Clinical Pharmacology Flashcards
(33 cards)
A ‘broad set of health care practices that are not part of that country’s own tradition and are not integrated into the dominant health care system’
Complementary and Alternative Medicine (CAM)
Concerns regarding herbal medicines…
ADRs and drug-drug interactions
Contamination, adulteration and misidentification
Lack of data
Mechanism of action of acupuncture
Stimulates pain fibres entering the dorsal horn of the spinal cord –> inhibition of pain impulses –> Stimulates release of endogenous opioids
(no evidence in conditions other than pain)
(risk as needles)
Risks of aromatherapy
Skin irritation
Excessive inhalation can cause headaches/ fatigue
Bronchial spasms (not safe in asthma)
Avoid during pregnancy – abortifacient
Body responsible for decentralised scientific assessment of medicines
(EU version of FDA)
European Medicines Agency (EMA)
Body responsible for making decisions on the cost effectiveness of pharmaceutical products in respect to their use in NHS Scotland
Scottish Medicines Consortium (SMC)
Sorts drugs into 3 categories:
Approved for use
Approved for restricted use
Not recommended
Licencing authority for drugs etc. in the UK
Medicines and Healthcare products Regulatory Agency (MHRA)
((Ensures medicines meet acceptable standards
Ensures the balance between safety and effectiveness ))
Roles of the MHRA
Authorises clinical trials of new drugs
Grants “marketing authorisation“ to approved drugs
Issues manufacturer’s / wholesale dealer’s licences to approved pharmaceutical companies
Continues to check the safety and effectiveness of approved drugs = pharmacovigilance
A voluntary scheme collecting info on... o ADRs o Medical device adverse incidents o Defective medicines o Counterfeit/ fake medicines o Safety concerns
Yellow card reporting scheme
(can be filed by healthcare professionals or members of the public)
Medicines with no marketing authorisation are called…
Unlicensed
Unlicensed formulations made when an existing formulation of a licensed product is not suitable for the patient are called…
Specials
a type of unlicensed medicine
Licensed medicines prescribed outwith the terms of the marketing authorisation are called…
Off-label
when using unlicensed/ off label medicines, full responsibility for the product is taken by the…
Prescriber
Classification of medicines
based on where they can be acquired
Prescription only medicines (POM)
- inc. Controlled drugs (CD)
Over the counter (OTC)
- Pharmacy (P)
- General sales list (GSL)
The 5 “R”s for prevention pf medical errors
o Right patient o Right drug o Right dose o Right route o Right time
Solute concentration per unit volume of solvent
Osmolarity
takes into account ALL solute concentrations
Solute concentration per unit mass of solvent
Osmolality
never measured in practice
The measure of the osmotic pressure gradient btw two solutions separated by a membrane
Tonicity
(Only influenced by solutes that CANNOT cross the membrane (as they can influence the osmotic pressure gradient) )
Composition of Total Body Water
2/3rds = Intracellular fluid
1/3rd = extracellular fluid
- 20% = plasma
- 80% = interstitial fluid
Osmolarity of all body fluids
285-290 mOsm/kg
Daily requirements
of water, sodium, potassium and glucose
o Water: 25-30ml/kg
o Sodium: 1mmol/kg
o Potassium: 1mmol/kg
o Glucose: 50-100g/day
Signs of hypovolaemia
Feels nauseous/ thirsty High HR + low postural BP Cold peripheries, no sweat Flat veins Concentrate oliguria
WARNING: dehydrated patients may be oedematous due to low oncotic pressure (low protein/albumin) or heart failure
Signs of hypervolaemia
Feels breathless, not thirsty
Warm and oedematous extremities
Distended veins
Dilute urine
How to treat… hypovolaemia
Resuscitation fluids if low BP
Rehydration fluids
o Use oral/NG route first if possible!!!
