The College of Optometrists

1) There are now 2 levels of exemptions level 1 which all optoms can use and level 2 wer optoms have to do a course/training.

I know that chloramphenicol(level 1) is now a P med and no longer a POM and that we can only to use it too treat bacterial conj.

Even tho its a P med do we still have to give the Px a signed order or is it ok to tell them to go to the chemist and ask for it (wots should we say if asked in pqe's)???

we're allowed to sell or supply any GSL/P meds that are in line with our professional practice. it no longer has to be an emergency for these two categories

CPL can be prescribed an optometrist for anything, not just acute bacterial conjunctivitis but CPL is only a P med for the treatment of bacterial conjunctivitis.

good point

John, to satisfy myself of the (legal, not ethical) situation.

I accept that medicines have liscenced indications when pharmacy (P) medicines, for example, chloramphenicol 0.5% for acute bacterial conjunctivitis; and sodium cromoglycate for SAC or PAC only, i.e. not GPC - though one could argue that GPC is a result of CL exacerbating SAC or PAC and thus could treat with this premise.

However, if we prescribe exempt POM drugs, can we do so for any condition or are there liscenced indications? For example, those listed by John Lawrenson in OT a while back:

www.optometry.co.uk/files/ a90b53eca3de358beaa87bc8a9111fee_lawrenson20050603.pdf

At present the only one that I wish to oppose is that for fusidic acid - bacterial conjunctivitis only. I feel that blepharitis would also be a good usage.

I ask as there were no liscenced indications mentioned in recent information by the MHRA:

http://medicines.mhra.gov.uk/inforesources/saleandsupply/optometrists.htm

My personal view is that the exempt POMs and P meds can be used for any purpose in the course of professional practice.

CPL or NaCrom are only a P med under certain circumstances so that must be borne in mind when Rxing NaCrom (only for SAC or PAC). With CPL it can only be supplied as a P med for acute bacterial conjunctivitis but could be Rx'd via a written order as topical cover for RCE for example.

The only other problem arises if the drug is used off label as far as the BNF is concerned.

so does that mean we do not have to provide a signed order for a P med?

yes