Study Guide to Drug Action1 Quiz (Class A) on 17/10/2017

MC x 15 (1 mark each), Fill in blanks x 17 (1 mark each), T/F x 16 (1 mark each),

Short Questions x 3 (4 marks each) = Total 60 marks

MC:

Pharmacy Legislations

Drugs that dont require prescriptions for retail sales P1, P1S1, P2, NP

Drug dispensed by hospital pharmacy: legal requirements

- All medicines cannot be supplied without a legal Rx, no matter it is P or NP

- All medi for outpatient use should have a designation to identify on the label
- Instructions on label should be in both Chinese & English
- No Poison book , Rx book & antibiotic book required but traceable record should be kept
- No separation of storage necessary for all non-DD drugs poisons no need to lock up
separately

Dosage Forms

Packaging of topical pharmaceuticals tubes, cans/ jars

Routes of Administration

Synonym of IV bolus ( IV push, IV injection ,IV infusion and IV drip)

Pharmacokinetics

Effects of P450 inducers induce the activity of the liver enzyme & increase metabolism of other
drug . Plasma conc of active drug is reduced , effect of these drugs are reduced

Method of calculation of maintenance dose Maintenance Dose = CL (volume per time )x

CpSSav(conc)

Pharmacodynamics

Types of Drug Receptors (ligand gated ion channel, G-protein coupled receptors, Enzyme-linked
receptors, intracellular receptors)

Antibiotics

Bacterial cell wall synthesis inhibitors-classes Beta-lactams ,Glycopeptides

Antibiotics not to be used in breastfeeding women & pregnant women Aminoglycosides,

Fluoroquinolones,

Antimicrobials

Drug for treating herpes anti herpes: Aciclovir, Valaciclovir, Famiciclovir

Proper use of Oseltamivir (Tamiflu) take orally, take for 5 days, first line for avian flu

Thyroid

Drug for hyperthyroid pregnant women Propylthiouracil PTU

DM

Mechanism of action of Metformin inhibits conversion of glycogen into glucose in liver, improves
tissue sensitivity to insulin , increase level of GLUT-4, decrease intestinal absorption of glucose

Know the sites of Insulin injection Thighs. Upper buttocks, abdomen, arms

Hormone Replacement Therapy

Role of progestogen prepare endometrium for possible pregnancy, protect endometrium by

preventing overgrowth of endometrial tissues, decreased pro. Level increase developing
endometrial cancer

Fill in the blanks:

Pharmacy Legislations

Record for dispensing P1S1S3 Kept in locked receptacle. Rx book (official record) must be kept for
inspection for 2 years from the date on which the last entry was made. Dispensed Rx should be
kept with the Rx book if it is only partially filled

Dosage Forms

Materials for plastic bags of large volume parenteral solutions PVC polyvinyl chloride : tend to
absorb certain drugs , less problem with polyethylene PE

Solvent for reconstitution of drug powder to be used for injection water for injection, shaken
with prescribed volume of sterile liquid (diluent)

Route of Administration

First step to start IV administration (to insert a venous catheter, a needle is inserted into a vein
mostly near the wrist, catheter is then pushed over the needle , needle s removed and tube
remains)

Pharmacokinetics

Grapefruit juice effect on P450 inhibitor :inhibit activity of liver enzymes, decrease metabokism
of other drug, lower metabolism of drugs, plasma conc of active drug is increased side effects
increased

Meaning of biological half life time taken for plasma conc to fall to half the original value

Pharmacodynamics
Syndrome associated with drug dependence withdrawal syndrome occur if the administration
stops.

Antacids effect on drug absorption of other drugs 1. Altering pH of the stomach content: raise
the pH from 1 to 5 , may affect the degree of ionization of Drug A 2. Binding effects prevent Drug
A from being absorbed ii. Cations of antacids, ii. Sucralfate , cholestramine iii. Fat/bile acid
binding drugs( absorption of fat-soluble vitamins)

Antibiotics

Purpose of Disk Diffusion Test to compare sensitivity of several antibiotics towards bacterium,
access potency of antibiotic, measure Minimum Inhibitory Concentration , tell it is bactericidal/
bacteriostatic

Mechanism of action of lipopeptides binds to cell membrane, causing rapid depolarization of

membrane & loss of membrane potential -> disruption of protein, DNA, RNA synthesis

Antimicrobials

Influenza vaccination frequency receives seasonal vaccine ( during the peak)

Ingredient of insect repellents DEET

Mechanism of action of azoles inhibit the enzymes involved in the biosynthesis od ergosterol,
essential components of the fungal cell membrane

DM

Mechanism of action of DPP4 inhibitors inhibit enzyme DPP-4, causes degradation of GLP-1, it
stimulates insulin secretion & inhibit glucagon release from pancreas-> DPP-4 inhibitors
indirectly stimulate the insulin secretion fr pancreas.

Treatment of gestational DM Animal insulins, human insulin . insulin analogues

Thyroid

Serious complication of antithyroid drugs agranulocytosis

Precaution when taking levothyroxine should begin with low doses , too high dose cause
symptoms of nervousness, palpitations or insomnia (typical hyperthyroidism) & osteoporosis
( increase Ca los fr bone & increased Ca excretion)

T/F:

Pharmacy Legislations

Exempmtions of Pharmaceutical Products in the Pharmacy & Poisons Ordinance ( Chinese

herbal medi, gases , medical gloves ( e.g. surgical dressings) )

Record for retail selling of P1S1 recorded in Poisons book and must be kept for inspection for 2
years from the date on which the last entry was made
Meaning of Expiry Date ( date after which the drugs effectiveness is unpredictable)

Dosage Forms

Characteristic of plastic tube for topical substances ( retain its shape after each squeeze, can
draw air from outside into the tube and cause contamination)

Problems with multidose eyedrops X suitable for contact lens users , preservatives can affect the
contact lens and cause adverse reactions in eyes, should not be used for more than one month
after opening

Routes of Administration

Anaesthetic machine: drug delivering mechanism (aloe composing a mixture of oxygen,

anaesthetics and ambient air, delivering it to the patient via a mask or tracheal tube)

Pharmacokinetics

Drug ionization effect on excretion Acidification of urine would increase reabsorption and lower
excretion of weakly acidic drugs . Alkalinization opposite effect

Characteristics of drugs to pass through blood-brain barrier (BBB) must be small & moderately
lipid-soluble

Pharmacodynamics

Meaning of large and small Therapeutic Index(T.I.) the larger the T.I., the safer and effective
the drug is , small T.I. has to be dosed carefully

Antibiotics

Drugs causing photosensitivity reactions Folate antagonists ( Sulphonamides ,Trimethoprim),

Tetracyclines, Quinolones, Fluoroquinolones

Well known problem associated with the use of chloramphenicol High toxicity to bone marrow
cells-> hemolytic anaemia , grey body syndrome

Antimicrobials

Vaccine for herpes IV Aciclovir : HSV encephalitis , VZV

DM

Storage of insulins store unopen refrigerator (2-8 oC) , opened-> r.t. for 1 month

Thyroid Dosing precautions of levothyroxine in elderly

should begin with lower dose , best to take on an empty stomach , avoid eating soy . iron & Ca
supplements, Al(OH)3. 1.6 mcg/kg/daily, 100-150 mg per day

Indication of Teriparatide 20 mcg SC once daily

Hormone Replacement Therapy

When to stop HRT for postmenopausal women once menopausal symptoms have disappeared,
between two to five yrs

Short Questions:

Antibiotics

Mechanism of action of beta-lactam interfere with synthesis of bacterial cell wall( not found in
human cell), bind to & inhibit penicillin-binding proteins(PBPs) involved in final stages of
synthesis of peptidoglycan

Examples of beta-lactams penicillin, cephalosporins , carbapenems

DM

Mechanism of action of Sulphonylureas SU stimulate insulin secretion by beta-cells in pancreas

Side effects of SU hypoglycemia & weight gain

Hormone Replacement Therapy

Proper way to use cyclic and continuous HRT

Cyclic: take estrogen every day & add progestogen for 10-14 days of menstrual cycle

Continuous: take estrogen & progestogen every day without a break , a monthly period would
not occur