ADAC – Module 2: Pre-2017 Textbook

A number of changes have occurred since the publication of your Module 2 textbook. In order to ensure that your knowledge is current, please read and implement the additional text.

Module 2: Pharmacy practice and procedures

A number of changes have occurred since the publication of your Module 2 textbook. In order to ensure that your knowledge is current, please read and implement the additional text below.


 

Section 1: Excipients (Additives)

Colouring agents

Please delete the highlighted text in the extract below, from your Module 2 textbook:

“If you want to find out whether a medicine contains any colourant or additive, look it up in the BNF or in the Summary of Product Characteristics (SPC), under the list of excipients.”

 

Section 1: Strength and Formulation

Your Module 2 textbook will state:

“Look up Diltiazem in the BNF. Read the information under:

  • standard formulations
  • longer acting formulations”

 

Please change this to:

“Look up diltiazem in the BNF. Read the information under ‘Prescribing and dispensing information’.”

 

Section 1: Creams

Dilution of creams and ointments

Your Module 2 textbook will state:

“However, if you are asked to dilute a cream or ointment, remember that the diluted product should be used within a short time, usually 14 days or less, and labelled as such.”

 

Please change this to:

“If you do dilute a cream or ointment, the diluted product should be used within a short time – as a guide, this is usually four weeks for creams and three months for ointments or less, and labelled as such.”

 


 

Section 2: Patient Safety

Your Module 2 textbook will state:

“the National Patient Safety Agency”

 

Please change this to:

“NHS Improvement (for England)”

 

Section 2: Clinical Governance

Clinical Audits

Your Module 2 textbook will state:

“Pharmacies must take part in one clinical audit and one multidisciplinary audit as decided by the Local Authority per year.”

 

Please change this to:

“Pharmacies in England and Wales must take part in one clinical audit and one multidisciplinary audit (as chosen by NHS England/the Local Health Board) per year. Pharmacies in Scotland and Northern Ireland undertake clinical audits as and when requested.”

 

Section 2: Clinical Governance

Information Governance

England

Please delete this section and replace it with:

“Community pharmacies in England have to complete an online IG toolkit once a year. This can be found at: www.igt.hscic.gov.uk.”

 

Section 2: Clinical Governance

Information Governance

Wales

Please delete this section and replace it with:

“Community pharmacies in Wales have to complete an online IG toolkit once a year, which can be accessed either from the Choose Pharmacy application, or the NHS Wales Quality Improvement Tools website.”

 

Section 2: Standard Operating Procedures

  1. Validate the prescription

The second bullet point in your Module 2 textbook will state:

“• check the date on the prescription, e.g. prescriptions are valid for six months only – unless they are Controlled Drugs (CDs) which are valid for 28 days”

 

Please add the following text to this bullet point:

“for Schedules 1, 2, 3 or 4 CDs.”

 

Section 2: Filing the Prescription Away

Your Module 2 textbook will state:

“Using this system makes it easy to get your prescriptions ready to send to NHS Prescription Services at the end of the month.”

 

Please change this to:

“Using this system makes it easy to get your prescriptions ready to send to the relevant pricing authority at the end of the month.”

 


 

Section 3: Mixing

Please add the following text:

“In community pharmacy, you may be required to reconstitute an oral antibiotic powder (for example, amoxicillin 125mg/5ml oral suspension) or prepare Zineryt® (by mixing a bottle of powder with a bottle of solvent). Always follow the instructions on the packaging when preparing these items every time, as different formulations or manufacturers may require different methods of preparation.”

 

Note: This may help students to correctly answer some of the exercises in the Module 2 assessment workbook.

 


 

Section 4: Medicine Measures

Your Module 2 textbook will state:

“• Oral syringes for delivering doses of less than 5ml.”

 

Please change this to:

“• Oral syringes for delivering doses of less than 5ml, or for administering medicines to patients for whom a spoon is not suitable, such as babies ”

 

Note: This may help students to correctly answer some of the exercises in the Module 2 assessment workbook.

 


 

Section 5: Treatment/Warning Cards

Please add the following text:

“In addition to alerting patients to special precautions, warning cards are also useful for alerting healthcare professionals, particularly emergency services, because usually these medicines should not be stopped abruptly and treatment must be maintained – for example, if the patient is taken to hospital and does not have their medicines with them. Patients should be advised to carry their warning cards with them at all times.”

 

Note: This may help students to correctly answer some of the exercises in the Module 2 assessment workbook.

 

Section 5: Answers to Exercises

Exercise 1

Please add the following text to the list of bullet points:

“• The words “Emergency Supply” if an emergency supply is made (discussed in Module 3)”

 

Exercise 1

Following the answers to Exercise 1 are the answers to Exercise 2. However, your Module 2 textbook will state “Exercise 1”. This has been repeated, and should state “Exercise 2”.

 


 

Section 7: Supply of Medicines to Care Homes

Your Module 2 textbook will state:

“There are strict rules for the use of medicines in care homes including storage and administration, these are covered by the Care Standards Act and homes are regularly inspected to ensure compliance.”

 

Please change this to:

“There are strict rules for the use of medicines in care homes including storage and administration. These are governed by different regulations in different parts of the UK. In England, for example, the relevant legislation includes the Health and Social Care Act 2008, and the Health and Social Care Act (Regulated Activities) Regulations 2010. Care homes should be regularly inspected to ensure compliance with the relevant regulations. The National Institute for Health and Care Excellence (NICE) has published guidance (SC1: “Managing medicines in care homes”), which is available from www.nice.org.uk.”

 

Section 7: Monitored Dosage Systems (MDS)

Dispensing MDS

Your Module 2 textbook will state:

“• Medicines should not be left in sealed monitored dosage systems for longer than 8 weeks”

 

Please change this to:

“• Medicines should not be left in sealed monitored dosage systems for longer than necessary, taking into account the stability of the individual medicines – in some cases, this should be no longer than one week”

 

Please also delete the following bullet point:

“• Tablets and capsules which are hard to tell apart should not be put into one compartment of the MDS”

 

Section 7: Monitored Dosage Systems (MDS)

Medicines Administration Record (MAR) Chart

Please use the MAR chart included at the end of this document, and disregard the MAR chart in the Module 2 textbook.

 


 

Section 8: Weights and Measures

Weight

Please add the following text:

“Separate long numbers with either spaces or clearly written commas. For example, it is difficult to read the number one million when written as 1000000;  it is much easier to read when written as 1,000,000 or 1 000 000. But it is very important that when using commas, they are written clearly, so they are not misread as decimal points – which could lead to a patient safety incident. For example, if the intended number 1,000 milligrams was read as 1.000 milligrams, this would result in a dose 1,000 times less than intended.”

 

Section 8: Other Calculations

Please add the following text:

“Note that one month is usually taken to mean 28 days.”

 

Section 8: Other Calculations

Your Module 2 textbook will state:

“It is important to write water to 200ml and not water 200ml as the final volume must be 200ml, you are not adding 200ml water as the other ingredients also take up volume. If you were to write water 200ml and the full 200ml were added this would change the total volume and the strength of each ingredient.”

 

Please change this to:

“It is important to write ‘water to 200ml’ and not ‘water = 200ml’. Because the final volume of the product must be 200ml, you are not adding 200ml of water, as the other ingredients also take up volume. If you use 200ml of water and add the other ingredients (20g chloral hydrate and 40ml blackcurrant syrup), you will end up with a final volume of over 240ml. Therefore, the amount of water used has to be less than 200ml.

 

However, you should not try to calculate the exact amount of water to add either – for example, by subtracting the amount of chloral hydrate and blackcurrant syrup used from 200ml.  This is because you do not know the volume of chloral hydrate – you only know the weight. 20g of chloral hydrate is not the same as 20ml of chloral hydrate.  Therefore, the correct way to make up this product is to add sufficient water, after the other ingredients, to make the total volume of the product 200ml – i.e. ‘water to 200ml’.

 

In the dispensary, when making up oral antibiotic powders with water, some containers specify the exact volume of water to add, and some do not; instead they instruct you to add water until you reach the required volume (usually 100ml). To help you do this, manufacturers mark the bottle with a line to indicate when you have reached 100ml. Therefore, you simply add water until you reach the marked line on the bottle.

 

Note that water is an example of a vehicle. A different vehicle may be listed in a given formula (instead of water), such as syrup.”

 

Section 8: Dose Calculations

And finally

Please add the following text:

“Even when you know how to perform calculations, mistakes can still occur through human error. To minimise the risk of calculation errors:

  • Pay close attention to detail, from the very start to the very end
  • Double check all of your work
  • Write out your working in full, without taking shortcuts (even if it seems easy)
  • Do not rush”

 

Note: The above additions to Section 8 may help students to correctly answer some of the exercises in the Module 2 assessment workbook.

 


 

Additionally, there is a Medicines Administration Record (MAR) Chart on page 6 of the available download (below) that you are able to print.

 

 


 

Download ADAC Module 2 Addendum for Pre-2017 textbook