SAQs

Question 1

Describe how receptors work and give a drug example. (4)

Answer 1

-Drugs bind to receptors to produce an effect
-Work via cell signalling
-Ionotropic, metabotropic, kinase linked and nuclear
-Drug example is steroids, takes hours to produce therapeutic effect

Question 2

Describe how ion channels work and give a drug example. (4)

Answer 2

• Used when rapid response is require
  -Drugs can block or modulate channels
  -4 types - ligand gated, voltage gated, mechanically gated and intra or extracellular gated.
  -Drug example is local anaesthetic

Question 3

Describe how carrier molecules work and give a drug example. (4)

Answer 3

-They are shape specific
-Can be targeted or blocked
-used to move substrate
across membranes
-Drug example is omeprazole

Question 4

Describe how enzymes work and give a drug example. (5)

Answer 4

-Enymes speed up reactions
-They act on a specific
substance.
-same shape as the substrate
-Work via competitive
inhibition
-Drug example is NSAIDS that block the production of prostaglandin

Question 5

Discuss the impact of age on absorption. (3)

Answer 5

-Absorption is how the body absorbs a drug and how quickly it enters the systemic circulation.
-This can increase or decrease with age due to reduced blood flow, hepatic and renal clearance.
-generally Indicates lower dosage required in the elderly.

Question 6

Discuss the effect of age on distribution. (3)

Answer 6

-Distribution refers to how a drug is distributed to its target area.
-Distribution is dependant on blood flow which is reduced in the elderly. lipid solubility and protein binding.
-Overall volume distribution is reduced

Question 7

Discuss the effect of age on Metabolism. (4)

Answer 7

-Metabolism refers to how the body metabolises a drug.
- Metabolism is mostly done in the liver.
-Age results in a delay of 1st pass metabolism due to a decrease in blood flow.
-Can mean the bioavailability of a drug is either higher or lower than that in a normal adult.

Question 8

Discuss how age can impact excretion. (4)

Answer 8

-Excretion refers to how a drug is removed from the body.
-Excretion occurs mainly via the kidneys.
-eGFr reduces with age means less availability to excrete drugs.
-Drugs will stay active in the body for longer.

Question 9

What would you consider when commencing drug therapy with a patient who has hepatic impairment? (9)

Answer 9

-Liver is main route of metabolising drugs
-Liver disease can alter the way drugs are metabolised and excreted.
-LFT testing is a poor indicator of liver efficacy
-Can cause hypoproteinaemia with drugs like prednisolone
-Can reduce clotting factor with drugs like warfarin
-NSAIDs can cause fluid overload due to excessive retention
-Guidelines for drug prescribing in hepatic patients found in BNF
-Individual needs, specialist advice.
-Liver disease can impair pharmacokinetics.

Question 10

How to describe management of a botox client. (9)

Answer 10

-Ensure in depth consultation on why the pt wants treatment.
-Include full medical history and current medications list. as certain medications enhance botulinum toxin effects ie, aminoglycoside abx and warfarin/aspirin can increase risk of bleeding.
-Allow a minimum of 48 hours between consultation and treatment.
-Give full explanation of benefits/risks/complications
-Assess pts physical need for treatment and say no if not appropriate for treatment ie, skin infection or myasthenia gravis.
-Get full written consent.
-Dosage would be as per Bocouture guidelines for each specific area.
-Post treatment leaflet given and explained in full.
- Follow up appointment booked for new clients 10-14 days post treatment.