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Lohit Pindoria - Pharmacy Interview Questions – Drug Development Pharmacology: Pharmacodynamics (depressing, stimulating, cytotoxicity, irritation, replacing substances) Pharmacodynamics (The action of the drug on the body) Desired activity The desired activity of a drug is mainly due to one of the following:

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Undesirable effects Cellular membrane disruption Chemical reaction Interaction with enzyme proteins Interaction with structural proteins Interaction with carrier proteins Interaction with ion channels Ligand binding to receptors: o Hormone receptors o Neuromodulator receptors o Neurotransmitter receptors Pharmacokinetics (The action of the body on the drug)

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Increased probability of cell mutation (carcinogenic activity) A multitude of simultaneous assorted actions which may be deleterious Interaction (additive, multiplicative, or metabolic) Induced physiological damage, or abnormal chronic conditions

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Liberation - the process of release of drug from the formulation. Absorption - the process of a substance entering the blood circulation. Distribution - the dispersion or dissemination of substances throughout the fluids and tissues of the body. Metabolism - the irreversible transformation of parent compounds into daughter metabolites. Excretion - the elimination of the substances from the body. In rare cases, some drugs irreversibly accumulate in body tissue, renal or hepatic metabolism (break down in active and for extractive).

Pharmacokinetics describes how the body affects a specific drug after administration. Pharmacokinetic properties of drugs may be affected by elements such as the site of administration and the dose of administered drug. These may affect the absorption rate.

Please talk about a current controversial issue regarding pharmacy, and your personal opinion towards it. Contraceptives: Religion and Morals of Pharmacist Can you tell me about a controversial drug in the media? FDA accused of being in contempt of court as they failed to reconsider restrictions on Plan B ((Levonorgestrel). The FDA said it would allow sale of Plan B without a prescription to all women 17 and older. But the agency said it would not make it available to younger women unless it received a request to do so from the company. Plan B consists of higher doses of a hormone found in many standard birth-control pills. Taken within 72 hours of unprotected sex, it has been shown to be highly effective at preventing pregnancy. But the medication has long been controversial. Some anti-abortion activists argue that the drug can cause the equivalent of an abortion in some cases by making the womb inhospitable to an embryo -- a claim disputed by many medical experts and reproductive rights activists. Why is organic chemistry important to pharmacy? Interaction of different chemical compound, how compounds choose to react, why compounds exist as they do Which science is most important in pharmacy and why? Chemistry, the study of chemical compounds and there mechanisms of actions What do you enjoy about the courses which you are currently doing? Organic chemistry, how compound have certain behaviours and preferences of reactions Do you know anything about any common drugs (e.g. NSAIDS and Paracetamol), how they are made, how the work within the body, issues with the drug? Aspirin (an NSAIDS), (C9H8O4), analgesic (painkiller), antipyretic (reduce fever), anti-inflammatory, Aspirin also has an antiplatelet effect by inhibiting the production of thromboxane, which under normal circumstances binds platelet molecules together to create a patch over damage of the walls within blood vessels. Because the platelet patch can become too large and also block blood flow, locally and downstream, aspirin is also used long-term, at low doses, to help prevent heart attacks, strokes, and blood clot formation in people at high risk for developing blood clots. It has also been established that low doses of aspirin may be given immediately after a heart attack to reduce the risk of another heart attack or of the death of cardiac tissue. The main undesirable side effects of aspirin are gastrointestinal ulcers (in stomach protective layer from acid, NSAIDS prevents maintenance), stomach bleeding, and tinnitus (ringing in ear), especially in higher doses. In children and adolescents, aspirin is no longer used to control flu-like symptoms or the symptoms of chickenpox or other viral illnesses, because of the risk of Reye's syndrome (liver damage and affects brain function). Steroids are synthetic drugs to mimic the body’s natural steroid cortisol. Aspirin adheres to cyclooxygenase-2 to prevent it from producing prostaglandin so it can’t signal the pain. How do Antihistamines work? Prevents histamines (leads to allergy type symptoms) being released from mat cells. Which of the antihistamines cause drowsiness? Piriton

Lohit Pindoria Can you name some Non-sedating antihistamines? Centirizin What is meant by a profession? A vocation which requires educational training What is an anti-fungal? Drug to treat against fungal infections e.g. athletes foot Why are pharmacists important in the health service? Your pharmacist can tell you a lot more about medicines and the components, than most doctors. Doctors know the medicines you need for your illness, but the pharmacist knows how the medicine is made. That is because they are not only pharmacist they are scientist. They study the compounds of different drugs, the weights and dosage of these drugs and how they can or should be administrated. Most prescription today are given with a leaflet so you can understand why this medicine was prescribed, how to take it, what medicines you should avoid, the list is endless. Most pharmacist can tell you a lot more about the medicines that you are prescribed, as well as how they interact with other medicines you are currently taking. That is why it is very important to stay with the same pharmacy, whether it is your local pharmacy or a popular chain store, because they have all your information in their computer. A great pharmacist will not only know what a medicine is for, he will tell what is does, the pros and cons of this medicine, all you have to do is ask. The best part is if you ask, and he cannot answer the question, in the world we live in today; he can look things up in the computer. What is the role of the primary care pharmacist? The work may include medicines management, prescribing advice, GP practice based work, professional development adviser and pharmacy clinical governance coordination. They may also work in GP practices as practice pharmacists. What are preventative medicines and there importance? Prevent development of further diseases, cheaper to prevent than to treat during, generally lower mortality rate in LEDC’s What would you take into account when prescribing drugs to a patient? Patient history, current medicines/alternatives, own knowledge, ensure patients understanding, fully understand patients problem, Why are drugs stored in particular ways in a pharmacy? Some at are at room temp because as high temps they can degrade the medicine, brown bottle to protect from light, refrigerated What is a medication? Something that prevents or relieves the symptoms of a disease What is a Generic Drug? Reasons for cheaper price? Drug that is without a patent and that can be produced by any approved manufacture, brand name more expensive as research, marketing, process, marketing When can a generic drug be produced? Drug patent expires and manufacturers are permitted to produce the generic alternatives What is a prescription drug? A drug that may only be sold by a pharmacist when authorised by a written prescription from a medical practitioner What is the differences between hospital, community and industrial pharmacy?

Hospital working with the healthcare team to ensure the selection of the best medication at the correct dose for an appropriate duration monitoring and preventing or minimising side effects and drug interactions providing medication counseling to patients dispensing medications for patients in wards, the emergency department and those attending outpatient clinics manufacturing specialised medications such as chemotherapy for cancer treatment, mixtures and creams etc offering specialist drug therapy advice to doctors, nurses and other healthcare professionals within the hospital visiting patients in their home after discharge to ensure safe medication management, and to prevent errors and readmission to hospital.

Industry

Industrial pharmacists research and develop new drug compounds. They test new medications for safety and efficacy, and may oversee production processes. In some cases, industrial pharmacists may also help market new drugs.

What is palliative care? Palliative care aims to alleviate pain and discomfort to improve quality of life for all patients with any end-stage illness What’s diabetes? A condition where the pancreas produces insufficient or no insulin, a hormone which controls sugar levels in the blood. Without insulin, the blood cannot absorb sugar into cells for energy and into liver and fat cells for storage. Why can't insulin be taken as a pill like the other medicines and hormones? Insulin is a hormone, also called a poly peptide, (a protein). For this reason, it cannot be taken orally, the stomach acids would destroy it. It must be injected just under the skin. You can inject it anywhere, but it will be absorbed fastest when injection in the abdomen or upper thigh. Other types of hormones can safely be taken orally without worry. They have a different makeup to them that is not destroyed by the stomach fluids.

Lohit Pindoria Name three drug delivery methods and explain each of them? Injecting has very fast delivery, ingestion is slow, inhaling through nasal passage has a fast response, patches are slow and so not addicting (addiction is far greater with increased rate of drug delivery into the blood stream), method of delivery depends on patients preferences, rate of absorption, dosage What are a metered-dose inhaler and a spacer? A metered-dose inhaler (MDI) is a device that delivers a specific amount of medication (in the form of a fine power) to the lungs, in the form of a short burst of aerosolized medicine that is inhaled by the patient. It is the most commonly used delivery system for treating asthma and other respiratory diseases. It can be difficult to use the correct technique with a metered-dose inhaler, we often recommend the use of a spacer. A spacer is a device that attaches to the metered-dose inhaler. It helps deliver the medicine to the airways of the lungs instead of the mouth. This helps the medicine work better and lessens side effects. Please explain dosage of inhalers compared to tablets? Dosage is a lot lower in an inhaler (micrograms) compared to a tablets (milligrams) Please name three medicines? Paracetamol, Aspirin, Ibuprofen How does penicillin work? Penicillin operates by dissolving the cell wall of bacteria, dispersing its cytoplasm and other cell systems. One essential component of the bacterial cell wall is transpeptidase, which accepts molecules of penicillin as a substrate attachment. The penicillin activates, preventing peptidoglycan reactions that strengthen links in the cell wall. This leads inevitably to cytolysis and cell death. While drug resistance, particularly strains increasingly immune to penicillin, has become big news recently, the development is long in coming. Since penicillium uses penicillin for the same purposes as humans, bacteria has already developed a set of defences. Many bacteria produce penicillinase, which rots away the penicillin clinging to transpeptidase. This evolutionary combat highlights another method through which penicillin and its derivatives operate. Because bacteria has developed such defences including double cell-walls which can't be fully dissolved, penicillin has evolved to work in concert with other chemicals such as aminoglycosides. Thus penicillin operates on several levels. In conjunction with aminoglycosides penicillin disrupts protein synthesis and even the reproduction of organelles within the bacterium. The future of pharmacy. Please continue. In the coming decades, pharmacists are expected to become more integral within the health care system. Rather than simply dispensing medication, pharmacists will be paid for their patient care skills. Medication Therapy Management (MTM) includes the clinical services that pharmacists can provide for their patients. Such services include the thorough analysis of all medication (prescription, non-prescription, and herbals) currently being taken by an individual. The result is a reconciliation of medication and patient education resulting in increased patient health outcomes and decreased costs to the health care system. In the United Kingdom, pharmacists who undertake additional training are obtaining prescribing rights. They are also being paid for by the government for medicine use reviews. Why not medicine or dentistry if you like healthcare and people? chemistry aspects over clinical decisions, more in-depth knowledge of drugs What is the difference between pharmacology and pharmacy? Pharmacology is the study of drug interaction in living organisms. Learning how a drug interacts in the human body, for example, a drug that only affects certain parts of the brain, or specific organs, but not others, due to the molecular structure of the molecule. Pharmacology is a more specific department of medicine. Pharmacy is a profession that ensures the safe use of medication and deals with patients, therefore pharmacists will need to have a wider knowledge of how a drug works, how it's formed and its side effects. Furthermore, Pharmacists will need to learn pharmacology, As well as microbiology, drug delivery, drug production, specific human anatomy and many more. I hope this helps. Why do old (out of date) eggs float in water? Fresh eggs are dense and filled with fluids. Yolk and albumen fill the available space inside the shell completely. Egg shells are actually porous however and as they age they lose moisture from inside the shell. This moisture loss is replaced by air and that air forms a bubble inside the shell which eventually gets large enough to make the old egg float on water. What are antibiotics? Medicines prescribed to help the body fight bacterial infections like gonorrhea and chlamydia. What is a drug overdose? The term drug overdose (or simply overdose or OD) describes the ingestion or application of a drug or other substance in quantities greater than are recommended or generally practiced. An overdose is widely considered harmful and dangerous as it can result in death. How do you feel about drug trials? Northwick park trials, what happened? What are drugs trials and how are they organised? Who gives permission for them to go ahead? Who takes part in such trials? Do people know things could go wrong? How common are problems such as those seen in this trial? What have experts recommended future trials? Six men became severely ill after being injected with an immune system stimulating, experimental drug called TGN 1412. The drug caused all six men to suffer multiple organ failure caused by, what has now been termed, a ‘cytokine storm’. At the Drug Discovery Technology Europe Summit this week, Duff presented a summary of the groups’ recommendations for the improved safety of future clinical trials involving novel and potentially risky drugs. The recommendations form a step-wise guide to ensure that lessons learned from Northwick Park are put into practice. They address each stage of the trial including the determination of an initial dose and suitable method of drug administration. in clinical trials, first there is simulated computer research then animal testing and finally human testing, small doses are first given to test for any side effects, All trials which take place in the UK have to be authorised by the MHRA (medicines and healthcare products regulatory agency), which decides if they are scientifically valid and properly designed. Please explain the synthesis of aspirin.

Lohit Pindoria In hospital pharmacy, what do you understand by a "clean room"? A pharmacy clean room is a low-level pollutant environment for the storage and preparation of medication in a hospital setting. Contaminants are constantly produced by facilities, machines and the people in the room. A clean room provides a locale where the air is constantly controlled. Clean rooms hold different coloured bins that separate medications, label makers and wash stations. Machinery housed in these rooms contributes in the production of these drugs. Clean rooms help ensure the production and manufacturing of medications in a clean safe environment. Clean rooms require proper attire that cover workers from head to toe. The standard uniform consists of gloves, face masks and a head cover. Workers must constantly maintain a clean environment in order to keep the room as contaminate-free as possible. The use of high efficiency particulate air filters) helps in maintaining clean air quality. Other filtration devices are also employed to help remove unnecessary particles from the room. Clean rooms are made according to size and the way airflow is circulated through them. People can choose from several types, including all-steel biosafe, hardwall, softwall, double-wall plastic, ventilation, powder-containment and negative-pressure clean rooms. Tell me about the different drugs you would expect to find in a hospital setting in comparison to community? More controlled drugs, drugs in forms of IV’s What do you know about radiopharmaceutics? Radiopharmacology is the study and preparation of radiopharmaceuticals, which are radioactive pharmaceuticals. Radiopharmaceuticals are used in the field of nuclear medicine as tracers in the diagnosis and treatment of many diseases. Many radiopharmaceuticals use technetium (Tc-99m). Draw a general Amino Acid.

What is a protein? Proteins (also known as polypeptides) are organic compounds made of amino acids arranged in a linear chain and folded into a globular form. The amino acids in a polymer are joined together by the peptide bonds between the carboxyl and amino groups of adjacent amino acid residues. What reaction makes proteins from amino acids? Condensation polymerisation reaction Draw a section of a protein.

What is the name of the link between individual amino acids? Amide linkage/Peptide linkage What are some challenges that pharmacists face? Keeping controlled substances in stock or not, keeping meds secure, wrong dosage, fake prescriptions, addicts, own knowledge for drug interaction , keeping up to date with trials and new drugs Drug classes These drugs are usually known in the UK as controlled drugs, because they are such by the meaning given to that term by the act itself. In more general terms, however, many of these drugs are also controlled by the Medicines Act 1968, and there are many other drugs which are controlled by the Medicines Act but not by the Misuse of Drugs Act. The Misuse of Drugs Act sets out three separate categories, Class A, Class B, and Class C. Class A drugs represent those deemed most dangerous, and so carry the harshest punishments. Class C represents those thought to have the least capacity to harm, and so the Act demands more lenient punishment. Being found in possession of a drug on this list is dealt with less seriously than would be if it were deemed that there is intent to supply the drug to others. Possession with intent to supply carries a maximum penalty of life imprisonment. What other health-care professions had i considered studying/entering? Medicine, not good lifestyle too many on calls, unsociable hours How patches work, why patches are used, when are patches used The patch adheres to the skin and delivers the medication through the blood stream. Some pharmaceuticals must be combined with substances, such as alcohol within the patch to increase their ability to penetrate the skin in order to be used in a transdermal patch. The molecules of the medication must be small enough to pass through the skin. There are five crucial parts to the transdermal patch which enable the success of the medication to be distributed into the bloodstream. There is the liner, the drug, the adhesive, the membrane and the backing. The liner is removed prior to use and protects the patch while it is not in use. Drug comes in contact with the liner and is the solution which is exposed to the skin. The adhesive binds the components of the patch together while keeping it adhered to the skin. The membrane controls the release time for the drug and is often used in many different layers to release a certain amount at a time. The backing is the part that is exposed to the air, and protects the drug at all times. All of these parts work as the sum of the whole to infuse the medication into the bloodstream, through the skin. Used when oral not tolerated, patients choice and other routes not desirable e.g side effects, used because of slow constant release. When you would choose to inject a drug and when you would choose to give drugs as a pill? Pill if can tolerate, injection is very severe for fast absorption, What does a pharmacist do? New contract, cholesterol + diabetes testing in community pharmacies, stop smoking programs, vaccinations