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pharmacology Flashcards

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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
what are the Scottish evidence based guideline
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.
26
what are the UK evidence based guidelines
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.
27
what are the aims of evidence based guidelines
support healthcare professionals provide is the best possible quality, reduces variations in practice, offers best value for money.
28
where must all prescription and administration records be filed
in patients medical records - on completion/ diacharge
29
list some other prescription sheets that may appear in a patients notes
``` 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
what are the aims of the MHRA (medicine and healthcare products regulatory agency)
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
what is required before any medicine can be used to treat someone in the UK
market authorisation from the MHRA (product license)
32
what is required before a drug is allowed to be clinically trailed in the UK
clinical trail authorisation form the MHRA
33
what are the roles of the MHRA (medicine and healthcare products regulatory agency)
* 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
how long are marker authorisations (product license) valid for
5 years
35
what are the roles of the SMC
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
what do the SMC review medications based on
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
which proffesions sit on the SMC
Pharmacists -Health economists Pharma representatives Lay representatives Physicians -NHS management
38
who must accept a medication before it is prescribed in scotland
SMC
39
what is the process of the SMC accepting a mediation to be licensed
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
what does the commission on human medicine (CHM) do
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
give an example of a drug that has benefited from the RCMF (rare conditions medicines fund)
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
what reporting scheme is used for adverse drug reactions
yellow card reports
43
how many deaths a year are contributed to by NHS medication errors
22,000
44
what percentage of hospital patients experience an adverse drug effect
just under 11% | increase hospital stay by 8.5 days
45
what patients are most at risk of an adverse drug reaction
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
what factors increase the rate of medication errors
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
list some people related causes of medication incidents
``` Fatigue/ Sleep deprivation Hunger Concentration: Stress: Distraction -Lack of training Lack of access to information Other factors: Alcohol, drugs & illness ```
48
in what stage do most medication errors occur
prescribing - 39% administrating - 38% dispensing - 12% transcribing - 11%
49
what things should you check about a patient before prescribing
``` age weight renal and hepatic function concurrent medication allergies pregnancy ```
50
what are the 5Rs of prescribing
``` right patient right drug right dose right route right time ```
51
what is a complementary alternative medicine
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
what things are included in CAM
``` herbal medicines massage homeopathic therapy acupuncture hypnosis aromatherpay Reiki meditation chinese medicine ```
53
who are high risk patients for using CAM
children pregnancy - teratogenesis poly pharmacy
54
what percentage of pregnant women have used CAM
60%
55
why do people take CAM
Think it’s safe, natural and harmless Perception that conventional medicine lacks/disregards a holistic approach relatives use
56
which is the biggest CAM used in the UK
herbal medicines - activity ingredients of plants
57
why do a lot of breast cancer patients take CAM (70%)
oestrogenic - soya, evening primrose, garlic, red clover, cranberry, grapefruit
58
what are the strongest predictors for CAM use during pregnancy
use by family or friends | use prior to pregnancy
59
what CAM were commonly used in pregnancy
raspberry , ginger, cranberry
60
what herbal drug has a major interaction with warfarin
St johns wart (depression)
61
what is the principle of homeopathy
minute concentration of toxins mixed with water or alcohol - water memory not proven
62
what is the principle of acupuncture
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
what conditions do people use acupuncture to treat
chronic low back pan stroke (? asthma/ epilepsy)
64
what may be complications of acupuncture
Infection, Pneumothorax, Pneumopericardium and Organ puncture
65
what is aromatherapy
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
what are harms of aromatherapy
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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