PDA Practice Points April 2016 Vol 21
Drug Impairment and Cautionary Advisory Labels
The Land Transport Amendment Act 2009 s(11A) states that a person should not drive while
impaired and their blood contains evidence of the use of [a] controlled drug or prescription
medicine.
To aid in a patient’s decision not to drive or operate heavy machinery after taking certain
medicines (e.g. benzodiazepines, opiates, TCAs), Cautionary Advisory Labels (CALs) should be
added to the medicine container by either using the premade yellow stickers, or adding the
information to the label itself.
However, CALs should not replace verbal advice as patients are notorious for not reading
container labels. Therefore both verbal and written warnings should be given if a certain
medication may impair a patient’s mind or body in any way (e.g. blood pressure medication may
cause hypotensive episodes and fainting as a result).
PDA has seen several cases whereby a patient has had an accident and blamed the pharmacy for
not warning them of the possible impairment the medicine they took could cause. CALs are only a
guide and each patient will be affected differently, so it is best to advise them of what effects
could happen.
Pharmacist Vaccinator Accreditation Requirements
To maintain Pharmacist Vaccinator status, a pharmacist must have completed a vaccinator
training course within the last two years (Appendix A4.1.1 of the Immunisation Handbook). This is
not to be confused with the date of the clinical assessment which takes place at the pharmacy.
Refresher courses can be done at a specified venue or online. If more than six months has passed
since the expiry of accreditation, a new clinical assessment is required.
In addition to vaccinator training, pharmacists need to complete the equivalent of a New Zealand
Resuscitation Council Level 4 course. This is also to be done every two years.
As a side note to all those who are not yet aware: Pharmacist Vaccinators can now administer
influenza vaccines to people aged 13 years and older (previously 18 and older) – refer Medsafe
classification database.
Medicines Available on a Supply Order
Practitioner’s Supply Order
The only medicines available for supply on a Practitioner’s Supply Order (PSO) are those found in
the Pharmaceutical Schedule under Section E: Part I. If a medicine is not on this list, it should not
be supplied on a PSO and should only be supplied to a named patient on a legal prescription.
Practitioners who are working in the Rural Areas under Section E: Part II of the schedule can order
any reasonable quantity of any product listed in the schedule (not just those in Section E: Part I),
provided all the requirements for the listing are met.
Bulk Supply Order
A Bulk Supply Order (BSO) is to be made by the licensee or manager of a registered private
hospital. All regular prescription medicines and Class B controlled drugs can be supplied on a BSO
(triplicate form required for Class B).
Funding of Supply Orders
If a PSO or BSO does not meet listing requirements (i.e. the medicine requires a special authority,
retail pharmacy specialist restriction, or the listing states “only on a prescription”), it will not be
funded.
If you have any issues you think would benefit a wider group of pharmacists please send them to
Carolyn ([email protected]) or Kurt ([email protected]).
The PDA team
Pharmacy Defence Association
Ph: 0800 PDA HELP (0800 732 4357)
Fax: 04 802 8208
email: [email protected]
website: www.pda.org.nz