Drugs

Question 1

What is the mechanism of action of Ramipril?

Answer 1

ACE inhibitor – reduces angiotensin II → vasodilation → lowers BP.

Question 2

Key counselling point for statins

Answer 2

Take at night
monitor LFTs especially ALT
report unexplained muscle pain.

Question 4

What is the risk of long-term PPI use?

Answer 4

Increased risk of low magnesium
fractures
C. diff infection.

Question 5

Common side effects of metformin?

Answer 5

GI upset
Lactic acidosis in renally impaired

Question 6

What to check before starting a beta blocker

Answer 6

Heart rate
Blood pressure
Asthma/Copd history

Question 7

Schedule and legal control of morphine?

Answer 7

Schedule 2 cd

Strict prescription and storage laws

Question 8

What’s the Yellow Card Scheme?

Answer 8

reporting system for adverse drug reactions.

Question 9

What are the core inhaler types in asthma management?

Answer 9

Previously relievers and preventers but currently it’s changed to AIR and MART

Question 10

What to include on a legal prescription?

Answer 10

Patient name
DOB (if <12)
date
drug name and dose
prescriber details

Question 11

Role of the pharmacist in safeguarding?

Answer 11

Recognising and acting on red flags, following procedures and refer if needed

Question 12

What is the mechanism of action of omeprazole?

Answer 12

Omeprazole is a proton pump inhibitor. It irreversibly inhibits H⁺/K⁺-ATPase in gastric parietal cells, reducing acid secretion

Question 13

What are key counselling points for amoxicillin?

Answer 13

Finish the course
Gi upset
Check for allergy and report rashes or breathing difficulties

Question 14

What is metformin used for and what is a key safety consideration?

Answer 14

Used for type 2 diabetes; risk of lactic acidosis—avoid in renal impairment.

Question 15

Why is warfarin difficult to manage clinically?

Answer 15

Narrow therapeutic index
many drug and food interactions
requires regular INR monitoring

Question 16

What’s the difference between bactericidal and bacteriostatic antibiotics?

Answer 16

Bactericidal kill bacteria directly; bacteriostatic inhibit bacterial growth.

Question 17

What’s the mechanism of salbutamol?

Answer 17

Beta-2 agonist — causes bronchodilation by relaxing smooth muscle in airways.

Question 18

What’s a major side effect of ACE inhibitors like ramipril?

Answer 18

Persistent dry cough, hyperkalaemia, angioedema.

Question 19

What are the four main types of insulin?

Answer 19

Rapid-acting, short-acting, intermediate-acting, and long-acting.

Question 20

What is the role of statins and a key side effect?

Answer 20

Lower LDL cholesterol; risk of myopathy/rhabdomyolysis.

Question 21

Name a drug with a narrow therapeutic index.

Answer 21

Digoxin, lithium, warfarin, theophylline.

Question 22

What is pharmacovigilance?

Answer 22

Monitoring the safety of a drug after marketing

Question 23

What’s the difference between pharmacokinetics and pharmacodynamics?

Answer 23

Kinetics = what the body does to the drug;

dynamics = what the drug does to the body.

Question 24

What’s bioavailability?

Answer 24

The fraction of administered drug that reaches systemic circulation unchanged.

Question 25

What does the term "first-pass metabolism" mean?

Answer 25

Drug metabolism in the liver after oral administration before it reaches systemic circulation.

Question 26

Who can prescribe under a Patient Group Direction (PGD)?

Answer 26

Pharmacists and other authorised healthcare professionals

Question 27

How long must pharmacy records for controlled drugs be kept?

Answer 27

2 years

Question 28

Name two key principles of the GPhC standards for pharmacy professionals.

Answer 28

Person-centred care, Professionalism Effective communication Maintaining knowledge and skills.

Question 29

What is the mechanism of action of penicillins?

Answer 29

Inhibit bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs).

Question 30

What is the main risk of combining clarithromycin with simvastatin?

Answer 30

Increased risk of rhabdomyolysis due to CYP3A4 inhibition.

Question 31

What’s the first-line treatment for uncomplicated UTIs in women?

Answer 31

Nitrofurantoin if egfr is more than 45 Trimethoprim if egfr is 45-30

Question 32

When is metronidazole contraindicated with alcohol and why?

Answer 32

Risk of disulfiram-like reaction

Question 33

What is antimicrobial stewardship?

Answer 33

interventions to improve antibiotic use, reduce resistance, and protect patients

Question 34

What is the mechanism of action of paracetamol?

Answer 34

Inhibits prostaglandin synthesis in the CNS

Question 35

What is the major risk with NSAIDs like ibuprofen in the elderly?

Answer 35

GI bleeding, renal impairment, cardiovascular risk

Question 36

What is naloxone used for and how does it work?

Answer 36

Opioid overdose; opioid receptor antagonist

Question 37

What’s the WHO analgesic ladder?

Answer 37

Stepwise approach to pain: non-opioid → weak opioid → strong opioid ± adjuvants.

Question 38

What is the mechanism of SSRIs like sertraline?

Answer 38

Inhibit reuptake of serotonin, increasing its availability in the synaptic cleft

Question 40

What are key side effects of antipsychotics like risperidone?

Answer 40

Weight gain, extrapyramidal symptoms, sedation, hyperprolactinaemia

Question 41

What is lithium used for and what’s a key safety concern?

Answer 41

Bipolar disorder; narrow therapeutic index, risk of toxicity.

Question 42

What is serotonin syndrome?

Answer 42

Excess serotonin → symptoms include agitation, sweating, tremor, confusion, fever. Can be life-threatening.

Question 44

What counselling point is crucial when starting an SSRI?

Answer 44

Takes 4 weeks to take effect and can increase risk of suicidal thoughts early on

Question 45

What is the MHRA responsible for?

Answer 45

Regulates safety, quality and efficacy of medicines and medical devices in the uk

Question 46

What is the maximum duration for supplying a Schedule 4 or 5 CD on a private prescription?

Answer 46

No legal limit Good practice 30 days

Question 47

What is the role of NICE in pharmacy?

Answer 47

Provides evidence-based guidance on treatments and care

Question 48

What is meant by ‘off-label’ use of medication?

Answer 48

Using a medicine outside its licensed terms

Question 49

What are Black Triangle drugs?

Answer 49

Newly licensed medicines under additional monitoring by the MHRA

Question 50

What is the mechanism of beta-blockers like bisoprolol?

Answer 50

Blocks b1 receptors, reducing heart rate and contractility

Question 51

What is the first-line treatment for stable angina?

Answer 51

BB and CCB

Question 52

How does warfarin work

Answer 52

Inhibits vitamin K-dependent clotting factors

Question 53

What is the antidote for warfarin overdose?

Answer 53

Vitamin K

Question 54

What is the mechanism of DOACs like apixaban?

Answer 54

Direct factor Xa inhibitor → prevents thrombin formation.

Question 55

What drug interaction should be avoided with nitrates like GTN?

Answer 55

Sildenafil

Question 56

What is the mechanism of metformin?

Answer 56

↑ insulin sensitivity, ↓ hepatic gluconeogenesis, ↑ peripheral glucose uptake.

Question 57

What is the mechanism of gliclazide?

Answer 57

Sulfonylurea → stimulates pancreatic insulin secretion

Question 58

What are the side effects of gliclazide?

Answer 58

Hypoglycaemia, weight gain.

Question 59

What is the mechanism of SGLT2 inhibitors

Answer 59

Inhibit renal glucose reabsorption

Question 60

What are the benefits of SGLT2 inhibitors beyond glucose control?

Answer 60

↓ CV risk, benefit in heart failure and CKD.

Question 61

What is levothyroxine used for and how is it taken?

Answer 61

Hypothyroidism; taken on an empty stomach

Question 62

What is the treatment for hyperthyroidism (e.g. Graves’)?

Answer 62

Carbimazole or propylthiouracil; beta-blockers for symptom control.

Question 63

What type of bacteria do narrow-spectrum penicillins (e.g. benzylpenicillin) target?

Answer 63

Mainly gram-positive bacteria and some gram-negative cocci

Question 64

What is the mechanism of macrolides (e.g. erythromycin)?

Answer 64

Inhibit bacterial 50S ribosomal subunit → inhibit protein synthesis.

Question 65

What important drug interaction do macrolides have?

Answer 65

Inhibit CYP3A4 → can increase levels of drugs

Question 66

How do fluoroquinolones (e.g. ciprofloxacin) work?

Answer 66

Inhibit bacterial DNA gyrase and topoisomerase IV → inhibit DNA replication.

Question 67

What are fluoroquinolone side effects to watch for?

Answer 67

Tendonitis

Question 68

What is the mechanism of action of trimethoprim?

Answer 68

blocks folic acid synthesis in bacteria