Pharmacology Flashcards
What is complementary and 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
What types of CAM are growing in use?
Herbal products Massage Aromatherapy Yoga Nutraceuticals Meditation Acupressure
How does the NHS use CAM, and how do patients use it?
60% of Scottish GP practices use homeopathic or herbal preparations
- contain active ingredients in parts of the plants
- usually adulterated with things such as heavy metals, bacteria
Patients use to: have control over health, dissatisfied with current regime, not holistic, side effects of current Tm, safe, natural, chronic symptoms, relatives use
What is the quality and safety of CAM remedies?
No safety or efficacy data for herbal remedies
Possible drug herb interactions
Homeopathy = dilutions, therefore ADRs are rare
What is the efficacy of CAM remedies, how are they regulated and reported?
Herbal remedies have little evidence, there is a lack of data for efficacy
No convincing efficacy data for homeopathy
Acupuncture is good for pain compared to placebo, but no other use
Homeopathy registered under the Simplified Scheme 1992, or National Rules Scheme 2006
Herbals need traditional use license,
Osteopaths and chiropractors are now state registered and regulated
What is the WHO guide to good prescribing?
It is a practice manual where you learn how to choose the drugs you will prescribe regularly
What is the role of MHRA, SMC, NICE and formulary committees?
MHRA: post marketing surveillance, assess and authorise for sale in the UK, devices, quality control, internet sales and counterfeiting, regulates clinical trials, statutory controls, promotion of safe use, manage research
Scottish Medical Consortium eg SMC/NICE: make decisions on the cost effectiveness of new/existing products in respect of their use in Scotland
Formularies: local ownership of decisions
Who are the stakeholders in prescribing and what is the cost of drugs?
Health stakeholders include patients, clinicians, advocacy groups and policy makers
Price of drugs vary between localities and over time
What are the licensing regulations for medicines?
Medical and healthcare products regulatory agency (MHRA): ensures medicines meet acceptable standards on safety, quality, efficacy & that balance between safety and efficacy achieved
What are the legal categories of medicine?
Unlicensed
Off label
Specials
Prescription only
Over the counter
What are national and local formularies?
National formularies provide an independent source of advice eg BNF
Local formularies reflect the hospital/primary care’s choices
