BNF Preface Flashcards
How should a biologic or biosimilar product be prescribed?
Using brand name - this is good practice, to ensure that substitution of a biosimilar medicine is not dispensed when a biologic (biological reference medicine) has been prescribed
Although theoretically there should be no important difference between biologics and biosimilars in terms of safety and efficacy, due to products not being identical and differ in terms of their complexity in structure it is best to prescribe by brand
Which biological medicines are available as biosimilars?
Epoetin alfa Etanercept Filgrastim Follitropin alfa Infliximab Insulin glargine Somatropin
When should brands be prescribed?
Only when there is a demonstratable difference in clinical effect between each manufacturer’s version, making it important that the patient should always receive the same brand
e.g beclometasone inhalers - clenil and Qvar
What preparations are considered to be ‘sugar-free’
1) Preparations which do not contain glucose, fructose or sucrose
2) Preparations which contain hydrogenated glucose, mannitol, maltitol, sorbitol or xylitol - as there is evidence that these do not cause detal caries
A product which is ‘freshly prepared’ means what?
Indicates that it must not be made 24hours before it is issued and that deterioration is likely to occur if preparation is stored longer for 4 weeks between 15-25degrees
e.g reconstituted antibiotics
What does the term ‘water’ refer to in the pharmaceutical sense?
Potable water drawn freshly and directly from the public supply and suitable for drinking
Boiled and cooled purified water
Patients should be advised about medicines which may have the ability to impair driving. As of 2015 a new offence of driving, attempting to drive, or being in charge of a vehicle, with certain specified controlled drugs in excess of specified limits came into action. What drugs are included in this group?
Benzodiazepines: Oxazepam Diazepam Temazepam Lorazepam Flunitrazepam Clonazepam
Opioids:
Methadone
Morphine
Amfetamines
These include drugs which metabolise into the drugs listed above such as selegiline which metabolises to amfetamine
Patients who have been prescribed or have legally purchased medicines (e.g codeine) OTC, which are listed in the drug driving offence, should be advised to do what?
Carry proof of prescribed medicine or purchase of medicine. This could be a repeat prescription, PIL etc
If a person has been found to be in excess of the specified limit of drug, but has been taking the drug according to their prescription, and their driving is NOT impaired, what can be done?
A statutory ‘medical defence’ can be raised
All dispensed medicines have the recommended label wording ‘Keep out of the reach and sight of children’. Is this wording a legal requirement?
‘Keep out of reach of children’ is a legal requirement
‘Keep out of sight of children’ is good practice to include
If a patient takes any Sch 2-4 (part 1) drug and is intending to travel abroad for greater than 3 months, what needs to be done?
They will need an import/export license from Home Office
Who can prescribe cocaine, dipipanone, or heroin for the treatment of addiction?
Only medical practitioners who hold a special license issued from the Home Office. Any other practitioner must refer patients to the appropriate medical practitioner for the treatment of addiction.
Healthcare professionals and coroners are urged to report suspected ADRs through what scheme?
MHRA - Yellow Card Scheme
What ADRs should be reported?
Any suspected ADR should be reported regarding drugs, blood products, vaccines, radiographic contrast media, complementary and herbal medicines.
For biosimilar or vaccines, batch number and brand name should also be reported
What is the description of the frequency of side-effects as reported in the BNF?
Very common: > 1 in 10 Common: 1 in 100 to 1 in 10 Uncommon: 1 in 1000 to 1 in 100 Rare: 1 in 10,000 to 1 in 1000 Very rare: < 1 in 10,000
