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Pharm Y1 > The Public Semester 1 > Flashcards

The Public Semester 1 Flashcards

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1
Q

What does vascular disease include?

A

Coronary heart disease
Stroke
Diabetes
Kidney disease

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2
Q

What is the target age group for the vascular risk assessment screening programme?

A

40-74

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3
Q

What 13 pieces of information should be obtained from someone undergoing a vascular risk assessment?

A 
Age
Gender
Smoking status
Family history of vascular disease
Existing treatment for hypertension
Postcode
BMI
Systolic blood pressure
Total and HDL cholesterol
Ethnicity
Rheumatoid arthritis 
Chronic kidney disease
Atrial fibrillation
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4
Q

At what percentage is vascular risk actionable with medication? What medication is given as standard?

A

At a risk of higher than 20%

Statins can be given

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5
Q

What is the name of the calculator developing for assessing vascular risk in the UK?

A

QRisk

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6
Q

What is the average total cholesterol value?

A

5.5mmol/L

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7
Q

What lifestyle factors contribute to vascular risk?

A

Physical inactivity, weight, smoking status, cholesterol levels, obesity, high blood pressure

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8
Q

What three types of medication are available for use in the UK as emergency hormonal contraception?

A 
Levonelle One Step (OTC)
Levonelle 1500 (POM)
Ella One (POM)
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9
Q

How much levonorgestrel do the Levonelle products contain?

A

1500mg

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10
Q

How does levonorgestrel work in EHC?

A

It appears to delay ovulation by up to a week and arrest the development of the ovarian follicle

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11
Q

When is levonorgestrel effective as an EHC?

A

Its effects are unknown if taken on or just after ovulation so the SPC states it is ineffective once the process of implantation has begun

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12
Q

What drug is present in Ella One and how much of it?

A

It contains 30mg of ulipristal

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13
Q

How does ulipristal work in EHC?

A

It interrupts the leutenising hormone surge just before ovulation, working later in the cycle than levonorgestrel

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14
Q

How long after UPSI is Ella One licensed for use?

A

Up to 120 hours

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15
Q

How long after UPSI is Levonelle licensed for use?

A

Up to 72 hours however there is evidence to show effectiveness up to 96 hours after UPSI

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16
Q

How long should a patient wait before breastfeeding after taking Ella One?

A

They should not breastfeed until 36 hours after ingestion

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17
Q

What type of drug can interact with Levonelle? And what is the result of this reaction?

A

Potent enzyme inducers (such as rifampicin) can increase metabolism of Levonelle and therefore reduce its efficacy

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18
Q

If an IUCD is inappropriate but a patient is taking potent enzyme inducers, what can be given as EHC?

A

Two Levonelle tablets can be given

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19
Q

What happens if an interaction between Levonelle and ciclosporin (potent enzyme inducers) occurs?

A

Toxicity increases so an IUCD may be more appropriate

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20
Q

Give examples of potent enzyme inducers.

A 
Rifampicin
Carbamazepine
St John's Wort
Phenylbutazone
Primidone
Ritonavir
Phenobarbital
Ciclosporin
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21
Q

How long after taking EHC should a patient return for another tablet if they vomit?

A

Levonelle- 2 hours

Ella One- 3 hours

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22
Q

On what grounds can EHC be given to an under 16?

A 
OTC Levonelle is unlicensed for this use
PGD can allow prescribing of EHC providing criteria is filled:
At risk of pregnancy
Deemed sufficiently mature to understand
Parental consent is discussed
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23
Q

Under what circumstances is it reasonable to believe COCP has failed?

A

EHC is indicated if two pills are missed in the first week and UPSI has occurred in the first or pill free week

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24
Q

Under what circumstances is it reasonable to believe POP has failed?

A

EHC is indicated if one pill is missed beyond the desired interval (12 hours for Cerazette, 3 hours for others)

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25
With the POP how long after EHC until contraceptive effect is reestablished?
48 hours after Levonelle | 9 days after Ella One
26
Under what circumstances is it reasonable to believe the contraceptive patch has failed?
If the patch remains fully or partially detached for 24 hours, apart from the patch free week, EHC is indicated
27
Under what circumstances is it reasonable to believe the vaginal ring has failed?
If expelled and remains outside the vagina for more than 3 hours or the ring free interval extends past 9 days, EHC is indicated
28
Under what circumstances is it reasonable to believe IUS/IUD has failed?
EHC is indicated if partial or full expulsion occurs, or it is removed mid cycle, and UPSI occurs 5 days before removal
29
Under what circumstances is it reasonable to believe Medroxyprogesterone Acetate has failed?
If more than 14 weeks since a DMPA injection has passed, contraceptive efficacy begins to wear off. Up to 120 hours after the 14 weeks EHC is indicated
30
What criteria must an EHC patient meet before using a PGD? And what does a PGD cover?
Age (potentially including under 16s) Patients meeting requirements may receive EHC free of charge, referrals should occur quickly, signposting to clinics and long term contraception should occur, clients excluded from criteria may purchase the service
31
What is considered the main aim when commissioning a minor ailments scheme?
Reducing demand for GP appointments
32
What are the three typical methods of access to MAS?
Vouchers: referral via the GP where patient is given a token to demonstrate entitlement to treatment. Passports: a form of registration issued by a pharmacist allowing access to target specific patient groups without the inconvenience of first going to the GP. Entitles use in the future but may limit number of visits over a certain time period. Open: patient can present whenever treatment is required and eligibility criteria is minimal.
33
What 5 criteria will GP surgeries look for before supporting MAS?
Patients will receive fast and effective care, advice and treatment. Patients will be referred back where needed. Surgeries are kept informed about patient care. The impact MAS has on the workload of the surgery. The MAS reflects their practice in treatments.
34
What is the most common reason for a GP consultation?
Skin infections
35
What is impetigo?
A bacterial infection of the skin often caused by staphylococcus aureus
36
Who is most commonly affected by impetigo?
Young children and people with underlying conditions such as eczema, head lice and scabies.
37
What is the most common form of impetigo?
Crusted impetigo- where lesions form around the nose and mouth which burst to form yellow-crusted, weeping plaques. It is very infectious.
38
What are the most common local and systemic treatments for impetigo?
Fusidic acid can be used to treat small areas of localised infection. Larger areas require systemic treatment for 7 days with Flucloxacillin or Clarythromycin.
39
What bacteria causes folliculitis, boils, carbuncles, whitlows?
Staphylococcal
40
What pre existing conditions increase risk of staphylococcal infections?
Dermatitis Immunosuppression Obesity Malnutrition
41
What is the treatment for folliculitis?
Daily use of antiseptic washes containing chlorhexidine or triclasan. Antiseptic emollients such as dermal or oilatum. Occasionally use of fusidic acid can be used on localised areas.
42
What bacteria causes hot tub folliculitis?
Infection of hair follicles by pseudomonas aeruginosa.
43
What symptom presents with hot tub folliculitis?
Rash consisting of 0.5-3cm red papule with central pustule that can erupt.
44
What are the differences between boils and carbuncles?
Boils- appear as painful red lumps that fill with pus, most commonly on hair bearing sites on the body. Carbuncles- appear as tender abscesses with discharge, most commonly on the back of the neck, shoulders, hips and thighs.
45
What are the treatments for boils and carbuncles?
Moist heat should be applied if they contain pus. Analgesics can reduce discomfort. They can be drained by practitioners. Antibiotics can be given for large lesions.
46
What bacteria causes erysipelas and cellulitis?
Strep. pyogenes
47
What is the difference between erysipelas and cellulitis?
Cellulitis involves subcutaneous tissue whereas erysipelas involves dermis and dermal lymphatics.
48
How does cellulitis present?
Inflammation and redness of the skin which can lead to blistering. Fever, nausea, malaise and shivering may be accompanying symptoms.
49
What is the characteristic symptom of erysipelas?
Orange peel like rash on the face of extremities.
50
What are the two main causes of fungal infection?
Dermatophytes that invade keratin. | Yeast which opportunistically invades warm, moist sites.
51
________ dermatophytes cause mild inflammation and spread from person to person.
Anthropophillic
52
_______ dermatophytes cause more severe inflammation.
Animal
53
What is the most common type of fungal infection?
Athlete's foot.
54
What are the three mains aims when treating athlete's foot?
Eradicating infection Promoting healing Preventing reinfection
55
What are the two types of fungal topical treatments?
Imidazole derivatives e.g. miconazole (fungistatic) | Allylamines e.g terbinafine (fungicidal)
56
What is onychomycosis?
Fungal nail infection
57
What is Candidiasis?
A yeast that causes infections of the skin folds, paronychia, genitals and mouth.
58
What is molluscs contagiosum?
A highly contagious pox virus, spread by contact, that forms flesh coloured papules. If left untreated, it will clear on its own.
59
What are viral warts caused by?
Infection of epidermal cells by the human papilloma virus.
60
What are the 3 different possible appearances of warts?
Plantar- verrucas, occur on the soles of feet Plane- smooth, flat topped and occur on the face or backs of hands Mosaic- rough, marginated plaques made up of tightly packed plantar warts
61
What are the 2 treatment options for warts?
Topical salicylic acid | Cryotherapy with liquid nitrogen
62
What are the symptoms of herpes labialis?
Tingling around the mouth | Formation of painful vesicles that burst and crust over
63
What is the treatment for eczema herpeticum?
Immediate systemic treatment with aciclovir
64
What causes shingles?
Reactivation of the herpes virus which has remained dormant since an episode of chicken pox.
65
What is the target age group for the Chlamydia screening services?
Under 25s
66
Under what circumstances may under 16s use the chlamydia screening service?
They must be Fraser competent
67
What do pharmacies offer as part of the chlamydia screening service?
``` Testing kits Advice on using the kit Returns for testing Contact chasing Treatment in line with a PGD ```
68
What symptoms can occur with chlamydia?
``` Usually asymptomatic Pain when urinating Unusual discharge Bleeding during/after sex Burning/itching in the urethra ```
69
What long term complications can occur with chlamydia?
Ectopic pregnancy Pelvic inflammatory disease Infertility Inflammation of the testicles
70
What is the standard treatment for chlamydia?
Azithromycin 500mg tablets | 2-4 tablets given in one dose
71
What is a PGD?
Documents permitting the supply of POMs to groups of patients without the need for an individual prescription
72
What are the 7 types of nicotine replacement therapy?
``` Gum Patch Lozenge Sublingual tablet Inhalator Nasal spray Oral spray ```
73
Name three diseases smokers have higher risk of?
COPD Cancer (lung) Cardiovascular disease
74
What risks do smoking present in pregnancy?
Still birth Premature delivery Low birth weight Oxygen deficiency
75
Give examples of the immediate benefits of quitting smoking.
``` Low blood pressure Reduced carbon monoxide levels Lungs clear Heart rate reduces Smell and taste improves ```
76
What is psychological dependence?
Feeling of satisfaction that requires periodic or continuous administration of the drug to feel pleasure or avoid discomfort
77
What is physical dependence?
Intensive physical disturbances that occur when administration is suspended
78
What are the 4 stages of drug use?
1. Experimentation 2. Recreational use 3. Problematic use 4. Addiction
79
Give three examples of stimulants.
Amphetamine Cocaine Ecstasy
80
Give three examples of depressants.
Opioids Benzodiazepines Cannabis
81
Give two examples of hallucinogens.
LSD | Magic mushrooms
82
What are the three measures of drug use?
Offences committed Surveys Treatment numbers
83
What are the risks of heroin use
Physical dependence Overdose HIV, hepatitis or bacterial infections Damaged veins
84
What are the 6 steps for injection of heroin?
Mix freebase heroin, acid (citric) and water to form salt Remove particles Draw through filter into a syringe Locate vein and tourniquet Insert needle into vein and draw up some blood Inject the drug and withdraw needle
85
What four areas should be avoided as injection sites?
Femoral vein Neck Penis Breast
86
When should the tourniquet be removing during the heroin injection process?
Before injection of the drug
87
Why should lemon juice and vinegar be avoided in the preparation of injectable heroin?
Lemon juice- risk of fungal infection | Vinegar- far too strong
88
What are the two stages of methadone treatment?
1- maintenance, substitute heroin with methadone by increasing dose 2- withdrawal, aim to become completely drug free, reducing the dose
89
What strength of buprenorphine tablets are available?
2mg and 8mg

Pharm Y1 (11 decks)

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