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MPharm Stage 2 Unit 1 > Unit 1 Science > Flashcards

Unit 1 Science Flashcards

1
Q

What are adrenergic receptors?

A

Cell surface proteins that adrenaline and similar molecules bind to, resulting in cellular and physiological changes.

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2
Q

What differentiates receptor subtypes?

A

They have similarities in structure but differ in some amino acid residues, leading to different interactions with binding molecules.

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3
Q

What are ß-adrenergic receptor agonists?

A

Drugs that bind and activate ß-adrenergic receptors, such as salbutamol (ß2-adrenergic receptor agonist).

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4
Q

What are ß-adrenergic receptor antagonists?

A

Drugs that bind and prevent the action of ß-adrenergic receptors by agonists, such as propranolol (mainly ß1-adrenergic receptor antagonist).

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5
Q

Where is the ß1 adrenergic receptor found and what does it do?

A

Found in cells of the kidney and heart; causes heart muscle to contract.

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6
Q

Where is the ß2 adrenergic receptor found and what does it do?

A

Found in lung, vascular, and GI smooth muscle cells; causes smooth muscle to relax.

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7
Q

Where is the ß3 adrenergic receptor found?

A

Found in adipocytes (fat storing cells).

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8
Q

What are adrenaline and noradrenaline?

A

Endogenous hormones released from the adrenal gland at the top of the kidneys.

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9
Q

What are on-target side effects?

A

Effects on tissues where the intended target receptors are present.

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10
Q

What are off-target side effects?

A

Effects on different targets due to unselective binding, generally rare.

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11
Q

How does salbutamol act on the body?

A

Binds and activates ß2-adrenergic receptors on smooth muscle surrounding bronchi, causing relaxation and increased lung capacity.

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12
Q

What are the on-target side effects of salbutamol?

A

Increased blood glucose levels and rapid increase in lactic acid levels.

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13
Q

What are the off-target side effects of salbutamol?

A

Tremors, increased heartbeat, and palpitations due to action on ß1-adrenergic receptors.

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14
Q

What are beta-blockers?

A

ß-adrenergic receptor antagonists, such as propranolol.

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15
Q

What are non-selective beta blockers?

A

Beta-blockers with high affinity for both ß1 and ß2 receptors.

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16
Q

How does propranolol act as an antagonist for ß1-adrenergic receptors?

A

Competitively binds to the ß1-adrenergic receptor on cardiac myocytes, reducing heart rate and cardiac output.

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17
Q

What wider effects does propranolol have as an antagonist?

A

Reduces anxiety, prevents migraines, and reduces intraocular pressure.

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18
Q

What are the on-target side effects of propranolol?

A

Bronchoconstriction and dry eyes.

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19
Q

What is the typical agonist for serotoninergic 5-histamine receptors?

A

Histamine.

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20
Q

How do antihistamines work in allergic reactions?

A

They are receptor antagonists at H1 receptors, preventing histamine from binding and stopping physiological effects.

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21
Q

What side effect is caused by H1 antagonism?

A

Drowsiness and sleepiness due to effects in the CNS.

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22
Q

Why do some H1 antagonists cause drowsiness more than others?

A

Older drugs cross the blood-brain barrier more easily than newer antihistamines.

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23
Q

What properties increase the chance of drugs crossing the blood-brain barrier?

A
  • High lipophilicity
  • Small size and molecular weight
  • Low hydrogen bonding potential
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24
Q

What is a common side effect of first-generation antihistamines?

A

Dry mouth or xerostomia.

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25
What activates muscarinic receptors and how does their inhibition cause dry mouth?
Activated by acetylcholine; inhibition decreases saliva production, leading to dry mouth.
26
What is therapeutic drug monitoring (TDM)?
Using blood level monitoring of drugs to ensure therapeutic effectiveness and safety.
27
Why might a patient need a different formulation of medicine?
Due to side effects from oral medication, dysphagia, or being nil by mouth.
28
What are enteral routes of drug delivery?
* Oral * Rectal
29
What are parenteral routes of drug delivery?
* Intravenous * Intramuscular * Subcutaneous * Depot * Topical
30
What is the advantage of intravenous drug delivery?
Bypasses absorption phase and allows precise dose delivery quickly.
31
What are the two main ways of delivering drugs intravenously?
* Bolus injection * IV infusion
32
What is the age classification for a neonate?
1st 4 weeks of life.
33
What is an absolute contraindication?
A situation where a drug could cause a life-threatening situation and should be avoided.
34
What affects drug absorption interactions?
Rate of absorption and total amount absorbed.
35
What are three mechanisms for absorption interactions?
* Changes in GI pH * Adsorption and chelation * Changes in GI motility
36
What is first pass metabolism?
The process where drugs are metabolized in the liver after absorption.
37
What is enzyme inhibition?
Reduced rate of metabolism, leading to higher plasma concentration and increased drug effects.
38
What is enzyme induction?
Increased rate of metabolism, resulting in lower plasma concentration and less drug effects.
39
What are drug elimination interactions?
Interactions that affect the elimination of drugs by the kidneys.
40
What is the 4-stage model in pharmacy practice?
1. Gather information 2. Exchange and develop ideas 3. Evaluate alternatives/solutions 4. Choose appropriate course of action
41
What are the two domains of competencies within the RPC framework?
* Consultation competencies (1-6) * Prescribing governance competencies (7-10)
42
What are the 10 principles of good prescribing?
* Be clear about reasons for prescribing * Take patient medication history into account * Consider other factors and risks * Consider patient ideas, concerns, and expectations * Select effective, safe, and cost-effective medicine * Adhere to national guidelines * Write unambiguous legal prescriptions * Monitor beneficial and adverse effects * Communicate and document decisions * Prescribe within knowledge, skills, and experience
43
What is the Duty of Candour?
A legal requirement for healthcare providers to be open and honest with patients and families when something goes wrong.
44
What are Patient Group Directions (PGDs)?
Protocols used when prescribing as part of a team.
45
What is the ABPI code of conduct?
Ensures responsible, ethical, and professional promotion of medicines in the pharmaceutical industry.
46
What does SBAR stand for?
* Situation * Background * Assessment * Recommendation
47
What is information governance?
A framework for handling information securely and confidentially.
48
What is the difference between anonymous and pseudonymous information?
* Anonymous: does not identify individuals * Pseudonymous: changed to make it unidentifiable
49
What is a Medication-Related Problem (MRP)?
An event or circumstance involving drug therapy that interferes with health outcomes.
50
What is the difference between compliance, adherence, and concordance?
* Compliance: extent of matching HCP advice * Adherence: extent of matching agreed recommendations * Concordance: focuses on consultation process between patient and HCP
51
What is an absolute contraindication?
A drug that could cause a life-threatening situation and should be avoided.
52
What factors assess the reliability of drug information sources?
* Currency * Credibility * Transparency * Independence
53
What are the classifications of adverse drug reactions (ADRs)?
* Augmented * Bizarre * Chronic
54
What does credibility refer to in the context of a source?
Is the source authoritative? Reputation and credibility of source.
55
What is transparency in relation to evidence?
Is it clear what evidence is used? Based on evidence from high quality research.
56
What does independence refer to in the production of information?
How was it produced and funded?
57
What are the classifications of ADRs?
* Augmented * Bizarre * Chronic * Delayed * End of use * Unexpected failure of therapy
58
What characterizes augmented ADRs?
Exaggeration of normal/pharmacological actions; relates to dose.
59
What defines bizarre ADRs?
Not expected from known pharmacological actions; non dose related and unpredictable.
60
What are chronic ADRs?
Persist for a relatively long time; dose and time related.
61
What are delayed ADRs?
Become apparent sometime after use of medicine; time related.
62
What does pharmacovigilance involve?
Science and activities relating to detection, assessment, understanding and prevention of adverse effects or medicine related problem.
63
What does NTRO stand for in assessing suspected ADRs?
* Nature of symptoms * Timing of reaction * Relationship to dose * Other possible causes
64
What considerations should be made regarding potential drug interactions?
* Known interactions * Seriousness of interaction * Possibility of avoiding drugs * Previous patient experience * Alternative safer drugs
65
What is the purpose of diagnostic testing?
To reach a state where we are adequately convinced of the presence or absence of a condition.
66
Why is monitoring important in medical treatment?
* Assess effectiveness of treatment * Ensure safe practice
67
What are reference ranges?
Defines the normal range for a lab test result based on a cut off point at either end of a normal distribution curve.
68
What does sensitivity of a test refer to?
Ability to show true positives; higher sensitivity means lower false negative rate.
69
What factors should be considered when interpreting test results?
* Patient's physical activity * Patient's age * Pregnancy * Race or nationality * Blood hormone levels * Timing of samples
70
What is therapeutic drug monitoring (TDM)?
Measurement and interpretation of a drug concentration in the blood plasma for drugs with a narrow therapeutic range.
71
When should TDM be performed?
* Optimize dose regimen * Explain lack of efficacy * Prevent/confirm toxicity * Evaluate drug interactions * Evaluate albumin impact * Evaluate organ function changes
72
When is it best to take a sample for TDM?
Trough levels should be obtained 15 minutes before the next scheduled drug.
73
What are the main steps in the Calgary-Cambridge model?
* Initiate the session * Gather the information * Explanation and planning * Closing the session
74
What skills are needed for effective consultations?
* Rapport * Questioning skills * Listening skills * Clarity of explanation * Structure
75
What does EDI stand for?
Equality, diversity, and inclusion.
76
What are the 9 protected characteristics under the Equality Act (2010)?
* Age * Disability * Gender reassignment * Marriage and civil partnership * Pregnancy and maternity * Race * Religion/belief * Sex * Sexual orientation
77
What is direct discrimination?
When someone with a protected characteristic is treated unfairly.
78
What is indirect discrimination?
When a policy applies to everyone but has a worse effect on someone with a protected characteristic.
79
What is harassment in the context of discrimination?
Repeatedly offensive behaviour.
80
What is victimisation?
Type of discrimination as a result of being involved in a discrimination or harassment complaint.
81
What are micro aggressions?
Intentional or unintentional behavioral or verbal insults that can be derogatory or discriminating.
82
What are health inequalities?
Unavoidable and unjust differences in health and wealth.
83
What factors lead to health inequalities?
* Socio-economic * Geography * Protected characteristics * Determinants of health * Groups vulnerable to being excluded * Lack of representation
84
What information should be collected for a medication history?
* Current medication * Past medication * Drug allergies/sensitivities * Who administers medicines * Compliance aid used
85
What does MHx stand for?
Previous medical history.
86
What does SHx stand for?
Social history.
87
What are some secondary sources of information for medication history?
* Community pharmacy PMR systems * Repeat prescriptions * Patient notes/medical record * GP referral letter * Previous discharge documents * Care home records * Outpatient appointment letters * Specialist clinics * NHS summary care record

MPharm Stage 2 Unit 1 (1 decks)

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