Drug History

Question 1

What are the legal ways of obtaining drugs?

Answer 1

- From a shop
(Paracetamol from the supermarket)
- From a pharmacist 
(eg: Emergency Contraception)
- From prescription 
(eg: Antibiotics)

Question 2

Why do we have drug regulation?

Answer 2

Prevents public advertisement and promotion of ineffective drugs.

Question 3

Explain ‘The Medicines Act 1968’

Answer 3

Required a license in order to buy / sell or manufacture medicines.

Question 4

What are the classification of medicinal products?

From a shop / pharmacist / prescription

Answer 4

From a shop - General Sale Medicines.
From a pharmacist - Pharmacy Medicines.
From a prescription - Prescription only medicines.

Question 5

What does General Sales Medicines (GSM) entail?

Answer 5

This is taken for commonly recognised ailments which last 2 -3 days.
Small doses are given in order to reduce chances of harm from overuse.
However, a few side effects can occur.

Question 6

What does Pharmacy Medicines entail?

Answer 6

These are ONLY available in pharmacies.

Used for short term treatments and need to be used MORE carefully than GSM.

Question 7

What does Prescription only Medicines entail?

Answer 7

ONLY available with prescription.
These drugs are:
- Direct / Indirect danger to human health.
- Frequent incorrect usage.
- Product is normally prescribed for injection administration (Known as Parenteral administration.)

Question 8

What are controlled drugs?

Answer 8

Controlled Drugs are prescription medications which are controlled under the ‘Misuse of Drugs 1971’. The classification is based on the harm when misused and their benefit in medical treatment.

Question 9

List the class system for controlled drugs and name some examples for each.

Answer 9

There are 3 classes. Class A, B and C.
Class A = Morphine / Heroin
Class B = Ketamine / Codeine
Class C = Diazepam / Zopiclone

Question 10

Which category of drugs does the ‘Misuse of Drugs Regulations’ apply to?

Answer 10

Only applies to controlled drugs.

Question 11

Why are some drugs strictly controlled?

Answer 11

• Drugs can cause harm.

- Antiangiogenesis

Question 12

What is antiangiogenesis?

Answer 12

Stops the development of NEW blood vessels = stops embryos developing normally.

Question 13

What are the two ways drugs can cause harm?

Answer 13

Adverse Drug Reaction - ADR

Adverse Drug Event - ADE

Question 14

Explain what is meant by an ‘Adverse Drug Reaction’.

Answer 14

Any reaction which is unintended and occurs at doses normally used in man.
Reasonable probability that it is caused by a drug

Question 15

Explain what is meant by an ‘Adverse Drug Event’.

Answer 15

Any medical occurrence in which someone administers a drug which has no causal relationship to the treatment.

Question 16

What is the procedure which occurs when an adverse drug reaction occurs?

Answer 16

A dose reduction is administered or the drug is completely stopped.
This prevents the negative side effects = Nausea / Dry Mouth / Dizziness.

Question 17

Why does an adverse drug reaction occur?

Answer 17

They are dose related and is often predictable due to the pharmacology of the drug.

Question 18

Explain what an allergy is.

Answer 18

An allergy is classed as an adverse drug reaction which is uncommon.

Question 19

What happens for an allergy to occur?

Answer 19

An allergy is brought about by the component of a drug binding to the host protein and causing a hapten to be created. The creation of a hapten triggers an immune response.

Question 20

What is sensitisation?

Answer 20

A mild allergic reaction is much more severe next time.

Gets worse each time

Question 21

What is anaphylaxis?

Answer 21

An indication that an allergic reaction has occurred and therefore, the person’s airways constrict.
As the airways constrict -> an obstruction could be present in the airways and thus, the person CAN’T breathe.

Question 22

What are some symptoms of anaphylaxis?

Answer 22

Fluid in the lungs / Blood pressure drops / Swelling of the face and throat.

Question 23

What are the main steps for drug taking history?

Answer 23

GREET THEM.
What drugs do they take?
What dosage they have?
When do they take it?
Do they take any other medications?
Ask again : DOUBLE CHECK.
Have they started / stopped any medications?
Do they drink / smoke / do drugs?
Do they know why they are taking the drugs?
Where there any problems with taking the drugs?
If so, offer them an alternative.
Where do they get the drugs from?
Do they have any allergies to drugs?
Do they get an other symptoms for the drugs they were taking? // Did they go to A&E?
Ask if they take any injected medication?
Thank Them.

Question 24

What are the potential challenges to taking drugs?

ADVERSE EFFECT

Answer 24

SOLUTION:

• Avoid if the allergy is there.
• Weigh up benefits and charms for side effects.

Question 25

What are the potential challenges to taking drugs?

DRUG INTERACTIONS

Answer 25

SOLUTION:

• Competent prescribing.
• Check prescriptions.
• Medication reviews.

Question 26

What are the potential challenges to taking drugs?

PHYSICAL IMPAIRMENT

Answer 26

SOLUTION:

• Change formulation.
• Usage of aids in order to make administration easier.

Question 27

What are the potential challenges to taking drugs?

MEMORY IMPAIRMENT

Answer 27

SOLUTION:

• Dosette Boxes.
• Alarms.
• Simplifying medications.
• Help from family / carers.

Question 28

What are the potential challenges to taking drugs?

DISCORDANT BELIEFS

Answer 28

SOLUTION:

• Explore beliefs.
• Shared decision making.