Competency Questionnaire for Pharmacists Supplying Free Levonelle to Young
People According to Patient Group Directive for Levonelle 1500 (February 2012)
Name ……………………………………………………………………………………………..
Pharmacy ………………………………………………………………………………………..
The Patient Group Directive (PDG) which enables accredited Pharmacists to provide
Levonelle free of charge to teenagers, was updated in January 2012.
Please read through the new PGD and answer the questions. A 90% pass rate is
required in order to be reaccredited. Please send your completed answer form by post
to:Lorraine Gosnell, Public Health Children &Young People Team, Sheffield City
Council, Moorfoot, Floor 7, West Wing, Sheffield S1 4PL by Friday 14 February 2014 .
Please tick or circle the appropriate answer(s)
1)
The Levonelle PGD is applicable to which of the following individuals?
a)
Request by a 17 yr girl due to condom failure 60hrs ago
b)
Request by a 14 yr old girl due to unprotected sex 80hrs ago
c)
Request by a 13 yr old due to unprotected sex 24hrs ago
d)
Request by an 18 yr old due to condom failure 36hrs ago
e)
Request by a 15 yr old who is Fraser competent due to condom failure
f)
Request by a 14 yr old who is not Fraser competent due to unprotected
sex
2)
The new PGD allows two “off label” inclusions, which are they?
a)
Request for emergency contraception more than once in the same cycle
b)
Request for emergency contraception due to one missed combined
contraceptive pill in the first week of packet.
c)
Request for emergency contraception when the patient is taking liver
enzyme inducing medication.
d)
Request for emergency contraception when unprotected sex occurred 80
hours ago.
3)
The criteria for exclusion under the PGD include which of the following?
a)
Pregnancy or suspected pregnancy
b)
Currently taking the combined contraceptive pill
c)
Levonelle taken in last menstrual cycle
d)
Levonelle taken in the current menstrual cycle
e)
Active liver disease
f)
Known allergy to Progestogens
February 2013
4)
What is an appropriate action (more than one answer) if a young women
presents for Levonelle 72 hours after having unprotected sex?:
a)
Refuse to give Levonelle and tell her to see her GP for a pregnancy test in
3 weeks time
b)
Explain that there are other options including ellaOne or a postcoital IUD
up to 120 hrs and refer to their GP
c)
Fast track the young woman to the Sheffield Contraception & Sexual
Health service
d)
Do a pregnancy test
e)
Advise that it is too late to do anything now, but she must use condoms in
future
5)
Patients should be given the following advice when being given Levonelle:a)
If they vomit within 3 hours of taking Levonelle they should return for a
replacement dose
b)
If they are on liver enzyme inducing medication they only need one tablet
nowadays
c)
Patients who are breastfeeding need to stop breastfeeding for 3 days
d)
They need to wait & take the tablet with their next meal
6)
Very common adverse reactions to Levonelle:
a)
Occur in greater than 1 in 100 cases
b)
Occur in greater than 1 in 10 cases
c)
Include Dizziness
d)
Include Breast tenderness
e)
Include Fatigue
7)
Which of the following medication may reduce the effectiveness of Levonelle?
a)
Bosentan
b)
Oxcarbazepine
c)
Penicillin
d)
Insulin
e)
Warfarin
f)
Ritonavir
8)
Levonelle may affect the dosage needed for which of the following medication?
a)
Sodium Valproate
b)
Phenytoin
c)
Ciclosporin
d)
Metformin
e)
Warfarin
February 2013
9)
Patients should be given the following advice when being given Levonelle:a)
Levonelle works by preventing ovulation & fertilisation
b)
The foetus could be severely handicapped if the treatment fails
c)
Not to worry if they vomit within 3 hours
d)
Levonelle is great as a regular form of contraception
e)
Their next menses may be delayed by a few days & that is normal &
nothing to worry about
f)
Warned about common side effects
g)
Given advice about on going contraception
10)
A patient who usually takes a pill method of contraception needs Levonelle when:
a)
She has missed one Noriday pill & had UPSI
b)
She has missed two combined pills & had UPSI in the first week of the
pack
c)
She has missed two combined pills & had UPSI in the second week of the
pack
d)
She has missed one combined pill & had UPSI in the first week of the
pack (no other pills missed previously)
11)
A patient who needs Levonelle because her usual pill method has failed should
be told the following:
a)
The Levonelle replaces that days pill
b)
The Levonelle should be taken as well as that days pill
c)
They need to use condoms for 7 days after missing a POP
d)
They need to use condoms for 7 days after missing a COC
12)
When giving Levonelle under the PGD you should always do which of the
following?
a)
Explain about possible side effects
b)
Explain that Levonelle is 95% effective
c)
Discuss STI screening & offer a Chlamydia test
d)
Advise to return if they vomit within 3 hours
e)
Discuss on going contraception esp LARC methods
f)
Advise to see their GP or attend SCaSH if their period is more than a
week late
13)
After using Levonelle women should be advised to do the following:a)
Not to worry if their next period is just a few days late
b)
Think about arranging on-going contraception
c)
Consider having a pregnancy test if their next period is more than 5 days
late or shorter than usual
d)
Arrange to have Chlamydia test
February 2013
14)
Sexual health advice and treatment can be given to Under-16s if they are Fraser
Competent. Which of the following statements about Fraser Competence are
true?
a)
Young people must tell their parents before they can get sexual health
treatment
b)
It must be in the young person’s best interests to be given sexual health
advice or treatment (including Levonelle)
c)
The young person must be able to understand the advice given
d)
It is important to record the assessment of Fraser competence whenever
an under-16 is given Levonelle.
e)
The young woman’s mental or physical health would suffer if she were
refused emergency contraception treatment
15)
When would you fast track a young person to SCaSH or their GP?
a)
UPSI greater than 72 hours ago
b)
15yr old woman who attends for Levonelle for 3rd time in past 2 weeks
c)
14yr old who had sex yesterday with 16yr old boyfriend
d)
16yr old with a positive pregnancy test
e)
14yr old who is upset because she was forced to have sex
16)
In which of the following circumstances would you do a pregnancy test?
a)
UPSI on day 9 of cycle
b)
Period is 2 days late & burst condom yesterday
c)
13yr old girl requests a pregnancy test
d)
19y old woman has missed her period
e)
15yr old had EC last month & attends for EC again today – no period
since last visit
February 2013