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Emergency supply at patient request — GPhC CRA MCQ

Instant feedback + full explanation. One question, done properly.

HardPharmacy Law and EthicsEmergency supply at patient requestGPhC CRA

A prescription for methotrexate 2.5 mg tablets for rheumatoid arthritis says “six tablets weekly” but the PMR and patient disagree about whether the established day is Monday or Friday. What should the pharmacist do?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Confirm the prescribed weekly dosing day before supply and reinforce it with the patient

Explanation lettering: E = shown as A · D = shown as B · B = shown as C · A = shown as D · C = shown as E

A is wrong because the unresolved day creates a real risk of duplicate or incorrect dosing. B is wrong because “take as directed” abandons a key methotrexate safety safeguard. C is wrong because reducing quantity does not resolve the schedule. D is wrong because a strength change requires prescriber authority and may introduce further error. E is correct: weekly methotrexate requires an unambiguous agreed day, clear directions and counselling to prevent fatal daily or duplicate dosing.

Reference: MHRA: once-weekly methotrexate safety measures. https://www.gov.uk/drug-safety-update/methotrexate-once-weekly-for-autoimmune-diseases-new-measures-to-reduce-risk-of-fatal-overdose-due-to-inadvertent-daily-instead-of-weekly-dosing GPhC: standards for pharmacy professionals. https://assets.pharmacyregulation.org/files/standards_for_pharmacy_professionals_may_2017_0.pdf