Extra OTC Notes Flashcards
Who can’t take codeine?
odeine containing products are NOT suitable for:
Children under 12 years
Anyone under 18 years who has had a tonsillectomy/adenoidectomy
Children aged 12 to 18 years who have problems with breathing
Breastfeeding women (as it may be passed through breast milk)
Customers who are CYP2D6 ultra-rapid metabolisers (a genetic condition which increases the risk of codeine toxicity)
What are the side effects of codeine?
Side effects of codeine can include drowsiness and blurred vision. If affected, customers should not drive or ride a bike. It is an offence to drive if your ability to drive safely is affected
At which age ranges does 70% of growth occur in?
Ages 1-10
As children go through different stages, what requirement changes?
Nutrition requirements
What should the diet consist of for pre-school children?
5 portions of starchy foods each day to give energy,
wholegrain options shouldn’t be given too often as they are more filling,
Aim for five portions of fruit and vegetables each day,
Dairy foods are a good source of calcium, should be full fat versions for under 5s.
Protein rich foods can provide iron, zinc, vitamin D and vitamin B
High sugary foods should not be given for too long and watch salt intake.
What should the diet consist of for children aged 5-11 year olds?
Advise on the following;
Healthy breakfast,
Healthy snacks,
Two portions of fish per week (one oily),
What does oily fish provide and can too much be good or harmful?
Oily fish can provide essential fatty acids, but too much of it can be harmful due to the build up of low-level pollutants.
What is the maximum amount of vitamin D a child aged 1-10 should not exceed?
Too much vitamin D supplementation can be harmful. Children aged one to 10 years should not have more than 50 mcg a day.
What is peadisure drinks/ powder good for?
Perfect for fussy eaters: parents reported an improvement in appetite in four weeks*2
Less sick days: parents reported a reduction in sick days by 64 per cent in 16 weeks*2
Support to get back on track: provides essential nutrients to help kids bounce back to health after feeling poorly
Boost for active kids: provides essential macro and micro nutrients to help keep them fit and healthy
What are some tips to give to parents of fussy eaters?
Gradually introduce a variety of different foods
Try small portions and praise them for eating
Give them the same food as the rest of the family to encourage them to try it
Present food in different ways
What policy does boots operate for age-restricted products?
Challenge 25
What does challenge 25 mean?
Anyone who looks under 25 should be asked for ID when purchasing age restricted items.
Which products may have age restrictions?
Christmas crackers, energy drinks, razor blades, e-cigarettes and refills.
What method should be used for challenge 25 situations?
STAR method
What does STAR method stand for?
STOP - stop and consider appropriateness of the transaction
Think - consider the age of the person in front of you. Do they look under 25?
Ask - if you think the customer looks under 25 then ask for ID
Refuse - if the customer cannot provide ID.
What are suitable forms of ID for challenge 25?
valid driving licence,
A valid passport,
a citizens card,
or any other photo identity card with the ‘PASS’ hologram and date of birth displayed.
What shall you do if you refuse a sale due to no ID being shown>
Log it into the refusal log which is stored at the till. Recording refusals in the log will show that you and your store are complying with the legislation.
What is the gut microbiota?
It is the name for the microorganisms living in a person’s digestive system.
how many different species of microorganisms does each person have in their digestive tract?
Each person has about 300 to 500 different species of bacteria, yeasts and protozoa in their digestive tract
Are all microorganisms harmful to our health?
whilst some microorganisms are harmful to our health, many are incredibly beneficial and even necessary for a healthy body
Intestinal bacteria are known to produce which vitamins?
known to produce certain B vitamins which help release energy from food. It is also estimated that half of the daily vitamin K requirement, which is important for blood clotting, is provided by intestinal bacteria.
Is there a link between weight and microbiota diversity?
Yes, there seems to be a link between long-term weight gain in humans and low microbiota diversity
Which other people with certain diseases may have a less diverse microbiota?
A number of studies have shown a less diverse microbiota in people with a range of conditions such as inflammatory bowel disease, psoriatic arthritis, type 1 diabetes, atopic eczema, coeliac disease and type 2 diabetes.
Is there more bacteria cells in your body than body cells?
There are more bacterial cells in your body than human cells. There are roughly 40 trillion bacterial cells in your body compared to around 30 trillion human cells.
What are probiotics?
Probiotics are live microorganisms that, when taken, may have certain health benefits.
What are the most commonly used probiotic species?
are lactobacillus and Bifidobacterium
What has research suggested about probiotics and what it can help with?
Some research has suggested that taking probiotics can support a healthy gut microbiota, and that it may prevent gut inflammation and other intestinal problems.
How can probiotics be taken?
Probiotics can be taken as a food supplement or may be found naturally in live yoghurt and fermented foods such as kefir, kimchi, and sauerkraut. However, the European Food Safety Authority (EFSA) has not approved any probiotic health claims.
What are prebiotics?
Prebiotics are typically the non-digestible carbohydrates that probiotics feed on. Increasing the amount of food for probiotics allows them to multiply and thrive in the gut.
What can prebiotics be found in?
Prebiotics can be found as a food supplement, often combined with a probiotic, or found naturally in foods such as asparagus, bananas, garlic and onions.
What is increased microbiota diversity an indicator of?
Increased diversity is a good indicator of gut health.
To encourage a diverse microbiota, customers could be advised to eat a diet that is high in what?
high in fibre-rich foods, e.g. fruits, vegetables and wholegrains.
What is guy dysbiosis and eating alot of what can cause this?
Gut dysbiosis is an imbalance of gut microbes, eating a lot of sugar or artificial sweeteners may cause gut dysbiosis.
What have studies linked the artificial sweetener aspartame to?
Artificial sweetener aspartame increases the number of some bacterial strains that are linked with metabolic disease, which may increase the risk of diabetes and heart disease.
Can exercise encourage the growth of a variety of gut bacteria?
Yes
What advice around antibiotics can increase microbiaota diversity?
Reduce unneccasary antibiotic usage, antibiotics should only be prescribed when they are really needed not only to reduce antibiotic resistance, but also because they can be damaging to the gut microbiota.
What can be given alongside antibiotics to reduce antibiotic acquired diarrhoea?
a probiotic could be considered alongside the antibiotic as there is evidence it may reduce antibiotic acquired diarrhoea.
What have studies suggested about psychological stress and gut microbiota?
Studies have suggested that psychological stressors can disrupt the microorganisms in the intestines, even if the stress is only short-lived.
In humans, a variety of stressors can negatively affect gut health, list a few of them?
Mental or emotional stress
- Environmental stress, such as extreme heat, cold, or noise
- Sleep deprivation
- Disruption of the circadian rhythm e.g. shift working
What is the link between sleep and gut microbiota?
A 2014 study indicated that irregular sleep habits and disturbed sleep can have negative outcomes for the gut microbiota, which may increase the risk of inflammatory conditions such as asthma and diabetes.
How much sleep per night should adults aim to get?
minimum 7 hours per night.
When we sleep the body moves between what cycles?
between REM (rapid eye movement) and non-REM sleep cycles.
How many stages of non-REM sleep are there?
three stages
When does REM sleep become increasingly deeper and longer?
towards the morning
Describe stage 1 of non-REM sleep?
The transition period from being awake to sleeping; a person’s eyes are closed but it is easy to wake them up. Brain activity, heart rate, breathing and eye movements start to slow down and the muscles start to relax.
Describe stage 2 of non-REM sleep?
Light sleep where the body temperature drops and eye movements stop. Brain activity, heart rate and breathing continue to slow down and muscles relax further.
Describe stage 3 of non-REM sleep?
When deepest sleep occurs; heart rate and breathing slow to their lowest levels during sleep and the muscles are completely relaxed. It is difficult to rouse someone from this stage of sleep; if they are woken up, they may feel disorientated for a few minutes. During this stage, the body repairs tissues, builds bone and muscle, strengthens the immune system and builds up energy for the next day
Describe REM sleep?
Occurs about 90 minutes after falling asleep. The eyes move rapidly from side to side while they are closed and brain activity increases. Breathing becomes faster and irregular, heart rate and blood pressure increase. Dreaming occurs mostly during REM sleep; the body becomes relaxed and immobilised, which prevents the person from acting out their dreams. REM sleep is important for learning and memory; this is when the brain processes information that has been taken in during the day and stores it in the long-term memory.
What may be some reasons why sleep may be affected?
Disruption of daily life Anxiety and worry Isolation and depression Increased family and work stress More screen time Stress-related fatigue.
What are ways to relax to help with sleeo?
a warm bath to help the body reach an ideal temperature for sleep; relaxation exercises such as light yoga stretches to help relax the muscles; using relaxation CDs or podcasts; reading a book; or listening to the radio to help relax the mind
What has mindfulness shown to do?
Mindfulness has been shown to make it easier to fall asleep, improve sleep time and sleep quality. It is all about understanding ourselves better and enjoying the world around us by being more aware of the present moment. One technique is using mindfulness meditation before bedtime. This involves sitting quietly and paying attention to thoughts, sounds and sensations (commonly the sensations of breathing or parts of the body) to help clear the mind.
How can aromatherapy used to help with sleep?
Essential oils to help with improving relaxation include lavender, camomile, bergamot and marjoram.7-10 Aromatherapy can be used in different ways before bedtime, e.g. using essential oils for massage or products containing essential oils such as a pillow spray.
Can antihistamines that cause drowsiness be used to help fall sleep?
it may be appropriate to recommend a P medicine sleeping product containing an antihistamine that causes drowsiness, such as diphenhydramine.
What warning must be given for OTC sleeping tabs?
That they are only for short term use to reduce psychological dependence on sleeping tablets.
What else can be advised about antihistamines being used for sleeping?
ou should also advise customers that antihistamines may have side effects including residual drowsiness the following day
Which vitamins help with reduction in tiredness and fatigue?
iron and vitamin B12
In regards to sleeping (insomnia), when should patients be referred to the GP?
Self-care advice and changing their sleeping habits hasn’t worked
They have had difficulty sleeping for months
Their insomnia is affecting their daily life in a way that makes it difficult for them to cope.
What advice can be given to patients to help them get a good night’s sleep?
Try to keep a regular sleep/wake pattern
Get out into natural light as soon as possible in the morning
Be more active – daytime exercise helps improve the quantity and quality of sleep (start with small amounts and build up gradually if you’re not accustomed to regular exercise)
Avoid stimulants containing caffeine (e.g. coffee, tea, cola, chocolate, energy drinks) for eight hours before bedtime
Don’t go to bed hungry, thirsty or just after eating a meal
Reduce screen time before bedtime
Don’t use alcohol to sleep and keep within the guideline not to regularly drink more than 14 units a week (both men and women)
Avoid nicotine before bedtime
Make sure the bedroom is cool, dark and quiet.
How many months are mothers recommended to exclusively breastfeed their baby?
for at least first 6 months of life
When a bay cries for more than 3 hours, on three days a week for at least a week, what can it be?
Colic
What other signs suggest colic?
Difficult to soothe,
Clench their fists and appear red in the face,
They may have a gurgling tummy,
may pull their knees to their stomach or arch their back,
What may HCPs recommend for long term treatment of colic?
Specially formulated milk like Aptamil Comfort - which can be used of the dietary management of colic and constipation.
What is reflux or posseting in babies?
when babies bring up a small amount of their milk. It’s normal for babies and thought to be related to their immature digestive system.
For reflux in babies what kind of milk maybe suggested by HCPs?
thickened milk
such as Aptamil Anti-reflux
Thickened with carob bean gum, helps feeds stay down,
What further advice can be given to customers for colic in babies?
Hold or sit the baby upright when feeding to prevent them from swallowing too much air in their milk
Wind the baby after feeds
Holding, cuddling and gently rocking the baby may help
Try distractions such as gentle white noise, taking the baby out in the buggy, singing or a soothing warm bath
Reassure parents/carers that it should resolve by the time the baby is six months old.
When should a referral to GP be made for babies with reflux?
They have tried different things to help with reflux with no success after two weeks
The baby has reflux that starts after six months of age
The baby still has reflux when they are over one year of age
The baby is losing/has stopped gaining weight.
When selling products for eczema - before stepping up treatment what should be checked?
Check they know how much and how often to apply the different types of products and recommend smaller travel-sized emollients to apply when out and about
How long should patient self care before consulting GP for an acute sore throat?
Around one week.
What self management OTC can patient take for acute sore throat?
Use suitable pain relief, such as paracetamol, ibuprofen or medicated sprays and/or medicated lozenges. Symptoms that have come on suddenly, purulence, severe inflammation or fever should be referred to the pharmacist.
How long should patient self care before consulting GP for an acute otitis media (Inner ear infection)?
About three days (can be up to a week)
What self management OTC can patient take for acute otitis media?
Use suitable pain relief.
Refer the following to the pharmacist: Customers who are generally unwell, affected with discharge from the ear and children
How long should patient self care before consulting GP for Sinusitis?
If it’s viral, it can last up to 10 days. If it lasts more than 10 days it is likely to be bacterial.
What self management OTC can patient take for Sinusitis?
Use suitable pain relief, saline nasal drops/spray or decongestants. Remember to advise customers how long they should use them for. Refer customers with persistent symptoms to the pharmacist.
How long should patient self care before consulting GP for acute cough?
Can last for around three weeks. Refer customers with a cough that lasts more than three weeks to the pharmacist.
What self management OTC can patient take for acute cough?
Honey or a suitable cough relief medicine may offer some relief of symptoms. Refer customers with other medical conditions to the pharmacist.
Note: A new continuous cough may indicate a Covid-19 infection (coughing a lot in one hour or three or more coughing episodes in 24 hours).
Is vitamin-D fat soluble?
Vitamin D is a fat-soluble vitamin which is found in foods such as oily fish, red meat, liver and egg yolks. Some foods, such as bread and spreads, are also fortified with vitamin D.
What is the main source of vitamin D?
Sunlight
What happens when the skin is exposed to UVB rays?
7-dehydrocholesterol (a substance found in the skin) is converted in the liver and kidneys to an active form of vitamin D3 that can be used by the body.
What does vitamin D contribute to the normal absorption and utilisation of?
calcium and phosphorus in the body
What are the two types of vitamins D?
vitamin D2 (ergocalciferol), which is produced by plants, such as mushrooms, and vitamin D3 (cholecalciferol), which is produced by animals.
Which vitamin D2 or D3 is suitable for vegans?
it is important to understand whether they are vegetarian or vegan. Vitamin D2 is always suitable for vegans, but vitamin D3 can be derived from an animal source (such as sheep’s wool) or lichen (a vegan-friendly source).
How is vitamin D insufficiency diagnosed?
By a blood test
What can prolonged vitamin D deficiency result in children?
a condition called rickets in children and a similar condition called osteomalacia in adults - both which affect the bone strength
What is osteomalacia?
A condition as a result of prolonged vitamin d deficiency in adults
Can patients with symptoms of rickets or osteomalacia be treated OTC?
No they should be referred to their GP.
What are the signs and symptoms of rickets?
Pain – the bones affected by rickets can be sore and painful, so the child may be reluctant to walk or may tire easily; the child’s walk may look different, e.g. waddling
Skeletal deformities – thickening of the ankles, wrists and knees, bowed legs, soft skull bones and, rarely, bending of the spine
Dental problems – including weak tooth enamel, delay
in teeth coming through and increased risk of cavities
Poor growth and development – if the skeleton doesn’t grow and develop properly, the child will be shorter than average
Fragile bones – in severe cases, the bones become weaker and more prone to fractures.
What are the signs and symptoms of osteomalacia?
Pain felt in the bones – often in the legs, groin, upper thighs and knees
Muscle weakness – tends to affect the thighs and the muscles in the shoulders and main trunk of the body
Slight cracks in the bone (partial fractures).
What is the recommended maximum daily intake of vitamin D for adults, including pregnant and breastfeeding women?
100 mcgs. maximum per day. Most people can be recommended to take minimum 10mcgs per day.
What can too much vitamin cause?
Taking too much vitamin D can cause too much calcium to build up in the body, weakening the bones and damaging the kidneys and the heart.
What can cause constipation?
Not eating fibre
not drinking enough water
constipation
What are the symptoms of constipation?
Stomach cramps,
Difficulty passing stools
stools are dry or lumpy
What is first line treatment for constipation?
dietary changes, Eat plenty of fibre rich foods, e.g. fruits, veg, wholegrains cereals),
increase intake of fibre gradually to avoid bloating or wind.
Increase activity levels and drink fluids to soften the stools.
How long can it take for dietary changes to work for constipation?
It can take up to four weeks for changes to have an effect.
What is first line laxative?
A bulk forming laxative - unless they have opioid induced constipation.
What is the second line treatment?
An osmotic laxative
What are examples of osmotic laxatives?
Macrogol or lactulose
How do osmotic laxatives?
These work by drawing water into the stool or retaining fluid in the stool.
How does dulcoSoft work?
Main ingredient Macrogol - so is a osmotic laxative. it works with the body to provide gentle and effective relief of constipation. Provides gentle and effective relief in 24-72 hours.
What are the side effects of macrogol?
Diarrhoea – Advise customers to stop using any laxative and to drink plenty of water to avoid dehydration
Indigestion or nausea – Taking macrogol with or after food can help
Bloating or wind – Try taking it between meals
Stomach pain – May be relieved by placing a hot water bottle over the area, eating smaller meals and taking time to eat slowly
Side effects should improve if customers reduce the dose, and they may feel better after passing stools.
