Session 1 - Lecture 0

Question 1

3 - Context – Why CPT?

Answer 1

• Number of drugs available to prescribe is increasing – can be good!
• 1.2 billion prescription items dispensed for last whole year of data - 2017 (population of ~ 55M)
• Almost all broad categories are increasing - more choice and number of prescriptions
• HT, HF and HL make up the greatest proportion of prescribed drugs
• Prescribing errors! Writing prescriptions, other clinicians prescribing, polypharmacy

{1. good bc means we’re better at targeting specific conditions but also means needs more working knowledge of drugs available!

2. ~30-40 prescriptions a day per doctor! including repeat or new - you need to make important decisions on whether appropriate and how it should be prescribed
3. Most prescribed drugs in CV disease category. hypertension, heart failure, hyperlipidaemia - Statins (greatest proportion of drugs) are a group of medicines that can help lower the level of low-density lipoprotein (LDL) cholesterol in the blood.
4. MDT aspect to writing scripts: lots of people involved. Polypharmacy - average UK senior citizen takes at least 7 or 8 meds at 1 time - so when you add/take away a drug need to think about other interactions}

Question 2

4 - Previous feedback and some changes

Answer 2

• Evidence - used to base decisions on px, explain why particular drugs are or are not used. Need to know this for making decisions when qualified.
• Digoxin - not first-line therapy anymore but still relevant - about 3,000,000 scripts a year (3000 scripts/month - so will need to consider it 3-4x/month per doctor)

Question 3

6 - Sessions

Answer 3

• Sessions will be grouped as themed, e.g. HT, HF and diuretics
• Polypharmacy - theme that will run throughout unit (consider disease state, multiple therapeutics being px).
• Anaesthetics - stand-alone intro for Phase 2 surgery placements
• Chemotherapy - stand-alone session but whatever field you go into you will encounter a chemo pt, so these drugs will be vital to know
• Clinical trials important in CPT, and EBM - consider clin trials, EBM, how to interpret guidelines - critique and make considerations about whether to use something or not.

Question 4

7 - Longitudinal themes

Answer 4

Longitudinal themes

• Review of relevant background and concepts
• Pharmacological Mechanisms of Action
• Pharmacokinetics and Pharmacodynamics
• Clinical Indications for Therapeutics
• Important and Common Adverse Drug Reactions (ADRs)
• Important Drug-Drug Interactions (DDIs)
• Drug Monitoring during Therapy
• Evidence Supporting Therapeutic Use - Clinical Trials

{Each lecture is own subject but within each lecture need to consider below

1. pathophysiology
2. links to PK
3. PK = how a body deals with a drug; PD = how the drug is acting on the body
4. where it’s appropriate to prescribe a drug, under what conditions/presentation
5. some more obvious than others.
6. polypharmacy - need good pt hx to ascertain
7. monitor for cytotoxicity, narrow therapeutic window; but also to actually monitor effect of the drugs – hope the drug is going to do what you hope it’s going to do e.g. reduce BP.
8. consider evidence base}

Question 5

7

Answer 5

7

Question 6

8

Answer 6

8

Question 7

9

Answer 7

9

Question 8

10

Answer 8

10

Question 9

11

Answer 9

11

Question 10

12

Answer 10

12

Question 11

13

Answer 11

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Question 12

14

Answer 12

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Question 13

15

Answer 13

15