Wed - Fri  :  8.00am - 5.00pm
Sat  :  8.00am - 1.00pm

prescribing and dispensing policy

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This policy sets out the practice protocols for prescribing, dispensing, storing and keeping records relating to medicines.

 

prescription writing

We do not provide NHS services and do not issue NHS presciptions – all prescriptions are issued on a private basis.

Where a patient requires medicines as part of their treatment, a private prescription will be provided.

Private prescriptions are printed using the practice’s clinical computer software and always include the following information:

  • The name, address and signature of the prescribing dentist;
  • The name, address and age of the patient;
  • The date of the prescription;
  • The name of the medicine (generic, wherever possible);
  • The dose, frequency and quantity to be supplied (without the use of potentially misleading decimals wherever possible);
  • Additional directions to the patient, where appropriate (eg avoid alcohol)

We avoid the use of abbreviations when writing prescriptions.

We do not issue prescriptions for controlled drugs and so do not keep copies of form FP10PCD.

We do not arrange for prescription medicines to be dispensed remotely unless there is no other viable option and it is in the patient’s best interests.

 

prescribing protocols

We prescribe medicines in accordance with the guidelines set out in “Antimicrobial Prescribing for General Dental Practitioners” published by the Faculty of General Dental Practice (UK) and the additional guidance set out in the BNF (British National Formulary) published jointly by the British Medical Association and the Royal Pharmaceutical Society.  Refer to these publications for full details of drug names, dosages and frequencies that are considered appropriate for use in general dentistry and the illnesses to which they apply.

Standard prescriptions for the most commonly used drugs are programmed into the practice computer system.  These should ALWAYS be double-checked against the current BNF and FGDP guidelines before use.

 

review and follow-up

Where a patient is prescribed an antibiotic, they must be reviewed/followed up after 48 to 72 hours.  If the infection has resolved, they should be advised to cease taking the medicine rather than to complete the course.

 

prophylaxis

Guidance issued by the National Institute for Health and Clinical Excellence (Clinical Guidelines CG64, issued March 2008) recommended that antibiotics no longer be prescribed on a prophylactic basis for the prevention of infective endocarditis on the basis that it is not cost effective.  This is restated in the FGDP guidelines (see above).

However, on reading the paper titled “Guidelines on prophylaxis to prevent infective endocarditis” by MH Thornhill et al, British Dental Journal Volume 220 No 2 (22 January 2016) we have decided that patients at high risk of developing infective endocarditis should be allowed to decide for themselves whether they wish to receive antibiotic prophylaxis.  If a patient chooses to have it, we will prescribe:

  • Amoxicillin 3g sachet to be taken 1 hour before the procedure OR
  • Clindamycin 2 x 300mg capsules to be taken 1 hour before the procedure (where the patient is allergic to penicillin)

Dosages stated are for adult patients.

 

additional help and information

In case of doubt, information on any aspect of drug therapy in dentistry can be obtained from the regional North West Medicines Information Centre (NWMIC) on 0151 794 8206.

 

dispensing medicines to patients

The practice does not dispense prescription medicines.

 

purchase of medicines

Medicines (including controlled drugs) may only be purchased from a recognised dental wholesaler (eg Kent Express, Henry Schein).

 

storage of medicines

The practice does not store prescription medicines.

The only controlled medicine held by the practice is Midazolam, which is listed as a Schedule 3 controlled drug under the Misuse of Drugs Regulations 2001. This is kept in the emergency drug kit for the management of status epilepticus and is not supplied to patients for use off the premises. As a schedule 3 controlled drug, it does not need to be stored in a controlled drug cabinet.

 

record-keeping

Since the practice does not store or dispense prescription medicines, the requirements in relation to record-keeping largely do not apply.

The only controlled drug we use is a Schedule 3 drug (Midazolam), so we do not need to maintain a controlled drugs register. Records of controlled drug purchases are kept (in the form of invoices) as part of the normal practice accounting system and are retained for more than 2 years.

We maintain records of prescriptions issued as part of individual patient clinical records.

 

adverse reactions and events

Adverse reactions to medicines are reported using the Yellow Card Scheme. It is the responsibility of the Clinical Director, Joanne Giddy, to deal with such reports and any team member who is aware of an adverse reaction to medicines must report it to her immediately.

Adverse events and errors relating to medicines must be reported to the Clinical Director, Joanne Giddy, who is responsible for investigating any such events and implementing any changes to our procedures that are necessary in order to minimise the risk of them being repeated.

 

Web version 4: 10.9.2016
Previous web versions: 8.2.2011 (reviewed 26.1.2012; 13.3.2013); 13.4.2013 (reviewed 19.6.2014; 5.6.2015); 5.8.2016 

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