pharmacology Flashcards Preview

specialities > pharmacology > Flashcards

Flashcards in pharmacology Deck (66):
1

up to what age do you write the age of the patient on a prescription

12

2

what details of the drug should go on a prescription

name, formulation, dose, frequency, quantity to be dispensed

3

how should you write a prescription

black ink, block capitals

4

why should you not write "" on a prescription

can be confused for 11

5

do you write brand names on a prescription

no, generic prescribing unless clinically significant bioavailability between brands

6

what is the dose of a liquid expressed at

milligrams of the active ingredient

7

how would you stop a medicine on a prescription

crossing name
date and sign

8

what is an off label medication

prescribed out with the terms of marketing authorisation. I.e. used for a different condition

9

what is the GMC guidance for unlicensed medication

You should usually prescribe licensed medicines in accordance with the terms of their licence. However, you may prescribe unlicensed medicines where, on the basis of an assessment of the individual patient, you conclude, for medical reasons, that it is necessary to do so to meet the specific needs of the patient.” (be able to justify)

10

what legal act introduced controlled drugs

The misuse of drugs regulations 2001

11

what can controlled drug cause

dependence - therefore abuse

12

how are controlled drugs kept

locked in cupboards

13

how many days are controlled drug schedules 2,3 and 4 allowed to be given for

30 days

14

what information for controlled drugs must be specified

formulation, strength and dose in words and figures

15

what act classifies different types of medications that need prescription

Human medicines regulations 2012

16

what are prescription only medications (POM)

normally new medicines until evidence of safety, written by an appropriate practitioner before it can be supplied e.g. doctor, dentist, advanced nurse practicioner.

17

what are Pharmacy (P) OTC medications

sold from a registered pharmacy premises by a pharmacist or a person acting under the supervision of a pharmacist, pharmacist must check for contra-indications or problems before sale

18

where can general sales list drugs be purchase (GSL)

suitable for general sale, can be sold in retail outlets

19

which 2 companies wrote the BNF

British Medical Association and the Royal Pharmaceutical Society

20

what information is given for all drugs in the BNF

indications and dosages
route of administration
contraindications/ cautions
side effects
drug interactions
medicinal products available

21

which speciality has its own BNF

paediatrics

22

where its the most up to date copy of the BNF

online

23

how often is the BNF updated

6 monthly
childs - 12 months

24

what resource does each local health board have to aid decisions when prescribing

joint formulary

25

what are the Scottish evidence based guideline

Developed by multidisciplinary working groups that follow a systematic review of available evidence and have the aim to reduce potential bias. After a set period of time, the guidelines are reviewed. Currently SIGN has 150 evidence clinical guidelines covering a wide range of topics.

26

what are the UK evidence based guidelines

national institute for clinical excellence
Amongst other things will provide recommendations, based on the best available evidence, on the appropriate treatment and care of people with specific diseases and conditions.

27

what are the aims of evidence based guidelines

support healthcare professionals
provide is the best possible quality,
reduces variations in practice,
offers best value for money.

28

where must all prescription and administration records be filed

in patients medical records - on completion/ diacharge

29

list some other prescription sheets that may appear in a patients notes

Diabetes Prescription sheet
Warfarin Chart
Fluid additive prescription sheet
Variable rate IV Infusion
Syringe volumetric Pump Record
Insulin infusion prescription sheet
Subcutaneous syringe pump recording chart

30

what are the aims of the MHRA (medicine and healthcare products regulatory agency)

Ensures that human medicines meet acceptable standards on safety, quality and efficacy.
Ensures that the sometimes difficult balance between safety and effectiveness is achieved. E.g. side effects against benefits

31

what is required before any medicine can be used to treat someone in the UK

market authorisation from the MHRA (product license)

32

what is required before a drug is allowed to be clinically trailed in the UK

clinical trail authorisation form the MHRA

33

what are the roles of the MHRA (medicine and healthcare products regulatory agency)

•Assessment & Authorisation of medicinal products for sale in UK
•Ensure medicine meets the standards of safety, quality and efficacy.
•Post-marketing surveillance – ADRs and incidents
•Monitor Internet sales & counterfeiting
•Clinical Trials regulation
•Statutory controls
•Promotion of safe use
•Manage British Pharmacopoeia & Clinical Practice Research Database

34

how long are marker authorisations (product license) valid for

5 years

35

what are the roles of the SMC

Provide advice to NHS Scotland regarding all new licenced medicines, new formulations of existing medicines and new indications for established products.
Principal remit is to make decisions on the cost effectiveness of new/existing pharmaceutical products in respect of their use

36

what do the SMC review medications based on

How well the medicine works
Which patients could benefit from it
Whether is as good or better than medicines the NHS already uses to treat the particular condition
Whether it is good value for money

37

which proffesions sit on the SMC

Pharmacists -Health economists
Pharma representatives Lay representatives
Physicians -NHS management

38

who must accept a medication before it is prescribed in scotland

SMC

39

what is the process of the SMC accepting a mediation to be licensed

3 month assessment process at time of launch
Submission by manufacturer Health economic analysis
Cost per QALY (£20-30,000)
Attempt to be fair and reasonable
Approved for use or approved for restricted use

40

what does the commission on human medicine (CHM) do

Advises Ministers on matters relating to human medicinal products
Advises Licensing Authority (LA)
Considers representations by an applicant or MA holder
Promotes collection and investigation of information relating to adverse Drug Reactions to human medicines.

41

give an example of a drug that has benefited from the RCMF (rare conditions medicines fund)

provision of ivacaftor to CF patients with G551D-CFTR mutation (~12% cases in Scotland)
shown 10% improvement in FEV1, respiratory symptoms and weight
QALY = £330,657 and cost per patient per year £182,625

42

what reporting scheme is used for adverse drug reactions

yellow card reports

43

how many deaths a year are contributed to by NHS medication errors

22,000

44

what percentage of hospital patients experience an adverse drug effect

just under 11%
(increase hospital stay by 8.5 days)

45

what patients are most at risk of an adverse drug reaction

Those undergoing cardiothoracic surgery, vascular surgery, or neurosurgery
Those with complex conditions
Those in the emergency room
Those looked after by inexperienced doctors
Older patients

46

what factors increase the rate of medication errors

More rapid turnover of patients
New drug developments, extending medicines into new areas
Increasing complexity of medical care
Increased specialisation
Increased use of medicines generally
Sicker and older patients, more vulnerable to adverse effects

47

list some people related causes of medication incidents

Fatigue/ Sleep deprivation Hunger
Concentration:
Stress:
Distraction -Lack of training
Lack of access to information Other factors: Alcohol, drugs & illness

48

in what stage do most medication errors occur

prescribing - 39%
administrating - 38%
dispensing - 12%
transcribing - 11%

49

what things should you check about a patient before prescribing

age
weight
renal and hepatic function
concurrent medication
allergies
pregnancy

50

what are the 5Rs of prescribing

right patient
right drug
right dose
right route
right time

51

what is a complementary alternative medicine

a broad set of health care practices that are not part of that country’s own tradition and are not integrated into the dominant health care system
a group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine

52

what things are included in CAM

herbal medicines
massage
homeopathic therapy
acupuncture
hypnosis
aromatherpay
Reiki
meditation
chinese medicine

53

who are high risk patients for using CAM

children
pregnancy - teratogenesis
poly pharmacy

54

what percentage of pregnant women have used CAM

60%

55

why do people take CAM

Think it’s safe, natural and harmless
Perception that conventional medicine lacks/disregards a holistic approach
relatives use

56

which is the biggest CAM used in the UK

herbal medicines - activity ingredients of plants

57

why do a lot of breast cancer patients take CAM (70%)

oestrogenic - soya, evening primrose, garlic, red clover, cranberry, grapefruit

58

what are the strongest predictors for CAM use during pregnancy

use by family or friends
use prior to pregnancy

59

what CAM were commonly used in pregnancy

raspberry , ginger, cranberry

60

what herbal drug has a major interaction with warfarin

St johns wart (depression)

61

what is the principle of homeopathy

minute concentration of toxins mixed with water or alcohol - water memory not proven

62

what is the principle of acupuncture

needles in trigger points for dealing with pain
(Stimulates pain fibres entering the dorsal horn of the spinal cord. These cause inhibition of pain impulses. Stimulate release of endogenous opioids and other neurotransmitters such as serotonin.)

63

what conditions do people use acupuncture to treat

chronic low back pan
stroke
(? asthma/ epilepsy)

64

what may be complications of acupuncture

Infection, Pneumothorax, Pneumopericardium and Organ puncture

65

what is aromatherapy

the use of concentrated essential oils extracted from herbs, flowers, and other plants to treat diseases. It is commonly administered by massaging into the skin.
(inhalation, diffusion, bath)

66

what are harms of aromatherapy

Skin irritation with frequent use
Photosensitivity-Avoid prolonged exposure to the sun,
Excessive inhalation can cause headaches and fatigue / Bronchial spasms (people with asthma should not use )
Insomnia -peppermint,