Em the pharmacist questions Flashcards
Which statement is incorrect?
A- Alendronic acid 70mg should be taken once daily at the same time each morning.
B- Alendronic acid should be taken with a full glass of water, at least 30 minutes before food, other drinks or medication.
C- Alendronic acid tablets must be swallowed whole.
D- Alendronic acid can increase the risk of atypical femoral fractures
E- Alendronic acid is contraindicated in hypocalcaemia
A- Alendronic acid 70mg should be taken once a day at the same time every morning is incorrect
A woman comes into the community pharmacy and asks for your advice on what paracetamol dose she should give her 2 year old child for fever?
A- 60mg every 4-6 hours
B- 120mg every 4-6 hours
C- 180mg every 4- 6 hours
D- 240mg every 4-6 hours
E- 360mg every 4-6 hours
C- 180mg every 4-6 hours
How long from the appropriate date is a prescription for diazepam valid?
A- 7 days
B- 28 days
C- 30 days
D- 6 months
E- 12 months
B- 28 days
Diazepam is a controlled drug which belongs to Sch4 P1
A GP requests that you do an emergency supply of a POM for a patient ?
Which statement is not true regarding emergency supply at request of the prescriber?
A- The patient does not need to be interviewed
B- The prescriber must provide a prescription within 48 hours
C- You must be satisfied that the prescriber is unable to provide a prescription immediately
D- An entry needs to be made in the POM register on the day of the supply, or if impractical the following day
E- Usual label requirements for POMs apply
B- The prescriber must provide a prescription within 48 hours
This is incorrect as it is within 72 hours not 48
What is wrong with a patient taking Lithium and Losartan ?
DRUG INTERACTION
Lithium and ARB
Increase lithium concentration = increasing risk of toxicity
A father presents to the pharmacy with his 2 year-old son. He tells you that his son developed a spotty rash across his body,which then turned into itchy fluid filled blisters.
Some of these vesicles are now starting to crust over to form scabs.
The patient also experienced loss of appetite and general malaise.
Based on this presentation, what is the most likely diagnosis?
A- Chickenpox
B- Scarlet fever
C-Measles
D-Rubella
E-Contact dermatitis
A- Chicken pox
A trainee pharmacist asks you to go through the topic of ‘sick day rules’ with them.
Which of the following medications is most appropriate to omit during periods of diarrhoea and vomiting?
A- Basal insulin
B- Clopidogrel
C- Indapamide
D- Oxycodone IR
E- Amlodipine
C- Indapamide
Indapamide is a diuretic and should be omitted in periods of diarrhoea and vomiting due to the risk of dehydration and AKI
- The GP provides a male patient with a prescription for nitrofurantoin to treat a lower urinary tract infection.
How many 50mg nitrofurantoin capsules would you expect to dispense to provide the full course of treatment?
A- 7 capsules
B- 9 capsules
C-12 capsules
D-21 capsules
E- 28 capsules
E- 28 capsules
For lower UTIs in men, usual dose is 50mg QDS
A patient hands you a prescription for fentanyl. Which of the following statements is correct?
A- This prescription is valid for 30 days from the appropriate date
B- It is strongly recommended that no more than 28 days supply can be prescribed on the prescription
C- It is strongly recommended that no more than 30 days supply can be prescribed on the prescription
D- You cannot dispense more than 30 days
E- This prescription can be put on a repeatable prescription
C- It is strongly recommended that no more than 30 days supply can be prescribed on the prescription
Fentanyl is a CD Sch2
A mother presents to the pharmacy with her 5 year old who has had cough and cold symptoms for the past 3 days. The main symptom is a dry tickly cough.
Which of the following is the most appropriate action?
A- Refer to GP
B- Sell guaifenesin syrup
C- Sell dextromethorphan syrup
D- Sell glycerol and sucrose syrup
E- Sell ibuprofen
D- Sell glycerol and sucrose syrup
There are no red flags and so no referral is necessary
Guaifenesin is for productive coughs
A patient in hospital is prescribed gentamicin as a multiple daily dose regimen.
The foundation doctor has asked for your advice regarding the blood results, as the trough level of gentamicin has come back high.
The peak level was normal.What is the most appropriate advice?
A- The interval between doses should be increased
B- The interval between doses should be decreased
C- The dose should be increased
D- The dose should be decreased
E- The dose and the dosing interval should be altered
A- The interval between doses should be increased
Trough high = interval should be increased
Peak high = dose decreased
You are working as a GP practice pharmacist and are conducting a COPD medication review for a patient.The patient continues to be breathless and have exacerbations.There are no asthmatic features or features suggestive of steroid responsiveness. Their medication list is as follows: Salbutamol inhaler PRN
If following NICE guidance, what would the initial recommendation be if a step up of treatment is required?
A- Add a LAMA only
B- Add a LABA only
C- Add an ICS only
D- Add a LAMA and LABA
E-Add a LABA and ICS
D- Add a LAMA and LABA
Already prescribed a SABA
NEXT STEP = SABA + LAMA AND LABA
A patient is prescribed clozapine for schizophrenia, and you are counselling them about potential side effects.
Under which circumstance should they seek immediate medical advice?
A- Diarrhoea
B-Constipation
C- Insomnia
D-Hypersalivation
E- Galactorrhoea
B- Constipation
Potentially fatal risk of intestinal obstruction, faecal impaction and paralytic ileus
What is the first line treatment for opioid induced constipation?
Osmotic and Stimulant
Laxido and Senna
Which antibiotic requires monitoring for new or worsening respiratory symptoms?
A- Nitrofurantoin
B-Amoxicillin
C-Clarithromycin
D-Doxycycline
E-Meropenem
A-Nitrofurantoin
Carries a risk of pulmonary adverse effects and patients should report any new or worsening pulmonary symptoms
A 16-year-oldgirl comes into the community pharmacy requesting emergency hormonal contraception on a Thursday morning at 10am. She tells you she had UPSI at 11pm on Sunday night. She does not want the copper coil fitting. She has no medical conditions and takes no regular medications. Her BMI is 23.
What is the most appropriate action?
A- Provide a tablet of EllaOne
B- Provide a tablet of Levonelle
C-Explain that it is too late to take emergency hormonal contraception and refer her to the GP or sexual health clinic to get the copper coil fitted
D-Explain that you cannot provide emergency hormonal contraception due to her age and refer to GP or sexual health clinic
E- Provide a double dose of Levonelle
A- Provide a tablet of EllaOne
Within the time frame of 5 days
Levonelle is not appropriate as greater than 72 hours since UPSI
You are processing a hospital discharge summary for an 82-year-old lady. She has dementia and was recently admitted to hospital following a fall.
One of her medications has been stopped due to its high anticholinergic burden. Based on this information, which medication is most likely to have been stopped?
A- Amitriptyline 30mg
B- Atorvastatin 20mg
C-Doxazosin 16mg
D- Mirabegron 50mg
E-Memantine 20mg
A- Amitriptyline 30mg
Amitriptyline has a high anticholinergic burden which increases the risk of falls
A 15-year-old girl presents to the pharmacy, requesting analgesia for period pain.
Which is the least appropriate analgesia option for this patient?
A- Aspirin
B- Paracetamol
C- Ibuprofen
D- Co-codamol
E- Naproxen
A- Aspirin
Least appropriate as aspirin is contraindicated in children under 16 years old due to the risk of Reye’s syndrome
Only when specifically indicated such as in Kawasaki disease
Which of the following should not be taken with food?
A- Aspirin 75mg
B- Rivaroxaban 20mg
C- Lansoprazole 30mg
D- Prednisolone 5mg
E- Ferrous sulfate 200mg
C- Lansoprazole 30mg
Should be taken at least 30 minutes before food
Which Vitamin should be avoided in pregnancy?
A- Vitamin A
B- Vitamin D
C- Vitamin K
D- Vitamin C
A- Vitamin A should be avoided in pregnancy due to its potential teratogenic affect
A patient asks you if their medication needs to be prescribed by brand.
In which circumstance would the same brand of product normally need to be maintained?
A- A patient prescribed primidone for essential tremor
B- A patient prescribed levetiracetam for epilepsy
C- A patient prescribed lacosamide for epilepsy
D-A patient prescribed phenytoin for epilepsy
E- A patient prescribed carbamazepine for trigeminal neuralgia
D- Phenytoin for epilepsy
Phenytoin, Carbamazepine and Primidone are Category 1 ANTIEPILEPTICS
Need to be prescribed by brand if used for epilepsy
By what route should Vinblastine be given ?
Intravenous ONLY
It is a vinca alkaloid
Incorrect administration can cause fatal neurotoxicity
Which adrenaline autoinjector is suitable for a 7-year-old for emergency treatment of anaphylaxis ?
300mcg
This is suitable for children aged 6-11 years old
What agent can be used in iron salt poisoning?
Desferrioxamine mesilate
