the professional

Question 1

what is an ADR

Answer 1

a response to a medicinal product which is noxious and unintended

Question 2

who can get an ADR

Answer 2

anyone who takes a drug

Question 3

are ADRs common

Answer 3

yes
major cause of hospital admissions
affect quality of life
cost to the MHS in hinders of millions
many are preventable

Question 4

classifications of ADRs

Answer 4

rawlins and thompson
DoTS

Question 5

what is rawlins and thompson

Answer 5

type A - dose related
common predictable
pharmacology related
low mortality
digoxin toxicity
constipation from morphine

type B - not dose related
uncommon and unpredictable
not related to pharmacology
high mortality
penicillin hypersensitivity
malignant
hyperthermia

Question 6

ACE inhibitor induced angioedema

Answer 6

life threatening
rare

Question 7

rawlins and thompson types C,F,E and F

Answer 7

C= long term
D = delayed
E = end of use
F = failure if treatment

Question 8

what does DoTS stand for

Answer 8

Dose
Time
susceptibility

Question 9

What are some issues with adverse drug reactions?

Answer 9

not enough information from clinical trials

Increased polypharmacy and comorbidities

Numbers of patients admitted to hospital with ADRs is increasing

Question 10

what is meant by susceptibility in DoTS

Answer 10

genetic factors
Age
Sex
Physiology altered
Exogenous factors
Disease

Question 11

what is pharmacovigilance?

Answer 11

New drug clinical trial to license drug

Product as license with a number of known side effects

Black triangle assessed

Question 12

what are some disadvantages of pharmacovigilance?

Answer 12

New unknown side-effects

Can be difficult to link to the drug

Sharing of information can be slow

Lots of harm can occur

Question 13

Why should we report adverse drug reactions?

Answer 13

important for patient safety

Continuous monitoring of old and new drugs

Provide data in special patient groups

Question 14

What does the yellow card scheme collect reports of

Answer 14

suspect of problems or incidents involving side-effects/adverse drug reactions

medical device adverse incidents

Defence medicines

Counterfeit or fake medicines or medicinal devices

Question 15

how to complete a yellow card

Answer 15

Online
Paper back of BNF
app

Question 16

what do you report on a yellow card

Answer 16

serious reactions to established drugs
even if well recognised
report suspicion not proven casualty

Question 17

What is a serious reaction?

Answer 17

allergy reaction which results in or prolongs hospitalisation

Fatal
Life-threatening
Disable
Incapacitating
Cause congenital abnormalities
Medically significant

Question 18

What are black triangle drugs

Answer 18

they mean intensive monitoring

Contains a new active substance
Is a biological medicine
New indications
Has conditional approval
Company been asked for more data

Question 19

Do you report a black triangle drug?

Answer 19

Yes

Question 20

What should you do if you are unsure whether to report

Answer 20

You should report

Question 21

Who can report?

Answer 21

doctors
Dentists
Hospital pharmacist
Community pharmacist
Nurse
Midwife
Health visitors
Pilot patient scheme
patients
Pharmaceutical companies

Question 22

what is the aim of stockleys drug interactions

Answer 22

To provide concise accurate and clinically relevant information to healthcare professionals

Question 23

how do you deal with household returns?
Disposal of medicines

Answer 23

advise patience to return, unwonted medication for safe disposal

Reduces environmental risk

Question 24

what is the NWFD
Disposal of medicines

Answer 24

non-waste framework directive

There are some exemptions

One exemption in the law allows the temporary storage at a collection point, but the following conditions apply

Waste of different types should not be mixed
You can’t receive payment for collecting the waste
Can’t collect waste as your main business activity

This is an exemption

Question 25

What did the environmental protection act 1990, introduce as a duty of care

Disposal of medicines

Answer 25

applies to all persons involved
Import
Produce
Carry
Keep
treat
Dispose of controlled waste

Ensures Transferred to authorised personnel
ensures records and audits
Make sure it is stored correctly
Make sure it’s a segregated/separated/not mixed

Question 26

what does the hazardous waste regulations 2005 State?

Disposal of medicines

Answer 26

keep hazardous, waste and nonhazardous waste, separate

Cytotoxic and cytostatic waste, separate

Question 27

tell me about emergency supply at the request of the prescriber

Answer 27

Emergency Supply - at the request of prescriber
• Relevant prescriber
GP, Dentist, NIP, PIP, Optometrist IP
• Emergency
- Genuine reason why a prescription cannot be provided immediately
• Prescription within 72 hours
• Directions
- In accordance with direction from prescriber
• Controlled drugs
Exemptions - Phenobarbitol for epilepsy
• Records
Must make record in POM register on day of supply or next day
ー
3 x Dates, 2 N+A, , details of medications supplied
• Labelling
Usual requirements

Question 28

tell me about emergency supply at the request of the patient

Answer 28

Emergency Supply - request of patient
• Interview
- HMR regulation v RPS
- Professional judgement - carers/children
- Immediate need?
• Previous treatment and dose
• Controlled drugs
- Exemptions as previous
• Length of treatment
- If CD: Maximum 5 days
- If POM: Maximum 30 days
- 1 OP - insulin/creams/inhalers/contraception
• Records
- 1 x Date, 1 x N+A, details of medications supplied, Reason