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Pharmacy - Year 1 > The Public - Sem1 > Flashcards

The Public - Sem1 Flashcards

1
Q

Describe the relationship between infectious disease and public health

A
  • Control of microbes and understanding of infection is required to uphold public health
  • Spread of infection has a negative effect on public health
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2
Q

What is the role of the pharmacist in managing public health?

A
  • Understand the cause of the disease
  • Manage spread of disease: treatment of those infected and educating on preventing transmission
  • Work with other clinicians to find best course of treatment
  • Educate public on symptom recognition and management
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3
Q

Describe the role of the community pharmacist

A
  • Promotion of public health and pharmaceutical services
  • Dispensing prescriptions
  • Medicines disposal
  • Encourage self care
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4
Q

What are the advanced pharmaceutical services?

A
  • MEDICINES USE REVIEW: Discussing treatment with patients, especially for those with long-term conditions
  • NEW MEDICINES SERVICE: Working with patients for new medicines, important to improve adherence
  • APPLIANCE USE REVIEW: Improving the way an appliance in used by a patient
  • STOMA APPLIANCE CUSTOMISATION: Customisation of a stoma device to increase comfort for the patient
  • FLU VACCINATION: Seasonal, given to those at a higher risk
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5
Q

What are the local pharmaceutical services and what do they depend on?

A
  • Depend on population needs
  • Stop smoking
  • Substance misuse
  • Minor ailments
  • Emergency hormonal contraception
  • Chlamydia screening
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6
Q

What is the national agenda for pharmacists in GP practices?

A
  • 470 pharmacists in 700 GP practices, carried out over 3 years
  • Scheme = £31million
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7
Q

Describe the role of a GP pharmacist

A
  • Prescription requests and medication queries/reviews
  • Routine blood tests and patient clinics
  • Reduce medication wastage
  • Manage long-term conditions
  • Train pharmacy mentees
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8
Q

What are the outcomes of public health from pharmacists working in GPs?

A
  • Better access to healthcare
  • Pick up excess from GPs and nurses, from budget cuts
  • Ensure effective use of medication
  • Become a first point of patient care
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9
Q

What are the entry levels of GP pharmacists?

A
  • Pre-reg, senior staff have a support/mentoring role
  • Junior pharmacist, senior staff support and mentor but juniors also support and mentor pre-reg. REFLECT on learning through this role
  • Senior pharmacists, support those below them while reflecting on their now understanding of pharmacy
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10
Q

Describe the career pathway for GP pharmacists

A
  • Progression from pre-reg to senior pharmacist

- Learning through mentoring others

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11
Q

Describe the direction of GPs and pharmacists

A
  • Promote care through pharmacist - primary/secondary care

- Established career pathway, new roles for pharmacists

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12
Q

Describe the role of industrial pharmacists

A
  • Drug development - discovery, design and research
  • Manufacture for clinical trials, more pharmaceutical development depending on response
  • Patenting, sales and marketing of drugs
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13
Q

Give an overview of the stages of drug development

A
  • Understand the chemical properties of the drug and the importance to its design
  • Design of formulation(s) and dose
  • Understand how the chemical properties of the drug affect its absorption, solubility, metabolism,
  • Understand how the rate/extent of absorption is affected by the dose and formulation
  • Develop and manufacture the drug
  • Create patent for the drug
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14
Q

Describe the role of a hospital pharmacist

A
  • Ward-based role
  • Working in the dispensary, preparing prescriptions for in- and outpatients
  • Extemporaneous preparation of medicines in a sterile setting
  • Providing information on medicines
  • Managing medicines for patients/clinicians
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15
Q

Describe the role of an academic pharmacist

A
  • TEACHING YOUNGER PHARMACISTS
  • Involved in setting/marking assignments and exams
  • Scholarship - Sharing of knowledge and practice and conferences
  • Social - Media, events, school visits, expressing the importance of pharmacy in public health
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16
Q

Outline the evolution of clinical pharmacy

A
  • Traditional pharmacy activities (e.g. dispensing)
  • Ward/clinical roles
  • Increased role of pharmacists in hospitals
  • Prescribing
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17
Q

What are the pay grades for a hospital pharmacist?

A
  • Newly qualified (Band 6) = £26, 041 - £34, 876
  • Further study and training (Band 7) = £31, 072 - £40, 964
  • Senior pharmacist (Band 8A-8D) = £39, 632 - £81, 618
  • Senior pharmaceutical manager (Band 9) = £77, 850 - £98, 453
  • Salary varies depending on skills, training and knowledge, as well as between NHS and private
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18
Q

How do hospital and community pharmacists work together for patient care?

A
  • Hospital pass on treatment plan to community after discharge
  • Discuss information to improve compliance (MUR and NMS)
  • Share info on patients with misuse history
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19
Q

Identify the contribution of hospital/academic pharmacists to public health

A
  • Integration of pharmacy into healthcare - increase public awareness of pharmaceutical services
  • Uphold standards of patient care
  • Comprehensive disease management (public education etc)
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20
Q

What is the meaning of public health medicine? Identify its domains

A

PHM - Improving population health

  • Health Improvement: Through monitoring public health and educating the population
  • Improving Services: Planning new services based on evaluations of existing ones and their efficacy
  • Health Protection: Protect from infection (prophylactic use of medication/education of reducing transmission)
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21
Q

What are the limitations to public health education?

A
  • Action depends on the individual and their circumstances
  • Some may be adverse/unable to change
  • No effect on poverty
  • Not very effective
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22
Q

Describe health promotion

A
  • Combination of education and environmental/legislative change
  • Makes healthier choices easier
  • More effective than health education
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23
Q

How can pharmacists improve public health?

A
  • Monitor prescribing data and identify inequalities
  • Develop policies and practices for health education
  • Improve services through regular evaluation
  • Health protection practices: monitoring bacterial resistance and managing epidemics
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24
Q

Describe the role of the World Health Organisation in health promotion

A
  • Worldwide guidance/standards for health and healthcare
  • Working with governments to improve healthcare programmes
  • Development and sharing of health technology and information
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25
Q

What are the 4 key commitments for the Bangkok Charter for Health Promotion?

A

Health Promotion should be…

1) A central part of the global development agenda
2) A core responsibility for all governments
3) A key focus of all communities
4) A requirement for good corporate practise

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26
Q

Define compliance, adherence and concordance

A
  • Compliance and Adherence: Following a clinical prescription as directed by a clinician
  • Concordance: Working with health professionals to decide a course of treatment (patient’s needs taken into account)
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27
Q

How can compliance and adherence be measured?

A
  • Direct: Measure drug concentration in the body, keep patients under observation during treatment
  • Indirect: Tablet counts and dispensing records, electronic monitors, ask patient
28
Q

What are the types of non-adherence?

A
  • Intentional: Drug misuse/deliberately not taking for some reason
  • Unintentional: Overdose/underdose due to poor understanding of treatment plan or poor fit to patient’s life
29
Q

What percentage adherence should be achieved to ensure efficacy of the treatment plan?

A

More than 80% adherence

30
Q

How can adherence be improved?

A
  • Simplify dose regimens: Lower frequency can make it easier for patients and prevent forgetfulness/effort to maintain treatment
  • Alter formulation: May be able to combine medicines to prevent the amount taken/may make it easier for the patient to take
  • Monitored dosage systems: Prevent over-/underdosing and forgetfulness
31
Q

What can affect adherence?

A
  • Disease: Long-term diseases may lower adherence due to the long duration of treatment and possible increase in the number of medications
  • Patients lifestyle: Treatment plan should fit into their lifestyle as well as possible
32
Q

How can concordance be measured?

A
  • Patient’s happiness regarding plan established together, ask about understanding of treatment plan (positives and negatives) and explain more if required
33
Q

What is self care?

A
  • Healthcare done by the patient themselves to maintain health and prevent illness
34
Q

Why should self care be encouraged?

A
  • Reduce resource wastage for minor treatments that do not require clinical attention
  • Coping mechanism for a growing population
  • Best mechanism for those with long-term conditions, they know best how the condition affects them and how to prevent this
35
Q

What are the benefits of self care? (Patient)

A
  • Better health and wellbeing
  • Reduce severity of symptoms and disruption (e.g. from numerous hospital trips)
  • Increased control, confidence and mental health
36
Q

What are the benefits of self care? (Healthcare systems)

A
  • Reduced need for emergency services
  • Less wasted resources/unnecessary admissions
  • Decrease GP visits by up to 40% and outpatient visits by up to 17%
  • Decrease in A&E admissions by up to 50%
  • Less use of medicines
37
Q

What patients group would self care benefit the most?

A
  • 60-80% of women
  • Parents of young children
  • Full time workers
  • Elderly patients
38
Q

Describe the role of the pharmacist in self care

A
  • Decrease the amount of unnecessary GP appointments
  • Treat minor ailments/give advice on treatment
  • More convenient for quick visits
  • Provide information on self care and make referrals where needed
  • Provide information on medicines (e.g. suggesting non-proprietary version may reduce cost for patient)
39
Q

What is the expert patients programme?

A
  • Help for those managing long-term conditions
  • Encourages patients to work with clinicians
  • Run courses to teach patients self management
40
Q

What is self medication?

A
  • Selection and use of medications by the patient to treat a self-identified condition/manage the symptoms
  • Can be used for prevention or treatment
41
Q

What influences self medication?

A
  • Less absence due to sickness
  • Increased number of medicines from POM to P
  • Better medicine availability
  • May be better financially
  • Communication regarding medicines
  • Alternative treatments (e.g. home remedies)
42
Q

What are the qualities of a profession?

A
  • Specialised knowledge and skill applied to their work
  • No self interest in their actions
  • Objective and non-judgemental
  • Adhere to guidelines for the profession
43
Q

What are the benefits of being a professional?

A
  • Status and higher social class
  • Intellectually challenged
  • Intellectual interests
  • Job security
44
Q

What is professional socialisation?

A
  • Selection, training, recruitment and regulation of a profession
  • In regards to those hired
45
Q

How did medical, nursing and pharmacy professions develop into their current status?

A
  • Regulations set

- Monopolies created - Single aim for each profession

46
Q

Why is Pharmacy considered a profession?

A
  • Specialised knowledge of drug use/pharmaceutical science
  • Can prescribe
  • Need to be present for sale of POMs
  • Regulatory bodies (GPhC and Fitness to Practise)
  • Advice and health promotion given
47
Q

Why isn’t Pharmacy considered a profession?

A
  • Less skills needed for dispensing
  • Medicines not always sold in pharmacies
  • May be instructed by other clinicians
  • Not exempt from self interest (sale of medicines in community)
48
Q

How will current initiative affect the professional status of pharmacy?

A
  • Increased professional status
  • Reduce number of medicines sold OTC
  • Training undertaken to prescribe
49
Q

What qualities are required of pharmacy students? (Patient)

A
  • Ability to communicate
  • Ability to show empathy and compassion
  • Accept patient diversity and always remain confidential
  • Adhere to code of ethics
50
Q

What qualities are required of pharmacy students? (Pharmacist)

A
  • Be aware of personal limitations and learn from/fix mistakes
  • Continue to develop knowledge as medicine develops
  • Teamwork
  • Maintaining a professional appearance
51
Q

How has the role of the community pharmacist in health promotion developed?

A
  • Provide more health advice than was given before the NHS

- Dispensing of medicines and educating patients on proper use

52
Q

What are the different levels of involvement for pharmacists within health promotion?

A
  • Self-led by patient and supported by pharmacy team
  • Programmes run by members of pharmacy team
    Programmes run by qualified pharmacist
53
Q

What are the barriers to involving pharmacies in health promotion?

A
  • Time: For the pharmacist and patient
  • Money: Pharmacist payment for services as well as financial status of patient to pay for treatment
  • Privacy: Presence of consultation rooms
  • Public view: Are pharmacists trusted?
  • Relevance: Pharmacist’s ability to help
54
Q

What are the national priorities of the ‘Choosing Health’ strategy?

A
  • Protect and improve national health
  • Reduce health inequalities
  • Create sustainable health care services
  • Improve the public health system
55
Q

How can a pharmacist contribute to the ‘Choosing Health’ strategy?

A
  • Aim to reduce antibiotic resistance (education/avoid unnecessary use)
  • Reduce incidence of TB (educate on transmission)
  • Reduce the population undertaking harmful lifestyles (smoking, heavy drinking, obesity)
56
Q

Define tolerance

A
  • Loss of/reduced normal response to a substance
57
Q

Define abuse

A
  • Excessive use of a substance that is unrelated to medical practice
58
Q

Define psychological dependence

A
  • A feeling that requires administration of the substance to prevent related discomfort
59
Q

Define physical dependence

A
  • Physical disturbances that occur from not taking a regularly used substance
60
Q

What are the patterns of drug use?

A
  • Experimentation: Does not always progress into addiction or abuse
  • Recreational: Used for fun
  • Problematic: Affects mood/ability to function, individuals may resort to crime as a form of supply
  • Addiction: Dependent on a drug
61
Q

What affects the addictive potential (high) of a drug?

A
  • Route of administration: Injecting creates a much faster and more prominent high, therefore more likely to create and addiction
62
Q

What types of drugs are there?

A
  • Stimulant: Quickens action of nervous system, creating euphoria and excitement
  • Depressant: Dampens action of nervous system, causing euphoria, content and wellbeing
  • Hallucinogen: Perceptions become distorted, and something of a fantasy
63
Q

What are the legal drug classes? (Give examples)

A
  • Class A: Most serious; include, LSD, ecstasy, heroin, cocaine, crack, mushrooms, injecting amphetamines
  • Class B: Amphetamines, cannabis, ritalin, pholcodine
  • Class C: Painkillers, ketamine, tranquillisers
64
Q

How is drug misuse measured?

A
  • Offences (responsible for 68% of crime in Britain)
  • Surveys
  • Treatments (although not all misusers may be identified)
65
Q

Why is ‘harm reduction’ adopted in terms of drug misuse?

A
  • Drug abusers may not stop just because of damage to health
  • May not seek advice due to fear of getting charged
  • Approach to help misusers inject safely if they’re going to do so - prevent wasted resources from injury through drug misuse
66
Q

What techniques are used for harm reduction in drug misusers?

A
  • Education: Teach them how to safely inject
  • Supply: Give sterile equipment to reduce the incidence of disease such as HIV
  • Safe disposal: Ask for used equipment to be returned and dispose of it properly (prevent diseases from sharing of needles)

Pharmacy - Year 1 (2 decks)

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