pharmacy laws and regulations

[Ray]

Hey guys, I have started my training at a local pharmacy a week ago. and i have got some concerns and would like to hear your opinions;
1- Destructing of CD drugs, which one does need to be witnessed from an authorizing officer? the ones from the pharmacy stock or the returned CD drugs from patients? or both? I am asking about what is LEGALLY REQUIRED.

2- when supplying a CD product, is it LEGALLY REQUIRED to ask for the patient ID( even if you know him) or its just GOOD PRACTICE?

3- i noticed some drugs we dispense as complete packs ie 2 packs of 30 tablets even that the Rx says 56 tablets. a)which drugs are dispensed in this way? b)how do we know or we just have to learn them? c)plus the reason behind providing some extra tablets please?

4- how many of you use electronic CD registering system? pharmacy i work at does not use an electronic version but i used a similar one at university few weeks ago while sitting for my dispensing module exam.
does it make things easier ie automatic balancing of methadone calculations? does it has the option to modify spelling errors or quantity registering errors?
5- who should I contact to learn more about ECLIPSE programe electronic registering and electronic prescription dispensing. Any links or advices if you used this tool? If not what dispensing tool do you guys use.

thank you for reading, I hope you read it all to enlighten me.

[Titch]

1. Authorised officer needs to destroyed pharmacy stock. Pharmacist can destroy patient returns - good practice to have a member of staff witness you doing this and NPA has a book for recording the process.

2. It is a legal requirement to check who is collecting the medication but you do not have to see ID to hand it out. If person collecting is a healthcare professional - the pharmacist MUST ask for ID but has discretion to supply if person has no ID.

3. I presume you mean drugs that are classed as "calender or special packs" The Drug Tariff displays a symbol next to each drug in part VIII that it recognises as a calender or special pack. This means that payment is automatically based on multiples of that pack size and whilst you can split them up to give the exact amount, common practice is to just give the complete pack to avoid cutting up the strips.
PSNC produce a list of all special containers/calender packs - up to you if you choose to learn them! Probably easier to be familiar with the common ones.

4. No experience of electronic CD register yet - don't think they are common practice yet.

5. Eclipse - I'm assuming you are meaning ETP, not sure if Eclipse can do ETP. I would ring Eclipse helpline and ask them for any info as from memory it does not have a help function built into it so very much depends on trial and error to find out how to do things!!

[Ray]

thank you for your reply, i will read your post in an hour and reply you back as i just got back from the pharmacy, i had a busy day, the pharmacy i work at dispensed around 500 items today" not sure if this is a lot but for me it seems a lot" and i am still on my 3rd day of the summer training, the pharmacist is going to a new shop tomorrow and we will have 2-3 locums coming weekly so i dont think things will get better!! but well i hope they all teach me more things as i am still new.
anyways gotta eat something and will get back to you
cheers

[Web Ferret]

Titch is correct in his replies.
I have only used a methadone electronic measure "Meathameasure". It was difficult to use once it went wrong but I managed to get one of my locum placements to arrange some training so I now have a better understand of why it goes wrong and what to do about it! This one does everything (and more) that you can do with a paper version.

500 is pretty average nowadays. There are a lot of shops that do less and a lot that do more. A good place to learn though as you will see a lot in a busy dispensary.

[Titch]

Originally Posted by Web Ferret

Titch is correct in his replies.

HER replies, please!!

[Pharmanaut]

Originally Posted by Titch

HER replies, please!!

The way the balance has shifted we will have to assume that all pharmacists are women.

[Ray]

1- even if the returned drug was CD sch 2, authorused officer does not need to witness the distruction?
2- for example, lets say for methadone patients , you already know them, is it legally required to ask for their ID? when recording it in the CD register, the pharmacy were i work at write NO for both spaces when it ask you was the ID asked for and was it shown? i told the pharmacist that at uni they told us we shoul ALWAYS ask for ID and record it as YES prove of ID was aske for, but we do not need to see the ID.
what do you think?
3- yes calender packs, thank you for the clarification, i checked the drug tariff book today looking for the symbol anyways the dispensing systems tells us by itself i.e when trying to label 56 tablets the ECLIPSE system itself notified me that dispensing to the nearest pack size is required which is 60
4- yes was wondering about electronic CD registering and how helpful it could be? anyways today i learnt that its ILLEGAL to cross or make any ammendments to the CD register record, specialy crossing a wrong quantity. was blamed for doing so but well this is how we learn.
5- dunno my pharmacist was wondering about it, the electronic Rx systems.


okay another busy day, but things went better at my 4th day here, as i managed to put on my trainers not the SHOES! less feet pain.
a learnt more new stuff and would like to share it with you all( i know you all know these things but well i feel like talking about it).
1- a patients come with a Rx for salmol-salbutamol 100mcg inhaler and others products, we did not have any remaining as we gave around 20 this morning, the guy barely could inhale and we could tell from the sound coming out from him( u know what i mean). the pharmacist decided to provide him with Easy-breath inhaler, he told me he has to justify it to PPA to be paid for it. what do u think?
2- never dispense from the bloody label, always from the script, gave out ramipril 10mg capsules rathern than tablets, u know capsules are more commenly prescribed.
3- methadone patients who miss more 3 doses are not allowed to get their next dose, tho dunno what we should do about it when they come the next day or who should we contact? can someone enlighten me here?
4- why cloramphenacol 1% eyes drops can be proved without the need for Rx while chloramphenacol 1% ointment need a Rx? any reason behind it? also i noticed that an emergancy supply was made for the ointment few weeks ago as it is shown on ECLIPSE, page 6 in BNF says we can do ES for INSULIN cream or ointment ONLY, does this mean its illegal to make ES of chloramphenacol ointment?
5- provided some needle exchange for patients.
6- witnessed the denaturation of some CD returned tablets and signed the register. what do we do after leaving them for 24 hours in the little box provided for their denaturation? can we simply get rid of them?

finally we managed to dispense 580 items today, from which around 100 as delivery service.

this is was my day for today, if the admin does not mind, i will be using this topic as a daily diary
thanks for reading

[Steve G]

why give an easy-breathe inhaler (I assume you mean the Salamol easy-breathe, which is breath actuated) to some one who can hardly inhale? Breath-actuated inhalers require an inspiratory effort to use, so would have made more sense to give a ventolin if you had any.

You can do an E/S of any drug, apart from sch 2 or 3 CDs (only exception is phenobarbitone for epilepsy). chloramphenicol ointment is a P now, so don't know why an E/S would be done, unless the GP requested it.

[Ray]

MEP says the ointment is POM, will check the product itself tomorrow.
not sure if we had ventolin, will check with the locum when he get back again. the thing is we will be having different locums working every week for 2-3 days, will make sure to ask him next time.
thanks steve

[Steve G]

Two problems with the printed MEP - it's not always up to date, and the terminology and exemptions are not always clear. The society's web site has up to date information on the legal classification of medicines - Rpsgb.org: Search legal classification of medicines

Chloramphenicol 1% eye ointment (POM) exceptions: but containing 1% chloramphenicol, for the treatment of acute bacterial conjunctivitis in adults and children aged 2 years and over, maximum length of treatment 5 days, and pack size 4g; please refer to proprietary names for the classification granted under the marketing authorisation.