A patient unknown to you visits the community pharmacy late on a Saturday evening asking for dexamethasone 0.1% w/v eye drops previously prescribed by an optometrist prescriber. What would be the most appropriate response?

• A. Refuse to dispense the medication and advise to see an optometrist
• B. Provide the full pack immediately
• C. Supply the smallest pack available and make a register entry in the POM register
• D. Refer to a GP for a new prescription

Answer: (C)

The key idea here is that pharmacists can provide an emergency supply of a prescription-only medicine when there is a reasonable expectation of ongoing need and no current prescription, provided the supply is small and properly documented. In this scenario, the patient asks for dexamethasone eye drops that were previously prescribed by an optometrist, and you don’t have an active prescription on their file. Supplying the smallest pack available as an emergency supply and recording the transaction in the POM register gives the patient access to treatment while maintaining an auditable trail and allowing time to verify the original prescription or arrange a full prescription if needed.

Dexamethasone eye drops are a potent corticosteroid and can carry risks if used inappropriately, so limiting to a small quantity reduces potential misuse while you pursue appropriate follow-up. If there were signs suggesting a more serious issue (e.g., suspected infection without professional input, or glaucoma risks), you would need to refer or seek further medical input rather than continue use.

So, the best approach is to provide the smallest pack and log the supply in the POM register, balancing patient access with safety and accountability.