1. Quality Use of Medicines (QUM) Flashcards
What is QUM?
Quality use of Medicines = QUM is one of the central objectives of Australia’s national medicines policy
Principles of QUM?
• QUM means
o Selecting management options wisely
o Choosing suitable medicines if a medicine is considered necessary and
o Using medicines safely and effectively
• The goal of the national strategy for QUM is to make the best possible use of medicines to improve health outcomes for all Australians
5 Rights of medicine Administration
• Right patient
• Right drug
• Right dose
• Right route
• Right time
• Additional
o Right documentation, Right reason, Right responseName the three drug information sources?
- AMH - Australian Medical Handbook
- MIMS
- eTG
Difference between drug information sources?
AMH
- monographs are on generic names
- o Relevant adverse effects
o Includes practice points
o Does not include pharmacokinetic parameters
o Used in clinical setting
MIMS
o Monographs are on product level/brand name
o Difficult to know what monograph to choose
o Need to look at each brand separately
o What the tablet looks like
o Drug interaction tool
o CMIs
o Provided by manufacturer
eTG
o Don’t have drug monographs
o Provides guidelines for management of a range of conditions
o Based on latest available international literature interpreted
What is CMI?
Consumer Medicines information
= leaflet that contains information on the safe and effective use of a prescription medicine.
- Written by the manufacturer of drug - Designed for consumer
Difference between CM and AMH information?
CMI
- Brand names
- Straight forward information with instructions on what to do before and after medication
- Consumer orientated with easier language to be able to understand
AMH
- Designed for administrator to understand what the drug does and how it works
- With harder language
Why might you need to modify a dosage form for administration to patient?
– Children/ Elderly
– Motor neuron and neurological diseases
– Loss of tongue muscles
– Stroke
– NBM – post operative or unconscious
– Unable to coordinate injections or injections
– Tubes in nose or mouth
Ways to modify medication?
– Oral dosage forms
o Crushing
o Dissolving
o Dispersing
– Injections
o Change site
o Change administration type
– Creams and ointment
– Patches (Can’t cut them or modify them)
5 potential issues modifying dosage forms?
– Increase risk of adverse effects.
– Result in treatment failure
– Altered absorption characteristics
o Cannot crush slow release tablets – will lead to over dose as they will get too much at once
– Altered medication stability
– Failure to reach site of actionDifference between generic and Brand name?
Generic - name of the drug within the medication
Brand - name given buy the manufacture
Prefix or Suffix
Gli -
Drug class - Sulfonylureas
Indication - Diabetes
Mechanism of action - increase pancreatic insulin and secretion
E.g. Gliclazide
Prefix or Suffix
-sartan
Drug class - angiotensin II receptor antagonists
Indication - hypertension
Mechanics of action - Block binding of angiotensin II
e.g. candersartan, eprosartan
Prefix or Suffix
-azepam
drug class - Benzodiazepines
Indication - anxiety
Mechanism of action - Inhaibit GABA
e.g. Alprazolam
Bromazepam
Prefix or Suffix
-caine
drug class - Local anaesthetics
Indication - Minor, major nerve block
Mechanism of action - Sodium channel blockage = reduced nerve conduction
e.g. Bupivacaine
Levobupivacaine
Lidocaine
Prefix or Suffix
-cillin
drug class - Penicillin antibiotics
Indication - Short term bacterial infections
Mechanism of action - Inhibits bacterial cell wall synthesis
e.g. Amoxicillin
Flucloxacillin
Prefix or Suffix
-cycline
drug class - Tetracycline antibiotics
Indication - Anti-infectives
Mechanism of action - Inhibits bacterial protein synthesis - 305 ribosome
e.g. Demeclocycline
Doxycycline
Minocycline
Prefix or Suffix
-dronate
drug class - Bisphosphonates
Indication - Osteoporosis
Mechanism of action - Decrease bone resorption by inhibiting osteoclasts.
e.g. Alendronate
Ibandronic acid
Pamidronate
Prefix or Suffix
-olol
drug class - Beta-blockers
Indication - Hypertension
Angina
Mechanism of action - Blocks beta adrenergic receptors in the heart
e.g. Atenolol
Bisoprolol
Metoprolol
Prefix or Suffix
-prazole
drug class - Proton pump inhibitors
Indication - GORD, Peptic Ulcer disease
Mechanism of action - Proton pump binding - reduces basal and simulated acid production
e.g.Esomeprazole
Lansoprazole
Omeprazole
Pantoprazole
Prefix or Suffix
- Pril
drug class - ACE inhibitors
Indication - hypertension, chronic heart failure
Mechanism of action - ACE inhibitors block conversion of angiotensin I to angiotensin II and also inhibit the breakdown of bradykinin.
e.g.Captopril
Enalapril
Prefix or Suffix
-statin
Drug class - HMG-CoA reductase inhibitors (statins)
Indication - Hypercholesterolaemia
Mechanism of action - Blocks the pathway for synthesising cholesterol in the liver
e.g. Atorvastatin
Fluvastatin
Pravastatin
Difference Between systemic administration and topical administration
Systemic = administered in a way that allows them to be absorbed into the systemic blood circulation
Topical = application to specific body surface areas, where they exert localised effects. (cream or loation)
– These drugs do not require absorption into the systemic blood circulation to be effective
Main routes of administration
Systemic
- Oral
- Parenteral
- Intravenous, subcutaneous, intra muscular, intrathecal, intra-articular
- Rectal (depends on purpose)
- Vaginal (depends on purpose)
Topical
- Dermal
- Inhalation
- Ocular
- Rectal (depends on purpose)
- Vaginal (depends on purpose)
