Abstract
Giving out of the right drugs in terms of quality and quantity is not an easy task as it needs the right expertise. However, the correct prescription is still not enough if the patient does not comply with the instructions of the doctor. Many people have died from negligence even after being given the right prescriptions. Here, prescriptions of various drugs from painkillers to antipyretics are looked at in details, but painkillers (analgesics) are covered more, as the reliable solution is sought. Disposal of these drugs is also covered as the rights of both the pharmacists and patients are also analysed. The merits of having the correct stock for customers and checking of expiry dates are also covered and many other related aspects are looked in greater details.
Introduction
The idea of taking the correct amount and quality of drugs is an area that needs the right training and expertise. Buying of drugs in pharmacies appears so obvious that even wrong drugs are easily bought and abused without any consideration of their long term effects on the health of individuals. Prescribers of drugs know the importance of having customers buy their drugs, and they always try to ensure that they have enough stock for their customers.
Part 1
Q.1 Explain why this (clobazam 10mg tablets 1BD times 60) prescription cannot be dispensed as it has been prescribed
Answer- Taking of the Clobazam drugs which are used to curb seizures, a prescription of 10 mg tablets to be taken once for 60 days is like being given an under dose because such drugs are supposed to be taken continuously. So if they are prescribed for such a limited time without letting the patient know that once they get finished he must come for more, then such a prescription is not correct. Prescriptions which are professional must be accompanied by the correct advice and counsel, if not then they are usually not correct ones.
Q.2 what would you do if presented with this prescription and why?
Answer- It is advisable to ask him the prescriber there and then about the correct frequency of taking these drugs, such that if he made a mistake he will have to correct if he insists being right without letting you know of the continuous case of the drugs, you can then report the prescriber to the government regulatory bodies.
Q.3 Compare the item on this prescription with products listed in the Blacklist (Part XVIII A and the ACBS list (Part XV)
Answer- In comparison the items look much prescribed incorrectly as such it seems there is a habit of not giving out correct prescriptions of such drugs.
Q.4 You go and check the stock and find that you are short of stock for metoprolol.You return to the counter to tell Mrs Gordon. She gets angry at you and starts shouting.
What would you say to Mrs Gordon?
Answer- You must use and choose your words carefully as per the protocol of prescribers, and in such a case you must really feel sorry and promise firmly to avail the drugs the next day.
Q.5 Mrs Gordon returns to collect the owing item the next day. Explain what would be included in an effective process of dealing with owed items
Answer- a)You must include a better carrying package which will encourage and attract the customer.
Before she goes Mrs Gordon says she is sorry for getting angry yesterday but her husband died last week and she is still very upset. She hands you a bag of medines that she says were her husbands. She says that his painkillers ‘something like MST are in there’
Answer- To be effective in dealing with returned items it is crucial to ask the owners the right questions by using the fact sheet and then encourage them to surrender the items for disposal and be told how wrong it is to own such items.
Q. 6 Explain the requirements for the disposal of returned patients drugs(that the not controlled drugs)
Answer- The returned drugs must have passed there expiry dates for them to be disposed as in such a case they are poisons. They must also have been damaged oor spoilt due to poor storage. These are not suitable for use.
Q.7 Compare the procedure for the disposal of patients returned MST tablets with MST tablets that have passed their expiry dates in the pharmacy.
Answer- The returned MST tablets are not disposed at a higher temperature like the expired ones ,due to the fact that the expired ones are more poisonous and unsuitable for use.
Q. 8 Define each of the following and identify two types of customer for each category that you come in contact with in your pharmacy.
Answer- a. internal customer The internal customers are the co-workers in the pharmacies or as in the case of a hospital that offers the goods and services to patients then the doctors and nurses of that facility can be said to be the internal customers. Like the external customers, they can also be injected, or have their blood drawn and get treated just the normal way. Customers are important in such facilities, and the fact that they are diversified; it is an asset to pharmacists. b. external customer The external customers are the usual customers, who normally come to buy drugs from the pharmacies. They form the majority in the two categories of customers.
Q.9Mrs. Avery comes into contact into your shop and says that how sister is staying with her the moment. She says that she knows that her sister came into the shop yesterday to get some medicines a d she was not feeling very well. Mrs Avery asks you what medicines her sister bought.
Q. 9 Would it be appropriate to provide the information Mrs Avery has asked for? Illustrate why it is important to keep patient information confidential
Answer-No,it would not be appropriate to provide the information Mrs Avery asked for. The patient information must be kept confidential so as to always maintain that trust between the patient and the doctor.
Q. 10 Give three examples of how you keep information confidential while working in the pharmacy.
Answer- i)By talking slowly and in low tones just to ensure that others who are near do not hear you
ii)In case of injury in a private part, take the patient in a private chamber for confirmation
iii) By practising self control while responding to any serious case such that others do not get to know what is going on
Part 2
Q. 11 What are the legal classifications of the items (fentanyl and denzpam) on the prescription above?
Answer- Drugs are generally classified into various ways, some of the common ones include; antipyretics-for fever, analgesics-for pain(painkillers),ant malarial-for malaria, antibiotics-for inhibiting germs, antiseptics-for preventing new burns, cuts and wounds from germs, and so on. The classifications are meant to ease the problem of identifying these drugs. So that any future reference of the available drugs becomes easy and manageable.
Q.12 Taking into account their legal classifications compare the different legal controls that apply to each of the items on this prescription.
Answer- Drugs, such as Fentanyls and Diazepams ,which tend to have different legal controls, which apply for their prescriptions. The Fentanyls are painkillers made from morphine. These are drugs, with very serious legal ingredients such that unless they are well taken care of they can easily be misused. They are normally used by cancer patients in lessening of the pains. The Diazepams on the other hand have also serious legal contents as they are used to accentuate euphoria in must patients. Their contents are not that legally acceptable in the market but for the sake of the good they do patients, they are controlled for use in making of these useful drugs.
Q. 13 Can these items be dispensed as written in the prescription(Fentanyls patches-50,apply 1 PM ,5mg,every 72 hours times 5 patches. Diazepam tablets take 1 PM times 30) above? Explain the reasons for your answer.
Answer- The dispensing is not exactly. Fentanyls must have a continuous prescription while the diazepams must be around 10mg/2.5 which is not far from the prescription.
Q.14 Explain what counselling/advice is necessary when handling out a prescription for fentanyl patches
Answer- In the case of following the correct advice while using fentanyls,it is advisable to change patches after every 72 hours. You must use more than one patch. The useless patches must be carefully disposed in dustbins. The place to stick the new patch must be carefully chosen. Alternate while sticking patches. Then carefully peel the plastic backing off the new patch(es)and stick finally out of the chosen area of skin.
Q.15 Which registration bodies could you contact to check the registration status of;
a. a doctor
b. a nurse prescriber
c. a dentist
Answer- Bodies to contact and check the regulations of doctors ,nurse prescribers and dentists are many such as The Medicines and Healthcare Products Regulatory Agency(MHRA),which usually checks the conducts of the prescribers .Such bodies work hand in hand with other partners to ensure that drugs are used as per the laid down laws and acts. Another example is that of Food and Drug Admission(FDA)in the United States, which also ensures that the procedures and applications of National Health Act(NHA) are followed as required.
Q.16 Can this prescription(co-amoxiclav 250/125mg tablets 1TDS times 21) be dispensed as it has been written? Explain the reasons for your
Answer- The use of a drug such as Co-amoxiclav with a prescription of 250/125mg tablets daily for 21 days is only suitable for children and not adults .If such a prescription is given to an adult then it must be reported to the government regulatory bodies to discourage wrong prescription of drugs to patients. Drugs must always be given out in the correct amounts and qualities, if not then action must be taken against those breaking the law.
Q. 17 List three other types of prescribers and compare what they are able to prescribe on NHS prescriptions including where you would find this information
Answer- i)NICE(National Insurance for Health and Clinical Excellence)
ii) NSF(National Service Frameworks)
iii)PCT
Q. 18 Describe the process for obtaining medicines like this(sodium chloride preservative)one to dispense.
Answer- The status of the patient must be checked, such as the symptoms of the infection and any possible allergies to the drugs.
Q. 19 Explain what the pharmacy would be reimbursed and remunerated for this prescription detailing any endorsements required.
Answer- The markets available of the drugs and also the available evidence are the two main factors to consider for reimbursement for the prescription. Any endorsements must be from be from NICE.
Q.20 Explain the process of counselling or advice necessary when handling out a prescription for eye drops and why such piece is important.
Answer-The process of advice gives a room to inform the patient in advance of any complications that might come with the use of the drug and how to handle them. The patient in this case is equipped in advance in case of any emergency
Q.21 State three reasons ,why patient counselling is important.
Answer-i.It encourages patients to take drugs willingly
ii’. It fosters understanding and knowledge of the states of patients
iii. It is a career field
Q.22 List three reference sources you could use to obtain information about medicines with an example of when you might use each one.
Answer- i)NICE(National Insurance for Health and Clinical Excellence)-for implementation and help of better health standards.
ii)NPSA(National Patient Safety Agency)-for efforts to identify ,and learn from patients safety incidents.
iii)CQC(Care Quality Commission)- to regulate health and order of social care services and mental patients.
Part 3
Q. 1 a. Describe the main function of GPhC in relation to pharmacists and pharmacy technicians.
Answer- To uphold the standards and public trust, in pharmacy.
b. List the seven principles of the standards of conducts, ethics and performance document.
Answer-
i) Patients must be first concern
ii) Judge in the interest of patient and the public professionally
iii) Show respect for all
iv) Encourage the public and patients to participate in decisions about their care.
v) Develop your profession knowledge and competence.
vi) Be honest and trustworthy.
Vii)Take responsibility for your working practices.
c. Now pick three of those seven principles and give details of two ways in which you apply these principles in your daily work.
Answer-i)whether in leisure or emergencies patients life must come first.
iii)Respect of others items and information must be shown at all times and levels.
v)Ensure that you are always knowledgeable and interested in the profession at all le) No matter what patients must be given first priority at all times, whether during leisure or emergencies
Q. 2 a. Describe your responsibilities and those of your employer under the Health and Safety and Work Act.
Answer- The health of the patients must be properly taken care of. The public must be encouraged to practise hygiene always. Both the employer and worker must co-ordinate the flow of drugs as required by the law.
b. Describe the process that should be followed if another member of staff dropped a bottle of Gavis.ion on their foot including the reporting of the incidents.
Answer- Gavinsion comes in plastic bottles, and if the contents come out then the member must be checked and given first aid for any possible allergies.
Q.3 Describe the importance of good stock management in a pharmacy with reference to the following;
- Stock rotation
Answer- It ensures that you always have the correct stock and of the right quality
-stock check
Answer- This gives room for easy evaluation of the vision and mission of the job as to improve effectiveness
-expiry dates
Answer- This will ensure always that you do not have adamagedor expired stock with you.
Q.4 Explain appropriate process for dealing with each of the following;
-receiving stock
Answer- Only receive stock from authorised dealers
-ensuring stoic is fit for purpose
Answer- Always ensure that you have confirmed the expiry dates of your stock and also keep confirming frequently.
-damaged stock
Answer- It must be disposed through the right channels and not to de thrown out anyhowly.
Q. 5 State three factors that could lead to stock becoming spoilt
Answer-i)Time factor
ii)poor storage facilities
iii)poor infrastructure or means of transport
Q. 6 a. State the purpose of Standard Operating Procedures (SOPs)
Answer- The prose of standard operating procedures is to ensure competence and quality services to all patients without any discrimination
b. Explain the importance of complying with SOPs when working in the pharmacy.
Answer- It leads to better curing of diseases and ailments as it becomes very effective after giving out correct prescriptions to patients.
Q. 7 describe the requirements that apply on emergency supply
a. at the request of a patient
Answer- The patient’s details must be taken by the pharmacist before applying for the emergency
b. at the request of a prescriber
Answer- The prescriber must be crtified one and must have a proven track record of competence.
Q. 8 Compare Part 1 and Part 2 on poisons as defined by the Poisons Act .1972
Answer- Part 1 deals with controlled drugs whereas Part 2 interprets the Schedule of Poisons Act.1972
Q.9 Describe the cascade system for veterinary medicines. State where you would find the Information:
Answer- Is a long-standing legal flexibility providing a balance in providing permission for veterinary medicines to be suitable products. The information can be found in NOAH(National Office of Animal Health)
For each of the following scenarios, refer to your pharmacy protocol and the questions you would ask the customer the products that you would recommend for these are not specified and the information that you would provide the customer .Ask when you would refer to the pharmacist
Q. 1 A middle aged female customer approaches the counter holding a packet of lemsip sachet that she has picked up from the counter. She then asks for 32 paracetamol tablets
Answer- The pharmacist must ask the customer if she has any allergies and also confirm from her how she got the lemsin sachets before giving out any medicines. The then must ensure that he checks the fact sheet as he asks the customer some questions connecting her request. The patient must also be cautioned against overdose and self-medication.
Q.2 A young female customer comes to the till with a packet of dulcolax tablets .You recognise her and think she purchased the same product last week.
Answer- The prescriber has a right to confirm his doubts from the customer by going through the fact sheet as he also provides a copy of the sheet to the customer for any clarifications before any prescriptions are made .He must also confirm that she is suffering from constipation.
Q.3 An elderly gentleman approaches you and asks you if you can recommend something for his wife who is at home with a terrible cough and cold
Answer- The pharmacist in this case must to know if the patient has any allergies, and in case he does not have the drugs he must refer the customer immediately to another pharmacy. In case it is an emergency he must also advice on monitoring the blood pressure.
Q.4 A woman pushing a young child in a buggy comes to the counter and asks some medicine for children.
Answer- In such a case the pharmacist must act with such an emergency by dispensing some drugs for the child after confirming what the child is suffering from then proceed with the next level of treating.
Q.5 A man approaches the counter and requests two packets of Sudafed One for him and another for his wife who both have awful colds
Answer- Here the prescriber must confirm in case of any allergies to the drugs before giving them out, and he must ensure that he follows the fact sheet exactly as it says. Then he must only dispense in right amount and to take care of the allergies, if any.
Q.6 A 30year old woman requests to purchase’ morning after pills’
Answer- The pharmacist must know whom is she buying for and after knowing he must use the facts at hand to either give out or let her have a test first as per the fact sheet. Advise to be taking them at the earliest chance.
Q.7 A 40 year old man asks to purchase imigran
Answer- The pharmacist must insist to know if the customer has any allergies to imigran before proceeding, and he must make sure that asks the questions as per the fact sheet. He must also advise against overdose.
Q.8 A 20 year old man wants to buy some codeine tablets and help him clear a cold he had for the last few days.
Answer- The patient must first have to fill the official form before proceeding any further then must also be advised against overdose.
Q.9 You hand Mrs Smith her prescription for captopal 25mg tablets .As you hand out the prescription you ask Mrs Smith how she is, she tells you that her blood pressure seems to be ok but she has sinus congestion and would want to buy some for day and night nurse capsules.
Answer- In such a case then the prescriber must reduce the dosage or advice Mrs. Smith to test her blood pressure without drugs as time goes by ,this is as per the fact sheet and protocol of pharmacy. Her progress must be closely monitored and drugs withdrawn.
Q.10. A woman who wishes to purchase piriton tablets for her pet dog.
Answer- Piritons are suitable for treating allergies and she must be advised against overdose.
Reference
1. Module 5 of the NPA(NATIONAL PHARMACY ASSOCIATION)
