Leyla Hannbeck, head of pharmacy at the National Pharmacy Association, discusses three of the 700 queries fielded by the NPA’s Pharmacy Services team every day

Question

What can be used to treat pregnant women who have scabies?

Answer

Pregnant women who have scabies can be treated with permethrin dermal cream 5 per cent. However, this should not be sold over the counter, as Lyclear Dermal cream is not licensed for OTC use in pregnant women. It therefore needs to be prescribed because OTC usage would be off-label. If the patient has an allergy to chrysanthemums, they should not use permethrin products. An alternative product would be malathion aqueous liquid 0.5 per cent, but it is currently unavailable: this would also need to be supplied on prescription as its use in pregnancy would be off-label.

Question

Do I have to keep emergency supply records in a written form or can I keep them on the PMR system?

Answer

 Records of emergency supplies do not have to be in a written form and it is legally acceptable to make a record on the computerised patient medication record (PMR) system. However, as the Human Medicines Regulations 2012 require that the entry made for an emergency supply must be “a written or computerised record kept for that purpose”, the entry should be kept as part of a record which is solely for the purpose of recording every sale or supply of a prescription-only medicine. Therefore, the only record of the emergency supply cannot be made solely on the PMR.

Question

Does Tostran gel 2% need to be stored upright?

Answer

Yes. The Summary of Product Characteristics (SPC) for Tostran gel 2% states in Section 6.4, special precautions for storage: “Store canister upright”. The SPC also states: “The canister should be stored in an upright position between use”. Tostran gel 2% should be stored in an upright position to ensure that the product is delivered correctly through the pump delivery system. Extra priming may be required if the canister is not stored in this way. In addition, air can get trapped and the product may not be released as efficiently if the canister is not stored upright.