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Legal Aspects Ocular Pharmacology Flashcards

(49 cards)

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1
Q

Define the term ‘Medicine’

A

A preparation given for the treatment or prevention of a disease

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2
Q

What does a medicine include?

A

Excipients- inactive ingredient - no therapeutic effect

Drug - active ingredient

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3
Q

Name some example of excipients within a medicine

A

preservatives
flavouring agents
Stabilisers
Lubricants

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4
Q

Define the term ‘ drug’

A

A chemical substance which will produce a specific physiological response within the body

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5
Q

What does INN stand for ?

A

International non-propriety name

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6
Q

What is the term used for a drug which has a brand name ?

A

Propriety name

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7
Q

What is the INN?

A

Common name for the drugs

General - not specific to any manufacturer

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8
Q

When was the opticians act first published ?

A

1958

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9
Q

When were the most recent changes made to the optician act?

A

2005

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10
Q

State what the original form of the Optician Act stated about optometrists

A

Refer all patients with an injury or disease of the eye to a medical practitioner for tx

Optometrists role was more of detection rather than diagnosis which meant lx access to meds

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11
Q

Who has powers to amend legislation ?

A

GOC

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12
Q

What changes and when were they made to the optician act

A

1999
The rules relating to injury or disease of the eye
Optoms may now choose to not refer patients with an eye disease/injury if no justification to do so
Optoms may now diagnose and manage
This means we need more access to medicines

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13
Q

When was the medicines act published ?

A

1968

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14
Q

What is the medicines act?

A

Regulates medication for both human and veterinary use including the manufacturing and supply of medicines .

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15
Q

The regulation of medicines within the UK is seen by who ?

A

MHRA

medicines and healthcare products regulatory agency .

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16
Q

The medicines act define three categories of medicines . What are they ?

A

General sales list
Pharmacy medicines
Prescription only medicines

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17
Q

Briefly explain what the GSL medicines is ?

A
  • Avail to pts without medical supervision
  • Don’t need rx , or approval from healthcare professional
    Can be sold by any retailers with secure locked premises
  • Can be bought of shelf of pharmacy , news agents and supermarkets
  • Don’t have a specific label
  • Ingredients , volume , concentration is deemed to be sufficiently safe for Public use without medical supervision
    Pts responsibility to read the information leaflet in the box and follow guidance on how to use meds safely and prevent ADR
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18
Q

What is ‘ Sales list’

A

eyedrops/ointment medication which are available for patients to purchase in same way as GSL meds.

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19
Q

Give some examples of products which fall within the Sales List group .

A

Artificial tears and ocular lubricants to alleviate sx of dry eyes
Contact lens rewetting drops to lubricate the CL
Eye baths /cleansers to soothe or cleanse an irritated eye

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20
Q

Give two clinical examples in which you would provide a GSL medicine to a patient .

Study These Flashcards
A
  1. Corneal Abrasion
    Sx - red , sensitive to light and painful right eye
    VA - reduced
    EE - large deep corneal abrasion seen with FS
    Management - paracetamol 500mg, 2tabs 4h apart for four days
  2. seasonal allergic conjunctivitis - HAYFEVER
    Sx - 2/52 itchy watery and red eyes
    EE - lacrimation, oedema , conjunctival hyperaemia
    Management - Certrizine 10mg , I tab per day
21
Q

Briefly explain what the P meds group is

Study These Flashcards
A
  • Can only be supplied to patient under supervision of pharmacist
  • No rx required
  • Can’t be bought of shelf
  • Can’t be sold by retailers or supermarkets without pharmacy
  • Pharmacist supervision is a control step for reasons - 1. Medication is sUITABLE for pt to use in terms of pts condition and other meds
    2. Warnings are highlighted ADR
22
Q

Give an example of a drug which falls into the GSL and P meds group

Study These Flashcards
A

Paracetamol 500mg , 16 tabs GSL
Paracetamol 500mg , 32 tabs P

Larger quantities require more supervision
MHRA advise retailers to allow 2 packs per customer only

23
Q

What rights to optoms have in relation to P meds ?

Study These Flashcards
A

Optoms can sell or supply only if

  1. Case of emergency
  2. It’s within their course if professional practise

2005 1. Dropped

24
Q

What is an diagnostic drug ?

Study These Flashcards
A

Used within an eye exam to investigate cause of patients sx and signs

25
What classification do diagnostic drugs fall within ?
P Meds
26
Give TWO examples example of a diagnostic P med ?
Flourescein sodium - examine tear film Examine cornea and conjunctiva Assess CL patients Production of this stopped in 2013 - now rely on imported products from Europe Phenylephrine hydrochloride (2.5/10%) mydriatic drug , high myopes , pts with sx of vision loss Gives detailed assessment of vitreous And retina
27
What is a therapeutic drug ?
Used to treat pt sx and clinical signs of disease /injury | Only supply after examination
28
Give two examples of an therapeutic p med used by optoms ?
Chloramphenicol , antibx Used it treat bacterial conjunctivitis Sx - mucopurulent discharge pus, conjunctival hyperaemia Management - chloramphenicol 0.5% eye drops , every two hours for two days then Every 4h for four days Otrivine antistin , for tx of seasonal drug allergic conjunctivitis Contains antazoline which is an topical antihistamine
29
Why isn’t chloramphenicol a GSL medicine ?
Need expert opinion May need review appt Risk of incorrect self diagnosis
30
Why isn’t otrivine antistin a GSL meds ?
Contains a decongestant Stimulates the SNS - leads to increase blood pressure and heart rate Needs to be used in caution in patients with cardiovascular disease , systemic hypertension and diabetes
31
Briefly example what the PoM group is ?
Highest level of medical supervision needed Require rx to take to pharmacy for dispenstion To protect pts safety for example due to nature of drug Example warfarin - blood thinner , reduce blood clots Puts pts at risk of stroke so needs close supervision
32
Give some examples of PoM
``` Salbutamol - asthma Amoxicillin - antibx Citalopram- antidepressant Atorvastatin- cholesterol Ramipril- Systemic Hypertenstion ```
33
Give an example of drug that falls into the P and PoM group
Co-codomol codeine+paracetamol Codeine 8mg P Codeine 30mg PoM Higher dose needs higher supervision
34
What exemptions to optoms have in relation to PoM
Exempted PoM - Use only | Exempted PoM - Use and Supply
35
Discuss the exempted PoM - Use only group
Topical anaesthetics - used to numb front of eye either for foreign body removal , measure of ocular pressure and stopping of blinking reflex Proxymetacainehydrochloride Oxybuprocaine hydrochloride Tetracaine hydrochloride Lidocaine hydrochloride
36
Why are drugs in exempted PoMs use only ?
Risk of overdose >4drops in one house Toxic to cornea high doses Masks pain without addressing root cause
37
In what situation would optoms use topical anesthetics
Contact tonometry , IOP | Probe needs to be in contact with patients cornea
38
Discuss the exempted PoM - Use and Supply
1. Mydriatics/cycloplegics Tropicamide and cyclopentolate (0.5/1%) 2 . Antibacterial Chloramphenicol eye drops 0.5% Chloramphenicol 1% eye ointment Fusidic acid 1%
39
What are each of the drugs used for in exempted PoM use and supply
Tropicamide - mydriasis , dilate pupil Cyclopentolate - susp acc , relaxed ciliary muscle Chloramphenicol - tx of bacterial conjunctivitis Fusicdic - tx of blepharitis
40
Blepharitis ...
Inflammatory condition which often includes bacterial infection of the eyelid margin The bacteria colonise eye lid particularly meibomian glands
41
what is the ruling with regards to GSL meds and optoms
can use as long as within course of practise | may sell or supply if considered to be effective tx for minor eye injuries or diseases
42
What should a signed order from an optom include
Date optoms details ( name , goc number, practise address) pt deatils - name , DOB, address medication details - name , drug , quantity , form , conc and optoms signature
43
In what situation may an optom provide a pt with a signed order
outside of an emergency for meds in the use and supply group
44
Why is tropicamide preferred over phenylephrine
more rapid and stable
45
tropicamide comes in two conc , what are they and how would you decide which conc to use for each pt
0.5 and 1% | conc is decided based on pts age and iris colour
46
state a therapeutic use of cyclopentolate
anterior uvietis
47
chloramphenicol l comes in two forms , drops and ointment , how is it decided which the patients receives
decided between practitioner and pt. ointments instilled - 2/4x per day , half freq of drops reduced dosing regimen found more convenient ointment may cause smeary effect on pts vision - certain near tasks difficult
48
P Med formulation of Chloramphenicol used for tx of what
bacterial conjunctivitis only. if optom wants to use foer other infections POM form must be used
49
fusidic acid is effective against which type of bacteria
staphylococal aureus

General Ocular Pharmacology (6 decks)

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