Week 1 - Drug therapy and Medication Flashcards
What settings do pharmacists work in?
- Hospital
- Community pharmacy
- Public health
- Pharmaceutical advisors
- Industry pharmacy
- Government
True or false: Medication is the most common type of intervention?
True
What are medicines?
Any substance or combination of substances which may be administered to human beings or animals with a view to making a medical diagnosis or to restoring, correcting, or modifying physiological functions in human beings or animals.
What are the ways medication can be taken?
- Taken orally
- Administered by injection
- Inhalation
- Suppository
- topical application
What are the 3 ways injected medicine can be administered?
- Subcutaneously
- Intramuscularly
- Intravenously
What are the 3 ways medicines are categorised?
- Schedule system
- Legal requirements
- Categories
What are some categories of medication?
Antibiotics analgesics antifungal antiviral antihypertensives
How can patients obtain medication?
- Private prescriptions
- PBS funded medication
- non-registered medications eg. special access schemes or medical trials
- illicit drugs
- family and friends
- over the counter
- complementary medicine
How are medications controlled in Australia?
Federal, state and hospital controls
What are the 2 federal controls of medication?
Therapeutic Goods Administration (TGA)
National drugs and poisons schedule committee
True or false: S1 in the national drug and poisons schedule committee is intentionally left blank?
True
Panadol belongs to which schedule?
S2 - pharmacy medicines
True or false: S3 is prescription only medicines?
False, S3 is pharmacy only medicines eg ventolin
What category is S4?
Prescription only medication
What category is Poisons?
S6
True or false: Opioid drugs are S8?
True
What category is S7?
Dangerous poisons
What category are illicit drugs?
S9
What are the 2 state controls of medication in Victoria?
- Drug, poisons and controlled substances act 1981
- Drug, poisons and controlled substances regulations 2017
What 3 considerations need to be made when deciding on route of administration?
- Type of medication
- Metabolism of medication
- Systemic or local effects
What is the buccal route?
Buccal administration involves placing a drug between the gums and upper lip/cheek where it dissolves and is absorbed into your blood.
What is sublingual?
Medication taken under the tongue
What are the 3 advantages of the buccal route?
- quick onset of action
- avoid first pass
- can be used in reduced consciousness
What are some issues of the buccal route?
- patient not understanding not to swallow
- storage and expiry of sprays
What are the 3 advantages of oral route medication?
- Simple
- self administered
- Safe
What are 4 disadvantages of oral route medication?
- Slow onset
- Metabolism
- variable absorption
- Swallowing difficulties eg, nil by mouth
What are 4 dosage forms of oral route medication?
- Tablets
- Capsules
- Effervescent/Dispersible
- Liquid
What are the advantages of the inhalation route?
- target dose to reduce side affects
- rapid absorption in anaesthetics
What are 4 methods of inhalation route administration?
- Metred dose inhalers (puffers)
- Aerosol inhalers
- Dry powder
- Nebulisers
What are the 3 types of puffer for Asthma and COPD?
- Preventors
- Relievers
- Combination
What is first pass metabolism?
When the concentration of a drug, specifically when administered orally, is greatly reduced before it reaches the systemic circulation, usually through the liver or gut wall.
What does a preventor puffer do?
It is long acting and aims to modify disease
What does a reliever puffer do?
It is a short acting, fast onset puffer aimed to relieve symptoms eg. shortness of breath.
What is a combination puffer?
A long acting bronchodilator which relaxes the muscles in the lungs while also widening the airways.
How are inhalation medications administered?
Through the nose or mouth
True or false: Inhalation route medications can only be used for local effects?
False, they can be used for local and systemic effects.
How are rectal route medications administered?
as liquids (enemas) or solid/semi solid (suppositories).
True or false: Rectal route medications can be used for local and systematic effects?
True
What affects bioavailability of rectal route medication?
The location of medication and primarily systemic absorption.
What are 2 advantages of rectal route?
- can be used if medications cannot be taken orally
2. local actions
What are 3 disadvantages of rectal route?
- Variable absorption
- Patient acceptance
- Less convenient
What is the Parenteral Route?
Drugs given by injection
What are the 3 main methods of parenteral route medications?
Intramuscular (IM)
Subcutaneous (SC)
Intravenous (IV)
What is the disadvantage of SC medication?
Small dose and less predictable absorption
What is the disadvantage of IM medication?
Small volume and slower onset than IV
What is the advantage of IV?
Fast onset and strict control of concentration in circulation.
What is the topical route?
Medication is administered on skin
What are 3 types of topical route?
Creams, liquids and patches
What types of topical route medications are used for local effects?
Creams and liquids
What topical route medications are used for systemic effects?
Patches
What are the 3 advantage of patches?
- Avoid first pass metabolism
- Continuous medication release
- can be long acting
What are the 2 disadvantages of patches?
- Local skin reactions
2. not all medication can be used this way
What are risk factors of medications?
- Using 5 or more medication
- using 12 or more doses per day
- significant changes in regime
- Drugs with narrow therapeutic index or that require monitoring
- Problems with language, literacy, cognition or physical ability
- Multiple prescribers or pharmacists
- Recent discharge from facility or hospital
Why are elderly patients at greater risk of problems with medication?
- Physical changes of metabolism, vision and dexterity.
- Increasing medications
- Increasing comorbidities.
What are type A adverse drug reactions?
Effects due to the pharmacological actions of the drug. This can include:
- Excessive effects of intended actions - Anticoagulants and increased bleeding
- Unwanted side effects – eg. Opioids and constipation
- Withdrawal effects
What are type B adverse drug reactions?
Unexpected effects. These include:
- May be immune medicated – allergy
- May have genetic component
What are factors affecting adverse drug reactions?
- multiple medication therapy
- age
- multiple disease states
- types of medication prescribed
- dosage
- route of administration
- race and genetic factors
- patient compliance
What are side effects of analgesia?
Sedation, dependence, withdrawals, falls
What are side effects of Sedatives?
Falls, dependence, cognitive impacts
What are side effects of antihypertensives?
Low blood pressure
What are the 5 unintentional factors contributing to compliance?
- Understanding
- Medication management
- Disease related factors
- Physical limitations
- Drug related factors
What intentional factors contribute to compliance?
Social and psychological factors
What does OD mean?
Once daily
What does BD mean?
Twice daily
What does TDS mean?
3 times a day
What does QID mean?
4 times a day
what does Q8H mean?
eight hourly
What does Q4H mean?
4 hourly
What does PRN mean?
As needed
What does STAT mean?
Immediately
