Let's try and do question 1a)

It's been awhile, but it's not that easy thinking of 'tips' to blog about under this kind of topic. So why don't we try and go through question number 1a) of the exam paper I posted back in July 2012? It feels like ages ago, but it was only last year.

I'm pretty rusty as I'm not currently in community or hospital, but here goes.

The question goes: (abbreviated version) what is the scheduling for the following drugs? In the UK this would be the equivalent of P meds for pharmacy meds, POM for prescription only, CD for controlled drug, etc.

So the first one is:

a) a cream containing terbinafine 1%. OK, let me think, this is an antifungal, probably for something like athlete's foot. In the UK they sell similar stuff which are either P meds, or I think you can buy something like that from supermarkets. I am guessing it's either the equivalent of a P or a POM med here, which would something like a P1 or S3 med - P1: needs to be sold in a pharmacy under the supervision of a pharmacist, but otherwise no biggie, S3: prescription only. So I'll have to look it up. And the quickest way to do that right now is to look it up on MIMS.com . So you type in 'terbinafine' in the search box, and then it gives you a list of options. You need to chose the branded proprietary option in order for this to work, which in this case is Lamisil. It helps when they use the same brands over here. And also, as the question is asking specifically about the cream, I choose the Lamisil cream option.
Scroll down and voila, under 'Poison Schedule', it says P2. Which means it doesn't even need to be sold in a pharmacy, but it stops short of being a non-poison (NP).

Another way of looking it up is using this list of all the different generic drugs licensed in HK with all their scheduling. It's a little confusing at first, but basically the first section is a list of all the pharmacist/prescription only meds, and is titled 'Part I' - P1/S1/S3. P1 means pharmacist only, S1 means the pharmacist needs to make a record of the sale, and S3 means prescription only. Some drugs are both P1 and S1, probably non-Rx drugs which are potentially abusable.
So what you do is try and look for terbinafine under Part I (assuming you have absolutely no idea), and it's there on page 37. And there it says terbinafine, P1, S1 and S3. Basically this means that it is a prescription only drug - but then it actually says - 'unless it is an external prep'. This means that terbinafine cream (without a strength specification as well) is not a P1 drug. So now what's left to determine is whether terb cream is a P2 drug, or a non-poison. At a guess it is more likely to be a P2 than a NP, but you can double check using the same list again, you just need to go further down where it then gives you a list of P2 drugs, and it is there, on pg 44. Ergo, terbinafine cream is a P2 med, can be sold in a pharmacy or a 'listed seller of poisons' (I don't know if supermarkets are allowed to have LSP status), and doesn't need a pharmacist hovering over your shoulder when you hand over your cash.

And there you have it, phew! I definitely won't be able to do any more examples tonight, but I hope this one helps. Ciao