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Pharmacology Flashcards

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USMLE® Step 1 flashcards
1
Q

When a drug’s adverse drug reaction is pharmacologically predictable, this is considered as what Type of reaction?

A

Type A

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2
Q

What is a lipid soluble drug?

A

Able to dissolves in fats, oils or fatty tissues

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3
Q

A client has been prescribed a lipid soluble drug. What effect would a low serum albumin have?

A

No difference in the drug response.

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4
Q

What type of drug TRIGGERS A RESPONSE in a receptor?

A

An AGONIST drug

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5
Q

Cocaine inhibits the re-uptake of:

A

Dopamine

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6
Q

Corcordance is an informed partnership agreement negotiated between

A

The Patient and Prescriber

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7
Q

“Half-life” is the time taken for…

A

the plasma concentration of a DRUG TO FALL BY 50%

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8
Q

Where are most drugs metabolised?

A

Liver

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9
Q

The study in the way in which the drug affects the body is called

A

PharmacoDYNAMICS

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10
Q

The side effects of a drug are listed in the BNF by order of

A

FREQUENCY ie the most common first

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11
Q

Which of the following antibiotics is nephrotoxic?

A. Cephalexin
B. Flucloxacillin
C. Phenoxymethylpenicillin
D. Streptomycin

A

Streptomycin.

Use BNF under Renal

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12
Q

Which group population is at greatest risk of a Type A drug reaction?

A

South East Asians

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13
Q

When after repeated administration, a given dose of a drug produces a decreased effect, or conversely, when increasingly larger doses must be administered to obtain the effects observed with the original use- what does this term relates to?

A

Tolerance

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14
Q

Which receptors do barbiturates work on?

A

Gamma-aminobutyric acid A (GABAa) receptors.

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15
Q

Which route of administration is the fastes to achieve therapeutic plasma levels?

A

Intravenous route

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16
Q

Which type of receptor is responsible for the analgesic properties of Morphine?

A

Mu receptors

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17
Q

Which type of receptor is responsible for the bronchodilator effects of Salbutamol?

A

Beta2 receptors (B2)

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18
Q

What type of drug blocks a receptor site called?

A

ANTAgonist

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19
Q

For how long is a prescription for a Schedule 2 drug valid?

A

28 days

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20
Q

Generic prescribing is prescribing using the

A

Approved Name

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21
Q

In the BNF Drug interactions are listed…

A

Twice - Alphabetically by drug name and by drug group interactions

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22
Q

Most drugs and their metabolites are excreted via?

A

The kidneys

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23
Q

SSRI is an abbreviation for

A

Selective serotonin re-uptake inhibitor

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24
Q

The first line treatment for anaphylaxis is

A

Intramuscular adrenaline

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25
Q

The removal of some or all of the drug by the liver before it has had a therapeutic effect is called

A

The 1st PASS EFFECT

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26
Q

What is the effect on absorption of a drug delivered via a transdermal patch if the client is pyrexial?

A

Drug absorption is increased

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27
Q

What monitoring should be instigated for a client commencing on an ACEi

A

Renal function tests

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28
Q

When assessing the efficacy of a drug, what information is required?

A

Numbers needed to treat and numbers needed to harm

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29
Q

When should a dry cough in response to a drug be reported using the yellow card scheme?

A

When the drug is marked by a black triangle in the BNF

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30
Q

What is a common side effect of beta blockers?

A

Bronchospasm

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31
Q

What is the study of pharmacokinetics?

A

What the body does to the drug.

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32
Q

Cytochrome P450 is main family of enzymes that are involved in what process?

A

Metabolism

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33
Q

A lipid soluble drug will be attracted to

A

FAT

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34
Q

A patient may have to have regular blood tests if they are taking a drug with what property?

A

A narrow therapeutic window

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35
Q

During metabolism an addition of a hydrogen molecule is called

A

Reduction

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36
Q

A “type B” adverse drug reaction should be reported via…

A

Yellow Card Scheme

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37
Q

All non-steroidal anti-inflammatory drugs (NSAIDs) work by inhibiting what?

A

NSAIDs inhibit the action of Cyclo-oxygenases

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38
Q

As a general principle, oral paediatric dosages are calculated based on what?

A

The child’s weight

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39
Q

When the body identifies a drug as an antigen, this is called

A

A drug allergy

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40
Q

How many steps are there in the prescribing pyramid?

A

Seven

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41
Q

Section 5 in the BNF considers drugs related to

A

Infections

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42
Q

The effects of topical preparations in infants and children are affected by:

a. Skin perfusion
b. Skin hydration
c. pH of the Drug
d. All of the above

A

All of the above

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43
Q

Under which circumstances is it acceptable to prescribe for a family member?

a. In a life threatening emergency
b. When they have run out of regular medication
c. It is never acceptable to prescribe for a family member
d. When they have non-serious illness/injury

A

In a life threatening emergency

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44
Q

What advice would you give a client on the safe storage of medicines?

A

Store out of reach of children

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45
Q

What is the effects on absorption of a drug delivered via a Transdermal patch if the client is HYPOthermic?

A

Drug absorption is decreased.

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46
Q

Which of the following antibiotics INHIBITS DNA synthesis?

A. Macrolides
B. Penecillines
C. Polymyxins
D. Ciprofloxacin

A

Ciprofloxacilin

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47
Q

Which of the following drug groups is most associated with avoidable drug-related admissions to hospitals?

A

NSAIDs

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48
Q

Which herbal preparations increase the risk of GI bleeding when taken with NSAIDs?

A

Garlic
Ginkgo Biloba
Ginseng

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49
Q 
Which of the following instructions is appropriate to write on an FP10?
A. Maximum 8 tablets in 24 hours
B. All of these
C. Label 20
D. As directed
A

Maximum 8 tablets in 24 hours.

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50
Q

What anti-bacterial agent is an Antifolate?

A

Trimethroprim

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51
Q

What advice would you give a patient for whom you have prescribed amoxicillin?

A

Take are regular intervals. Complete the course unless otherwise directed.

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52
Q

Appendix 4 in the BNF deals with…

A

Wound Management

53
Q

The terms child or children are used generically to describe age ranges from…

A

aged 1 month - 17 years

54
Q

Breastfeeding is generally accepted to be safe in women taking:

a. Warfarin
b. Rituximab
c. Amantadine
d. Methotextrate

A

Warfarin

55
Q

Generic prescribing is prescribing using the…

A

Approved name

56
Q

How should the prescriber endorse a prescription for a drug that is contraceptive purposes to ensure it is dispensed free of charge?

A

♀

57
Q

If a patient has received an overdose of a benzodiazepine two hours ago which drug would be given?

A

Flumazenil

See BNF page 1440

58
Q

___ data summarises drug and appliances prescribing patterns for an individual prescriber.

A

PACT data

59
Q

The active ingredients in Marvelon are

A

Desogestrel +

Ethinylestradiol

60
Q

What circumstances must the quantity of the drug to be dispensed be included on an FP10?

A

When the medicine is to be taken as required (PRN) but the frequency and numbers of days treatment is not specified.

61
Q

What does the acronym WWHAM stand for?

A 
W -Who is it for? 
W -What are the symptoms? 
H - How long have the symptoms been present? 
A - any Action taken so far? 
M - any other Medication?
62
Q

____ chain is the audit storage mechanisms to ensure the viability of a vaccine

A

Cold chain

63
Q

Which of the following antibiotics INHIBITS CELL WALL SYNTHESIS?

A. Penecillins
B. Polymyxins
C. Macrolides
D. Ciprofloxacin

A

PENICILLINS

64
Q

Cranberry juice, garlic and St John’s Wort interacts with which type of drug group?

A

Coumarins such as Warfarin

65
Q

Which of the following is good advice for a prescriber relating to pharmaceutical representatives?

A. Decide if the information is evidence or marketing
B. Refuse to see even with an appointment
C. Accept drug information at face value
D. Accept all offers of free gifts

A

Decide if the information is evidence or marketing.

66
Q

Which of the following is not a feature of an aspirin overdose?

Sweating
Hypoventilation
Vasodilatation
Tinnitus

A

Hypoventilation

67
Q

Which of the following statements is true of Gram positive organisms?

a. Lower likelihood of developing antibiotic resistance
b. Greater likelihood of developing antibiotic resistance
c. Thinner cell walls than gram negative organisms
d. Small amounts of peptidoglycans in the cell wall

A

Lower likelihood of developing antibiotic resistance

68
Q

Which section in the BNF identifies drugs affecting the musculo-skeletal system?

A

Section 10

69
Q

Ispaghula Husk is an example of what type of laxative?

A

Bulk forming laxative

70
Q

If a drug has a relatively short half life the route for administration is likely to be:

a. Oral 3 - 4 times a day
b. By subcutaneous injection
c. Orally once a day
d. By depot injection

A

Oral 3-4 times daily

71
Q

Which diuretic is known to be Ototoxic?

A

Loop diuretics

72
Q

Salbutamol is an example of a drug that is a ______ agonist.

A

b2 Adrenoreceptor agonist

73
Q

Which of the following drugs should be used with caution if the client has diabetes mellitus?

a. Thiazide diuretics
b. Beta Blockers
c. Tricyclic Antidepressants
d. All of these

A

Thiazide diurectics - this can exacerbate diabetes and gout.

74
Q

SSRIs are from which group of drugs?

A

Anti-depressants

75
Q

What is the receptor in Ranitidine?

A

(Histamine) H2 receptor antagonist

It heals gastric and duodenal ulcers by reducing gastric acid output as a result of the Histamine H2-receptor blockade.

76
Q

What should patients avoid when taking Metronidazole?

A

Drinking alcohol.

77
Q

Who is responsible for ensuring that the client understands the dosing regimen?

A

Prescriber.

78
Q

Which of the following is not a common side effect of a β² adrenoceptor agonist?

a. Bradycardia
b. Tremor
c. Insomnia
d. Palpitations

A

Bradycardia

79
Q

Why would you anticipate a client may complain of a dry mouth, constipation and blurred vision following a prescription for an antimuscarinic drug?

A

Antimuscurinic drugs decrease smooth muscle activity.

80
Q

In relation to renal excretion in neonates and infants, adult levels of renal function are achieved by the age of 1 year.

True or False

A

True.

81
Q

Which class of drug inhibits the action of cyclo-oxygenases?

A

NSAIDs

82
Q

Which drugs are considered the first line treatment for Hyperlipidaemia?

A

Statins

83
Q

Diazepam is contra-indicated in which type of condition?

A

Severe hepatic impairment

84
Q

There is enough of the population are immunised to to limit the spread of the disease is a term called…

A

Herd Immunity

85
Q

Which organisation identifies the drugs that may be prescribed on the NHS budget?

A

NICE -

National Institute for Health and Clinical Excellence

86
Q

Security of unused prescription pads (FP10) is the responsibility of…

A

Employer and prescriber

87
Q

When writing a prescription, what information is absolutely compulsory or required by law?

A

The prescriber’s qualification and PIN

88
Q

What is the effect on absorption of an oral drug if gut motility is increased?

A

Drug absorption is decreased.

89
Q

Which drugs are considered the first line treatment for uncomplicated hypertension in a young Caucasian diabetic?

A

Angiotensin Converting Enzyme Inhibtor (ACEi)

90
Q

What is a common side effect of a beta blocker?

A

Bronchospasms

91
Q

Clozapine can cause ____

A

Agranulocytosis

92
Q

Which antibiotics inhibit PROTEIN SYNTHESIS?

A

Macrolides.

93
Q

Which antibiotic inhibits bacterial cell wall systhesis?

A

Penicillins

94
Q

As an independant and supplementary prescriber when would a Clinical Management Plan (CMP) be legally required to prescribe a medication?

A

When prescribing for a client outside your normal scope of practice.

95
Q

In a patient with a mild asthma attack, why is it considered best practice to use a salbutamol inhaler rather than a nebuliser?

A

Sufficient drug will reach the target receptors without much systemic absorption.

96
Q

Olivia has been given a prescription for clarithromycin. What is the advice regarding clarithromycin administration in a patient with hepatic impairment? Select the correct answer.

A

Avoid in severe hepatic impairment if renal impairment is also present.

97
Q

You get called to Sara who is 22. 4 days ago she was supplied a course of amoxicillin for a productive cough with green sputum with fever. Sara now has signs of severe systemic illness. She says she took a few of the tablets but kept forgetting. What is the most likely reason for the progression of the illness?

A

The lack of adherence has led to an insufficient time above the minimum inhibitory concentration to have had an effect on the bacteria.

98
Q

When are benzodiazepines most effective in a tonic clonic seizure and why?

A

In the first 30 minutes as there is a significant decrease in the number of inhibitory GABAa receptor subunits after this time.

99
Q

Jason is 19 yrs old, who has injected opioid and is unresponsive. On clinical assessment, he was also bradypnoeic. As a result of the presenting symptoms, he was given IM injection of naloxone which improved his respiratory function and consciousness levels but after a short time he becomes bradypnoeic and unresponsive again. What is the most likely reason for this?

A

Naloxone has a short half life relative to the opioid and the naloxone is therefore eliminated quicker.

100
Q

Geoff is a 65 year old gentleman who was prescribed an anticoagulant when he was diagnosed with atrial fibrillation. The medication is given to reduce the formation of clots and reduce the chance of stroke.

Rivaroxaban impacts the normal clotting cascade by which of the following?

A

Inhibits factor Xa action.

101
Q

Solomon has been given codeine by his doctor but explains that the pain is not improving and the medicine doesn’t seem to be working. He also takes Ramipril. What is the most likely reason that his pain is not improving?

A

Solomon has a deficiency in the CYP2D6 enzyme resulting in him not achieving therapeutic levels of the active metabolite.

102
Q

Adam is a middle-aged male patient, who regularly consults the internet for solutions to his various ailments. Recently he has decided to ‘self-prescribe’ a daily dose of aspirin.

Aspirin impacts the normal clotting cascade by which of the following?

A

Inhibits COX-1 action

103
Q

What is the advice regarding chloramphenicol administration in pregnancy?

A

There is a risk of neonatal grey baby syndrome if used in third trimester so it should be avoided.

104
Q

Victoria is an older lady who has been suffering from arrythmias and heart failure for several years. Many of her treatments failed to work, resulting in a hit or miss approach to her drug management. Eventually she was treated with digoxin, which appears to stabilise her symptoms quite well.

Effective digoxin therapy is associated with which of the following?

A

Increased Left Ventricular Ejection Fraction

105
Q

A histamine antagonist has which of the following properties?

A

Anti-emetic

106
Q

In palliative care why is the subcutaneous route often used to administer medicines?

A

It maintains a steady plasma concentration, avoiding the peaks and troughs of other routes

107
Q

You intend to give your patient an injection of morphine. You check the medicine with someone else and then pass the syringe to your ambulance technician colleague to administer. Is this legally allowed? Select the correct statement regarding the legality of the action

A

No, it is listed under the Human Medicines Regulations 2012 schedule 17 which means that only Paramedics can administer it.

108
Q

If lorazepam and buccal diazepam are shown to have less adverse effects after the termination of the seizure, why to ambulance trusts not routinely give these instead of diazepam?

A

Diazepam is more stable under the likely storage conditions

109
Q

Which of these is not a side effect of a tricyclic antidepressant?

a. diarrhoea
b. lucopaenia
c. postural hypotension
d. tremor

A

Diarrhoea

110
Q 
Which of these antibacterial agents is a Macrolide?
Erythromycin
Ciprofloxacin
Gentamycin
Trimethoprim
A

Erythromycin

111
Q

Dysport and Neurobloc are trade names associated with

A

Botulinum neurotoxin type A

112
Q 
Which of the following is not a feature of an aspirin overdose?
Hypoventilation
Sweating
Tinnitus
Vasodilatation
A

Hypoventilation

113
Q

Antipsychotics can cause:

a) raised prolactin levels
b) reduced prolactin levels
c) raised cortisol levels

A

Raised prolactin levels

114
Q 
Which of the following factors limits the request for an inappropriate prescription?
Education of the patient and population 
  Seeking advice from microbiologists 
  Fear of complications or litigation
  Pressure from pharmaceutical companies
A

Education of the patient and population

115
Q

Who authorises payments to contractors for the dispensing of NHS prescriptions?

A

Prescription Pricing Authority

116
Q

Which of the following organisms produces collagenase?
Streptococci and Staphylococci
E. coli and Klebsiella
Clostridium tetani and Clostridium botulinum
Salmonella and Treponema

A

Streptococci and Staphylococci

117
Q

Which of the following statements is correct

NSAIDs can cause gastric irritation when given by rectal route
Metoclopramide delays gastric emptying
Gentamicin is a bacteriostatic macrolyde
As a independent prescriber you are only permitted to prescribe a POM

A

NSAIDs can cause gastric irritation when given by rectal route

118
Q 
Which of the following conditions is a contra-indication to prescribing a Tricyclic antidepressant?
  Recent myocardial infarction
  Recent Stroke
  Recent Kidney disease
  All of these
A

Recent myocardial infarction

119
Q

Following which phase trial could a new pharmaceutical drug be given marketing authorisation (a licence)?

A

Phase 3

120
Q 
Which of the following conditions would be a contra-indication to prescribing an ACE inhibitor
  Pregnancy
  Kidney disease
  Liver disease
  Porphyria
A

Pregnancy

121
Q 
Which of the following is not a good reason to issue a prescription?
  To meet client expectation
  To relieve symptoms
  As a trial of diagnosis 
  To prevent future illness
A

To meet client expectation

122
Q

Vicarious liability is when
The employer accepts liability for the employees actions
The employee accepts liability for their own action
No harm has occurred to the client from the employees action
The client accepts responsibility for the employees actions

A

The employer accepts liability for the employees actions

123
Q 
You have administered haloperidol to a patient presenting with Acute Behavioural Disturbance.   Considering the pharmacokinetics of haloperidol, which medicine is most likely to result in an adverse event when both medicines are in the systemic circulation at the same time?
Itraconazole - a CYP3A4 inhibitor 
  Phenytoin - a CYP2C9 inhibitor 
  Nefazodone - a CYP3A5 inhibitor 
  Chlormethiazole - a CYP2E1 inhibitor
A

Itraconazole - a CYP3A4 inhibitor

124
Q

Paracetamol can be given by the IV route but must be given slowly. Which of the following statements is correct regarding this?

It is believed that the excipient, mannitol, causes hypotension.

The half life of paracetamol is longer by the IV route so the drug will last longer in the system.

Rapid rises in systemic paracetamol cause ototoxicity.

The advice to give it slowly is for best-practice to ensure that users have time to check the product in case of an error.

A

It is believed that the excipient, mannitol, causes hypotension.

125
Q

Vicarious liability is when

The client accepts responsibility for the employees actions
The employee accepts liability for their own action
No harm has occurred to the client from the employees action
The employer accepts liability for the employees actions

A

The employer accepts liability for the employees actions

126
Q

You are called to Mike, a 26 year old male. On arrival he is very agitated, sweaty, tachycardic, tachypnoeic, non compliant and is very manic and not engaging.

His friends explain that he has been out with them all night and consumed lots of alcohol and 6 ‘lines’ of cocaine.

What best describes one of the main actions of cocaine on the central nervous system:

It increases acetylcholine concentrations in the synapses
It decreases glycine concentrations in the synapses
It increases dopamine concentrations in the synapses
It decreases histamine concentrations in the synapses

A

It increases dopamine concentrations in the synapses

127
Q

Geoff is a 65 year old gentleman who was prescribed an anticoagulant when he was diagnosed with atrial fibrillation. The medication is given to reduce the formation of clots and reduce the chance of stroke.

Warfarin impacts the normal clotting cascade by which of the following?

Inhibits factor IX action
Inhibits Vit K oxidase-reductase reaction
Inhibits COX-1 action
Inhibits factor Xa action

A

Inhibits Vit K oxidase-reductase reaction

128
Q

You intend to give your patient a hydrocortisone injection for severe asthma. You check the medicine with someone and then pass the syringe to your ambulance technician colleague to administer. Is this legally allowed? Select the correct statement regarding the legality of the action.

No, the medicines are under your care as the Paramedic and must only be given by you.

Yes, it is listed under the Human Medicines Regulations 2012 schedule 19 and therefore they are allowed to administer it in an emergency.

Yes, it is listed under the Human Medicines Regulations 2012 schedule 17 which allows this use by technicians.

No, as this medicine requires a PGD to be administered.

A

Yes, it is listed under the Human Medicines Regulations 2012 schedule 19 and therefore they are allowed to administer it in an emergency.

129
Q

You are called to Margaret, a 56 year old female who has been complaining of acid reflux. She has a history of post-menopausal osteoporosis and takes Alendronic Acid 10mg daily. After discussions with her GP, you both agree that Gaviscon (Sodium bicarbonate & Calcium carbonate) is the best course of treatment for Margaret. Which of the following pieces of advice must she be given prior to commencing this treatment?

There are no known interactions
Alendronic acid should be taken 30min after Calcium carbonate
You Answered
Alendronic acid should be taken 30min before Sodium bicarbonate

Alendronic acid should be taken 30min before Calcium carbonate

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Alendronic acid should be taken 30min before Calcium carbonate

Non Medical Prescribing (1 decks)

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