MEP 3.2 Professional and legal issues: Pharmacy medicines

what are Pseudoephedrine and ephedrine used for

decongestant

why is their legal rules regarding Pseudoephedrine and ephedrine P medicine classification

potential misuse in the illicit production of methylamphetamine (crystal meth)

What are the legal restriction limiting with supply of Pseudoephedrine and ephedrine as P meds

legal restrictions regarding the quantity supplied

what is the legal limit of Pseudoephedrine to be supplied as a P med in one sale

720mg

what is the legal limit of ephedrine to be supplied as a P med in one sale

180mg

can you sell Pseudoephedrine and ephedrine as P meds at the same time

no this is illegal

who can sell Pseudoephedrine and ephedrine as a P med

the pharmacist of a member of staff that is trained suitably

Do we always have to sell Pseudoephedrine (<720mg) and ephedrine (<180mg)

NO - it can be refused where there are reasonable grounds of suspecting misuse

Can we have stereotypes regarding people misusing Pseudoephedrine and ephedrine? Why?

NO - a person purchasing these items may not be a 'user' of crystal meth therefore we cannot conform with stereotypes.

what are key signs of possible misuse (7 key points)

Lack of symptoms (not suffering from a cold or unable to describe symptoms)

Rehearsed answers

impatient or aggressive (e.g. in a rush)

oportunistic (waiting for busy periods or when less experienced staff on)

Specific products (e.g. wanting certain brands)

paraphernalia (wanting other items to make the crystal meth e.g. acetone, lithium batteries)

Quantities (wanting large quantities)

Frequent requests

who can you contact if there are suspicions

local GPhC inspector, Local controlled drugs liason officer, police officer or accountable officer

what are the 3 methods of emergency contraception

copper intrauterine device (Cu-IUD)

oral ulipristal acetate

oral levonorgesterol

what is the licensing for P levonogesterol 1500mcg

women aged 16 and over and within 72 hours of UPSI

what is the licensing for P ulipristal 30mg

120 days UPSI

Can a pharmacist provide advance supply of EHC

yes they can

what must a pharmacist be sure of prior to giving advance dose of EHC

that the patient is competent to use it and it is clinically appropriate

what should you do if your religious beliefs go against EHC

Let the employer know, can refer if appropriate

what source is there for patients suspected domestic abuse or sexual abuse

the department of health - Responding to domestic abuse

Gives information regarding confidentiality, records and sharing records.

theres also safeguarding children

can we give ulipristal to people under the age of 16

yes it's not contraindicated by the manufacturer

what needs to be considered when supplying EHC <16 year old

children <13 (this is illegal report to social services)

make sure the children are similar age and that it was consentual

give contraception advice

ensure confidentiality

what is the maximum legal supply of P paracetamol and aspirin

100

what is the logistical maximum supply of P paracetamol and aspirin

96 (pack sizes are 16 or 32)

what is the licensed indication for OTC codeine/dihydrocodeine

short term treatment of acute, moderate pain that is NOT releived by paracetamol, ibuprofen or aspirin alone.

ALL OTHER PREVIOUS INDICATIONS E.G. COLD, FLU, COUGH, SORE THROAT AND MINOR PAIN HAVE BEEN REMOVED.

what is the maximum pack size of OTC codeine or dihydrocodeine is made

32

What warnings must be on the boxes for OTC codeine or dihydrocodeine

"can cause addiction or headache"

"for 3 days max"

what is the recommended OTC supply of codeine or dihydrocodeine

one pack or max 32 dose units

what should we do if a patient keeps coming in to the pharmacy asking for codeine/dihydrocodeine for pain

ensure they are referred suitably