Intro into Clinical Pharmacology

Question 1

Define Therapeutics

Answer 1

The Branch of medicine concerned with the treatment of the disease and action of remedial agents

Question 2

Define Prescribing

Answer 2

The authorization of the use of treatment

Question 3

Define Prescriber

Answer 3

The person who signs the prescription is responsible – this is a legal responsibility

Question 4

Define adverse drug reaction

Answer 4

defined as any undesired outcome of taking a medication

Question 5

Who has the main responsibility in prescription of drugs

Answer 5

• the person who signs the prescription (prescriber) carries the main responsibility
• Dispenser(pharmacist) and administrator (Nurse) also have some but less responsibility

Question 6

what should doctors try to do when prescribing

Answer 6

• Maximise clinical effectiveness
• Minimise harm
• Avoid wasting resources
• Respect patient choice

Question 7

how many people take at least 8 medications a week

Answer 7

• Over 1 in 10 of 65+

- Over 1 in 4 of all 85+

Question 8

how many people have adverse reactions to drugs

Answer 8

• In any 6 months over 75% of 70+ year olds have an adverse drug reaction

Question 9

How many medications are not take as prescribed

Answer 9

• 50% of medications are not take as prescribed

Question 10

name the 10 principles of prescribing

Answer 10

1. Be Clear about the reasons for prescribing
2. Take into account the patients medication history before prescribing
3. Take into account other factors that might alter the benefits and risks of treatment
4. Take into account the patients’ ideas, concerns and expectations
5. Select effective, safe, and cost-effective medicines individualised for the patient
6. Adhere to national guidelines and local formularises where appropriate
7. Write unambiguous legal prescriptions using the correct documentation
8. Monitor the beneficial and adverse effects of medicines
9. Communicate and document prescribing decisions and the reasons for them
10. Prescribe within the limitations of your knowledge, skills and experience

Question 11

what does it mean to be clear about the reasons for prescribing
(Ten Principles of prescribing)

Answer 11

• Establish accurate diagnosis

- Be clear in what the patient is likely to gain from the prescribed medicines

Question 12

what should you consider in the patients medication history before prescribing
(Ten Principles of prescribing)

Answer 12

• Obtain an accurate list of current and recent medication including over the counter
• Prior adverse drug reactions and drug allergies either from patient or carers

Question 13

what other factors should you consider that might alter the benefits and risks of treatment
(Ten Principles of prescribing)

Answer 13

• Consider other individual factors that might influence prescription, for example physiological changes with age, pregnancy, impaired kidney, liver, heart function

Question 14

what should you take into account when prescribing

Ten Principles of prescribing

Answer 14

Take into account the patients’ ideas, concerns and expectations
- Form a partnership with the patient when selecting treatments making sure that they understand and agree with the reasons for taking the medicine

Question 15

how do you select effective, safe and cost effective medicines for the patient
(Ten Principles of prescribing)

Answer 15

Select effective, safe, and cost-effective medicines individualised for the patient

• Benefits should out weight the potential harms
• Prescribed medicines that are off label only if satisfied that alternative medicine would benefit the patients needs
• Choose the best formulation, dose, frequency, route of administration and duration of treatment

Question 16

name how to adhere to national guidelines and local formularises
(Ten Principles of prescribing)

Answer 16

• Be aware of guidance but always consider the individual needs of the patient
• Select medicines with regard to costs and needs of other patients
• Be able to identify access and use reliable and validated sources of information such as the BNF and evaluate potentially less reliable information critically

Question 17

how do you write unambiguous legal prescriptions

Ten Principles of prescribing

Answer 17

• Be aware of common factors that cause medication errors and how to avoid them

Question 18

How do you monitor the beneficial and adverse effects of medicines
(Ten Principles of prescribing)

Answer 18

• Identify the benefits and adverse effects of treatment can be assessed
• Know how to revise a prescription based on this information
• Report adverse drug reactions via the yellow card scheme
• Stop medicines when appropriate

Question 19

How do you communicate and document prescribing decisions and the reasons for them
(Ten Principles of prescribing)

Answer 19

• Communicate clearly with patients, their carers and your colleagues
• Give patient information about how to take the medicines, the benefits expected, adverse effects and any monitoring needed – patient information included in dispensed package insert, read it in the summary of product characteristics
• Use the clinical record to document prescribing decisions/reasons accurately

Question 20

how do you prescribe whiten the limits of your knowledge, skills and experience

(Ten Principles of prescribing)

Answer 20

• Always seek to keep knowledge and skills that are relevant up to date
• Seek the advice and support of qualified professional colleagues
• Make sure that where appropriate, prescriptions are checked

Question 21

what are the types of adverse drug reactions

Answer 21

• Physical harm
• Mental harm
• Loss of function

Question 22

how many adults go into hospital due to adverse reactions

Answer 22

• 1 in 16 of all adult admissions to hospital is due to an ADR
• 16.6m admissions in England 2017-18

Over a 1m due to ADR

• 3 in 4 were avoidable
• Median be stay of 8 days
• 4% of NHS bed capacity
• Projected cost of >500m billion annually

Question 23

How do you reduce adverse drug reactions

Answer 23

• Sound understanding of the patient, condition being treatment and medications available to treat the condition

Question 24

Name two ways to report adverse drug events

Answer 24

• Yellow Card Scheme

- Eudravigilance – in Europe