PHRM MCQ Flashcards
1
Q
What is an antibacterial?
A
A substance that destroys bacteria or suppresses bacterial growth or reproduction
2
Q
What is a microbial?
A
Substances that destroy microorganisms and suppress microbial growth or reproduction
3
Q
What is the difference between an antimicrobial and an antibiotic?
A
Antibiotics are produced naturally (e.g. from mould). Antimicrobials may be produced from synthetic or biological material
4
Q
What is antimicrobial resistance? (AMR)
A
AMR is a microorganisms ability to grow and reproduce or to survive exposure to an antimicrobial.
5
Q
When does AMR occur?
A
It occurs when an antimicrobial that was previously effective is no longer effective. AMR is exaberated by human factors e.g. too much antimicrobial use.
6
Q
What is antimicrobial stewardship?
A
A systematic approach to optimising antimicrobial therapy.
7
Q
What are bacteria?
A
One of the major groups of microoraganisms, some of which can infect and cause disease in humans and animals.
8
Q
What are Critically Important Antimicrobials?
A
Last resort antimicrobials for human infection
9
Q
What is empiric treatment?
A
Treatment given without confirmation of the cause of disease and based on clinical judgement.
10
Q
What are microorganisms or microbes?
A
Microscopic living organisms e.g. bacteria, viruses, protozoa, parasites, some fungi.
11
Q
What is One Health?
A
A concept that recognises that the health of people is connected to the health of animals
12
Q
What is susceptibility testing?
A
Used to determine if a microorganism is susceptible or not to a selection of antimicrobial agents
13
Q
Abbreviation: AHI
A
Animal Health Ireland
14
Q
Abbreviation: AMS
A
Antimicrobial stewardship
15
Q
Abbreviation: AMR
A
Antimicrobial resistance
16
Q
Abbreviation: AMU
A
Antimicrobial use
17
Q
Abbreviation: BSI
A
Bloodstream infection
18
Q
Abbreviation: CIDR
A
Computerised infectious disease reporting
19
Q
Abbreviation: DDD
A
Defined daily dose
20
Q
Abbreviation: DoH
A
Dept. of health
21
Q
Abbreviation: EARS-Net
A
European antimicrobial resistance surveillance network
22
Q
Abbreviation: FAO
A
Food and agriculture organisation
23
Q
Abbreviation: HCAI
A
Healthcare assocaited infection
24
Q
Abbreviation: HPRA
A
Health products regulatory authority
25
Abbreviation: ID
Infectious disease
26
Abbreviation: MDR
Multi drug resistance
27
Abbreviation: MDRO
Multi drug resistance organism
28
Abbreviation: OIE
World organisation for animal health
29
Abbreviation: PVP
Private veterinary practitioner
30
Abbreviation: RVL
Regional veterinary laboratory
31
Is penicillin more commonly used in humans or animals?
Humans
32
What is the most common causative pathogen of BSI in humans?
E.coli
33
Name two types of zoonotic bacteria
Salmonella
| Campylobacter
34
Abbreviation: iNAP
Ireland's National Action Plan
35
Where does Ireland rank in terms of antimicrobial use in animals?
17th / 30 (2016)
36
How long have antimicrobials been in use for animals?
since 1950s
37
Why is AMU in animals of concern to humans?
Passed on through consumption of products, contact with treated animals, the environment. This can affect effective treatment of infections in humans.
38
What is the role of the HPRA?
Approve veterinary drugs. Gather information nationally on the consumption of veterinary antimicrobial drugs
39
Where does Salmonella live?
In the GI tract of domestic and wild animals
40
How is Salmonella transmitted?
Direct contact with infected animals or humans, contact with faecally contaminated environments, ingestion of faecally contaminated food or beverages.
41
Are E.coli normally found in the body?
Yes, in the gut flora of healthy animals
42
What are Carbapenems?
Antimicrobials licensed exclusively for humans
43
Are tetracyclines more commonly used in humans or animals?
Animals
44
What drug classes are used in veterinary?
Usually older drug classes compared with human medicine. 88% are from classes such as penicillins and tetracyclines.
45
List 7 risk factors for the development of AMR
Too low dosage, too short duration, too long duration, too often, blanket measure in an untargeted manner, treatment of bacteria that are not susceptible to antibiotics, treatment of diseases caused by viruses or other germs not susceptible to antibiotics.
46
Abbreviation: EMA
European Medicines Agency
47
Who publishes advice regarding antibiotics?
HPRA
48
What does the European Surveillance of Veterinary Antimicrobial Consumption (ESVAC) do?
Gathers information on the consumption of antimicrobial drugs for veterinary use anually
49
Explain AMR
Once bacteria becomes resistant, antimicrobials are no longer effective, meaning they can no longer help to control or treat diseases.
50
Why should we prevent AMR?
To ensure the efficacy of antimicrobials is preserved.
51
Abbreviation: MRL
Maximum residue limit
52
What is a residue?
The small amount of agricultural and veterinary chemicals, or their breakdown products, that remain in or on an agricultural product. Can be described as a contaminant if it causes health, safety, or cleanliness concerns.
53
Give some examples of residues
Antibiotics, anthelmintics, fungicides, fumigants, hormonal growth promotants
54
What are antibiotics?
Medicines that have anti-bacterial properties
55
When might AMR be suspected?
When an AM appears to have failed to work
56
When should a vet report a lack of efficacy and who to?
When an AM appears to have failed. Report to HPRA or to company responsible for marketing the product.
57
What factors will a vet assess before prescribing AM to dairy cows? (6)
previous culture results and antibiotic responses on the farm
claimed cure rate of product for existing infections, claimed period of protection for new infections
required minimum dry period milk withdrawl periods
option of using a combination of tea sealer and antibiotic dry cow treatment.
58
When can a product be used off-label?
By veterinarians only in specific circumstances
59
What should farmers be aware of when using AM in dairy cows?
Cow must be clearly marked so milk is not used for human consumption, adhere to withdrawl periods, may interact with other drugs e.g. steroids which can affect withdrawl period, some have a long withdrawl period (gentamicin = 214 days for meat), can transfer AMR to calves, dispose of in slurry tank!
60
Why must sheep dips be diluted?
They are concentrated chemicals that are hazardous to farmers.
61
What is the only authorised way to administer a sheep dip in Ireland?
Plunge dipping baths
62
Why should sheep baths be calibrated?
To ensure operator uses correct quantity of dip concentrate
63
How can a farmer protect themselves when using sheep dip?
Proper planning
good dipping facility design
PPE e.g. rubber gloves, wellington boots, apron, waterproof trousers or leggings, face shield.
64
Why is there a limit of veterinary medicines in Ireland?
Small market size
65
List 5 aims of the European Commisions proposal to regulate veterinary medicines
```
Increase availability
reduce administrative burden
stimulate competetiveness and innovation
improve function of internal market
address AMR
```
66
How does the HPRA improve veterinary medicine availability
Enable companies to have common packaging
Medicines with limited but important use and no alternative are termed service items- a fee category at a fraction of the cost
67
What is the temperature requirement for heat-sensitive medicines e.g. vaccines
2-8 degrees celcius
68
Why is proper storage important
stability can be affected by adverse storage conditions which may impair product quality, safety or efficacy.
69
What should you do when you receive a heat-sensitive medicine?
Verify conditions have been met by supplier.
| Put in fridge.
70
How to monitor heat-sensitive medicine?
Identify hot/cold spots in fridge
No contact with water, moisture or ice
Back up plan if fridge fails
Monitor temperature with logger
71
Why has worm resistance developed in sheep?
Worming sheep year on year with wormers that contain chemicals of the same chemical class. Out of date system. Practice of treating all sheep in a farm at the same time with the same wormer.
72
3 signs of worm resistance in sheep
Live weight gain is failing year on year, individual animals failing to thrive despite nutrition and no disease, animals scour even with treatment
73
Explain worm resistance
Once worms are killed in the sheep, they can no longer shed eggs. This means coast is clear for eggs from resistant worms to take over. The resistant worms lay eggs that contain the genes coding for resistance to the class of wormer being used.
74
List 4 ways to prevent worm resistance
Targeted treatment
Biosecurity measures (eg quarantine)
Monitoring health and production of flock
Managing pasture
75
How does the HPRA help in choosing an appropriate wormer?
Labelling chemical class. There are 5 chemical groups.
76
Abbreviation: SCOPS
Sustainable control of parasites in sheep
77
List ways to prevent worm resistance
```
Only treat affected animals.
Use appropriate chemical class.
Weigh animals to ensure correct dose.
Rotate chemical classes.
Monitor productivity of flock.
```
78
What is effective protocol for introducing new sheep?
Worm them and leave them to stand for 24 hours in a concrete stall. Use a newer-class wormer.
79
Abbreviation: o.d.
once daily
80
Abbreviation: s.i.d.
once daily
81
Abbreviation: b.d. or b.i.d
twice daily
82
Abbreviation: t.i.d.
three times daily
83
Abbreviation: t.d.s.
three times daily
84
Abbreviation: q.i.d
four times daily
85
Abbreviation: e.o.d.
every other day
86
Abbreviation: q12h
every 12 hours
87
Abbreviation: cap.
capsule
88
Abbreviation: susp.
suspension
89
Abbreviation: tab.
tablet
90
Abbreviation: ng
nanograms
91
Abbreviation: µg
micrograms
92
Which is larger, a nanogram or a microgram?
Nanogram
93
When can a repeat prescription be given out?
When the prescription specifically states that it is acceptable
94
What is an acceptable time between consultations on an animal's records for repeat prescriptions?
About 3 months, but varies!
95
Abbreviation: MA
marketing authority
96
What must all authorised products display?
A VM or EU code
97
Abbreviation: VMP
Veterinary Medicinal Products
98
What are the 6 categories of authorised veterinary medicines?
```
VPO-1 : veterinary practioner only
Prescription only: POM
Prescription only exempt: POM(E)
Pharmacy only: PS
Licensed merchant: LS
Companion animal medicines: CAM
```
99
Who can dispense a VPO?
can only be sold or supplied by a vet
100
Who can dispense POM?
A pharmacist
101
Who can dispense POM(E)?
May be sold by a pharmacy but sale must be personally made by a pharmacist
102
Who can dispense PS?
Pharmacy only
103
Who can dispense LM?
From a pharmacy, without prescription, under supervision of a pharmacist. Also available from places like co-ops.
104
Who can dispense CAM?
Pharmacies under supervision of pharmacist, pet shops
105
What is the cascade system?
Prescription of human drugs for animals where there is no alternative
106
What is a Schedule 1 drug?
Little or no therapeutic value, e.g. cannabis
107
What is a Schedule 2 drug?
Much therapeutic value but highly addictive e.g. fentanyl
108
What is a Schedule 3 drug?
records required eg. ketamine
109
What is a Schedule 4 drug?
-pam or -lam drugs e.g. diazepam
110
What is a Schedule 4 part 2 drug?
anti-epileptics e.g. phenobarbitone
111
What is a Schedule 5 drug?
low strength preparations e.g. paracetamol. No CD requirements except keep invoice 2 years.
112
What schedule is Ketamine?
Schedule 3 in Ireland, 2 in Northern ireland
113
What schedule is buprenorphine?
2 in ireland, 3 in UK
114
What must be included in the controlled drugs register?
Details regarding dispensing and purchasing
115
What drug is commonly dispensed to cats to administer at home?
Transmucosal buprenorphine
116
What is a side effect?
An expected but unwanted effect of normal drug therapy
117
What is an adverse reaction?
And undesired occurrence that results from taking medication correctly.
118
What is pharmacovigilance?
A monitoring system based on reports of suspected adverse reactions
