Pharmacology and therapeutics

Question 1

Pharmacology definition

Answer 1

Study of drug action

Question 2

Clinical pharmacology definition

Answer 2

The application of pharmacological principles in patient care

Question 3

Therapeutics definition

Answer 3

The attempted remediation of a health problem, usually following a diagnosis (‘treatment’)

Question 4

BNF

Answer 4

British National Formulary

• all medication used in UK listed in alphabetical order
• at back has interactions: important to check if prescribing for px who takes other medicines
• sections ordered by drug classes

Question 5

Net Formulary

Answer 5

Shows recommended first-line, second line and restricted choices
Link to the relevant sections of BMF and selected local and national guidelines

Question 6

What can you prescribe as a dentist?

Answer 6

Antiseptics
Antibacterial Drugs
Antifungal Drugs
Antiviral Drugs
Artificial Saliva
Drugs for Oral Ulceration
Analgesics and pain management
Anxiety management (sedatives)
Vitamins
Fluorides
Antihistamines
Decongestants

Question 7

What can you prescribe from the BNF as a dentist?

Answer 7

You can prescribe anything as a dentist on a private basis
On the NHS, you can only prescribe from the Dental Practitioners Formulary (‘List of Dental Preparations’)
-except in hospital, where you can prescribe anything on the NHS

Question 8

Why would we be able to prescribe anti-epileptic drugs?

Answer 8

Trigeminal neuralgia

Question 9

Prescribing privately

Answer 9

You can prescribe anything, however, you may want to remember the GDC’s position:
“We would like to remind all dentists that it is a criminal offence to prescribe drugs other than to meet the identified needs of your patients.
You must make an appropriate assessment of your patient’s condition, prescribe within your experience and competence and keep accurate records of the treatment”

Question 10

When might you prescribe something privately?

Answer 10

Codeine if patient has pain that is not resolving after ibuprofen and paracetamol
Midazolam for intravenous sedation – done on FP10PCD form (“Private, Controlled Drug”)
Choice of antibiotic not within the DPF, and appropriate experience (e.g. if they are allergic to some)

Question 11

Classifying medicines

Answer 11

General Sales List (GSL) a.k.a. over the counter (OTC) – e.g. paracetamol
Pharmacy only medicine – e.g. co-codamol 8/500
Prescription only medicine – e.g. amoxicillin, co-codamol 30/500
Controlled Drug – Schedules 1, 2, 3, 4, 5

Question 12

Controlled drugs

Answer 12

Schedule 1-5

Question 13

Schedule 1

Answer 13

No medicinal use e.g. ecstasy, LSD

Question 14

Schedule 2

Answer 14

Subject to full controlled requirements, but have medicinal use

• e.g. cocaine (vasoconstrictor)
• e.g. heroin (diamorphine - given for MI)

Question 15

Schedule 3

Answer 15

subject to written requirements, but not safe custody requirements or keep registers – just invoices for 2 yrs
-e.g. midazolam, temazepam

Question 16

Schedule 4

Answer 16

Benzodiazepines other than midaz/ temaz and also Z-drugs (murdered writer!) - no CD requirements

Question 17

Schedule 5

Answer 17

Due to strength, are exempt from CD requirements e.g. Oramorph

Question 18

What should be on a prescription?

Answer 18

1. Px details
   - name, address, age DOB
2. What you are prescribing
   - drug
   - dose
   - form
   - route
   - frequency
   - duration
3. Signing
   - sign, date, name in capitals
4. Practice details
   - practice stamp - address
   * for private script, same info but include GDC number as pharmacy can trace it and confirm you are actively registered*

Question 19

Shorthand for routes and dosage

Answer 19

PRN - pro re nata (as required)
Stat - statim (immediately)
QDS - quater die sumendus (four times daily)
BD - bis in die (twice daily)
TDS - ter die sumendus (three times daily)
nocte (at night)
IV - intra venous
IM - intra muscular
PO - per oro (oral)
SC - sub-cutaneous
PR - per rectum
PV - per vagina
TOP - topical
M/W - mouthwash

Question 20

Adverse drug reactions

Answer 20

Must inform MHRA about serious suspected adverse reactions to all medicines marked with Black Triangle in BNF (Yellow card)
You should also:
1. Report all serious px incidents to National Reporting & Learning System if such incidents not automatically reported where you work
2. Inform px’s GP, pharmacy that supplied the medicine, local controlled drugs accountable officer and medicines manufacturer