A patient requests a replacement Nitrolingual spray at 11:30 pm with no record of prescription. What is the most appropriate course of action?

• A. Sell one spray at cost price plus retail mark-up, and make no records
• B. Refuse sale and advise to go to A&E
• C. Record as loan and advise buy on next day
• D. Provide a full replacement with pharmacist's authorization

Answer: (A)

When a patient is in immediate need of a prescribed medicine and there is no prescription on hand, a pharmacist can provide an emergency supply to prevent harm. Nitroglycerin spray is used to relieve angina quickly, so giving a single spray now can avoid a potentially dangerous chest pain episode while the patient arranges a formal prescription.

Providing one spray at cost price plus a small markup recognizes the urgent need and helps the patient access essential treatment without delay. The aim is to balance safety with access—you’re offering a direct, practical solution to tide the patient over until a proper prescription can be obtained. In practice, you would verify there are no contraindications and ensure the patient understands they should obtain and present a prescription as soon as possible.

The other options either deny timely relief, rely on a more extensive replacement without a prescription, or imply actions that aren’t appropriate in an urgent scenario (such as giving full replacement without a prescription or avoiding any documentation).