Pharmacology

Question 1

What is a P medicine

Answer 1

1. Any medicine not on general sale list
2. Must be sold under the supervision of a pharmacist

Question 2

What are off label meds?

Answer 2

Manufacturer of the medicine has not applied for license for this use

Example: Amitriptyline for neuropathic pain

Question 3

What are unlicensed meds?

Answer 3

1. Mixing two license drugs together
2. Used in paediatric as “specials”
3. Used in the best interest of the patient

Question 4

What is General sale list?

Answer 4

Can be bought without supervision of a pharmacist

For example: paracetamol

Question 5

What is the definition of an independent prescriber?

Answer 5

Responsible and accountable for the assessment of patients conditions and for the decisions about clinical management

Question 6

What is supplementary prescribing?

Answer 6

1.Works in partnership an independent prescriber who has to be a doctor or dentist.

2.Cannot work independently.

3. Dietitians and radiographers are only allowed to be SP

Question 7

Patient group directions (PGD)

Answer 7

1. Is a legal framework that allows pharmacists, nurses and paramedics to administer certain drugs under a directive.
2. It is not a form of prescribing
3. It is a criminal offence to supply a drug if it’s not in a directive.

Question 8

What is polypharmacy?

Answer 8

1. Multiple medications prescribed to one person
2. Prevalent in older people
3. Adverse reactions? Is the amount of drugs appropriate for the patient?

Question 9

What is accountability?

Answer 9

1. Consequences of an action or inaction

Question 10

Clinical negligence

Answer 10

Breaching a duty of care

Question 11

What is clinical governance?

Answer 11

1. Auditing
2. Clinical effectiveness
3. Risk management
4. Guidelines
5. Reporting problems

Question 12

Deprescribing?

Answer 12

Process of withdrawal of a medication
1. Is the medication appropriate?
2. Goal is to manage polypharmacy

Question 13

What are non cellular drugs

Answer 13

1. Anti-acids (gaviscon)
2. Laxatives (osmotic and bulk forming)
3. Antibiotics (target bacterial cells)

Question 14

How do Cellular drugs work?

Answer 14

By interacting with receptors on the surface of cells or enzymes (which regulate the rate of chemical reactions) within cells.

Question 15

What is an agonist drug?

Answer 15

Binds and activates certain receptors on cells, causing a biological response

Question 16

What is an antagonist?

Answer 16

1. A chemical substance that binds to and blocks the activation of certain receptors on cells, preventing a biological response.
2. Most antagonists work by competing with a neurotransmitter or hormone. They bind reversibly to the receptor

Question 17

What is transduction?

Answer 17

The process by which a virus transfers genetic material from one bacterium to another.
(Communicates from outside the cell and functional changes happen within the cell)

Question 18

What is bioavailability?

Answer 18

How much of the drug reaches the plasma/extent of absorption

Question 19

What compromises the bioavailability of a drug?

Answer 19

1. Pregnancy
2. Severe burns
3. Ascites
4. Liver damage can increase bioavailability

Question 20

Small volume of distribution?

Answer 20

1. Stays mainly in the blood stream
   For example: Gentamicin

Question 21

Large volume of distribution?

Answer 21

Has a propensity to leave the plasma and enter the extravascular compartments of the body

Question 22

Distribution factors of bioavailability?

Answer 22

1. Protein binding
2. Tissue binding
3. Lipid solubility
4. Blood flow to tissues

Question 23

Stages of pharmokinetics?

Answer 23

1. Absorption
2. Distribution
3. Metabolism
4. Excretion

Question 24

Prescribing to overweight patients

Answer 24

If the drug volume is SMALL do not base prescribing on weight

If drug volume is LARGE calculate based on weight

Question 25

How is plasma protein binding effected with low albumin?

Answer 25

Causes drugs that are usually protein bound to be free in the plasma, allowing for higher drug levels, more rapid hepatic metabolism

Question 26

Examples of intrinsic adverse reactions?

Answer 26

1. Age 2. Gender 3. Race 4. Genetics

Question 27

Examples of extrinsic adverse reactions?

Answer 27

1. Drug interactions 2. Environment 3. Smoking 4. Alcohol 5. Diet

Question 28

What is a type A adverse reaction?

Answer 28

1. Low morality 2. Predictable 3. Common

Question 29

What is a type B adverse reaction?

Answer 29

1. Rare 2. Idiosyncratic 3. High morality

Question 30

Type C adverse reaction?

Answer 30

Continuous reaction

Question 31

Type D adverse reaction?

Answer 31

Delayed reaction

Question 32

Type E reaction?

Answer 32

Stopping meds - example benzo withdrawal

Question 33

What is the purpose of a loading dose?

Answer 33

Flood the tissue to reach equilibrium with the circulating blood volume

Question 34

What are narrow therapeutic index drugs?

Answer 34

A small difference in dose or blood concentration may lead to serious therapeutic failure and/or serious adverse reaction Example: tacrolimus

Question 35

What is drug clearance?

Answer 35

Clearance describes the process of drug elimination = volume of fluid cleared of drug from body per unit of time

Question 36

What is drug elimination?

Answer 36

Drug elimination is the irreversible removal of a drug from the body by all routes of elimination 1. Excretion - removal of the intact drug 2. Bio transformation- drug is chemically converted into a metabolite (enzymatic process)

Question 37

Phase 1 metabolism?

Answer 37

1. Oxidation 2. Hydrolysis 2. Reduction

Question 38

Phase 2 metabolism?

Answer 38

1. Conjugation of drug with glucuronic or sulphuric acid

Question 39

What is biotransformation of a drug?

Answer 39

1. Chemical alteration by various body systems making it more easily excrete from the body 2. Primarily happens in the liver