Prescribing

Question 1

What is pharmacology?

Answer 1

The study of how drugs interact with biological organisms (cells/organs/body)

Question 2

Give the two types of pharmacological effect

Answer 2

• Therapeutic : beneficial

- Harmful : side effects/toxicity

Question 3

What is an important balance in a drug?

Answer 3

Therapeutic effect more significant than side effects

Question 4

What is a drug?

Answer 4

Synthetic/natural chemical substance altering biological function

Question 5

What are drugs used for in disease? (3)

Answer 5

• Treatment
• Prevention
• Diagnosis

Question 6

What two effects do drugs have on biological function?

Answer 6

• Evoke

- Stop

Question 7

What attributes are important for a successful drug? (5)

Answer 7

• Specific effects
• Particular targets
• Target recognition
• Action selectivity
• Beneficial v adverse effects

Question 8

What is the important for a successful drug in terms of drug targets?

Answer 8

Recognises target by being selective for it so won’t hit other targets

Question 9

Why is it important for a successful drug not to hit other targets?

Answer 9

Therapeutic use - hitting other targets causes side effects

Question 10

Why are drugs selective and not specific? (2)

Answer 10

• Every drug will hit more than 1 target depending on concentration of the drug in blood circulation so not specific
• But selective at right dose

Question 11

What 3 names do drugs have?

Answer 11

• Chemical
• Generic
• Brand

Question 12

What are the problems with brand names? (3)

Answer 12

• Hard to pronounce
• Varies depending on location
• Could change

Question 13

What are the brand names for adrenaline? (2)

Answer 13

• Eppy

- Simplene

Question 14

What is the USA generic name for adrenaline?

Answer 14

Epinephrine

Question 15

What is the brand name for isoprenaline?

Answer 15

Saventrine

Question 16

What is the USA generic name for isoprenaline?

Answer 16

Isoproterenol

Question 17

What is the brand name for diazepam?

Answer 17

Valium

Question 18

What is the brand name for ibuprofen?

Answer 18

Nurofen

Question 19

What is the USA generic name for sildenafil?

Answer 19

Viagra

Question 20

Why is it better to use drug generic name?

Answer 20

Site of action

Question 21

Why are drugs taken? (4)

Answer 21

• Produce cure
• Suppress symptoms
• Prevent disease/symptom
• Recreational reasons

Question 22

Give an example of a drug that slows the progression of a disease but has no curative effect

Answer 22

Donepezil: Alzheimer’s

Question 23

What is donepezil used for in Alzheimer’s?

Answer 23

Helps management of memory deficit as disease progresses but no curative effect

Question 24

Give an example of a drug that prevents a disease/symptom

Answer 24

Quinine: Malaria

Question 25

What determines whether to give a drug? (4)

Answer 25

- Likely patient benefit - Adverse effect probability and severity - Healthcare/social cost of adverse effects - Financial drug cost in relation to benefit

Question 26

Give an example of a drug that has a high financial cost in relation to benefit

Answer 26

Beta interferon in MS treatment

Question 27

Give an example of a drug that has a low financial cost in relation to beneift

Answer 27

Statins (lipid lowering drugs) given to over 50s

Question 28

Explain how beta interferon in MS treatment has a high financial cost in relation to benefit

Answer 28

Costs £20,000 a year, has no real benefit, only flu like symptoms

Question 29

Explain how statins have a low financial cost in relation to benefit

Answer 29

Increases function on society, over £400K per life saved

Question 30

What are the potential problems of drug therapy? (6)

Answer 30

- Insufficiently selective - Drug target structure and function change - Lack of disease process knowledge - Patient variability - Drug interactions - Idiosyncratic reactions

Question 31

What is the problem in drug therapy with drugs being insufficiently selective?

Answer 31

Drugs should hit 1 drug target when in right range but could still hit others

Question 32

What is the problem with drug target structure and function change?

Answer 32

- Target being hit could cause: 1) Development of new symptoms 2) Makes drug ineffective

Question 33

What are the aspects of patient variability that can affect drug therapy and side effects? (5)

Answer 33

- Age - Gender - Pregnancy - Genetics - Other prexisting diseases

Question 34

How does patient age variability affect drug therapy?

Answer 34

Very old/very young patients have slower metabolism | - Lower dosages needed because otherwise drug concentration goes up too fast and side effects more likely

Question 35

How does patient gender affect drug therapy?

Answer 35

Women are effected by hormonal cycles

Question 36

How are drug interactions becoming more of a problem in drug therapy?

Answer 36

More people are being given multiple prescriptions

Question 37

Explain how drug interactions affect warafrin use with neurofin

Answer 37

- Neurofin can bind to albumin instead of warafrin | - Warafin conc goes up in blood = very dangerous

Question 38

Explain the drug interactions of barbiturates (used in 60s - now out of use) with the contraceptive pill

Answer 38

- Barbiturates induced liver enzymes to metabolise hormones in contraceptive pills - Women using them for depression/anxiety would fall pregnant

Question 39

Define idiosyncratic

Answer 39

Not understood/predicted

Question 40

What 2 aspects of a drug can another drug affect in drug interactions?

Answer 40

- Distribution | - Metabolism

Question 41

What is a positive example of drug interaction?

Answer 41

Two drugs synergising - working together to be more effective