GPhC Dispensing Practice — Questions and Answers
Question 1: When dispensing a prescription for a Schedule 2 controlled drug, what specific record must be made in the controlled drug register?
- Only the drug name and quantity
- Date of supply, name and address of the patient, prescriber details, quantity supplied, and the running balance (Correct answer)
- Just the patient's name and date
- No register entry is required for Schedule 2 drugs dispensed on NHS prescriptions
Correct answer: Date of supply, name and address of the patient, prescriber details, quantity supplied, and the running balance
The Misuse of Drugs Regulations 2001 require comprehensive entries in the CD register for Schedule 2 drugs including: date of supply, drug name/form/strength, quantity supplied, person collecting, prescriber name and address, and (good practice) a running balance. Entries must be made on the day of supply or the next day.
Question 2: A patient presents with an NHS prescription written 4 months ago. What should the pharmacist do?
- Dispense as normal — NHS prescriptions have no expiry
- Inform the patient that NHS prescriptions are valid for 6 months from the date on the prescription
- Inform the patient the prescription is no longer valid as NHS prescriptions expire after 6 months, but check if it was issued within that period (Correct answer)
- Refuse to dispense and destroy the prescription
Correct answer: Inform the patient the prescription is no longer valid as NHS prescriptions expire after 6 months, but check if it was issued within that period
NHS prescriptions in England are valid for 6 months from the date on the prescription (unless the prescriber has specified an earlier date). A 4-month-old prescription is still within validity. The pharmacist should check the date and dispense if within the 6-month window, applying clinical judgement about whether the treatment is still appropriate.
Question 3: During the final accuracy check of a dispensed prescription, the pharmacist notices the tablets are the correct generic medicine but a different brand from what the patient usually receives. The prescription is written generically. What is the correct action?
- Reject the dispensed item and reorder the patient's usual brand
- The prescription is written generically so any brand is acceptable — proceed with the accuracy check and counsel the patient about the different appearance (Correct answer)
- Contact the prescriber to change to a branded prescription
- Tell the patient to return the tablets if they experience any problems
Correct answer: The prescription is written generically so any brand is acceptable — proceed with the accuracy check and counsel the patient about the different appearance
When a prescription is written generically, any brand of that generic medicine meeting the required specification can be dispensed. The pharmacist should proceed with the accuracy check and proactively inform the patient that the tablets may look different but contain the same medicine. This prevents confusion and supports adherence.
Question 4: What is the correct procedure for endorsing an NHS prescription that has been dispensed with a broken bulk (part of an original pack)?
- No endorsement is required for broken bulk
- Endorse the prescription with 'BB' followed by the pack size and quantity supplied (Correct answer)
- Write 'part pack' on the prescription
- Endorse with the total quantity in the original pack
Correct answer: Endorse the prescription with 'BB' followed by the pack size and quantity supplied
When a full original pack is not supplied (broken bulk), the pharmacist must endorse the prescription with 'BB' and include details of the pack size used and the quantity supplied. This ensures correct reimbursement from the NHS and creates an accurate dispensing record.
Question 5: A patient's prescription specifies 'metformin 500mg tablets — 56 tablets'. The pharmacy has both standard and modified-release metformin 500mg in stock. Which should be dispensed?
- Either formulation can be dispensed as the dose is the same
- Only the standard-release formulation, as modified-release would need to be specified on the prescription (Correct answer)
- The modified-release formulation as it has better compliance
- Whichever is cheaper for the pharmacy
Correct answer: Only the standard-release formulation, as modified-release would need to be specified on the prescription
Standard-release and modified-release formulations are not interchangeable. If the prescription simply states 'metformin 500mg tablets' without specifying MR or SR, the standard-release formulation should be dispensed. Modified-release formulations have different pharmacokinetic profiles, dosing schedules, and are prescribed specifically when intended.
Question 6: During dispensing, a pharmacist notices a prescription for amoxicillin 250mg/5mL suspension with directions 'take 5mL three times a day for 7 days' but the quantity prescribed is only 50mL. What should the pharmacist do?
- Dispense 50mL as written on the prescription
- Contact the prescriber to clarify — the dose and duration require 105mL, not 50mL (Correct answer)
- Dispense 100mL as the nearest available pack size
- Dispense 50mL and tell the patient to return for more
Correct answer: Contact the prescriber to clarify — the dose and duration require 105mL, not 50mL
The required quantity is 5mL × 3 times daily × 7 days = 105mL, but only 50mL has been prescribed. This discrepancy between dose/duration and quantity could mean the course will be incomplete. The pharmacist should contact the prescriber to clarify whether the quantity, dose, or duration needs correcting to ensure the patient receives a complete course.
GPhC Dispensing Practice
When dispensing a prescription for a Schedule 2 controlled drug, what specific record must be made in the controlled drug register?