Dispensing Practice Flashcards

When dispensing a prescription for a Schedule 2 controlled drug, what specific record must be made in the controlled drug register?

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.

A patient presents with an NHS prescription written 4 months ago. What should the pharmacist do?

Answer: Inform the patient the prescription is no longer valid as NHS prescriptions expire after 6 months, but check if it was issued within that period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.

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?

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.

What is the correct procedure for endorsing an NHS prescription that has been dispensed with a broken bulk (part of an original pack)?

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.

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?

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.

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?

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.