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Professional Practise 1 > Mixed > Flashcards

Mixed Flashcards

1
Q

Describe the two types of resistance

A
  1. Inherent resistance - gram negative bacterias outter membrane provides permeability barrier
  2. Acquired resistance - over time treatment fails as resistance acquired
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2
Q

Describe the two types of evolution

A
  1. Vertical evolution - random mutation which causes resistance e.g. if you miss a day of ABs
  2. Horizontal evolution - bacteria can swap resistance genes by cell-cell contact
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3
Q

Name four mechanisms of drug resistance

A
  1. Prevent entry of drug or pump drug out of cell
  2. Alter breakdown of drug to an inactive form
  3. Changes the target site which ABs bind to
  4. Alter cell metabolism to counteract drug action
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4
Q

Four ways of managing AB resistance

A
  • Prudent AB prescribing
  • Hand hygiene
  • Enhanced environmental cleaning
  • Personal protective equipment
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5
Q

How are new antibiotics designed

A
  • Alter usual site for binding to D-Ala-D-Ala to also bind D-Ala-D-Lac (transpeptidase inhibition
  • Another site altered that leads to cell membrane permeability
  • Third modification can facilitate inhibition of transglycosylase
  • Make more potent and effective again resistant organisms. Many other examples
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6
Q

UKs current five year plan to target AMR

A
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7
Q

What are the two AMS toolkits the UK uses to reduce AMR

A
  • Target (primary)
  • Smart and then focus (secondary)
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8
Q

What is health literacy

A
  • Health literacy is the degree to which individuals have the capacity to obtain, process and understand basic health information
  • AND access services needed to make appropriate health decisions, including accessing
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9
Q
A
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10
Q

Advantages and disadvantages of sublingual med

A
  • Under tongue
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11
Q

Advantages and disadvantages of subcutaneous med

A

A subcutaneous injection is given into the subcutaneous fat under the skin. The skin is made up of different layers. Underneath the epidermis and dermis, which contain sweat glands and hair follicles, is a layer of fat. This is the area into which subcutaneous injections are given

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12
Q

Advantages and disadvantages of inhalation

A
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13
Q

Advantages and disadvantages of transdermal

A

Patches

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14
Q

What is a care card

A
  • Recognises products, symptoms that require a pharmacist referral
  • Pharmacists can personalise this and make additions
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15
Q

How do you carry out a differential diagnosis

A
  • Take patient history
  • Physical examination
  • Diagnostic test
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16
Q

Definition concordance?

A

“The degree to which the patient and the health care practitioner agree about the nature of the illness and the need to for management, and the relative risks and benefits of the proposed line of treatment”

17
Q

Describe the categories of non-adherence

A
  1. Unintentional non-adherence:
    • Forget
    • Cant open packaging
    • Doesnt understand instructions
    • Cant swallow
  2. Intentional non-adherence:
    • Changing the dose
    • Stopping med to see what happens
    • Deciding to take some medication and not others
18
Q

Name the different categories for pricing in the drug tariff?

A
  1. Category A: Popular generic drugs which are widely available. Price is based on average list price from 2 wholesalers and 2 manufactures
  2. Category M: Drugs which are readily available, the price is calculated by the DoH based on information submitted by manufactures - negotiable
  3. Category C: List of drugs not usually available as generic and items based on particular or manufacturer
19
Q

When should you endorse a prescription?

A
  • If its more then one pack
  • If quantity used is written as number of days of treatment
20
Q

What is BB endorsement?

A
  • Its a broken bulk endorsement
  • Payment for a complete pack even though only some tablets were dispensed
  • You then endorse it with a BB
21
Q

Name the FOUR types of NHS prescriptions

A
  1. Paper FP10
  2. EPS1 (barcoded FP10 signed in ink)
  3. EPS2 (signed, sent and claimed electronically) linked to nominated dispenser site
  4. EPS4 (signed, sent and claimed electronically) NOT linked to nominations
22
Q

What arent on EPS?

A
  • Items which arent on dm + d coded
  • Private prescriptions - Non NHS privately prescriptions can be signed electronically but not sent to the pharmacy using the NHS spine
  • Private schedule 2 or 2 controlled drugs - these need to be printed on FP10PCD
23
Q

Staff involved in medicines x4

A
  • Trust chief executive
    • Overall responsibility for medicine supply
  • Chief pharmacist
    • Responsible for ensuring systems in place for all aspects of safe & secure handling of medicines in the Trust
  • Responsible pharmacist - the pharmacist must be registered with the GPhC
  • Nurse ward manager/sister
    • Responsible for safe keeping of medicines on the ward
24
Q

Types of ARDs

A
25
Q

Pharmacists role in managing ADRs (Describe 6 ways)

A
  • Identify patients at risk of ADRs - like extreme ages, females, history of intolerance
  • Identify drugs known to produce ADRs and monitor patients
  • Avoid use of drugs causing ADRs where an equally effective and safer alternative exists
  • Review patients medicines: stop unnecessary medicines, check for interactions and contradictions
  • Ensure patients are counselled on the correct use of their medication
  • Report ADRs
26
Q

Name the steps of dispensing overview

A
  1. Professional/clinical assessment of prescription
  2. Label a prescription
  3. Assemble it
  4. Accuracy check a prescription
  5. Hand out prescription and patient counselling
27
Q

What five information is critical to the safe use of medicine

A
  1. Name of medication
  2. Strength
  3. Way of administration
  4. Dosage information
  5. Warnings
28
Q

What are the pillars of clinical governance? And apply them to pharmacy practise

A
  1. Patient/public involvement - allows them
  2. Clinical audit - improving from your own doings
  3. Risk management - Health and safety training, SOP training, new starter inductions
  4. Clinical effectiveness - making practise more evidence based
  5. Staffing management/training -
  6. Use of info - data protection and confidentiality
  7. Premise standards - cleanliness and appropriate (privacy, safe, tidy, seating area)
29
Q

Five main standards for a pharmacist

A
  • Identifying and managing risks in your pharmacy
  • Staffing issues
  • Pharmacy premises
  • Delivery of pharmacy services
  • Equipment and facilities
30
Q

Name the 7 essential services a community pharmacist has to do (by NHS)

A
  1. Dispense
  2. Repeat dispense
  3. Disposal of unwanted medicine
  4. Promotion of a healthy lifestyle
  5. Signpost patients
  6. Support for self care
  7. Clinical governance
31
Q

Name the four ethical schools/theories

A
  1. Deontology - the four bioethical principles
  2. Consequences - weighing up the right and wrongs
  3. Virtue - Places value on the moral character of the actor rather than acts or outcomes of acts
  4. Context
32
Q

DESCRIBE the four biomedical ethical principles

A
  1. Non-maleficence: To not cause harm, could include withdrawing treatment that harms patient
  2. Beneficence: Promote the well being of others, benefit to the patient
  3. Respect for autonomy: Right of a competent adult to make informed decisions, including to refuse (even life-saving) treatment and * Freedom to act independently.
  4. Justice: Fairness - distribute health care resources (goods and service), Same respect to patients in different circumstances.
33
Q

The framework for ethical decision making (7 steps)

A
  1. Determine the facts
  2. Define the ethical issues
  3. Analyse the problem: identify major principles, rules, values
  4. Develop and evaluate solutions
  5. Make a decision
  6. Act
  7. Assess and reflect on decisions
34
Q

Name the GpHC pharmacy standards

A
35
Q

The stages of supplying medication in a hospital pharmacy?

A
36
Q

When is a GSL not a GSL

A
  • For use as an anthelmintic
  • For parenteral administration
  • For use as an eye ointment
  • For use as an enema
  • For use mainly for irrigation of wounds or of the bladder, vagina or rectum

Professional Practise 1 (9 decks)

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