Test your knowledge

Try these sample AKT questions provided by Dr Mahibur Rahman from Emedica

1. Which of the following drugs is listed under Schedule 1 of the controlled drugs regulations 2001?

A – Diamorphine

B – Methylphenidate

C – Mescaline

D – Cocaine

E – Pethidine

2. Which of the following statements does not apply when prescribing drugs other than temazepam that fall under Schedule 2 of the Misuse of Drugs Regulations 2001?

A – They cannot be prescribed on repeat prescriptions or under repeat dispensing schemes.

B – Patient’s details must be written so as to be indelible.

C – The patient’s full address must be provided, “no fixed abode” is not acceptable.

D – The form of the drug is required even where there is only one form available (eg, tablet/liquid).

E – They cannot be prescribed without the patient’s NHS or Community Index number.

3. The PRACtICe study commissioned by the GMC looked at prescribing and monitoring errors in general practice. What proportion of prescriptions studied contained either a prescribing or monitoring error?

A – 1%

B – 2%

C – 3%

D – 4%

E – 5%

Answers

1. The correct answer is C: Mescaline.

Schedule 1 controlled drugs do not have any recognised medicinal use. They are not usually available in general practice and are restricted to licensed parties for research use. Other Schedule 1 drugs include coca leaf (but not cocaine which is Schedule 2), cannabis, and lysergide (LSD). All the other drugs mentioned in this question are Schedule 2 drugs.

2. The correct answer is D: The patient’s full address must be provided, “no fixed abode” is not acceptable.

This is a tricky question as it is negatively framed – it asks for the statement that does NOT apply. If the patient is homeless “no fixed abode” is acceptable as the patient’s full address.

When prescribing Schedule 2 and Schedule 3 drugs (with the exception of temazepan) the following details must be included and written so as to be indelible:

– The patient’s full name, address (“no fixed abode acceptable”), and age

– The patient’s NHS number or in Scotland the Community index number

– The name and form of the drug, even if only one form exists

– The strength of the preparation and the dose to be taken

– The total quantity of the preparation, or the number of dose units, to be supplied in both words and figures

– Signature of the prescriber (must be handwritten) and date (date can be printed)

– Address of the prescriber (practice or hospital address)

Controlled drugs under Schedule 2 include diamorphine, morphine, pethidine, glutethimide, oxycodone, methadone and cocaine.

3. The correct answer is E: 5%. The PRACtICe study looked at 6,048 unique prescription items for 1,777 patients. 

The research found that 1 in 20 (5%) of prescription items contained either a prescribing or monitoring error, affecting about 1 in 8 patients. Most of these were minor, or of moderate severity, with less than 1 in 550 (0.18%) of all prescribed items containing an error considered to be ‘severe’. Factors contributing to these errors included inadequate training in prescribing, distractions and poor use of existing IT solutions for safer prescribing. Full details of the study can be found here.

Dr Mahibur Rahman is the medical director of Emedica, and works as a portfolio GP in the West Midlands. He is the course director for the Emedica AKT and CSA Preparation courses, and has helped hundreds of GP trainees achieve success in their MRCGP, AKT and CSA examinations each year.

MPS members can get a £20 discount off the Emedica MRCGP courses. Details of the courses are available at www.emedica.co.uk