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Drugs In Healthcare > Quick > Flashcards

Quick Flashcards

1
Q

Medicines act 1968

A

Provided a statutory framework for the manufacture,import,export,supply and control of medicines
Categorises medicines and specified restrictions on each category

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2
Q

Define ADR

A

Any reaction that is noxious, unintended and occurs at doses normally used

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3
Q

Define ADE

A

Any untoward medical occurrence in someone administered a drug which doesn’t necessarily have a casual relationship with thus treatment

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4
Q

Sensitisation define

A

A mild allergic reaction could be much more severe next time

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5
Q

Benefits of prescribing

A

Treatment of disease
Symptoms control
Reduce risk of future disease

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6
Q

Prescribing risks

A

Allergy
ADR
Poor adherence

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7
Q

Taking drug is history: what

A

Name of medication
Dose
Route
Any recent changes
NB: OTC/herbal remedies/recreational drugs/contraceptives

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8
Q

Taking drug is history: why

A

Do they know what the medication is for?

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9
Q

Taking drug is history: how

A

How does the patient take them?
Any adherence issues (do they forget? Refuse to take)

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10
Q

Taking drug is history:harm

A

Have they ever had a bade reaction to it?

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11
Q

Solution for drug interacts

A

Competent prescribing and checking prescriptions
Medication reviews

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12
Q

Solution for physical impairment?

A

Change formulation
Use of aids to make administration easier

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13
Q

Solution for memory impairment

A

Dosette boxes, alarms, help from family/careers
Simplifying medications

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14
Q

Solution for discordant beliefs/priorities

A

Exploring beliefs and prorities
Shared decision making

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15
Q

Solution for Adverse effect

A

Avoid if allergy
Weigh up benefits and harms for side effect

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16
Q

Define symptom:

A

A feeling which is depature from the normal state or function

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17
Q

Disease define:

A

A disorder of structure or function that usually produces specific symptoms

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18
Q

Primary prophylaxis

A

Preventing a diseased/event that hasn’t occurred yet
E.g contraceptive pill/meningitis vaccine

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19
Q

Secondary prophylaxis

A

Preventing the recurrence of a disease/event that has already occurred
E.g taking statin after a heart attack

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20
Q

Prescribing cascade define:

A

Process whereby the side effects of drugs are treated by other drugs

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21
Q

Diagnostic purpose

A

Drugs that are used to determine the cause of a disease/symptoms

22
Q

Recreational drugs

A

Drugs used for lifestyle factors
To feel a certain
Performance enhancement
To loose weight/ change appearance

23
Q

Principles of prescribing

A

Effectiveness, safety , accessibility ,cost

24
Q

Efficacy

A

Capacity of a drug to produce an effect

25
Q

Effectiveness refers to

A

How well a drug work in the real world

26
Q

Considerations for effectiveness

A

Does this proble require a drug
Is this the right drug : for the patient? / for the problem?

27
Q

Safety net

A

Advise patients to inform health professional if they experience specific symptoms

28
Q

Adherence refers to

A

Taking a drug as agreed

29
Q

Acceptability refers to?

A

How well the patient can tolerate taking a medicine

30
Q

Measuring bp

A

Seated, chair with aback feet on floor
Rest for at least 5 mins
Arm supported at level of heart
Ensure no tight clothing = constricts arm
Place cuff on 2cm above brachial artery
Bladder should be appropriately sized
Repeat 3 times

31
Q

3 places where bp measure

A

Office- in clinical setting
Home- bp monitor at home
Ambulatory- portable/ambulatory device used to take bp readings throughout the day

32
Q

Postural hypotension

A

Systolic bp fall > 20 mmHG after 1/3 minds

33
Q

Secondary causes of hypertension

A

Renal disease
Endocrine disease
Drugs-NSAIDs/oestrogen/corticosteroids
Obstructive sleep apnoea
Pregnancy induced hypertension

34
Q

Ramipril

A

ACE inihibitor

35
Q

Losartan

A

Angiotensin receptor blocker

36
Q

Amlodipine , verapamil

A

Calcium channel blocker

37
Q

Atenolol

A

Beta blocker

38
Q

Renin produced in kidney in response to?

A

Decreased GFR ETC

39
Q

ANGIOTENSIN 2 has multiple effects to?

A

Increase in blood pressure

40
Q

How can burden of CVDs be reduced?

A

Public health (everyone)
Primary prevention (those at high risk)
Secondary prevention (those who already have CVD)

41
Q

Why is CVD a development issue in low -middle income countries?

A

Lack of integrated primary health care programmes for early detection and treatment
Less access to effective and equitable health care services
Poorest people affected most

42
Q

Which body does Apex Pharmaceuticals need to apply to for a license to market the new drug in the UK?

A

MHRA
The correct answer is Medicines & Healthcare products Regulatory Agency (MHRA), which reviews evidence to say whether a drug CAN legally be used in the UK. NICE reviews evidence and produces guidelines to advise whether a treatment SHOULD be used.

43
Q

His blood pressure in clinic while sitting was uncontrolled, at 154/97 mmHg.
Investigations have revealed that he has severe renal disease.

Which of the following best describes his classification of hypertension?

A

This is secondary hypertension, where there is raised blood pressure due to another disease. This is not resistant hypertension (raised blood pressure despite taking 3 blood pressure lowering medications), postural hypotension (significant drop in blood pressure on standing) or white-coat hypertension (raised blood pressure in a clinical setting, but low when at home). The UK guidance currently does not use the phrase “borderline” hypertension.

44
Q

LEFT VS RIGHT SIDED HEART FAILURE

A

e correct answer is Breathlessness. Breathlessness in this case is caused by excess fluid in the lungs from back pressure from the left side of the heart, which is not able to pump blood effectively around the systemic circulation. This can cause pulmonary oedema and pleural effusions. Leg swelling (peripheral oedema) would point more towards right sided heart failure. This is due to back pressure from the right side of the heart, which is not able to pump blood effectively into the lungs. Chest pain, palpitations and dizziness can have many causes and do not help distinguish between left and right sided heart failure.

45
Q

. She has been diagnosed with ischemic heart disease and the pain she experiences is angina.

She has been prescribed glyceryl trinitrate spray and told to take a low dose of aspirin a day.

What is the reason for the aspirin?

A

Aspirin reduces platelet aggregation so reduces the likelihood of clot occurrence. Whilst aspirin does not reduce the demand vs supply imbalance seen with IHD it does reduce a factor that can make the situation worse ie clot occurrence in coronary bed that is already compromised.

46
Q

TRYING TO DECIDE The best drug to use to treat a rare but serious skin condition.

Which of the following sources would provide the most robust advice to help make their decision?

A

The correct answer is National guidelines.

National guidelines assimilate information from all available reputable sources into one document. Unlike systematic reviews, they also take into account the availability and costs of drugs in the country. Randomised controlled trials only take into account data from that particular trial, which may only be relevant in particular populations or settings. The BNF provides prescribing info but not advise on what drug to select

47
Q

Which type of documentation will communicate to the GP any changes to Mrs Adeyeye’s medication?

A

he TTO is prescribed by hospital doctors to clearly document to the GP what has happened to a patient’s medications whilst they were in hospital. Doctors in hospital prescribe on an inpatient drug chart. Doctors in the community (e.g. a GP) prescribe on FP10s. A medical clerking is where doctors in hospital ask about the drug history but is not a prescription or communicated to the GP. A clinic letter may document what drugs a patient is taking but is used in the outpatient setting

48
Q

Which of the following medications is associated with an increased risk of type 2 diabetes mellitus?

A

Corticosteroids are associated with an increased risk fo Type II diabetes. The other medications are not assocaiated with type II diabetes. SGLT2 inhibitors are used to treat Type II diabetes mellitus.

49
Q

A 63-year old woman is newly diagnosed with hypertension. She is asymptomatic and has no other medical conditions. She describes herself as of Carribean family origin.

Based on NICE/BIHS guidance, which of the following classes of antihypertensives is most appropriate first-line treatment?

A

he first line management of hypertension for a patient who is 55 years old or older, OR a person of African or Carribean family origin, is calcium channel blockers. ACE inhibitors would be appropriate for people aged 55 or under, or Type II diabetics. Beta-blockers, diuretics and spironolactone are not typically first-line treatment, unless there are other conditions that provides a compelling additional reason.

50
Q

Which of the following drug classes would be most effective to reduce preload?

A

The correct answer is Loop diuretic (e.g. furosemide). Loop diuretics (and aldosterone antagonists, not mentioned above) act within the nephron to increase diuresis and reduce blood volume, thus reducing preload. Calcium channel blockers (and other antihypertensives) reduce afterload by lowering blood pressure. Beta blockers and digoxin are used to control heart rate and rhythm. Statins are important in heart failure caused by ischaemic heart disease but have no effect on prel

Drugs In Healthcare (12 decks)

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