Week 7

Question 1

what is a formulary?

Answer 1

a list of medicines

Question 2

what information is given in the BNF?

Answer 2

everything you would need to know about drugs
also gives an overview of how to treat various different diseases and conditions

Question 3

what are the roles of a pharmacist?

Answer 3

anticipate interactions before they occur
recognise them if they occur
counsel patients on their therapy

Question 4

what do the different classifications of interactions mean?

Answer 4

severe-life threatening or permanently detrmental
moderate-considerable distress, incapacitate patient
mild-unlikely to cause concern in the majority of patients

Question 5

what is in the drug tariff

Answer 5

basic prices of drugs
the ‘black-list’
dpf,npf and nmip
appliances
fees paid to contractors
prescription charges

Question 6

what is allowed on an NHS Rx?

Answer 6

drugs
foods
toiletries
cosmetics
appliances
incontinence appliances
stoma appliances
reagents

Question 7

what does rINN stand for?

Answer 7

recognised international non-proprietary name
which means that blacklisted brands can be sold generically as long as the generic name isnt also listed

Question 8

what is the generic name?

Answer 8

the name of the active ingredient

Question 9

what is the brand name?

Answer 9

the trademarked name given by the company marketing the drug

Question 10

what is present on the SLS list? (selected list scheme)

Answer 10

some medicines that arent blacklisted can only be prescribed on the NHS in defined circumstances
(different list for WALES and eng)

Question 11

who fixes the prices for commonly used generic drugs in the drug price list?

Answer 11

DoH

Question 12

what NHS prescribing lists are in the drug tariff?

Answer 12

dental practitioners
nurse prescribers
non-medical independant prescribing

Question 13

in what form do dentists order medicines?

Answer 13

FP10(D) or WP10(D)

Question 14

what can nurse prescribers prescribe?

Answer 14

medicines listed in the NPF
stoma and incontinence appliances
appliances listed in part IXR
reagants listed in IXR

Question 15

what can non-medical independant prescribers prescribe?

Answer 15

must all work within their own proffesional competance and expertise

Question 16

what is the definition of evidence based medicine?

Answer 16

is the conscientious,explicit and judicious use of current best evidence in making decisions about the care of individual patients

Question 17

what are levels of evidence for evidence based medicine?

Answer 17

animal and laboratory studies
case report or case series
case control studies
cohort studies
randomised controlled trial
meta-analysis
clinical practice guidlines

Question 18

what are the two types of study designs?

Answer 18

experimental study design
observational study designs

Question 19

what are examples of experimental study designs?

Answer 19

animal and laboratory studies
randomised controlled trial(RCT)

Question 20

what are examples of observational study design?

Answer 20

cohort studies
case-control studies
cross-sectional studies

Question 21

what happens in animal and laboratory study?

Answer 21

animal research uses animals to test potential pharmaceuticals prior to human trials

Question 22

what are the disadvantages of animal and laboratory study?

Answer 22

its application is limited considering the difference between human and animal physiology
experiments are undertaken in highly controlled environment

Question 23

what happens in cross-sectional studies?

Answer 23

an observational study design where outcomes and exposures are measured concurrently
participants are selected based on set inclusion and exclusion criteria
population based research

Question 24

what is a case control study?

Answer 24

type of observational study which looks at 2 groups of people
one has the condition you are interested in and the other doesnt

Question 25

what are the advantages of case-control study?

Answer 25

less expensive
easier to do and takes less time
useful when obtaining follow-up data that is difficult to obtain due to the nature of the population being studied
more effecient if the disease is rare
the design may be the only ethical way to evaluate something

Question 26

what are the disadvantages of case-control study?

Answer 26

potential recall bias
subject to selection bias
generally do not allow investigators to calculate an incidence or absolute risk

Question 27

what is a cohort study?

Answer 27

research participants over a period of time

Question 28

what are the advantages of a cohort study?

Answer 28

can more clearly ahow the time of exposure and development of the outcome because the subjects are without the disease at baseline
allows for evaluation of more than one outcome as it relates to an exposure

Question 29

what are the disadvantages of a cohort study?

Answer 29

can be expensive and time consuming as of needing to follow a large number of people
loss of follow up can begin to introduce bias
may not be good for rare diseases

Question 30

what is a randomised controlled trial (RCT)?

Answer 30

a trial in which subjects are randomly assigned to one of two groups
treatment vs placebo

Question 31

what are the advantages of the ranomised controlled trial?

Answer 31

considered the gold standard
this design allows for washout of most population bias
reduced influence by cofounders
reduced variability in the outcome
easier to blind patients than obsorvational studies

Question 32

what are the disadvantages of the randomized controlled trial?

Answer 32

generally more time consuming
tend to be more expensive

Question 33

what is a systematic review?

Answer 33

a literature review that is designed to locate, appraise and synthesize the best available evidence relating to a specific research question to provide informative and evidence-based answers. this can then be combined with proffesional judgment to make decisions about how to deliver interventions or to make changes to policy

Question 34

what is meta-analysis?

Answer 34

the use of statistical methods to summarize the results of independant studies. by combining information from all relevant studies, meta-analysis can provide more precise estimates of the effects of health care than thoses derived from the individual studies included within a review.

Question 35

what are the advantages of meta analysis?

Answer 35

objective evaluation of research findings

Question 36

what are the disadvantages of meta analysis?

Answer 36

not all topics have sufficient research evidence to allow a meta-analysis to be conducted

Question 37

what are the advantages of guidlines?

Answer 37

Are on topic of relevance to population (usually determined by NHS England or the Department of Health and Social Care).
* Thorough and transparent development process to ensure fairness.
* Representative stakeholders involved in the process.
* Guidelines are developed using thorough literature reviews of many RCTs and other forms of evidence.
* Directly applicable to patients.
* Often take into account a huge number of potential treatments and drug classes, e.g. type 2 diabetes guidelines.
* Complex issues simplified.
* Regularly reviewed.
* Take into account cost considerations.

Question 38

what are the disadvantages of guidelines?

Answer 38

resources
conflict of interest

Question 39

what is an endpoint?

Answer 39

an endpoint is an event or outcome that can be objectively measured in a study

Question 40

what are primary endpoints?

Answer 40

the main results that are measured at the end of a study to see if a given intervention was effective

Question 41

what are secondary endpoints?

Answer 41

these are additional events of interest but which the study may not be specifically poweredd to assess

Question 42

what are patient oriented endpoints?

Answer 42

an ideal endpoint should be a valid and applicable measure of how a patient feels, functions and survives

Question 43

what are disease oriented endpoints?

Answer 43

do not directly measure how a person feels, functions or survives but should be so closely associated with a clinically meaningful endpoint that they are taken to be a reliable substitute for them