, hydrocortisone states not to apply to broken skin, so 3, the lorry driver definitely should not receive any. Number 4 also should not be supplied as its on her face. Number 5 should not receive it as he has already used it for greater than the recommended 1 week. Both options 1 and 2 are possible. The BNF states that hydrocortisone cream 1% can be used in nappy rash (as long as they are not neonates). But I think OTC packs of hydrocortisone state not to be used in under 10 year olds.
I am going to go for A-give it to the woman with contact dermatitis. But what made me doubt if the answer should be A was the fact it was her first time to suffer from dermatitis and also it is a mild case...

Please tell me if im right or wrong?
Many thanks to everyone
Proteuspal

[Fleegle]

Nice dog.

Re. No. 1....I would give one tablet of generic atenolol to cover one day, and should they be desperate for the Tenormin LS brand, tell them it will be in next morning. Contacting GP is probably the correct response, but hard to do if after 5pm when they're in the pub, or weekend when they're on the golf course.

Re. No. 2...Correct. HC 1% is indicated in a mild case of first-time contact dermatitis.

Fleeg.

[Proteuspal]

Cheers Fleegle

Yeah I am a fan of the Bernese Mountain dog breed. Got one at home, very similar to the one in the pic.
Cheers for your help. So the Hydrocortisone one is fully sorted. The Tenormin one seems to be a case of both answer 1 and 2 are kinda right. You could call the Doctor (and presumably they would fax through the script and send the original over later).
However, you could also give them an owing slip and tell them to come back in the morning. Like you said though, they may be desperate for todays dose...so waiting until the morning may not be an option, thus making answer 1 more correct. This is one of those questions which seems there may be no definitive answer, other than answer 3 is definitely wrong. I think I would go with answer 1 also, as this should, in theory allow the patient to get todays dose.

Thanks for helping me out, im doing a lot of lone study these days on exam papers (and speaking to my tutor during the day). Much different to the group study days of uni. So I may be enlisting the help of willing knowledge lenders here on the forum!

Many thanks
Proteuspal

[johnep]

If the pt had LS before then where did they get it, and why come to you?
Otherwise action is correct.
johnep