Non-Medical Prescribing Revision

Question 1

What does ADME stand for ?

Answer 1

Absorption
Distribution
Metabolism
Excretion

Question 2

Most drugs are absorbed in what organ?

Answer 2

Small intestine

Question 3

Factors that affect absorption?

Answer 3

Size of drug molecule
How lipophilic the drug is
How ionised the drug is
Surface area available
PH of food

Question 4

What is first pass metabolism?

Answer 4

Where the drug is broken down (metabolised) in the liver before it ever reaches the systemic circulation

Question 5

What affects drug absorption?

Answer 5

Food
Concordance
Formulation
Route of administration

Question 6

Tell me 3 examples of routes of administration?

Answer 6

IV- complete absorption
Oral- partial absorption
Topical-partial and variable

Question 7

What is a loading dose?

Answer 7

Dose to reach therapeutic levels

Question 8

What is volume of distribution? (Vd)

Answer 8

Amount of drug that needs to be in the body to achieve a particular concentration

Question 9

When a drug is highly protein binding, this means?

Answer 9

The drug is inactive

Question 10

What affects metabolism?

Answer 10

Age
Other drugs
Genetic factors

Question 11

What affect does enzyme inhibiting drugs have?

Answer 11

Reduce the affect of the medication and slow down the drug process.

Question 12

How many phases of metabolism are there?

Answer 12

Two

Phase 1
Phase 2

Question 13

For drugs to be excreted they need to be ?

Answer 13

Hydrophilic

Question 14

What does EGFR mean ?

Answer 14

Estimate glomerular filtration rate - estimate of how well that kidneys are functioning.

Question 15

What is half life?

Answer 15

Time required for the plasma concentration of a drug to reduce by half.

Question 16

Explain
Inductor and inhibitor

Answer 16

Inductor- increases metabolic clearance

Inhibitor- slows down metabolism

Question 17

What is an agonist?

Answer 17

An agonist is a chemical that activates a receptor to produce a biological response.

Question 18

What is an antagonist?

Answer 18

A substance that stops the action or effect of another substance

Question 19

What is affinity?

Answer 19

The strength of attraction between two substances

Question 20

What is efficacy?

Answer 20

efficacy describes the maximum response that can be achieved with a drug

Question 21

Drugs associated with displacing other medicines from plasma proteins are listed in the BNF as ?

Answer 21

Incompatible in Appendix 1

Question 22

Pharmacodynamic interactions are common and fall into two categories

Answer 22

1- additive effects of drugs with similar reactions

2- competing effects of drugs with opposite actions

Question 23

What is normally the first indicator of renal insufficiency?

Answer 23

Poor urinary output

Question 24

An adverse drug reaction ADR is not the same as an adverse side effect ASE

Answer 24

TRUE
ADR is a negative event
ASE may have some beneficial side- effects

Question 25

The study of ADRs is called ?

Answer 25

Pharmacovigilance

Question 26

An ADR can be classified into how many classes

Answer 26

6
Type A, B, C, D, E and F

Question 27

If a patient reports a ADR (Type A augmented effect) the prescriber may ?

Answer 27

Stop the medication
Reduce the dose of the drug
Switch to an alternative drug

Question 28

Name 3 major group of drugs involved in adverse drug reactions

Answer 28

Antibiotics
Antipsychotics
NSAIDs
Drugs with narrow therapeutic window
Lithium
Diuretics
Benzodiazepines
Newly licensed drugs

Question 29

The elderly often have changes in sensitivity to drugs because of ..

Answer 29

A reduction in drug binding sites
Impaired organ function
Altered metabolising enzyme systems in the liver

Question 30

What is a ligand?

Answer 30

A ligand is defined as any molecule or atom that irreversibly binds to a receiving protein molecule

Question 31

Explain the significance of the black triangle next to some drugs in the BNF

Answer 31

New or monitored drugs that are under surveillance

Question 32

Explain phase 1 metabolism ?

Answer 32

Phase I reactions of drug metabolism involve oxidation, reduction, or hydrolysis of the parent drug, resulting in its conversion to a more polar molecule.

Question 33

Explain phase 2 metabolism?

Answer 33

Phase II reactions involve conjugation by coupling the drug or its metabolites to another molecule, such as glucuronidation, acylation, sulfate, or glicine

Question 35

What is a G protein linked receptor?

Answer 35

G protein-linked receptors (GPLR), form a large group of evolutionarily related proteins that are cell surface receptors that detect molecules outside the cell and activate cellular responses.

Question 36

what is a ligand-gated ion channel?

Answer 36

Ligand-gated ion channels are ion channels that can open in response to the binding of a ligand. To form a channel, this type of cell-surface receptor has a membrane-spanning region with a hydrophilic (water-loving) channel through the middle of it. The channel lets ions to cross the membrane without having to touch the hydrophobic core of the phospholipid bilayer.

Question 37

What is a kinase linked receptor?

Answer 37

A kinase-linked receptor (KLR) is a transmembrane receptor, which uses second messenger signalling that triggers a cascade of cellular events.

Question 38

Explain bioavailability?

Answer 38

In pharmacology, bioavailability is a subcategory of absorption and is the fraction (%) of an administered drug that reaches the systemic circulation.