Revision (class) Exam Questions Mix PASP and Science Based Questions

1. One of the medications that the patient is taking 'Medication A' has a log P value of -0.42. The distribution of Medication A is affected by pH. Explain how a log P value of -0.42 would influence the ADME profile of this drug (4 marks) log p value -0.42 = very soluble in water, not very lipophillic A = [absorption] being hydrophillic, medication A has low absorption + potential lower bioavailability, this could affect how quickly + efficently the drug enters the bloodstream - less likely to cross the biological membrane D =[distribution] lower log P value indicates that Medication A is less likely to penetrate cell membranes + tissues, leading to a higher conc in the blood + extracellular fluid - this may affect the Vd (volume of distrubution) of the drug in the body M= (metabolised makes molecule more polar) low metabolism - a hydrophillic drug like Medication A may undergo minimal metabolism in the liver. - this could impact the drug's half-life + clearance rance E [excretion] = high excretion (usually excrete water-soluble drugs) - Medication A is more likely to be excreted through the kidney + less prone to reabsorption in the renal tubules Molecule A is capable of ionisation 2. One of the medications that the patient is taking 'Medication A' has a log P value of -0.42. The distribution of Medication A is affected by pH. Using appropriate figures to support your answer, predict which common (DRAW) - looking at functional groups that are ionisable, polar - ionise = have electronegative atoms /charges COOH, NH2 (amine), amides, OH (acidic functional groups in an acidic environ = not ionise) 1/5 functional groups may be present in Medication A 3. If there are many - too water soluble H-bond donors/ac- - difficult to distribute ceptors? 4. What are the ad- target delivery = deliver medication directly into the vantages of inhaler lungs medication? - rapid onset = inhalers provide quick relief as the medication directly enters the lungs + bloodstream - lower systemic side effects = inhalers reduce systemic side effects compared to oral medications by targeting the affected area - convenience = portable + easy to use - reduced dosage = inhalers often require lower doses compared to oral medications for the same therapeutic effect 5. What is the legal name for a prescriber? appropriate practitioner 6. What is the leBody corporate gal term in the Medicines Act 1968 for a group of pharmacies which has a superintendent pharmacist? 7. When can P med- if a 2nd pharmacist is present icine be sold from the pharmacy with2/5 out RP being present? 8. What do most drugs can cause? - GI problems - e.g. nausea, vomiting, diarrhoea 9. Talking to a patient at the pharmacy counter is a key skill for pharmacists. You are asked to speak with a patient. Mr IP wishes to buy paracetamol for an adult who has aches + pains related to a cold. a) What questions would you ask Mr IP before deciding to sell a medicine? Why are these questions important? - before deciding to sell a medicine, pharmacists use a communication style called WWHAM 10. Talking to a patient at the pharmacy counter is a key skill for pharmacists. You are asked to speak with a patient. Mr IP wishes to buy paracetamol for an adult who has aches + pains related to a cold. Important questions for Mr IP: - medical conditions - if have any check for interactions - current medications = prevent drug interactions with paracetamol - symptoms + duration - the WWHAM questions are important, it cover info if the patient is eligible for drug - it is a systematic approach to counseling so that the pharmacist doesn't miss anything and carry also the necessary info - the pharmacist could expand WWHAM by looking at safety netting, allergies these questions are important for safety use of paracetamol for the patient. 11. Talking to a pa- mention strength and dose tient at the pharma- - give 500mg paracetamol tablets can be sold over the cy counter is a key counter (OTC) in a pharmacy 3/5 skill for pharmacists. You are asked to speak with a patient. Mr IP wishes to buy paracetamol for an adult who has aches + pains related to a cold. - patient DOES NOT take anything else containing paracetamol - if someone goes over the maximum dose = seek urgent medical advice - recommend paracetamol 500mg every 4-6 hours, max dose is 8 in 24 hours - caution against liver damage by not exceeding max dose b) What advice would you have for Mr IP if you choose to supply paracetamol tablets? Answer should include dosage + safety info necessary to protect patients taking this product 12. What advice would you have for Mr IP if you choose to supply paracetamol tablets? Answer should include dosage + safety info necessary to protect patients taking this product - paracetamol is an analgesic medicine to treat pain. It is available as a prescription-only medicine (POM) but also can be sold through pharmacies as a Pharmacy (P) and in very small packs as a general sale list medicine (GSL) - when sold in a pharmacy the strength of the tablets is 500mg + the usual pack size is 32 tablets - a maximum of 3 whole packs (96) tablets can be sold over the counter (OTC) by/under the supervision of a pharmacist (top answer) - part packs must not legally be sold + law says quantities of 100 or more tablets are POM - The usual dose of paracetamol 500mg tablets for an adult in pain is taken one to two tablets every four to six 4/5 hours when required - do not take more than 2 tablets at any one time - do not take more than 8 tablets (4g) in 24 hours - do not take anything else containing paracetamol while taking this medicine - talk to a doctor at once if you take too much of this medicine, even if you feel well 13. What are the legal classifications of medicine in the UK? Which 2 pieces of legislation apply to this classification system? Using Paracetamol 500mg tablets as the examplar to illustrate the restrictions on pack sizes + sales in each class - the Medicines Act 1968 and Human Medicines Regulations 2012 govern all the sales + supply of medicines in the United Kingdom there are 3 classes of medicines in this legislation: - prescription-only medicines (POM) - pharmacy medicine (P) - general sales list medicines (GSL) (P + GSL = OTC) - POM can only be sold or supplied against a prescription and under patient group direction (PGD) / emergency supply - P sold in a pharmacy by/under the supervision of a pharmacist. must be sold in full packs if under supervision RP must be present - GSL sold from any lockable premises, must be sold in small packs - max 100 tablets of GSL - P restricted to 32 tablets 14. What does word 'legislation' in exam refer to? law 5/5