Dispensing Practice & Controlled Drugs Flashcards

A pharmacist dispenses methotrexate 2.5 mg tablets. What is the critical safety counselling point?

Answer: Methotrexate is taken ONCE weekly — daily dosing can be fatal

Methotrexate must only be taken once weekly for inflammatory conditions (not daily). Inadvertent daily dosing has caused severe toxicity and deaths. This must be explicitly counselled.

Which pharmacist-initiated service involves reviewing all medicines for an older patient with multiple long-term conditions?

Answer: Medicines Use Review (MUR) / Structured Medication Review (SMR)

Structured Medication Reviews (in PCNs) and previously MURs involve pharmacists reviewing the complete medicines regimen of patients on multiple medications to optimise therapy and reduce harm.

What is the purpose of the 'safe haven' fax number in hospital pharmacy practice?

Answer: A designated secure fax number for receiving confidential prescription and patient information

Safe haven fax numbers are designated, supervised fax lines in healthcare settings (including pharmacies) for receiving sensitive information such as CD prescriptions and patient records securely.

A dispensary technician checks a dispensed item. What is the legal limitation of this role?

Answer: Accuracy checking by technicians is legally permitted for certain accredited technicians, but the final clinical check must be by a pharmacist

Accredited checking technicians (ACTs) can perform accuracy checks in some settings, but the clinical appropriateness check — ensuring the prescription is medically safe — must be performed by a pharmacist.

Which supplement should be prescribed alongside methotrexate for rheumatoid arthritis?

Answer: Folic acid 5 mg once weekly (not on methotrexate day)

Folic acid 5 mg weekly (taken on a different day to methotrexate) is prescribed to reduce methotrexate side effects including mouth ulcers, nausea, and protection against folate deficiency.

What is a 'specials' medicine in the context of UK pharmacy?

Answer: An unlicensed medicine manufactured to meet a specific clinical need not met by licensed products

Specials are unlicensed medicines manufactured under a Manufacturer's Specials Licence (MS) when no licensed product is suitable for a patient's individual clinical need (e.g., specific dose, formulation, or excipient-free version).