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pharmacology Flashcards

1
Q

up to what age do you write the age of the patient on a prescription

A

12

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2
Q

what details of the drug should go on a prescription

A

name, formulation, dose, frequency, quantity to be dispensed

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3
Q

how should you write a prescription

A

black ink, block capitals

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4
Q

why should you not write “” on a prescription

A

can be confused for 11

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5
Q

do you write brand names on a prescription

A

no, generic prescribing unless clinically significant bioavailability between brands

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6
Q

what is the dose of a liquid expressed at

A

milligrams of the active ingredient

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7
Q

how would you stop a medicine on a prescription

A

crossing name

date and sign

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8
Q

what is an off label medication

A

prescribed out with the terms of marketing authorisation. I.e. used for a different condition

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9
Q

what is the GMC guidance for unlicensed medication

A

You should usually prescribe licensed medicines in accordance with the terms of their licence. However, you may prescribe unlicensed medicines where, on the basis of an assessment of the individual patient, you conclude, for medical reasons, that it is necessary to do so to meet the specific needs of the patient.” (be able to justify)

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10
Q

what legal act introduced controlled drugs

A

The misuse of drugs regulations 2001

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11
Q

what can controlled drug cause

A

dependence - therefore abuse

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12
Q

how are controlled drugs kept

A

locked in cupboards

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13
Q

how many days are controlled drug schedules 2,3 and 4 allowed to be given for

A

30 days

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14
Q

what information for controlled drugs must be specified

A

formulation, strength and dose in words and figures

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15
Q

what act classifies different types of medications that need prescription

A

Human medicines regulations 2012

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16
Q

what are prescription only medications (POM)

A

normally new medicines until evidence of safety, written by an appropriate practitioner before it can be supplied e.g. doctor, dentist, advanced nurse practicioner.

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17
Q

what are Pharmacy (P) OTC medications

A

sold from a registered pharmacy premises by a pharmacist or a person acting under the supervision of a pharmacist, pharmacist must check for contra-indications or problems before sale

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18
Q

where can general sales list drugs be purchase (GSL)

A

suitable for general sale, can be sold in retail outlets

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19
Q

which 2 companies wrote the BNF

A

British Medical Association and the Royal Pharmaceutical Society

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20
Q

what information is given for all drugs in the BNF

A 
indications and dosages
route of administration 
contraindications/ cautions
side effects
drug interactions
medicinal products available
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21
Q

which speciality has its own BNF

A

paediatrics

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22
Q

where its the most up to date copy of the BNF

A

online

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23
Q

how often is the BNF updated

A

6 monthly

childs - 12 months

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24
Q

what resource does each local health board have to aid decisions when prescribing

A

joint formulary

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25
Q

what are the Scottish evidence based guideline

A

Developed by multidisciplinary working groups that follow a systematic review of available evidence and have the aim to reduce potential bias. After a set period of time, the guidelines are reviewed. Currently SIGN has 150 evidence clinical guidelines covering a wide range of topics.

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26
Q

what are the UK evidence based guidelines

A

national institute for clinical excellence
Amongst other things will provide recommendations, based on the best available evidence, on the appropriate treatment and care of people with specific diseases and conditions.

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27
Q

what are the aims of evidence based guidelines

A

support healthcare professionals
provide is the best possible quality,
reduces variations in practice,
offers best value for money.

28
Q

where must all prescription and administration records be filed

A

in patients medical records - on completion/ diacharge

29
Q

list some other prescription sheets that may appear in a patients notes

A 
Diabetes Prescription sheet			
Warfarin Chart
Fluid additive prescription sheet			
Variable rate IV Infusion
Syringe volumetric Pump Record			
Insulin infusion prescription sheet
Subcutaneous syringe pump recording chart
30
Q

what are the aims of the MHRA (medicine and healthcare products regulatory agency)

A

Ensures that human medicines meet acceptable standards on safety, quality and efficacy.
Ensures that the sometimes difficult balance between safety and effectiveness is achieved. E.g. side effects against benefits

31
Q

what is required before any medicine can be used to treat someone in the UK

A

market authorisation from the MHRA (product license)

32
Q

what is required before a drug is allowed to be clinically trailed in the UK

A

clinical trail authorisation form the MHRA

33
Q

what are the roles of the MHRA (medicine and healthcare products regulatory agency)

A
  • Assessment & Authorisation of medicinal products for sale in UK
  • Ensure medicine meets the standards of safety, quality and efficacy.
  • Post-marketing surveillance – ADRs and incidents
  • Monitor Internet sales & counterfeiting
  • Clinical Trials regulation
  • Statutory controls
  • Promotion of safe use
  • Manage British Pharmacopoeia & Clinical Practice Research Database
34
Q

how long are marker authorisations (product license) valid for

A

5 years

35
Q

what are the roles of the SMC

A

Provide advice to NHS Scotland regarding all new licenced medicines, new formulations of existing medicines and new indications for established products.
Principal remit is to make decisions on the cost effectiveness of new/existing pharmaceutical products in respect of their use

36
Q

what do the SMC review medications based on

A

How well the medicine works
Which patients could benefit from it
Whether is as good or better than medicines the NHS already uses to treat the particular condition
Whether it is good value for money

37
Q

which proffesions sit on the SMC

A

Pharmacists -Health economists
Pharma representatives Lay representatives
Physicians -NHS management

38
Q

who must accept a medication before it is prescribed in scotland

A

SMC

39
Q

what is the process of the SMC accepting a mediation to be licensed

A

3 month assessment process at time of launch
Submission by manufacturer Health economic analysis
Cost per QALY (£20-30,000)
Attempt to be fair and reasonable
Approved for use or approved for restricted use

40
Q

what does the commission on human medicine (CHM) do

A

Advises Ministers on matters relating to human medicinal products
Advises Licensing Authority (LA)
Considers representations by an applicant or MA holder
Promotes collection and investigation of information relating to adverse Drug Reactions to human medicines.

41
Q

give an example of a drug that has benefited from the RCMF (rare conditions medicines fund)

A

provision of ivacaftor to CF patients with G551D-CFTR mutation (~12% cases in Scotland)
shown 10% improvement in FEV1, respiratory symptoms and weight
QALY = £330,657 and cost per patient per year £182,625

42
Q

what reporting scheme is used for adverse drug reactions

A

yellow card reports

43
Q

how many deaths a year are contributed to by NHS medication errors

A

22,000

44
Q

what percentage of hospital patients experience an adverse drug effect

A

just under 11%

increase hospital stay by 8.5 days

45
Q

what patients are most at risk of an adverse drug reaction

A

Those undergoing cardiothoracic surgery, vascular surgery, or neurosurgery
Those with complex conditions
Those in the emergency room
Those looked after by inexperienced doctors
Older patients

46
Q

what factors increase the rate of medication errors

A

More rapid turnover of patients
New drug developments, extending medicines into new areas
Increasing complexity of medical care
Increased specialisation
Increased use of medicines generally
Sicker and older patients, more vulnerable to adverse effects

47
Q

list some people related causes of medication incidents

A 
Fatigue/ Sleep deprivation				Hunger
Concentration: 		
Stress: 
Distraction				-Lack of training
Lack of access to information 	Other factors: Alcohol, drugs & illness
48
Q

in what stage do most medication errors occur

A

prescribing - 39%
administrating - 38%
dispensing - 12%
transcribing - 11%

49
Q

what things should you check about a patient before prescribing

A 
age
weight
renal and hepatic function 
concurrent medication 
allergies
pregnancy
50
Q

what are the 5Rs of prescribing

A 
right patient
right drug
right dose
right route
right time
51
Q

what is a complementary alternative medicine

A

a broad set of health care practices that are not part of that country’s own tradition and are not integrated into the dominant health care system
a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine

52
Q

what things are included in CAM

A 
herbal medicines
massage 
homeopathic therapy 
acupuncture
hypnosis 
aromatherpay 
Reiki 
meditation 
chinese medicine
53
Q

who are high risk patients for using CAM

A

children
pregnancy - teratogenesis
poly pharmacy

54
Q

what percentage of pregnant women have used CAM

A

60%

55
Q

why do people take CAM

A

Think it’s safe, natural and harmless
Perception that conventional medicine lacks/disregards a holistic approach
relatives use

56
Q

which is the biggest CAM used in the UK

A

herbal medicines - activity ingredients of plants

57
Q

why do a lot of breast cancer patients take CAM (70%)

A

oestrogenic - soya, evening primrose, garlic, red clover, cranberry, grapefruit

58
Q

what are the strongest predictors for CAM use during pregnancy

A

use by family or friends

use prior to pregnancy

59
Q

what CAM were commonly used in pregnancy

A

raspberry , ginger, cranberry

60
Q

what herbal drug has a major interaction with warfarin

A

St johns wart (depression)

61
Q

what is the principle of homeopathy

A

minute concentration of toxins mixed with water or alcohol - water memory not proven

62
Q

what is the principle of acupuncture

A

needles in trigger points for dealing with pain
(Stimulates pain fibres entering the dorsal horn of the spinal cord. These cause inhibition of pain impulses. Stimulate release of endogenous opioids and other neurotransmitters such as serotonin.)

63
Q

what conditions do people use acupuncture to treat

A

chronic low back pan
stroke
(? asthma/ epilepsy)

64
Q

what may be complications of acupuncture

A

Infection, Pneumothorax, Pneumopericardium and Organ puncture

65
Q

what is aromatherapy

A

the use of concentrated essential oils extracted from herbs, flowers, and other plants to treat diseases. It is commonly administered by massaging into the skin.
(inhalation, diffusion, bath)

66
Q

what are harms of aromatherapy

A

Skin irritation with frequent use
Photosensitivity-Avoid prolonged exposure to the sun,
Excessive inhalation can cause headaches and fatigue / Bronchial spasms (people with asthma should not use )
Insomnia -peppermint,

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