GPhC Patient Safety & Clinical Pharmacy

Question 1

What is the 'five rights' framework in medication safety?

Accepted Answer

Right patient, right drug, right dose, right route, right time

Answer

The five rights are a widely used medication safety framework: right patient, right drug, right dose, right route, and right time — all must be confirmed to prevent medication errors.

Question 2

Which drug interaction should be identified when a patient on ramipril is prescribed potassium supplementation?

Accepted Answer

Hyperkalaemia risk — ACE inhibitors reduce aldosterone, raising potassium levels

Answer

ACE inhibitors reduce angiotensin II-mediated aldosterone secretion, decreasing urinary potassium excretion. Adding potassium supplements increases hyperkalaemia risk, potentially causing dangerous arrhythmias.

Question 3

A patient on warfarin starts a course of amiodarone. What monitoring is required?

Accepted Answer

Increased INR monitoring; warfarin dose likely needs to be reduced

Answer

Amiodarone inhibits CYP2C9, reducing warfarin metabolism and significantly increasing INR. Warfarin dose often needs to be halved. Enhanced INR monitoring is essential when starting amiodarone.

Question 4

What is meant by 'polypharmacy' and when does it become a concern?

Accepted Answer

Use of multiple medicines; becomes a concern when it increases risk of interactions, side effects, and non-adherence

Answer

Polypharmacy (typically defined as ≥5 medicines) raises patient safety concerns due to increased drug interaction risk, adverse effects, pill burden, and adherence challenges, particularly in elderly patients.

Question 5

Which score is used to assess bleeding risk in patients with atrial fibrillation being considered for anticoagulation?

Accepted Answer

HAS-BLED score

Answer

HAS-BLED estimates bleeding risk in AF patients on anticoagulation. It scores factors including Hypertension, Abnormal renal/liver function, Stroke history, Bleeding tendency, Labile INR, Elderly (>65), Drugs/alcohol.

GPhC Registration Practice Test

GPhC Registration Practice Test

GPhC Patient Safety & Clinical Pharmacy