Pharmacy Daily | PDL warns on forged scripts

PHARMACISTS are being reminded of their obligations to take "reasonable steps to satisfy themselves that a prescription has been issued by an authorised prescriber," with a new update from Pharmaceutical Defence Limited (PDL) providing guidance on actions to be taken in the event a forgery is suspected.

PDL says S4 and S8 drugs are the most likely to be forged, especially benzodiazepines and opioids, but added that pharmacists should also consider other medications which may be abused such as anabolic steroids, and medications such as Catapres which can be used to mask the symptoms of withdrawal from drugs of dependence - for example if a patient had sold their prescribed takeaway dose of an opioid substitute.

"The supply of such medicines in the absence of a legal prescription results in unacceptable risks to the public," PDL noted, with pharmacists having an obligation to notify the state health department and in some jurisdictions, the police, if they believe a prescription has been forged or altered.

Another PDL alert issued last week centres on so-called "APINCH" medicines - classified as high risk covering Antimicrobials, Potassium & other electrolytes, Insulins, Narcotics and other sedatives, Chemotherapeutic agents, and Heparin & other anticoagulants.

The APINCH list is tabled by the Clinical Excellence Commission (checklist HERE), with PDL highlighting a host of examples where legal consequences have ensued from dispensing errors.

Injectable antibiotics require the pharmacist to warn the patient of early signs of an allergic reaction, while insulins have caused issues such as mix-ups between NovoRapid and NovoMix.

Chemotherapeutic agents such as methotrexate should be a top of mind alert for pharmacists, while the increasing use of Direct Oral AntiCoagulants (DOACs) had also led to a rise in the number of incidents involving anticoagulants.

Finally PDL also highlighted risks around Digoxin - more on APINCH at cec.health.nsw.gov.au.