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BNF GPhC > Community Pharmacy (OTC) > Flashcards

Community Pharmacy (OTC) Flashcards

1
Q

How long should daktarin gel be applied for?

A

During symptomatic period and for 7 days after symptoms have cleared up

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2
Q

What would be first line for period pains (primary dysmenorrhoea)?

A

NSAID

Can offer paracetamol as well or if NSAID contraindicated

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3
Q

What doesOtrivine Extra Dual Relief nasal spray contain and what is it used for?What is the age licensing for OTC?

A 
Symptomatic treatment of nasal congestion and rhinorrhea in connection with common colds.

Ipratropium bromide
xylometazoline hydrochloride

> 18 years
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4
Q

What would be first line for a sprain?What is second line?

A

Paracetamol or TOPICAL NSAIDIf no improvement after 48 hours of injury, use an oral NSAID

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5
Q

What should you recommend if a pregnant or breastfeeding lady comes in with oral thrush?

A

Refer

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6
Q

True or false:In oral thrush, white patches cannot be removed easily from the tongue

A

False- they can be removed easily leaving a red base

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7
Q

What are the symptoms of oral thrush?

A

Patches of curd-like, white or yellowish plaques that can occur anywhere in the mouth, especially the cheeks, gums,palate, and tongue. These are easily removed, revealing an underlying red base that is not usually painful.

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8
Q

What is this?

A

Angular stomatitis-
soreness, erythema and fissuring at the angles of the mouth

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9
Q

How does the afe licensing of OTC loperamide differ in the following indications:i) Acute diarrhoeaii) Acute diarrhoea associated with IBS

A

i) 12 years and older

ii) 18 years and older if associated with IBS, and need to have diagnosis by the doctor

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10
Q

What age should you refer someone with constipation?

A

<18 to rule out underlying causes

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11
Q

Constipation lasting how long with no identifiable cause prompts a referral?|

A

2 weeks adults

1 week children

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12
Q

When should you stop using EarCalm and what is the maximum number of days you can use it OTC?

A

Treatment should be continued until two days after symptoms have disappeared but no longer than 7 days

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13
Q

What age is acetic acid (EarCalm) licensed in?

A

12+

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14
Q

What are the main differences of presentation for viral and allergic conjuctivitis?

A

Viral can be bilateral or unilateralAllergic is bilateral, red and gritty

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15
Q

Is allergic conjuctivitis contagious?

A

No

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16
Q

What iare the different types of conjunctivitis?

ALLERGIC?
VIRAL?
BACTERIAL?

A

Allergic conjuctivitis

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17
Q

What is this?

A

Bacterial conjuctivitis

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18
Q

What is this?

A

Blepharitis

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19
Q

What is the advice for patients with blepharitis?

A

Maintain good eyelid hygiene (BD then OD)Remove debris from eyelids, can use baby shampoo to do thisWarm compressEye make up can make the condition worse

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20
Q

In patients with blepharitis, can their eyelids stick together?

A

Yes, can also be itchy and have a build up of debris

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21
Q

How long does acute otitismedia usually last?When would antibiotics be indicated?

A 
3 days (can be up to a week)
If symptoms do not improve by themself after 3 days or if patient is systemically unwell, consider antibiotics (amoxicillin)
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22
Q

A rash like this indicates what?

A

Scarlet fever - refer

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23
Q

A rash like this indicates what?

A

Chicken pox

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24
Q

What is the likely diagnosis and what would you do if a child presented with this in community pharmacy?

A

Scarlet FeverRefer as it is caused by Strep A and need antibiotics

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25
Q

What are the symptoms of scarlet fever?

A

Sore throat, fever, extensive red rash (sandpaper like as it is rough)The rash usually starts on the trunk before spreading. NO rash on the face but cheeks can be flushed Strawberry tongue - red papillae and white coating

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26
Q

Scarlet fever is caused by what?

A

Group A strep

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27
Q

Should Hedrin (dimeticone) be applied to wet or dry hair?

A

Dry

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28
Q

Apart from if the child is very young, after how many days should a child see their GP with a fever?

A

If it hasn’t reduced after 5 daysAny other warning signs e.g. if it isn’t reduced by paracetamol, if they have a rash etc

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29
Q

What are the symptoms of Reye’s Syndrome?

A
  • Vomiting repeatedly- Tiredness and lack of interest or enthusiasm- Rapid breathing- SeizuresAs the condition progresses, the symptoms may get more severe and more wide-ranging, and can include:-Irritability, or irrational or aggressive behaviour-Severe anxiety and confusion that’s sometimes associated with hallucinations- Coma (loss of consciousness)
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30
Q

The difference between German measles and measles (morbilli) is what?

A

Measles manifests itself with white spots in the mouth.

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31
Q

Rubella is also known as what?

A

German measles

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32
Q

Which illness is characterised by white spots surrounded by a red ring on the inner cheek and gums?

A

Measles

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33
Q

A patient has severe itchy hands, particularly at night. You notice silver lines with a dot at the end in the webs of her fingers.What is this?

A

Scabies

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34
Q

Discharge coming out the ear can indicate what?

A

Ear infection- refer

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35
Q

What is the dose of paracetamol for 12-15 years?

A

480-750mg QDS

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36
Q

What is the dose of paracetamol for 10-11 years?

A

500g QDS

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37
Q

What is the dose of paracetamol for 8-9 years?

A

375mg QDS

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38
Q

What is the dose of paracetamol for 6-7 years?

A

250mg QDS

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39
Q

What is the dose of paracetamol for 4-5 years?

A

240mg QDS

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40
Q

What is the dose of paracetamol for 2-3 years?

A

180mg QDS

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41
Q

What is the dose of paracetamol for 6 months-2 years?

A

120mg QDS

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42
Q

What is the dose of paracetamol for 3-5 months?

A

60mg QDS

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43
Q

What is the dose of paracetamol for a 2 month old?

A

30-60mg TDS

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44
Q

What does Level 1, 2 and 3 healthy living pharmacies entail?

A

Level 1- Promoting health, wellbeing and self-care (profession-led)Level 2 - Providing services (commissioner-led)Level 3 - Providing treatment (commissioner-led)

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45
Q

How many levels of healthy living pharmacy is there?

A

Level 1, 2 and 3Need to be on the HLP register

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46
Q

Miss W is a 19 year old patient who has developed several painful red lumps and patches (that measure 1-5 cm) on her lower legsWhat advice should you give?

A

These lumps are characteristic of erythema nodosum. Treatment is usually rest and painkillers such as NSAIDs.- The bumps and patches last about two weeks before fading like a bruise.

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47
Q

Psuedoephedrine is cautioned in what conditions?

A

DiabetesHypertensionHeart diseaseAngle-closure glaucoma

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48
Q

If a patient presents to the pharmacy with subconjuctival haemorrhage, what you recommend??What would warrant a referral?

A

There should be no pain and the patient should be reassured that symptoms will resolve in 10 to 14 days without treatment. However, a patient with a history of trauma should be referred to exclude ocular injury.

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49
Q

What is the dosing instruction for Viagra?

A

One 50 mg tablet taken with water approximately one hour before sexual activity - max of one tablet in 24 hoursIf Viagra Connect is taken with food, the onset of activity may be delayed compared to the fasted state

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50
Q

Viagra OTC is licensed from what age?

A

18 years

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51
Q

What is the max duration of days is licensed for OTC naproxen for painful periods?

A

3 days

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52
Q

What is the dosing instruction for naproxen OTC for painful periods?

A

Day 1- Take 2 tablets (500 mg) and then one tablet (250 mg) after 6 to 8 hours if needed.Max 3 tablets in a dayMax 3 days

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53
Q

Children under what age are legally too young to consent to sexual activity?

A

13 years

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54
Q

What is the advice regarding levonorgestrel EHC and breastfeeding?

A

Potential exposure of an infant to levonorgestrel can be reduced if the breast-feeding woman takes the tablet immediately after feeding and avoids nursing at least 8 hours following Levonelle

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55
Q

What is the advice regarding ulipristal EHC and breastfeeding?

A

After using ulipristal breast feeding is not recommended for a week because it is present in breast milk.During this time expressing and discarding the milk is advised to maintain lactation.

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56
Q

In what clinical conditions is the use of EHC levonorgestrel not recommended?

A

Severe malabsorption syndrome e.g. Crohn’s Severe hepatic impairment

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57
Q

In what clinical conditions is the use of EHC ulipristal not recommended?

A

Severe hepatic impairmentAsthma which is being treated by oral glucocorticoids

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58
Q

What is the advice surrounding EHC ulipristal and vomiting?

A

If vomiting occurs within 3 hours another tablet should be taken as soon as possible

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59
Q

If a patient has taken EHC, after how any days of an overdue period must they do a pregnancy test?

A

More than 5 days overdue

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60
Q

Can you take a second dose of levonorgestrel within the same cycle?

A

EMC does not advise it as it can disturb the woman’s period

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61
Q

What is the advice surrounding EHC levonorgestrel and vomiting?

A

If the patient vomits within 3 hours of taking levonorgestrel, she should repeat the same dose she took previously.

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62
Q

Levonorgestrel is less effective in women with a BMI over what?

A

26 - may need a double dose as per FSRH advice

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63
Q

If a patient has taken CYP3A4 enzyme inducing medicines or herbal products in the last 4 weeks, and an IUD is not suitable, what EHC and what dose should they have?

A

2 tablets of levonorgestrel 1500 micrograms should be taken within 72 hours of unprotected sex

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64
Q

True or false:Ulipristal EHC is not recommended for patients who have taken CYP3A4 enzyme inducing medicines or herbal products in the last 4 weeks

A

True

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65
Q

What is the dose of levonorgestrel for EHC?

A

1500 micrograms

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66
Q

What is the dose of ulipristal acetate for EHC?

A

30mg

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67
Q

What age is levonorgestrel licensed for OTC?

A

16 years and over

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68
Q

How may hours after unprotected sex is Levonorgestrel licensed for?

A

72 hours (3 days)

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69
Q

How may hours after unprotected sex is Ulipristal Acetate licensed for?

A

120 hours (5 days)

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70
Q

Can you catch chickenpox from someone with shingles?

A

Yes if you have not had chickenpox before

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71
Q

Can you catch shingles from someone with chickenpox?

A

No

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72
Q

How soon do you get symptoms after coming into contact with chickenpox?

A

1-3 weeks

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73
Q

How long before symptom onset is chickenpox contagious for?

A

Usually from 2 days before spots appearUntil the spots have crusted over- considered contagious until no new lesions have appeared for 24 hours

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74
Q

A non blanching rash can be a symptom of what?

A

MeningitisThe rash does not fade when pressed with a glass

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75
Q

What is the dosing instruction for amorolfine for fungal nail infections?What time scale for toenails and fingernails?

A

Apply to the nail once weeklyHas to be applied regularly until all the affected nail has grown out6 months for fingernails9-12 months for toenails

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76
Q

What is Onychomycosis?

A

Fungal nail infection

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77
Q

At what age would you refer a patient if they requested a PPI for first time dyspepsia symptoms?

A

55 years(Refer those over 45 years of age who suffer from long term recurrent symptoms of indigestion or heartburn)

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78
Q

Do PPIs provide immediate relief?

A

No- start to work after a day or soIf a patient needs immediate relief, an antacid or alginate is more appropriate

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79
Q

What is the dose for pantoprazole OTC?

A

20mg OD

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80
Q

What is the minimum age for pantoprazole OTC?

A

18 years

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81
Q

Is it recommended that a child with bacterial conjunctivitis does not go to school?

A

No - should still go to school

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82
Q

If a patient presents to the pharmacy with bacterial conjunctivitis, but wears contact lenses, what should you do?

A

Refer - needs to be advised chloramphenicol on the advice of a doctor / contact lens practitioner Hard contact lens users and disposable contact lens users can start using their lenses again after successfully completing a course of treatment.Soft contact lens wearers should wait 24 hours after completing a course of treatment before starting to use their lenses again.

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83
Q

What are the storage requirements for chloramphenicol i) Eye dropsii) Ointment

A

Store eye drops in the fridgeOintment does not need to be in the fridge but store at no more than 25°C

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84
Q

What are the dosing instructions for chloramphenicol ointment?What about if used with the eye drops?

A

Apply 3-4 times a day for 5 daysEye drops during the day, and the ointment just one application at night

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85
Q

What are the dosing instructions for chloramphenicol eye drops?

A

Total 5 days One drop into affected eye every 2 hours for the first 48 hours and every 4 hours after

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86
Q

If a male patient asks for tamsulosin OTC but mentions he suffers from postural hypotension, what should you do?

A

ReferCan cause postural hypotension

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87
Q

After how many weeks of tamsulosin OTC does the patient have to get assessed by a doctor?

A

6 weeks and they can agree whether further supplies are appropriate Then an annual review after this

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88
Q

How many weeks of tamsulosin is supplied initially?

A

2 weeks

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89
Q

What is the supply criteria for tamsulosin OTC?

A

Male patients 45-75 yearsHad symptoms for a minimum of 3 months2 weeks supplied initially and then if there is an improvement in symptoms, a further 4 weeks can be supplied (14 days after starting)

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90
Q

Can sumatriptan be used as a prophylactic for migraines?

A

No- it is for acute attacks

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91
Q

If a patient comes in asking for sumatriptan but is on an a MAOI, what should you do?

A

Refer

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92
Q

If a patient comes in asking for sumatriptan but is on an SSRI/TCA, what should you do?

A

ReferRisk of serotonin syndrome if used together

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93
Q

What is the supply criteria for sumatriptan OTC?

A
  • > 18 years-
    Needs to have a migraine diagnosis by doctor/pharmacist
    -Established pattern of migraine - history of 5 or more attacks over a period of at least a year
  • Have tried simple analgesia and it hasn’t worked
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94
Q

If a patient comes in asking for tranexamic acid OTC for heavy periods, but is on warfarin/DOAC, what should you do?

A

Refer Heavy period may be due to anticoagulation

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95
Q

What is the max number of days you should use tranexamic acid OTC for?

A

4 days

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96
Q

What are the dosing instructions for tranexamic acid OTC?

A

Taken only once heavy bleeding has started 2 500mg tablets TDS until symptoms are alleviated (Can be increased to 8 tablets a day 4g for heavier periods)It will not work properly if taken before menstruationIt should not be taken for more than 4 consecutive days

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97
Q

What is tranexamic acid licensed for?

A

Heavy menstrual bleeding over several cycles with regular cycles

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98
Q

Is evaluation a stage in the transtheoretical model of change?

A

No

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99
Q

What are the 6 stages of transtheoretical model of change?

A
  1. Pre-contemplation2. Contemplation3. Preparation4. Active5. Maintenance6. Relapse
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100
Q

Sturgeon (cinnarizine) is licensed from what age?

A

5 years

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101
Q

Kwells OTC is licensed from what age?

A

4 years

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102
Q

Joy Rides OTC is licensed from what age?

A

3 years

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103
Q

What is the active ingredient in Joy Rides?

A

Hyoscine hydrobromide

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104
Q

Phenergan OTC is licensed from what age?

A

2 years

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105
Q

Loratadine OTC is licensed what from age?

A

2 years (as long as they weigh more than 30 kg)

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106
Q

Lyclear cream OTC is licensed for what age?

A

2 years (Under this age needs medical advice)

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107
Q

Mebendazole OTC is licensed for what age?

A

2 years

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108
Q

OTC choramphenicol is licensed for what age?

A

2 years

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109
Q

What age is Diarolyte relief OTC licensed for?

A

1 year(Under this age needs medical advice)

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110
Q

Piriton OTC (chlorphenamine) is licensed from what age?

A

1 year

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111
Q

Hedrin and Derbac liquid is licensed from what age OTC?

A

6 months

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112
Q

Daktarin 2% oral gel is licensed from what age otc?

A

4 months

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113
Q

Nurofen OTC is licensed from what age?

A

3 months

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114
Q

Calpol OTC is licensed from what age?

A

2 months

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115
Q

Woodwards Gripe water OTC is licensed for what age range?

A

1 month- 1 year

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116
Q

Gaviscon is licensed for what age OTC?

A

12 years

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117
Q

Rennie is licensed for what age OTC?

A

12 years

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118
Q

Voltarol gels OTC are licensed for what age?

A

14 years

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119
Q

Feminax ultra OTC is licensed for what age?

A

15-50 years

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120
Q

Nytol is licensed for what age OTC?

A

16 years

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121
Q

Azithromycin (OTC for chlamydia) is licensed for what age?

A

16 years

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122
Q

Canesten thrush cream is licensed for what age range OTC?

A

16-60 years

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123
Q

Tranexemic acid is licensed for what age OTC?

A

18-45 years

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124
Q

Corticosteroid nasal sprays are licensed for what age OTC?

A

18 years

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125
Q

Anusol Plus HC is licensed for what age OTC?

A

18 years

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126
Q

Buccastem is licensed for what age OTC?

A

18 years

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127
Q

What advice would you give to breastfeeding women being treated for scabies?

A

Breastfeeding women should remove the treatment from the nipples before feeding, and reapply afterwards.

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128
Q

What is the MHRA advice surrounding the sale of oral lidocaine for children?

A
  • Gone from GSL to P medicine- Restriction of pack size of 10g- Moved to second line after non-pharmacological management
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129
Q

Is oral lidocaine for children (Anbesol, Bonjela):- P medicine- GSL - POM?

A

P medicineChanged from GSL in late 2018 Max pack size 10g

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130
Q

What is the patient advice surrounding sunlight and cold sores?

A

Sunlight can trigger cold sores so direct sunlight should be avoided and sun screen should be applied.

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131
Q

Tamsulosin 400mcg capsules can be sold to what group of patients over the counter?How long can they take this before assessment is needed by a doctor?

A

Treatment of functional symptoms of benign prostate hyperplasia inmen ages 45-75 yearsCan be taken for up to 6 weeks before clinical assessment by a doctor

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132
Q

Is Ella One recommended in a patient with severe uncontrolled asthma?

A

No, especially if being treated with an oral glucocorticoid

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133
Q

What age are Tyrozets (benzocaine) lozenges licensed in?

A

> 3 years

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134
Q

What age is otrivine child nasal drops licensed in?

A

6-12 years Contains xylometazoline

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135
Q

What age can you sell OTC diphenhydramine cough syrup?

A

> 6 years (Benylin children’s night cough)

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136
Q

What age can you sell OTC guaifenesin cough syrup?

A

> 6 years (Benylin chesty cough for children)

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137
Q

Coughing up thin and frothy mucous can suggest what?

A

Left ventricular failure

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138
Q

At what age are you eligible for the free flu vaccine?

A

65 years and older

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139
Q

What age range is OTC tranexamic acid licensed for in heavy periods?

A

18-45 year olds

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140
Q

Are OTC steroid creams licensed for psoriasis flare ups?

A

No

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141
Q

Can you give steroid creams OTC to pregnant women?

A

No

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142
Q

What areas can you not put OTC steroid cream?

A

Facial skin, broken skin, genitalsYou can put it on ears as this does not count as your face

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143
Q

What steroid creams are available OTC?

A

Hydrocortisone 1% and clobetasone butyrate 0.05%

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144
Q

What is the maximum number of days to use OTC steroid cream?

A

7 days

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145
Q

What is the minimum age to use hydrocortisone 1% cream OTC?

A

10 years

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146
Q

True or false:Diuretics can cause dry eyes

A

True

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147
Q

What can you offer OTC for angular stomatitis?

A

Clotrimazole 1% cream

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148
Q

What is angular stomatitis?

A

Cracked fissures in the corners of the mouth

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149
Q

If a patient has diabetes and presents to the pharmacy with oral thrush, what should you do?

A

Refer

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150
Q

What anticoagulation interacts with miconazole oral thrush gel and prompts a referral?

A

Warfarin

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151
Q

Should miconazole oral gel be applied before or after meals?

A

After and held in the mouth as long as possible

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152
Q

What is the minimum age to use miconazole 2% oral gel for oral thrush?

A

> 4 months

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153
Q

What is a common side effect on the teeth if a patient is having chlorhexidine mouthwash?

A

Stains teeth brown

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154
Q

What is the minimum age to use Difflam spray?

A

6 years

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155
Q

What is the minimum age to use Difflam mouthwash?

A

12 years

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156
Q

An ulcer lasting than more than how many weeks should be referred?

A

More than 3 weeks- exclude oral cancer

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157
Q

Can you treat bacterial conjunctivitis OTC for pregnancy and breastfeeding?

A

No- refer

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158
Q

What age would you refer for bacterial conjunctivitis?

A

<2 years

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159
Q

What age range is Feminax ultra licensed for?

A

15-50 years

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160
Q

What NSAID (stronger than ibuprofen) is available OTC for primary dysmenorrhoea?

A

Feminax ultra 250mg naproxen

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161
Q

Can you treat a pregnant person OTC for thrush?

A

No- refer

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162
Q

Women who have had more than how many episodes of thrush in 6 months- when should you refer to GP?

A

More than 2 episodes in last 6 months

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163
Q

True or false:Poorly controlled diabetes is linked with thrush

A

True

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164
Q

What age groups should be referred in vaginal thrush?

A

<16 years>60 years

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165
Q

What should you do if someone comes into the pharmacy with impetigo?

A

Usually needs a prescription to treat it so refer

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166
Q

How can sweat rashes be treated OTC?

A

Topical imidazoles e.g. Daktarin

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167
Q

How can ringworm (tinea corpis) and jock itch (tinea cruris) be treated OTC?

A

Most local infections can be treated adequately with topical antifungal preparations. Imidazoles (clotrimazole, econazole, miconazole) or terbinafine are suitable first-line treatments for groin infections and skin ringworm.

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168
Q

Amorolfine lacquer is licensed OTC for what condition and what is the age restriction?

A

Fungal nail infection18 years and over

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169
Q

What is the maximum number of nails you can treat OTC for fungal nail infection?

A

2 If more than this, need to refer

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170
Q

What is the minimum age for Lamisil OTC (terbinafine) for athelete’s foot (tinea pedis)?

A

> 16 years

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171
Q

What is 1st line for athlete’s foot in pregnancy and breastfeeding?

A

Topical imidazoles e.g. Daktarin Gold

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172
Q

Where should you apply scabies lotion?

A

All over the body

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173
Q

What is first line for scabies in pregnancy and BF?

A

Permethrin 5% w/w cream (Lyclear®)

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174
Q

What is first line for scabies?

A

Permethrin 5% w/w cream (Lyclear®)

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175
Q

How many times should you apply head lice treatment and how many days should you leave between each treatment course?

A

TwiceAt least 7 days between

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176
Q

What is recommended as first line for head lice treatment in asthma and eczema?

A

Wet combing If treatment needed, Dimeticone e.g. Hedrin

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177
Q

What is recommended as first line for head lice treatment in pregnancy and BF?

A

Wet combing If treatment needed, Dimeticone e.g. Hedrin

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178
Q

What age group is mebendazole not suitable for?

A

<2 years

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179
Q

What is the dosing instructions for mebendazole in threadworm?

A

Once only doseCan be repeated after 2 weeks if it has not cleared upEveryone in the house should be treated

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180
Q

What is 1st line for pregnancy in threadworm?

A

Strict hygiene measures Refer if this has not worked

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181
Q

What groups of patients is sumatriptan OTC unsuitable for?

A
  • Previous myocardial infarction- Ischaemic heart disease, e.g. angina- Peripheral vascular disease- Cardiac arrhythmias (including Wolff-Parkinson-White syndrome)
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182
Q

What is the maximum dose of OTC sumatriptan?

A

Single 50mg dose stat
Can take another 50mg tablet but has to be at least 2 hours after taking the first tablet
Max 100mg in 24 hours for the same attack BUT symptoms have to have improved after taking the first tablet
If there is NO response to the first tablet, should not take a second tablet

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183
Q

What is the licensed age range for sumatriptan OTC?

A

18-65

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184
Q

Bonjela preparations containing choline salicylate is unsuitable for which age group?

A

Under 16 years

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185
Q

What is a purpuric rash?

A

One which does not blanch white on pressure

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186
Q

Systemic decongestants are contraindicated in patients taking what medicine class?

A

MAOIsRisk of hypotensive crisis

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187
Q

Systemic decongestants should be used with caution in what group of patients?

A

They should be used with caution in people with diabetes, hypertension, hyperthyroidism, raised intraocular pressure, prostatic hypertrophy, hepatic or renal impairment, or ischaemic heart disease.

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188
Q

How can you treat croup?

A

No medical treatment as it is viral but can offer antipyretic treatment if fever is present

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189
Q

What time of the day are symptoms of croup the worst?

A

At night

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190
Q

What is croup?

A

Croup in children is caused typically by the parainfluenza virus. It often starts with a cold and develops into a characteristic barking cough

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191
Q

A cough for how many weeks would prompt a referral?

A

Longer than 3 weeks

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192
Q

Can you use anusol HC plus ointment OTC in pregnancy and breastfeeding?

A

No

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193
Q

How many days max should you use Anusol HC plus ointment OTC?

A

7 days max(contains hydrocortisone)

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194
Q

What are the symptoms of haemorrhoids?

A

Bleeding, perianal itching, mucus discharge and pain

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195
Q

What age can you sell Colpermin IBS relief capsules OTC? (peppermint oil)

A

15 years and over

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196
Q

What age can you sell Buscopan OTC?

A

12 years and over

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197
Q

What age can you sell mebeverine OTC?

A

> 18 years

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198
Q

What kind of laxative should be used for IBS?

A

Bulk forming

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199
Q

Does rectal bleeding from haemorrhoids need to be referred?

A

No unless excessive bleeding occurs or has occurred for more than 3 weeks

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200
Q

What is the maximum dose of GSLloperamide a day?What is the maximum dose of P medicine loperamide a day?

A

12mg (6 caps a day) for GSL

16mg (8 caps a day) for P

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201
Q

What age can you sell loperamide OTC to?

A

12 years and over

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202
Q

What is the difference between Diarolyte and Diarolyte Relief?

A

Relief contains rice power and normal diarolyte is glucose based

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203
Q

What are danger symptoms in a diarrhoea patient that prompts a referral?

A 
Confusion
Drowsiness
Passing little urine
Dry mouth
Sunken eyes
Duration of 3 days or longer in adults
>24 hours in babies
>48 hours in young chuldren
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204
Q

Is Movicol is licensed for acute, chronic or both types of constipation?

A

Chronic

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205
Q

What age can you sell ispaghula husk OTC to?

A

> 6 years

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206
Q

What age can you sell Sodium picosulphate (Dulcolax pico liquid) OTC to?

A

> 10 years

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207
Q

What age can you sell Senna OTC to?

A

> 12 years

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208
Q

How long does it take for bulk forming laxatives to work?

A

12- 72 hours

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209
Q

If a patient has constipation along with tiredness, what could be underlying causes?

A

HypothyroidismAnaemia

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210
Q

At what point is constipation classed as chronic?

A

Lasting 6 weeks or more

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211
Q

Why are stimulant laxatives not really recommended in breastfeeding and pregnancy?

A

Not advisable in the third trimester as it may induce uterine contractions. Senna enters the breast milk, so may cause colic and diarrhoea in the infant.

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212
Q

What are the safest laxatives to use in pregnancy and breastfeeding?

A

Bulk forming and osmotic

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213
Q

What are the preferred type of laxative in children?

A

OsmoticBulk forming

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214
Q

How long does it take for glycerol suppositories to work?

A

Within 30 mins

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215
Q

Frequent use of stimulant laxatives can lead to what?

A

Fluid and electrolyte imbalance

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216
Q

Why must bulk forming laxatives be taken with adequate fluids?

A

To avoid intestinal obstruction

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217
Q

Generally, laxatives should be avoided in constipation as first line and lifestyle measures should be tried. What exemptions would you want to treat with laxatives?

A

If straining would exacerbate a condition e.g. angina Or increase bleeding risk e.g. haemorrhoids

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218
Q

What is 1st line for constipation?

A

Lifestyle measures

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219
Q

When would you refer with colic?

A 
Failure to put on weight
OTC treatment failure
Danger symptoms
Over anxious parents
Symptoms have not resolved past 4 months of age
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220
Q

What are symptoms of colic?

A

High pitched cryingOften at same time of dayDrawing knees up to stomach

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221
Q

How can you treat colic OTC?

A

Anti-foaming agents e.g. simethicone (Dentinox, infacol)Gripe waterEffectiveness is lacking however and it should resolve by itself in time

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222
Q

What is colic?

A

When a baby cries with no obvious causeLinked to disorder of GI tract, post partum depression, anxious parentsAffects babies < 6 months old

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223
Q

What is the dose of OTC esomeprazole, and what is the max time it can be used for?

A

20mg OD2 weeks maximum

224
Q

What age can you sell OTC esomeprazole to?

A

> 18 years

225
Q

What age can you sell esomeprazole to?

A

> 18 years

226
Q

What age can you sell OTC omeprazole to?

A

> 18 years

227
Q

What is the OTC omeprazole dose and how long can they be used for and when would you refer?

A

10mg/20mg OD 4 weeks maximumHowever, if symptoms have not resolved in 2 weeks, referAny danger symptoms e.g. unexplained weight loss, refer

228
Q

In what group of patients is orlistat licensed for OTC?

A

> 18 years
BMI >30
OR
BMI >28 with rf diabetes/hypertension/hypercholesterolaemia

229
Q

True or false:Smoking can contribute to dyspepsia

A

True

230
Q

True or false:Being overweight can contribute to dyspepsia

A

True

231
Q

What is max dose of ranitidine OTC?

A

75 mg tabletsDo not take more than 2 in 24 hours

232
Q

H2 antagonists e.g. ranitidine. What age can you sell them to OTC?Can you sell them to pregnant and breastfeeding women?

A

Over 16 yearsNo

233
Q

Minimum age Benzoyl Peroxide can be used in?

A

12 yearsAcne treatment

234
Q

Ulipristal Acetate

A

Licensed for any girl of child bearing age

235
Q

Daktarin oral gel (Miconazole)

A

licensed from 3 months

236
Q

Clotrimazole 1% cream

A

For fungal skin infections (e.g. ring worm)Can be used in adults and children (no licensed age mentioned)

237
Q

Age range for Thrush treatments?

A

Clotrimazole 2% cream
Clotrimazole 10% internal cream
Clotrimazole pessary
Fluconazole 150mg capsuleAll 16- 60 years

238
Q

Minoxidil 2% + 5%? (Regain)Age range

A

18 years- 65 yearsOTC Hair loss treatment

239
Q

Fluconazole capsule 150mg?

A

Used for thrush so16 - 60 years (refer outside of this range)

240
Q

Ispaghula Husk (Fybogel)?

A

6 years

241
Q

Senna?

A

12 years

242
Q

Acrivastine? (antihistamine) Age range

A

12 - 65 years

243
Q

Antihistamines:Chlorphenamine liquid? (piriton syrup)

A

Liquid: over 1 years (safest choice for young children)Chlorphenamine Tablets: 6 years

244
Q

Clotrimazole 2% cream? Age range?

A

16 - 60 years when used for thrush

245
Q

Ranitidine?

A

16 years

246
Q

Cough cold remedies containing chlorphenamine, promethazine, diphenylhydramine, tripolidine (antihistamines)?

A

6 years (Any cough/ cold remedy containing actives like antihistamines, expectorants, suppressants and stimulants should not be used in under 6 years, and never first line in 6- 12 years, if used then maximum 5 days)

247
Q

Dexomethorphan?

A

6 years (Any cough/ cold remedy containing actives like antihistamines, expectorants, suppressants and stimulants should not be used in under 6 years, and never first line in 6- 12 years, if used then maximum 5 days)

248
Q

Guafenesin?

A

6 years(Any cough/ cold remedy containing actives like antihistamines, expectorants, suppressants and stimulants should not be used in under 6 years, and never first line in 6- 12 years, if used then maximum 5 days)

249
Q

Esomeprazole, Pantoprazole, Omeprazole?

A

18 years

250
Q

Steroid nasal sprays (beconase, flixonase)?

A

18 years

251
Q

Co-codamol?

A

12 yearsBut guidance states codeine containing products for pain relief should only be used in over 12’s when ibuprofen and paracetamol have failed. Codeine containing cough remedies should only be used in over 18 years as risks (of respiratory problems/ dependence) outweigh benefits

252
Q

Simple linctus (pead)?

A

1 year

253
Q

Amorolofine?

A

18 years

254
Q

Levornorgestrel?

A

16 years

255
Q

Cetirizine?Loratidine?

A

2 years

256
Q

Sumatriptan?Age range

A

18 years - 65 years

257
Q

Paracetamol?

A

2 months

258
Q

Tranexamic acid? For menorrhagia (heavy bleeds)

A

18 years

259
Q

Pseudoephedrine?

A

6 years(Any cough/ cold remedy containing actives like antihistamines, expectorants, suppressants and stimulants should not be used in under 6 years, and never first line in 6- 12 years, if used then maximum 5 days)

260
Q

Aspirin?

A

16 years

261
Q

Loperamide?

A

12 years

262
Q

Chloramphenicol eye drops/ eye ointment?

A

2 years

263
Q

Mebendazole?

A

2 years

264
Q

Ibuprofen?

A

Suspension or suspension sachets- 3 monthsTablets: 12 years

265
Q

Naproxen 250mg tablets (Feminax Ultra)?Age range

A

15 - 50 years

266
Q

Tamsulosin 400mcg tablets (FloMax)?Age range

A

45 years - 75 years

267
Q

Clobetasone (eumovate) 0.05% cream?

A

12 years

268
Q

Eurax HC (hydrocortisone 0.25%) cream?

A

10 years

269
Q

Hydrocortisone (hc45) 1 % cream?

A

10 yearsMax 15g tube

270
Q

Minimum age to buy Clamelle (azthromycin for chlamydia) OTC?

A

16 years

271
Q

What condition presents with a rash, white coating of the tongue, plus headache and fever leading up to it?

A

scarlett

measles, white koplik spots+conjunc ;)

272
Q

We know codeine should be avoided for pain in children 12-18 years where possible. Who would you chose to give codeine to out of a 24 year old ethiopian man and a 31 year old Norweigan man?

A

The norweigan man
African/ ethiopian and middle eastern people are more likely to be ultra-rapid metabolisers of codeine so do not give to these patients.

273
Q

If a patient using Benzoyl Peroxide experiences drying, burning or peeling of the face, should they stop using the product?

A

Just advise reducing the frequency of administration- stop using for a day or two then reduce to OD or use on alternate days

274
Q

Can Gaviscon be used in pregnant women suffering from gastro-oesophagul reflux ?

A

Yes: remember your acronym APPLE: A= Antacids
Acid reflux is common in preganancy when the baby gets larger towards the end: they respond well to Alginate products like Gaviscon- can take through the day and night

275
Q

We say that stimulant laxative are not first line constipation remedies, however when may we chose to recommend it?

A

If someone has been constipated for a while e.g. 10 days (refer if over 14 days) as these work quickly (6-12 hours) so may be appropriate for one-off use.

276
Q

If patients are using several topical agents, when should the emolient be applied?How often can emollients be applied?

A

Before…. Leave at least 5 mins between applying to allow absorption.
emollients contain no active so can be applied as many times.. but general guidance is 2-3 times a day.

277
Q

Can you get monoxidil on NHS prescription?

A

NO

278
Q

How is allergic rhinitis differentiated from the common cold? What are reatment options OTC for this?

A

Allergic rhinitis presents as: sneezing, nasal discharge and nasal itching

Could use:

Loratidine- 1st line

2nd line:Sodium cromoglicate nasal drops (but take 1-2 weeks to work)- a mast cell stabiliser

Or steroid nasal spray (over 18’s)

Other options:

Azelastine- the only nasally administered antihistamine OTC

chlorphenamine (antihistamines)

279
Q

What are simeticone drops indicated for?

A

Infant colic-excessive, frequent crying in a baby
One week trial of simeticone drops recommended:drops are designed to help release bubbles of trapped air in your baby’s digestive system.

280
Q

Referral symptoms for ear conditions? (Considering Otitis Externa and Ear wax are the only ones that can be treated OTC!- Need to rule out otitis media- infection of inner ear)

A

Mucopurulent discharge (pus)- otitis media

Pain on palpitation of the mastoid area

Generalised inflammataion of the pinna

Impaired hearing in a CHILD

Slow-growing growths in elderly

Symptoms present over 4 days

OTITIS EXTERNA COMMONLY ASSOCIATED WITH A COLD./FLU!

281
Q

What does treatment of Otitis externa involve?

A

ACETIC ACID (earcalm spray)- one spray to the affected ear TDS, max frequency 2-3 hours, continue for 2 days after symptoms gone

Choline salicylate drops- Earex Plus

282
Q

What are the signs and symptoms of Otitis externa?

A

itching
irritation
Some discharge
Oedematous (fluid build up) leading to conductive hearing lossEar canal/ external ear are red, swollen and eczema like

283
Q

What is a buldging spot on a babies forehead accompanied by vomiting, fever, cold hands likely to indicate?

A

early signs of meningitis- refer to A and E!

284
Q

What do the yellow and what do the pink Migraleve tablets contain, and what is the max of each to be taken in 24 hours?

A

Pink: Paracetamol, codeiene, Buclizine
Yellow: Paracetamol, codeine

Max in 24 hours: 2 pink + 6 yellow

285
Q

Which eye drops used in glaucoma can cause a change in eye colour?

A

Prostaglandin analogues:

BIMATOPROSTLATANOPROSTTRAVOPROST

286
Q

Where does the new inhaler, Fostair Nexthaler, containing steroid Beclometasone and LABA formoterol, need to be stored?

A

At room temp

Its the old fostair (inhalation solution) that needs to be kept in a fridge

287
Q

Where should Latanoprost eye drops be stored?

A

In the fridge

288
Q

What presents as the following image accompanied by sore throat, headache, high temperature?

A

Scarlet fever

Antibiotics needed- refer
With treatment, most people recoverin about four tofive days and can return to school 24 hours after starting antibiotic treatment.Without treatment, you’ll be contagious for one to two weeks after symptoms appear.

289
Q

If a patient has recently had their tonsills out (tonsillectomy) or adrenal glands out (adrenectomy) what OTC drug is cautioned?

A

If they have sleep apnoea (i.e. find it hard to breathe at night) then CODEINE is cautioned as can cause respiratory problems which can be fatal (Fatal ADRs reported)

290
Q

What is the only contact lense solution that can be applied whilst contact lenses are still in the eye?

A

Re-wetting solution

291
Q

How does plaque psoriasis present?

A

Silvery white scales, when scraped away pinpoint bleeding occurs from the capillaries

292
Q

Which travel sickness medication would be most appropriate for a young child, 4 years old?

A

Hyoscine hydrobromide (licesned for over 3 years [joy rides]) or meclozine for over 2 years

293
Q

What are the likely side effects of the antihistamines/ anticholinergics used in travel sickness?

A

Dry mouth!
Sedation
be careful with other medication that can cause sedation: alcohol, TCA’s, opioids

294
Q

The mainstay of treatment OTC of travel sickness involves antihistamines:CinnarizineMeclozineCyclizinePromethazine: Promethazine Hydrochloride (Phenergan) and Promethazine Teoclate (avomine)OR Anticholinergics:HyoscineWhich one of these has a 24 hour duration of action?Which one causes most sedation?Which is the most effective for the prevention of motion sickness?

A

24 hour duration: Promethazine Teoclate
Most drowsiness: Promethazine Hydrochloride (Phenergan)
Most effective: Hyoscine hydrobromide

295
Q

Which emollient does not contain Urea?

A

hydromol

296
Q

Oramorph20 mg/mL solution- schedule? Expiry?

A

Schedule 2 CD
Anything over 2.6mg/ml (13mg/5ml) is schedule 2
4 month expiry
The lower strength (2mg/ml) has a 3 month expiry

297
Q

Most eye drops will have an expiry of _____. What expiry do chloramphenicol eye drops have, considering they contain an antibiotic?

A

28 days

still 28 days for chloramphenicol- it it just reduced to 14 days on wards at slam. Patients are still advised to discard the drops 5 days after opening (after finishing the course)

298
Q

Co-amoxiclav oral suspension will have an expiry of ____ once it is made up

A

7 days

299
Q

Eye drops containing a lubricant only (e.g. propylene glycol) will expire in _____

A

6 months

300
Q

Pseudoephidrine is contra-indicated in which condition?What about phenylephrine?

A

Pseudoephedrine: Hypertension, coronary artery disease, MAOI’s in the last two weeks
Phenylephrine: diabetes (as may increase glucose) and CV disease

301
Q

What is information governance? How often do community pharmacies need to provide IG assurances to the NHS?Does the Information Governance lead need to be a pharmacist?

A

IG is all to do with confidentiality and how to handle patient sensitive data.
Pharmacies need to submit IG assurances annually.
The lead does not need to be pharmacist but needs enough authority to make changes in information handling

302
Q

What does ‘Freshly prepared’ mean?What does ‘Recently prepared’ mean?

A

Freshly prepared: 24 HOUR EXPIRY

Recently prepared: 28 day expiry

303
Q

Can nursing homes bring their waste medicines to your pharmacy to dispose of?Can the public: what will you do with the waste?

A

No- must use their own waste disposal
Only the public can bring it to the pharmacy: this is an essential service for the pharmacy to act as a collection point for waste medicines: sort it into solids, liquids and ampoules and arrange for waste contractor to pick it up.
Must not store waste for longer than 6months, or over 5 cubic meters

304
Q

Can GTN be bought OTC?

A

YES
Both sub-lingual tablets and spray are P medicines
NB: Their effects last for 20-30 minutes, but in an emergency situation, repeat dose after 5 mins if no relief.

305
Q

Orlistat impaires the absorption of Fat soluble vitamins. Which are the Fat soluble vitamins?

A

A (retinol)

D (D, colecalciferol/alfacalcidol)

E (tocopherol)

K (phytomenadione)

Water soluble:
B1- thiamine
B2- riboflavin
B6- pyridoxine
B12- folic acid

C- ascorbic acid (scurvy)

306
Q

How many days of co-codamol30/500mg tablets could you give maximum as an emergency supply?

A

5 days max

As co-codamol contains codeine 30mg which is a schedule 5 CD!

307
Q

Is sunlight a good cure for cold sores?

A

Sunlight can trigger cold sores so direct sunlight should be avoided and sun screen should be applied.

308
Q

What is Lyme disease caused by? What does the rash present as?

A

Caused by bacterial infection fromTick bites
An early symptom of this condition is a characteristic “bulls eye on a dartboard” rash (called erythema migrans) that isn’t itchy
Usually treated with Doxycycline, amoxicillin or cefuroxime for 2-4 weeks

309
Q

What do we use to treat Oral thrush?

A

Topical Miconazole gel- Daktarin oromucosal gel

(Nystatin 2nd line, Fluconazole 3rd line if topical preps can’t be used/ patient has a dry mouth)

310
Q

Why hasthe safety of using medicines containing codeine to treatcoughsandcoldsin children younger than 18 been reviewed?

A

Because of the potential for serious problems like slowed or difficultbreathing.
Children, especially those who already havebreathing problems, may be more prone to these effects
Differences in metabolism of codeine: codeine is converted to Morphine in the body, this cause cause respiratory difficulties.
This use in under 18’s only applies to codeine linctus for colds/ cough; codeine containing products for pain relief can still be used in > 12 years, sold to > 16 years.

311
Q

Amorolfine (Curanail, Loceryl) can be used for fungal nail infections. What is the directions for this?

A 
Apply 1-2 times a week for:
6 months for finger nails
9- 12 months for toe nails
Apply after filing and cleansing
BNF age limit: 12, OTC age limit: 18. 3 ml pack is a P
312
Q

What is the organism causing athletes foot? How is athletes foot treated?

A

TINEA PEDIS

Topical imidazole(Miconazole) can be used- Apply twice daily and continue for 10 days after the lesions have healed

Bnf states under topical antifungals: to prevent relapse these should be continued for 1-2 weeks after healing

Could also consider Griseofulvin

Nystatin, oral thrush- 7 days, then 48hours after lesions have healed

313
Q

It is recommened people include oily fish in their diet to help reduce CV risk. Can you think of any examples of these?

A

Mackerel
Salmon
Sardines

314
Q

A patient with a productive cough for the last week requests a product containing dextromethorphan because they have heard good things. What do you do?

A

They may have requested Benylin Dry Cough
Similar product: Benadril Tickly Cough containing Pholcodine
These are cough SUPPRESSANTS
Should NOT suppress a productive cough- need to get the mucous out- so recommend an expectorant (Guaiphenesin)

315
Q

Children under __ should not be given cough and cold medication OTC containing PSEUDOEPHEDRINEPHENYLEPHRINEDEXTROMETHORPHANPHOLCODINEGUAIFENESINChlorphenamine, brompheniramine,diphenhydramine, doxylamine, promethazine and triprolidine.

A

Children under 6 years old
Medicines containing:
ANTITUSSIVES (suppressants) (DEXTROMETHORPHANPHOLCODINE)
Expectorants (GUAIFENESIN, ipecacuanha)
Nasal decongestants (pseudo, phenylephrine, ephedrine, oxymetazoline, xylometazoline)
Antihistamines:Chlorphenamine, brompheniramine,diphenhydramine, doxylamine, promethazine and triprolidine.
For use in 6-12 years they should be SECOND LINE and be used for no more than 5 DAYS

316
Q

Can pseudoephidrine cause drowsniess?Can guaifenesin cause drowsiness?Can dextromethorphan?

A

No
Remember pseudoephidrine (SUDAFED) can be abused- stimulating- side effects include restlessness and insomnia, and hallucinations!
Guaifenesin does not cause drowsiness
Dextromethorphan can cause a little bit of drowsiness

317
Q

What does sodium Citrate do to the pH of urine?

A

Cystitis sachets
It increases the pH- makes urine more alkaline
Acidic urine in cystits- hence the burning feeling

318
Q

If a specific brand is stated on a prescription (e.g. Losec capsules- Omeprazole) can you give the generic if you run out of the branded?

A

No

Must legally prescribe that brand unless you ask the prescriber to change the Rx to generic

319
Q

What is cinnarazine and what is it used in?

A

characterized as an antihistamine and a calcium channel blocker
Used for travel sickness and vertigo and tinnitus (problems with inner ear)
Very sedating
Found in Stugeron- 2 tablets 2 hours before travel

320
Q

What is the medication causing drowsniess usually included in cough/ cough rememdies to help people sleep?

A

Diphenhydramine
A sedating antihistamine, found in things like Night nurse.
Also found in sleep aids such as sominex

321
Q

Is it pharmacologically rational for a cough/cold remedy to contain dextromethorphan and guanefenesin? What about dextromethorphan and ammonium chloride?

A

No:Dextromethorphan is a cough suppressant so person coughing less
Guanefenesin and ammonium chloride both cough expectorants which means they make it easier to cough things up: work against eachother

322
Q

What formulations have more potential for abuse by addicts?

A

Sugar free

Syrup base less liable to abuse

323
Q

How is payment for Instalment precriptions worked out?

A

Payment is based on each occasion the pharmacist provides an instalment to the patient; i.e. each time the patient collects their drug from the pharmacy
Pharmacy needs to fill out back of prescriptioneach time the patient picks up an instalment

324
Q

What drugs can be given on instalment prescriptions (FP10MDA) Other than Methadone?

A

Schedule 2 Controlled Drugs;
Buprenorphine;
Buprenorphine/naloxone (Suboxone);and
Diazepam

325
Q

What age are steroid nasal sprays e.g. beconase, flixonase, not suitable in?

A

Under 18’s

326
Q

What antihistamine do we usually give to children?

A

Chlorphenamine maleate

Suitable for 1 year and over

327
Q

What kind of medicine is Dextromethorphan?

A

Cough suppressant (antitussive)

328
Q

What kind of medication is Guaiphenesin?

A

Cough EXPECTORANT
These claim to make the coughing easier while enhancing production of mucus and phlegm.
Other example: Acetylcysteine, ammonium chloride

Not effective in children

329
Q

A patient presents with the following at your pharmacy. They ask for some Brolene eye drops. What do you do?

A

This is a subcojunctival haemorrhage

Ask them if it is painful- any pain then refer

Ask them if they are on WARFARIN- if yes seek medical attention ASAP

Have you had any injury to the eye recently?

If no to the above- reassure the patient that it is self limiting, usually better within 2 weeks and no OTC products are recommended

330
Q

What organism causes RING WORM?

A

Tinea Corporis

331
Q

URINE COLOURS?SENNARIFAMPICINLEVODOPANEFOPAMNITROFURANTOINCO-DANTHRUMERCO-DANTHRUSATETRIAMTERENESULFASALAZINEENTACAOPONEPHENINDIONE

A
332
Q

Fexfenadine OTC advice?

A

Avoid apple/orange juice, minimises exposure, ok

333
Q

Unsightly big left toe, no pain, thickened?

A

Amorolfine 5% nail lacquer

334
Q

Mr P
smoking 23 years
needs to consider stopping, recent titration asthma,
Stage of cycle?

A

Preparation stage at present; if engages in smoking cessation regime he will move to Action

335
Q

OTC smoking cessation options?

A

Nicotine- patches/lozenges/gums/inhalors

Varenicline/Bupropion POM meds, OTC under PGD only

336
Q

smoking cessation follow up monitoring?

A

2 weeks after NRT start

4 weeks after stopping smoking, CO levels monitor, aim for <10 parts per million

337
Q

Otitis externa symptoms?

A

dry skin
muffled hearing
itchy canal
history eczema/hayfever swimming

338
Q

OTITIS EXTERNA TREATMENT?

A

OTC ACETIC ACID (if >12 years+no history of perforated ear drum).
1 spray at least TDS after each activity, max. dose 1 spray every 2-3 hrs.
Up to 2 weeks use

339
Q

Fluticasone 0.05% nasal spray OTC requirements?

A

18 years+
Alternative is ES, patient request
Or just get a prescription

340
Q

Nappy rash symptoms?

A

Red blotches on bottom
Hot, sore-looking skin
Irritable baby
Pimples/spots

341
Q

NAPPY RASH TREATMENT?

A

1st line- change nappies frequently+use tightly fitting water-proof pants
Expose to air, barrier application, each nappy change (barrier after steroid)
Discomfort? Hydrocortisone 0.5/1%, AVOID IN NEONATES, MAX. 1 week treatment
Candidal infection? Clotrimazole cream, avoid barrier till fungal clear

Nappy rash, fungal, 7 days after clear

342
Q

NAPPY RASH REFERRALS?

A

> 2 weeks
Yellow Crusts
Broken skin

343
Q

MEBENDAZOLE
AGE?
REINFECTION AFTER 2 WEEKS?

A

AGE? 2 years+

REINFECTION AFTER 2 WEEKS? Take another dose

344
Q

Levonelle
Take within?
Vomit within X hours, take second dose?

A

Take within? 72 hours
Vomit within X hours, take second dose? 2 hours
Use higher dose for patients >70kg, BMI > 26kg/m^2

345
Q

ellaOne
Take within?
Vomit within X hours, take second dose?
AVOID?

A

Take within? 120 hours
Vomit within X hours, take second dose? 3 hours
AVOID? for 1 week after administration/during!

346
Q

A drug that induce hepatic
enzyme activity and considerably reduce the
emergency hormonal contraceptive effect?

A

Topiramate (antiepileptic)

347
Q

CLOTRIMAZOLE

CAUTION/REFERRAL?

A

UNDER 16/OVER 60
First occurence
2 episodes past 2 months/>2 in past 6 months
SAFE? female, diabetic history, last used pessary 1 year ago

348
Q

SICK DAY RULES
Dehydration (vomiting, diarrhoea & fever)
CAN TEMPORARILY STOP WHAT DRUGS?

A

DIURETICS
ACE INHIBITORS
METFORMIN
NSAIDs

349
Q

OTC SUMATRIPTAN?

A

It is indicated for the acute treatment of migraine attacks, with or without aura, in adults aged 18 to 65 years
at least 5 in past year

350
Q

Reasons for

depot antipsychotic?

A

Improved patient compliance

Reduced peaks/troughs in efficacy

351
Q

Treatment for a patient with a potassium level of 6.6mmol/L?

A

Calcium gluconate 10% plus insulin and glucose 50%

352
Q

Treatment for a patient with a sodium level of 152mmol/L?

A

Hydration and stop possible offending drugs

353
Q

raised TSH and low T4 levels=?

treatment?

A

HYPOTHYROIDISM

LEVOTHYROXINE

354
Q

Prolongation of the QT-interval?

A

DOMPERIDONE
CITALOPRAM
CLARITHROMYCIN
ERYTHROMCYIN

355
Q

LEVONELLE/ULI SIDE-EFFECTS

A

BOTH ABDOMINAL PAIN, N&V, HEADACHE

356
Q

LEVO VS ULI

A
357
Q

HYDROCORTISONE 1% LICENSING?

A

10+

358
Q

TERBINAFINE 16+

A
359
Q

LEVO AVOID BREASTFEEDING JUST 8 HOURS

A
360
Q

12+ steroid?

A

clobetasone

361
Q

bacterial infection?

A

not hydrocortisone

362
Q

Give oral antifungal if topical an L

A
363
Q

CARDIAC SYMPTOMS
REFER TO GP?
REFER TO A&E?

A

REFER TO GP? 55+ new symptoms
REFER TO A&E?
heart attack, jaw/arm pain
slurred speech

364
Q

HEADACHE

UREGNT REFERRAL TO A&E?

A

SUDDEN

365
Q

HEADACHE

NON-URGENT REFERRAL TO GP?

A

MIGRAINE, few days

366
Q

STOMACH PAIN

URGENT REFERRAL TO A&E?

A

SUDDEN SEVERE, abdominal pain

367
Q

STOMACH PAIN

NON-URGENT REFERRAL TO GP?

A 
dyspepsia
period
pain
injury
food poisoning
weight loss
368
Q

FEVER URGENT REFERRAL TO A&E?

A

UNDER 3 MONTHS

RASH DOES NOT GO AWAY

369
Q

SEPSIS URGENT REFERRAL TO A&E?

A

slurred speech, confusion, shivering, cold, muscle pain

370
Q

CARDIAC SYMPTOMS

URGENT REFERRAL TO A&E?

A

breathlessness, chest pain, left arm pain, coughing up blood

371
Q

CARDIAC SYMPTOMS

NON-URGENT REFERRAL TO A&E?

A

HEARTBURN

372
Q

RESPIRATORY SYMPTOMS

URGENT REFERRAL TO A&E?

A

SOB, wheezing, radiating pain,

373
Q

RESPIRATORY SYMPTOMS

NON- URGENT REFERRAL TO GP?

A

COPD, asthma, symptoms, lifestyle

374
Q

NEUROLOGICAL SYMPTOMS URGENT REFERRAL TO A&E?

A

numbness, spine movement, stroke

375
Q

NEUROLOGICAL SYMPTOMS NON-URGENT REFERRAL TO GP?

A

muscle weakness,

376
Q

SIGNS OF CANCER URGENT REFERRAL TO A&E?

A

mouth ulcers, unexplained weight loss, radiating oedema

377
Q 
OTC DO WWHAM
WHO
WHAT
HOW LONG
ACTION
SYMPTOMS
A
378
Q

WHAT IS THIS?

A

STYE

379
Q

RINGWORM?

A
380
Q

ROSACEA?

A

butterfly like

381
Q

SCABIES

A
382
Q
A
383
Q

SHINGLES

A
384
Q

VERRUCA FEET

WARTS HAND COMMON

A
385
Q

VERRUCCA

A
386
Q

WARTS?

A
387
Q

CONTACT DERMATITIS

A
388
Q

PSORIASIS FACT?

A

Psoriasis often occurs on extensor surfaces (elbows and knees), trunk, flexures, sacral
and natal cleft, scalp and behind the ears, and umbilicus. This is an image of plaque
psoriasis, which generally presents as large plaques. There is usually a clear
delineation between normal and affected skin. May be pink or red, but in people with
pigmented skin this may not be obvious. Scale is typically silvery in colour.
Psoriasis may be caused by infection, drugs (including corticosteroid withdrawal),
ultraviolet light exposure, trauma, hormonal changes, stress, smoking, and alcohol.

389
Q

What is this?
A cattle farmer visits the pharmacy for advice. He noticed a strange patch of skin on his arm after work yesterday, which is itchy. He
hasnʼt put anything on it yet as he is unsure what it is. Upon examination, it is almost a perfect circle 2 cm in diameter and appears red
and scaly around the edges and silvery in the middle

A

Tinea corporis

390
Q

What is indoramin?

A

Alpha-blocker, careful with tamsulosin!

391
Q

What are the symptoms of hay fever? (4)

A
  1. Rhinorrhoea
  2. Nasal congestion
  3. Itching
  4. Allergic conjunctivitis
392
Q

What are the referal criteria for hay fever? (5)

A
  1. Pregnancy
  2. Suspected infection
  3. Drug induced
  4. Structural or mechanical reasons
  5. Systemic conditions associated with mucus (e.g. CF)
393
Q

Which drugs can induce symptoms of hay fever? (7)

A
  1. ACE inhibitors
  2. Beta blockers
  3. Chlopromazine
  4. Aspirin
  5. NSAIDs
  6. Cocaine
  7. Diverse effect of nasal decongestants
394
Q

What is the first line treatment for someone presenting with general symptoms of hay fever?

A

Non-sedating antihistamine

395
Q

At which age are Cetirizine and Loratadine both licensed from?

A

2 years

396
Q

At which age is Acrivastine licensed?

A

Over 12

397
Q

How often should a non-sedating antihistamine be taken?

A

Once daily

398
Q

If a patient taking a non-sedating antihistamine experiences “breakthrough” symptoms, which drug can you recommended instead?

A

Sedating antihistamine taken at shorter intervals

399
Q

At what age is chlorphenamine syrup licensed?

A

Over 1

400
Q

At what age are chlorphenamine tablets licensed?

A

Over 6

401
Q

At what age is promethazine licensed? (syrup and 10mg tablets)

A

Over 2

402
Q

Can promethazine 25mg tablets be sold OTC for hay fever?

A

No, licensed for insominas in patients over 16

403
Q

If patient is experiencing nasal congestion due to hay fever, what is the recommended OTC treatment?

A

Nasal corticosteroid

404
Q

At what age are beconase and nasonex both licensed for?

A

Over 18

405
Q

When should nasal corticosteroids be taken for maximal effect?

A

A week before hay fever begins

406
Q

Is sudafed nasal decongestant spray recommended for hay fever?

A

Not recommended but can be used as an adjunct

407
Q

What is the maximum recommended duration of use for sudafed nasal spray and why?

A

7 days - risk of rebound congestion

408
Q

At what age is sudafed blocked nose spray?

A

Over 12

409
Q

Which 2 drugs can be applied topically if the patient is experiencing allergic conjunctivitis?

A
  1. Mast cell stabilisers

2. Occular antihisatmines

410
Q

How long does it usually take for a common old to resolve?

A

7 days

411
Q

How long does it usually take for a common old to resolve in children?

A

14 days

412
Q

What is used for symptomatic relief of a cold?

A

Paracetamol and ibuprofen

413
Q

What advice do you give patients with colds?

A

Keep hydrated and rest

414
Q

As well as paracetamol and ibuprofen, what else can be used to treat symptoms of a cold?

A

Intranasal decongestants

415
Q

Is there a place for oral decongestants when treating a cold?

A

They can be used in the short term but the benefit is small

416
Q

As well as lifestyle measures, what must patients be counselled on when buying cough and cold medicines?

A

The risk of paracetamol overdose

417
Q

Which cough and cold medicines should be avoided in those under 6? (4)

A
  1. Anti-tussives
  2. Expectorants
  3. Topical and oral decongestants
  4. Antihistamines
418
Q

In patients under 6, what can be used for symptomatic relief of cough and cold?

A
  1. Paracetamol and ibupofen

2. Simple cough remedies

419
Q

If a patient is over 1, what can be recommended for symptomatic relief of cough and cold?

A

Warm drink of honey and lemon

420
Q

What are 5 self care measures for cough and cold that can be purchased OTC?

A
  1. Steam inhalation
  2. Vapour rubs
  3. Gargling salt water
  4. Menthol sweets
  5. Nasal saline drops
421
Q

What are the 2 types of cough?

A
  1. Productive (chesty)

2. Non-productive (dry)

422
Q

How long does an acute cough last?

A

Less than 3 weeks

423
Q

What should you do if a patient presents with a cough lasting longer than 3 weeks?

A

Refer for further investigation

424
Q

How long must a cough last to become chronic?

A

Over 8 weeks

425
Q

What is the most likely cause of a cough?

A

Viral upper respiratory tract infection

426
Q

What is a trigger for croup?

A

Recent viral infection

427
Q

At what age does croup normally occur?

A

Between 3 months and 6 years

428
Q

How long does croup usually resolve?

A

48hours

429
Q

When should you refer someone with croup for medical intervention? (2)

A
  1. Over 48 hours

2. Severe

430
Q

A patient presenting with which symptoms is likely to have pneumonia? Requires urgent referral to GP (5)

A
  1. High fever
  2. Malaise
  3. Headache
  4. Breathlessness
  5. Pleuritic pain
431
Q

Give an active ingredient of expectorants

A

Guafenasin

432
Q

Give 4 active ingredients of anti-tussives

A
  1. Codeine
  2. Pholcodeine
  3. Dextromorphan
  4. Antihistamines (diphenyldramine)
433
Q

At which age is codeine linctus licensed for OTC?

A

Over 18

434
Q

Does the MHRA advise the use of cough and cold medicines in children 6-12?

A

No, only supplementary to best principles of care

435
Q

Who should not have codeine at all?

A

Under 18s with sleep apnoea who have had tonsil and adenoid surgery

436
Q

In which patients should codeine be used with caution?

A

12-18 difficulty breathing

437
Q

symptoms of hemorrhoids

referral symtoms

A 
itching
feeling like the bowel is not empty
bleeding on toilet paper or in bowl
pain
REFER
after 1 week of OTC treatment
recurrent episodes
sharp stabbing pain on deification
large vol of blood or blood mixed in stool (black and tarry)
accompanying systemic symptoms (N&V, loss of appetite)
438
Q

Hemorrhoids treated OTC for ………… should be referred

A

1 week

439
Q

what does sharp stabbing pain on deification indicate?

A

anal fistula

440
Q

advice for hemorrhoids

A 
avoiding constipation (fluids, fiber and exercise)
don't strain
441
Q

three types of things used in hemorrhoid preparations

A

local anaesthetics
astringent
anti-inflamatory

442
Q

where should local anesthetics be used on hemorrhoids?

A

only externally and not on broken skin (the anesthetic can be absorbed into systemic circulation and is toxic)

443
Q

how long can you use a local anesthetic for haemerrhoids

A

5-7 day

444
Q

what is the action of this ingredient of hemorrhoid preparations:
bismuth oxside

A

astringent

445
Q

what is the action of this ingredient of hemorrhoid preparations: cinchocaine

A

local anesthetic

446
Q

what is the action of this ingredient of hemorrhoid preparations:
muccopolysacharide polysulfate

A

fribrinolytic

447
Q

what is the action of this ingredient of hemorrhoid preparations:
shark oil

A

skin protectant

448
Q

what is the action of this ingredient of hemorrhoid preparations: yeast extract

A

wound healing angent

449
Q

sumitriptan is licensed for a max of how many attacks per month

A

4

450
Q

Should levothyroxine or liothyroxine be maintained on the same brand?

A

liothyronine

451
Q

alternative to carbimazole that may cause Liver tox

A

propylthyuricil

452
Q

When would you refer for a cold?

A

Ear ache that is severe

Vulnerable patient groups e.g. very young, very elderly, heart disease, lung disease, severe asthma

Fever and cough that is persistent

Chest pain

Shortness of breath that can’t be explained

453
Q

When would you refer for a cough?

A

Longer than 3 weeks and not improving

Chest pain

Shortness of breath

Wheezing

Recurring cough present at night

Whooping cough/croup

Cough or wheezing that may be drug induced e.g. ace inhibitors and beta blockers

Yellow, green, brown or blood stained phlegm/sputum

Offensive or foul smelling phlegm/sputum

454
Q

When would you refer for a sore throat?

A

Dysphagia (difficulty in swallowing)

Longer than 7-10 days

Hoarseness persisting for more than three weeks

Sore throat with a skin rash

White spots, exudate or pus on the tonsils with a high temperature and swollen glands

Recurrent bouts of infection

Suspected adverse drug reaction e.g. carbimazole

Failed treatment

Breathing difficulties

455
Q

When would you refer for ear wax?

A

Foreign body in the ear

Pain

Dizziness

Tinnitus

Treatment failure

456
Q

When would you refer for a headache?

A

Headache associated with recent head injury/trauma

Children under 12

Associated with stiff neck, fever and or rash

Sudden onset and or severe pain

Suspected adverse drug reaction e.g. oral contraceptive pill

Associated with drowsiness, blackouts, unsteadiness, visual disturbances or vomiting

Recurring headaches

457
Q

When would you refer for constipation?

A

Blood in the stools

Pain on defecation

Suspected drug induced constipation e.g. opiates, antidepressants

With abdominal pain, vomiting or bloating

Weight loss

Failed treatment

Change in bowel habit of more than 2 weeks

458
Q

When would you refer for diarrhoea?

A

Persistent change in bowel habit

Recent travel which was abroad

Presence of blood/mucus in the stools

Diarrhoea with severe vomiting and fever

Signs of dehydration e.g. dry mouth, drowsiness or confusion, passing little urine, sunken fontanelle and eyes

Longer than 3 days in older children and adults (longer than 1 day in babies under 1 years and 2 days in children under 3 years and elderly)

Suspected drug induced diarrhoea e.g. antibiotics

Severe abdominal pain

459
Q

When would you refer for dyspepsia?

A

Unexplained weight loss

Suspected drug induced dyspepsia e.g. ferrous sulphate, NSAIDs

Persistent vomiting

Persistent symptoms (more than 5 days) or recurring

Black or tarry stools

Severe pain

Pain radiating to other areas of body e.g. arm

Symptoms developing for the first time in patients aged 45 years or over

Dysphagia (difficulty in swallowing)

Failed treatment

460
Q

When would you refer for haemorrhoids?

A

Blood in the stools

With abdominal pain or vomiting

Weight loss

Persistent change in bowel habit

Longer than 3 weeks

461
Q

When would you refer mouth ulcers?

A

Lasting longer than 3 weeks

Suspected adverse drug reaction e.g. NSAIDS

Crops of 5-10 or more ulcers

Rash

Diarrhoea

With weight loss

Involvement with other mucous membranes

462
Q

When would you refer for cystitis?

A

Diabetics

Immunocompromised patient

Pregnant

Men

Children

Elderly women

Vaginal discharge

Haematuria (presence of blood in the urine)

With fever, nausea and or vomiting

Pain or tenderness in the loin area

Recurrent cystitis

Failed treatment

Longer than 2 days

463
Q

When would you refer for Primary dysmenorrhoea?

A

Abnormal vaginal discharge

Heavy or unexplained bleeding

Showing signs of systematic infection e.g. fever

Symptoms suggesting secondary dysmenorrhoea

464
Q

When would you refer for vaginal thrush?

A

Diabetics

More than two attacks in the last six months

Failed OTC treatment

Pregnant

Vulval or vaginal sores ulcers or blisters

Vaginal discharge that is green-yellow or blood stained

Vaginal discharge that is foul smelling

Under 16 or over 60 years of age

No improvement within 7 days of treatment

Previous history of STD (sexually transmitted infection) or exposure to partner with STD

Abnormal or irregular vaginal bleeding

Any associated lower abdominal pain or dysuria

465
Q

When would you refer for athlete’s foot?

A

Not responded to the appropriate treatment

Nail involvement

Spreading to other parts of the foot

Diabetics

Signs of bacterial infection e.g. weeping, pus or yellow crusts

466
Q

When would you refer for cold sores?

A

Longer than 2 weeks

Lesions inside the mouth

Eye is affected

Immunocompromised patients

Signs of secondary bacterial infection e.g. weeping, pus, yellow crust

Babies and children

Severe, widespread or worsening lesions

Painless lesion

467
Q

When would you refer for warts and verrucas?

A

Anogenital warts

Facial warts

Diabetics

Immunocompromised patient

Bleeding or itching

Changed in size or colour

OTC treatment that has been unsuccessful following 3 months of treatment

468
Q

What OTC meds should be avoided or used with caution in asthma?

A

Aspirin and NSAId
Cough suppressants e.g. codeine, pholcodine and dextromorphan
Head lice preparations containing alcohol

469
Q

What OTC meds should be avoided or used with caution in those with prostate enlargement?

A

Those that may precipitate urinary retention:

Anticholinergics e.g. sedating antihistamines, Kwells and Buscopan

Decongestants e.g. phenylephrine

470
Q

What OTC meds should be avoided or used with caution in glaucoma?

A

Anticholinergics e.g. sedating antihistamines, Kwells and Buscopan

Corticosteroids e.g. Beconase nasal spray

471
Q

Name some OTC medicines that are prone to abuse

A 
Opioid analgesics
Laxatives
Stimulants
Antihistamines
Cough/cold preparations e.g. Sudafed
472
Q

Sodium hyaluronate 0.2% eye drops?

A

Once opened the bottle can be used for up to 90 days

473
Q

condition blocked sweat ducts?

A

miliar/heat rashkeep skin coolloose clothingplenty fluidsCalm

474
Q
A
475
Q

MHRA WARNINGS1. PPI’s- c diff, osteo, gastric cancer masked, hypomagnesaemia, b12 L long-term2. Hydrochlorothiazide- non-melanoma skin cancer3. Domperidone- qt prolongfation4. Ondansteron- oral cleft5. Clozapine- intestinal obstruction, constipation, report6. Erythromycin- qt prolongation7. Ciprofloxacin- tendons, ruputured, avoid in kids, seizure threshold L8. Loperamide- qt prolongation9. Bisphosphonates- atypic necrosis, jaw, hearing10. Finasteride- teratogenic, female, handling

A
476
Q

naproxen+steorids no good, bleed

A
477
Q

URINE COLOURS

A
478
Q

perfect circle, central clearing, defined edges?

A

tinea corporis, ringwor

479
Q

Chloramphenicol

eye drop vs ointment?

A

Drops:

ONE drop into the affected eye(s) every two hours for the first 48 hours, then decrease the dose to every four hours
During waking hours only.

Ointment:
If using alone - Apply approximately one cm of ointment between the lower eyelid and the eye three to four times daily

If using with eye drops - One cm of ointment between the lower eyelid at night

5 days MAX

480
Q

DROPS DURING THE DAY, OINTMENTS DURING THE NIGHT

A
481
Q

Optrex storage?

A

fridge!

482
Q

Mometasone directions?

A

Two sprays into each nostril once a day until symptoms are controlled, then one spray into each nostril daily.

483
Q

MOMETASONE CRAZY ADMINISTRATION

A

Shake container well before each use
Before first administration the spray should be primed, this is achieved by actuating the pump ten times until a fine mist is obtained; re-prime with two sprays if the pump has not been used for 14 days
Advise person to blow their nose gently
Hold bottle upright
Bend head slightly forward
Close one nostril as spray is administered in the other nostril, breathe in slowly through your nose. Breathe out through your mouth. Use second spray if appropriate
Repeat with the other nostril
Wipe the nozzle with a clean tissue or handkerchief
Discard once all sprays have been used or after two months of first opening

484
Q

MOMETASONE STORAGE?

A

Do not use after expiry date.

Use within two months of first opening.

485
Q

CHLORPHENAMINE IS SEDATING! LORADATINE IS PREFERRED, AWAKENESS, NON-SEDATING

A
486
Q

PREGABALIN, MHRA, TERATOGENIC!

A
487
Q
A
488
Q

wet combing regimen?

A

The recommended regimen for wet combing treatment is four sessions spaced over 2
weeks (on days 1, 5, 9, and 13).

It takes about 10 minutes to complete the process on short hair, and 20–30 minutes for long, frizzy, or curly hair. Two combing procedures are recommended at each treatment session.

489
Q

permethrin?

mebendazole?

A

1 week

2 week

490
Q

permthetrin

Scabies?

Head lice?

A

2 month+

6 month+

491
Q

A 25-year-old woman asks for something to treat her eyes. Both of her eyelids are sore and her eyes feel gritty. She reports no pain or change in vision and she has no medical conditions.

A

Blepharitis is a condition where the eyelids look inflamed and the eyes may feel gritty, itchy or as though they are burning.

492
Q

LIDOCAINE?st

A

Apply a pea sized blob of gel (see circle shown in the patient information leaflet) to a clean fingertip
and spread gently onto the sore area of the gum. If necessary, repeat the dose after 3 hours. Do
not use more than 6 times in one day (24 hour period).

493
Q

HAND FOOT MOUTH?

A

PARACETAMOL ETC WILL DO!

494
Q

QUICKEST FOR CONSTIPATION?

A

GLYCEROL SUPPOSITORY!

495
Q

SILDENAFIL AGE?

IBUPROFEN?T

A

18+
ibuprofen calm, it’s the tamsulosin n watnot
alpha blockers, b blockers, etc

496
Q

35+, SMOKING?

A

VTE RISK FACTOR!

497
Q

ALELRGIC RHINITIS, FLUTICASONE PREFERRED?

A
498
Q

ALLERGIC RHINITIS ORDER?

A

MILD- azelastine

MODERATE- fluticasone

499
Q
A

tinea corporis

500
Q

SEPSIS, NO FLUIDS, GP ASAP!

A
501
Q

FEXOFENADINE AGE?

A

12+

Apple juice and orange juice decrease the exposure to fexofenadine.120mg in adults and children!

502
Q

LACTULOSE-LACTOSE INTOLERANT, GUESS

A
503
Q

SCARLETT FEVER, HIGH TEMP, GP ASAP!!

A
504
Q

RINGWORM, CLOTRIMAZOL 1%, CALM

A
505
Q
A

A

506
Q

itchy scalp does not mean?

A

Head lice, u gotta detect comb etc and confirm!

507
Q

impetigo, kid otc?

A

hydrogen peroxide is cool

508
Q

Itchy scalp X= head lice, no need to wash high temp either, scabies/mebendazole?

A
509
Q

MICONAZOLE DIRECTIONS, FUNGAL?

A

APPLY BD+10 DAYS AFTER LESIONS HAVE HEALED

510
Q

SUBARROHCNOI?

A

KICKED IN THE HEAD, stress

511
Q

4 year old, cough?

A

glycerin honey and lemon linctus

512
Q

bacterial conjunctivitis, treatment?

A

pick one

drop or ointment :/

513
Q

chloramphenicol drop?

A

ONE drop into the affected eye(s) every two hours for the first 48 hours, then decrease the dose to every four hours

514
Q

CLOTRIMAZOLE 2%?

CLOTRIMAZOLE 1%?

A

CLOTRIMAZOLE 2%? vaginal thrush

CLOTRIMAZOLE 1%? skin, nappy rash

515
Q
A

Canesten HC

fungal
itching
Treat

516
Q

heavy cold
Abdomen
elderly
itchy?

A

VARICELLA ZOSTER!

517
Q

post-herpetic neuralgia?

A

amitriptyline!

518
Q
A 
A- Desosest rel 712W
missed pile tall
ASAP useprotection
forfurther 2days
In this case only
4hourspassed
noneedfor Erk
519
Q
A

ANALF ISSURE

520
Q

haemorrhoids?

A

lumps, out of anus
itching/burning/pain/swelling
rectal bleeding
straining/incomplete

521
Q

anal fissure?

A

sharp pain

522
Q

cold sores treatment?

A

aciclovir!

523
Q

SLEEPY TIME ANTIHISTAMINE?

A

DIPENHYDRAMINE

524
Q

1ST LINE IMPETIGO OTC?

A

BENZOYL PEROXIDE

525
Q

ORAL CANDIDIASIS?

FUNGAL?

A

ORAL CANDIDIASIS? 7 days after lesions have healed

FUNGAL? BD+10 days after lesions have healed

526
Q

SCABIES, PERMETHRIN?

THREADWORM, MEBENDAZOLE?

A

SCABIES, PERMETHRIN? 1 WEEK

THREADWORM, MEBENDAZOLE? 2 WEEKS

527
Q

BACK PAIN?

A

1st line- NSAID
2nd line- Codeine with/without paracetamol
3rd line- spasm, short course benzo, diazepam

528
Q

baby, paracetamol post-immunisation dose?

A

up to 6months
60mg right after vaccination
60mg 4-6hrs after first dose
60mg 4-6hrs after second dose

529
Q

MODAFINIL?

A

Contraception during+2 months after

530
Q

FLUOROQUINOLONE?

A

heart valve regurgitation

531
Q

taking desogestrel?

A

day 1 of cycle then continous

532
Q

levonorgestrel+desogestrel?

A

you can take same day str8 away

533
Q

groin, sore/wet/itchy/smelly?

A

clotrimazole/miconazole? str8

534
Q

meningitis?A

A

notifiable!

535
Q

SHINGLES?

A

GO A&E ASAP

536
Q

A 26-year-old asks to purchase the morning after pill. She had intercourse
last night and the condom split. She takes carbamazepine for epilepsy. Which
action would be most appropriate for the pharmacist to take?

A

double up levonelle!

537
Q

An 8-year-old has had a cold and very sore throat for 2 days and has a
temp of 39.2C. Her throat appears very red, her tongue is red with tiny white
spots, and she has a widespread red rash that feels rough but blanches when
pressure is applied. What is the likely cause of her symptoms?

A

SCARLETT FEVER, WHITE SPOTS!

538
Q

scarlett?

A

go GP quick ting!

539
Q

Orlistat dose?

A

1 tds!

540
Q

orlistat no weight loss within 12 weeks?r

A

stop treatmetn!

541
Q

gastroenteritis?

A

diarrhoea!

542
Q

tranexamic acid+pill?

A

UNSUITABLE!

543
Q

TRANEXAMIC ACID?

A

no effect on period
max 4 days
n&v DIARRHOEA COMMON
x pill

544
Q

MAX. SILDENAFIL DOSE?

A

50MG

545
Q

Trichomoniasis is?

A

Parastici1

546
Q

MENINGITIS, CAPILLARY REFILL?

A

5 SECONDS? REFER

547
Q

meningitis CRT>X REFER?

A

3 SECONDS!

548
Q

temp> x?

A

39 referral

549
Q

REYE’S SNDROME?

A

HELLA VOMITING

550
Q

metformind oesn’t cause dysuria!

A
551
Q

tranexamic acid irrregular cycle?

A

avoid

552
Q

sumatriptan+smoking?

A

no problem

553
Q

TAKEN ULIPRISTAL?

A

TAKE BARRIER TILL NEXT PERIOD

554
Q

fexofenadine+juice?

A

don’t mix bruh

555
Q

derbac lotion

A

24hours!

556
Q

permethrin cream?

A

2+, scabies, 12hrs

557
Q

CLOTRIMAZOLE 2%?

CLOTRIMAZOLE 1%?

A

BNF GPhC (48 decks)

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