Patient Safety & Clinical Pharmacy Flashcards

What is the purpose of a 'medication use evaluation' (MUE) or drug use review in clinical pharmacy?

Answer: To systematically assess prescribing patterns to identify areas for improvement in drug therapy

MUE/drug use review is a structured, ongoing programme assessing whether medicines are being prescribed, dispensed, and administered appropriately, safely, and cost-effectively.

A patient on spironolactone and an ACE inhibitor develops muscle weakness. What electrolyte abnormality is most likely?

Answer: Hyperkalaemia

Both spironolactone (potassium-sparing diuretic) and ACE inhibitors increase serum potassium. Combination therapy can cause dangerous hyperkalaemia, manifesting as muscle weakness or arrhythmias.

Which antibiotic class should be avoided in children under 12 years due to effects on developing joints?

Answer: Fluoroquinolones (e.g., ciprofloxacin)

Fluoroquinolones can damage developing cartilage in children and adolescents, causing arthropathy. They are generally avoided in children under 18 unless no safer alternative exists.

What is the primary concern when prescribing NSAIDs to an elderly patient with chronic kidney disease?

Answer: Worsening renal function due to prostaglandin inhibition reducing renal blood flow

NSAIDs inhibit prostaglandins that maintain renal vasodilation in patients with CKD. This can precipitate acute-on-chronic kidney injury, especially in elderly patients with reduced renal reserve.

What is a 'high-alert medication' in patient safety terms?

Answer: A medicine that bears a heightened risk of causing significant patient harm when used in error

High-alert medications (e.g., insulin, anticoagulants, concentrated electrolytes) require special safeguards because errors in their use are more likely to cause serious or fatal patient harm.

Which drug is associated with QT interval prolongation and increased risk of torsades de pointes?

Answer: Amiodarone

Amiodarone prolongs the cardiac action potential and QT interval, increasing risk of torsades de pointes — a potentially fatal polymorphic ventricular tachycardia.