Pharmacology

Question 1

What are drugs

Answer 1

Substances used or administered with a view to restoring, correcting or modifying physiological, immunological or metabolic action.

Question 2

Who is the UKs regulatory agency

Answer 2

Medicines and healthcare products regulatory agency (MHRA).

Question 3

Types of meds regulated

Answer 3

Prescription only (POM)
Controlled (codeine)
Pharmacy only (PC)
General sale (GSL)

Question 4

Common drugs

Answer 4

Analgesics
Laxatives
PPIs
Anti histamine

Question 5

What does active ingredient do

Answer 5

Delivers mode of action and produces side effects

Question 6

What inactive ingredient do

Answer 6

Alters drugs physical properties/ fillers colours sweeteners could trigger food intolerances or allergies

Question 7

What compound does aspirin contain

Answer 7

Salicin

Question 8

What are pharmacokinetics of a drug

Answer 8

The movement of the drug in the body
Absorption
Distribution
Metabolism
Excretion

Question 9

Explain first pass metabolism

Answer 9

Process when drug taken orally, is absorbed from the GIT and taken via portal vein into liver. Results in drug concentration being reduced by time it reaches systemic circulation.

Question 10

What is meant by bioavailability

Answer 10

Amount of drug that reaches blood stream for distribution

Question 11

What are the routes of administration

Answer 11

Oral
Sublingual- spray
Topical
Parenteral - injection

Question 12

What factors effect absorption

Answer 12

Gut motility- diarrhoea/ constipation
Malabsorption- reduced absorption (celiac)

Question 13

How is a drug distributed in the body

Answer 13

Binging to plasma proteins
Binding to other tissues - in bones / muscles
Accumulating in lipids

Question 14

What is drug metabolism

Answer 14

Process when drugs are chemically changed from lipid to water soluble form for excretion

Question 15

Explain phase 1 of metabolism

Answer 15

Drug is altered to make suitable for phase 11 reactions or for excretion this involves CYP 450 family of enzymes

Question 16

Explain phase 11 metabolism

Answer 16

Molecules from phase 1 are conjugated to a more water soluble product to aid excretion.

Question 17

What is the pharmacodynamics of a drug

Answer 17

How the drug interacts with the body to exert its affects.

Question 18

Which drugs are know to have a narrow therapeutic index

Answer 18

Digoxin
Warfarin
Lithium

Question 19

What’s the term poly pharmacy mean

Answer 19

When a person is on serval drugs

Question 20

What drugs does garlic interact with

Answer 20

Cholesterol, blood pressure, anticoagulants and anti platelet

Question 21

What does ginkgo interact with

Answer 21

Anti platelets and anticoagulants

Question 22

With which drug should grapefruit be avoided and why

Answer 22

Statins and digoxin because it inhibits CYP 3A4 for 24hours which could make drug toxic levels in the body.

Question 23

Which food reduce effects of warfarin

Answer 23

Green veggies due to insoles and vit k content

Question 24

What nutrient depletions are caused by statins and explain mechanism

Answer 24

CoQ 10

Blocks synthesis of mevalonic acid which is precursor for cholesterol and CoQ10

Question 25

What nutrients do antibiotics deplete and mechanism

Answer 25

Biotin (B5) B6 B2 B1 B12 Vit K By destruction of intestinal micro flora may lead to decreased production of B vitamins and vitamin K

Question 26

Nutrient depletion of antacids and mechanism.

Answer 26

Calcium Folate Iron Chromium Increased gastric pH may reduce absorption. Aluminium ones reduce calcium

Question 27

Contradictions and side effects of ACE inhibitors and Angiotensin 11 antagonists

Answer 27

Contradictions - pregnancy and breast feeding Side effects - hyperkalaemia, constipation, diarrhoea, nausea and vomiting.

Question 28

Statins - contradictions, interactions and side effects.

Answer 28

Contradictions- pregnancy, breast feeding and liver disease. Interactions - grapefruit & pomegranate Side effects- GIT disturbance’s, myopathy, fatigue, rhabdomyolysis

Question 29

Digoxin - contradictions, cautions, interactions and side effect

Answer 29

Contradictions- heart block, ventricular tachycardia Caution- hypokalaemia (low potassium) low blood mg Interactions - hawthorn Side effects- nausea vomiting diarrhoea loss of appetite

Question 30

PPIs cautions and side effects

Answer 30

Cautions - liver disease, pregnancy, masks symptoms of gastric cancer Side effects- headaches, GI disturbances, infections and SIBO due to low pH, Low B12, low magnesium, iron deficiency

Question 31

Nutrient depletion of Proton pump inhibitors

Answer 31

Beta carotene, calcium, chromium, magnesium, iron, vit c, zinc Reduced gastric acids inhibit absorption

Question 32

Levothyroxine - action, contra indications, cautions and side effects

Answer 32

Mode of action - lifelong replacement Contra indications - thyrotoxicosis Cautions- elderly, cardiovascular disorders. Side effects- headaches, insomnia, tremor anxiety. Interaction- oral iron and calcium take 4 hours apart.

Question 33

SSRIs - mode of action, contraindications and side effects

Answer 33

Mode of action - selectively inhibit the re-uptake of serotonin (5-HT) Contraindications- poorly controlled epilepsy Side effects- GIT disturbance, constipation, diarrhoea, anxiety, insomnia.

Question 34

What is serotonin syndrome and symptoms

Answer 34

Excess of serotonin due to therapeutic drug use, overdoes or interactions. When two or more drugs are affecting serotonin at the same time. Symptoms- confusion, disorientation, exaggerated reflexes, fever, sweating, hypotension.

Question 35

NSAIDs - mode of action, contraindications, cautions and side effects

Answer 35

Mode of action - inhibits the activity or COX 1 and COX 2 thereby inhibiting prostaglandin synthesis. Contraindications- peptic ulcer, IBD, Cautions - asthma, cardiac impairment, increase bleeding with warfarin. Side effects- risk of gastric ulceration, kidney damage.

Question 36

Natural Alternatives to NSAIDs

Answer 36

Willow bark Turmeric Ginger Boswellia All COX inhibitors COX and LoX inhibitors- onions asparagus, apples and berries.