Taking A Drug History

Question 1

Why do we have drug regulation?

Answer 1

To prevent public advertisement and promotion of ineffective drugs.

Question 2

What are the ways drugs can be obtained? Legally

Answer 2

From a shop
Pharmacy
Prescription

Question 3

What is the medical act 1968

Answer 3

A statutory framework for the manufacture, import, export, supply and control of medicines.

Question 4

Wha are the classifications of medicinal products?

Shop, pharmacy and prescription

Answer 4

Shop = general sales medicine (GSM)
Pharmacy = pharmacy medicines 
Prescription = prescription only medicines (POM)

Question 5

What is general sales medicines?

Answer 5

For common short lived and easily recognised ailments.
Can cause few side effects in normal use
Small does are given to reduce chances of harm from inappropriate use.
Examples: paracetamol and antihistamines

Question 6

What are pharmacy medicines?

Answer 6

For common short lived easily recognised ailments
Used more carefully than GSMs
Pharmacy staff discuss with patients to clarify
Chosen medicine is appropriate
It will be used correctly
Whether they need to see another health professional
Example; emergency contraceptive, codeine

Question 7

What are prescription only medicines?

Answer 7

Drugs where:
Direct or indirect danger exists to human health
Frequently incorrect use can lead to danger of human health
Product is usually prescribed for parenteral administration (injection)
For example insulin, morphine and antibiotics

Question 8

How can drugs cause harm?

Answer 8

Adverse drug reaction (ADR)

Adverse drug event (ADE)

Question 9

What is antiangiogenesis

Answer 9

It stops the development of new blood vessels which stops embryos developing normally

Question 10

What is an adverse drug reaction?

Answer 10

Any reaction that is ‘noxious, unintended and occurs at doses normally used in man’.
There is a reasonable probability that it is caused by a drug.
Negative side effects

Question 11

What is an adverse drug event?

Answer 11

Any medical occurrence I. Someone when a drug doesn’t have a causal relationship with the treatment.

Question 12

What is an allergy?

Answer 12

A type of adverse drug reaction
It is triggered by an interaction between the drug and host protein -generating a ‘happen’ which drives an immune response

Question 13

How can an adverse drug reaction be counteracted?

Answer 13

By dose reduction or stopping the drug.

Question 14

What are the four steps in taking a drug history?

Answer 14

What
Why
How
Harm

Question 15

What are the potential challenges to taking drugs, adverse effects and its solution?

Answer 15

Allergy and side effects
The solutions are to avoid a drug if there is an allergy.
Weigh up the benefits and harm for side effects.

Question 16

What are the potential challenges to taking drugs, drug interactions and its solution?

Answer 16

Amlodipine increases the blood level of simvastatin increasing risk of side effects.
Solution = competent prescribing and checking prescriptions.
Medical reviews

Question 17

What are the potential challenges to taking drugs, physical impairment and solution?

Answer 17

Problems with swelling, dexterity and getting to pharmacy

Solution = changing formulation, using aids to make administration easier

Question 18

What are the potential challenges to taking drugs, memory impairment and solution?

Answer 18

Forge to take medicines, accidental overdose, forgetting to take prescription.
Solution = dosette boxes, alarms, help from someone
Simplifying medications

Question 19

What are the potential challenges to taking drugs, discordant beliefs

Answer 19

Differences in beliefs or treatment priorities between prescriber and patient
Solution = exploring beliefs and priorities, shared decision making

Question 20

Drug history What:

Answer 20

What is the name of the medication
Dose = strength and frequency
Route of drug
Any recent changes

Question 21

Drug history, why

Answer 21

Do they know what the medications are for?
Treat a disease
Prevent a disease from occurring
Symptom relief
Treat the effects of another medication (prescribing cascade)

Question 22

Drug history, how

Answer 22

How does the patient take them?

Are there any adherence issues?

Question 23

Drug history, harm

Answer 23

Have they ever had a bad reaction to a medication

If so what was the reaction