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Pharmacy Pre-Reg > Fun Facts > Flashcards

Fun Facts Flashcards

1
Q

Which childhood disease should ibuprofen be avoided in due to increased risk of skin and soft tissue infections?

A

Chicken pox (Varicella infections)

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2
Q

Which diuretic has an MHRA alert relating to increased risk of non-melanoma skin cancer?

A

Hydrochlorothiazide

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3
Q

Which diuretic is first-line in treating hypertension?

A

Indapamide

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4
Q

Which diuretic can cause increased blood glucose, therefore exacerbating diabetes?

A

Bendroflumethiazide

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5
Q

Which three antihypertensives can be used in pregnancy?

A

Labetalol
Nifedipine
Methyldopa

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6
Q

Which four beta blockers DO NOT cause sleep disturbances and nightmares? Why?

A 
Water soluble:
Celiprolol
Atenolol
Nadolol
Sotalol
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7
Q

Which eight beta blockers are cardioselective?

A 
Metoprolol
Atenolol
Nebivolol
Celiprolol
Bisoprolol
Acebutolol
Betaxolol
Esmolol
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8
Q

What is the MHRA alert associated with corticosteroid use?

A

Serous chorioretinopathy - monitor for visual disturbances

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9
Q

What are three MHRA alerts associated with SGLT2s?

A

Risk of DKA
Fournier’s gangrene
Risk of lower limb amputation

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10
Q

Which SGLT2 can be used for treatment of HF?

A

Dapagliflozin

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11
Q

Which two antidiabetic medications are safe in renal impairment?

A

Pioglitazone

Linagliptin

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12
Q

What are two conditions that would be closely monitored for with pioglitazone?

A

HF

Bladder cancer

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13
Q

Why can’t tetracyclines be used in children under 12?

A

Binds to calcium in bones and teeth, can cause dental hyperplasia and tooth discolouration

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14
Q

Why can’t aspirin be used in under 16s?

A

Risk of Reye’s syndrome

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15
Q

What can be used to treat an overdose of benzodiazepines?

A

Flumazenil

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16
Q

What is the MHRA alert for antipsychotics in dementia patients?

A

Increased risk of death/stroke

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17
Q

What is used to treat methotrexate toxicity?

A

Calcium foliate

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18
Q

Which antibiotics have an MHRA alert for causing cholestatic jaundice?

A

Flucloxacillin

Co-Amoxiclav

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19
Q

When would you stop a LMWH due to a decreasing blood result?

A

Platelets dropping by 30-50% of initial value

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20
Q

What would you do if a warfarin patient had an INR of 5-8 but no signs of active bleed?

A

Withhold 1-2 doses of warfarin until <5 and reduce maintenance dose

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21
Q

What would you do if a warfarin patient had INR>8 but no bleeding?

A

Stop warfarin and give PO phytomenadione, the IV solution can be given orally

Repeat dose of phytomenadione after 24 hrs if INR still high

Restart warfarin when INR<5

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22
Q

What would you do if a warfarin patient had INR >8 and active bleeding? What blood result would you look at for a sign of bleed?

A

Hb dropping = sign of bleed

Give IV infusion of phytomenadione, repeat after 24hrs if INR still high

Restart warfarin when INR<5

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23
Q

What is done in a warfarin patient with a major bleed?

A

Stop warfarin

Give IV phytomenadione and dried prothrombin complex (if unavailable, can give fresh frozen plasma but this is less effective)

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24
Q

What would you do if a warfarin patient had an INR 5-8 band showed signs of bleeding?

A

Stop warfarin

Give IV phyto

Restart warfarin when INR<5

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25
Q

INR target and range for AF/1st episode DVT and PE/cardioversion

A
  1. 0-3.0

2. 5 - target INR

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26
Q

INR target and range for recurrent DVT/PE despite anticoagulation and INR>2

A
  1. 0-4.0

3. 5 - target INR

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27
Q

Can EllaOne be used as EHC whilst breastfeeding?

A

Yes, but advise the mother not to breastfeed for the next 7 days

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28
Q

In what pre-existing conditions would you avoid using mefloquine for malaria prophylaxis?

A

History of depression

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29
Q

What is the reaction when sildenafil is given alongside alpha blockers?

A

Can cause significant hypotension

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30
Q

What is the hypertension target in pregnancy?

A

135/85

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31
Q

What is the hypertension target in patients over 80?

A

150/90

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32
Q

What is the hypertension target in patients with renal disease/diabetes?

A

130/80

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33
Q

What drug is 1st line for scarlet fever and what is the alternative if the patient has a penicillin allergy?

A

Phenoxymethylpenicillin 1st line

Azithromycin if penicillin allergic

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34
Q

Which PPI should not be used alongside clopidogrel and why?

A

Omeprazole - reduces efficacy of clopidogrel

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35
Q

Can sodium valproate be used in pregnancy for epilepsy or bipolar?

A

Epilepsy - contraindicated unless no other option

Bipolar - do not use

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36
Q

What colour can urine turn when taking nitrofurantoin?

A

Yellow/brown

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37
Q

What colour can urine turn when taking rifampicin/rifabutin?

A

Orange/red

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38
Q

What colour can urine turn when taking sulfasalazine?

A

Yellow/orange

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39
Q

What colour can urine turn when taking entacapone?

A

Red/brown

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40
Q

What colour can urine turn when taking levodopa preparations?

A

Reddish/darker

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41
Q

What colour can your urine turn when taking senna?

A

Red/yellow

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42
Q

What tests should be included in 6-monthly monitoring with lithium?

A

Renal function
Thyroid function
Bodyweight/BMI
Serum electrolytes

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43
Q

What are the signs of methotrexate toxicity?

A 
Yellowing of eyes
Stomach pain
Fatigue
N&V
Reduced appetite
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44
Q

What is the interaction between omeprazole and methotrexate?

A

Omeprazole decreases clearance of methotrexate

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45
Q

What is the MHRA alert regarding PPIs?

A

Subacute cutaneous lupus erythematosus - presents as lesions on the skin

46
Q

What conditions can PPI use increase the risk of?

A

C. diff
Osteoporosis/fractures
Gastric cancer

47
Q

What electrolyte disturbance can be caused by PPI use?

A

Hypomagnesaemia

48
Q

What are the typical tetrad of symptoms in neuroleptic malignant syndrome?

A

Altered mental state
Muscle rigidity
Hyperthermia
Tachycardia

49
Q

If presenting with disabling ischaemic stroke and new AF, when should anticoagulation be started?

A

Start in 2 weeks after high dose aspirin

50
Q

What is the pre-contemplation stage of behaviour change?

A

No intention of changing behaviour, denial of a problem

51
Q

What is the contemplation stage of behaviour change?

A

Knows they have a problem, not yet ready to make changes

52
Q

What is the most appropriate type of diuretic to use alongside digoxin and why?

A

Potassium-sparing, hypoK+ can lead to digoxin toxicity

53
Q

How should vinca alkaloids be administered?

A

Intravenously - intrathecal administration can cause severe neurotoxicity

54
Q

What are the four Cs for causing C. diff?

A

Clindamycin
Co-amoxiclav
Cephalosporin
Ciprofloxacin (quinolones)

55
Q

What are the recommended weekly units for alcohol intake?

A

14 units a week

56
Q

What is the recommended intake of salt daily for adults?

57
Q

Give two examples of food that are purine rich

A

Red meat

Seafood

58
Q

What is the serum uric level target for maintenance treatment of gout?

A

<300micromol/L

59
Q

Rank the topical corticosteroids from most potent to least potent:

  • Hydrocortisone
  • Betamethasone
  • Clobetasone butyrate
  • Clobetasol propionate
A

Most potent

Clobetasol propionate
Betamethasone
Clobetasone butyrate
Hydrocortisone

Least potent

60
Q

What should be monitored annually in children using long-term ICS?

A

Height and weight

61
Q

What can be used in community for a patient experiencing hypoglycaemia?

A

15-20g glucose or sucrose

150-200ml pure fruit juice

62
Q

What effect can antipsychotics have on blood sugars?

A

Hyperglycaemia

63
Q

What schedule CD is temazepam?

A

Schedule 3

64
Q

What is the interaction between sumatriptan and tramadol?

A

Increased risk of serotonin syndrome

65
Q

What schedule CDs are amphetamines?

A

Schedule 2

66
Q

What are the most common symptoms of otitis media in children?

A

Irritability, crying, pain, fever

67
Q

What effect can long-term topical steroid use have on hair?

A

Hypertrichosis - overgrowth of hair

68
Q

What are 4 side effects of long-term topical steroid use?

A

Skin depigmentation
Skin atrophy
Telangiectasia (spider veins)
Adrenal suppression

69
Q

What is kaolin used for?

A

Mild-moderate diarrhoea
Mouth sores
Can cause blood to clot quicker

70
Q

Is kaolin commonly misused?

A

No, it is sometimes in a preparation with morphine as an anti-diarrhoeal but alone it is rarely misused

71
Q

What lifestyle advice should be given to patients using clioquinol preparations?

A

The cream can stain clothing

72
Q

Which drugs are inducers of CYP enzymes? (CRAP GPS)

A 
Carbamazepines
Rifampicin/rifabutin
Alcohol
Phenytoin
Griseofulvin
Phenobarbitone
Sulfonylureas
73
Q

Which drugs are inhibitors of CYP enzymes? (SICK FACES.COM)

A 
Sodium valproate
Isoniazid
Cimetidine
Ketoconazole
Fluconazole
Alcohol and grapefruit juice
Chloramphenicol
Erythromycin
Sulfonamides
Ciprofloxacin
Omeprazole
Metronidazole
74
Q

What is the dose of tamoxifen in breast cancer?

A

20mg daily

75
Q

Which antibiotic is commonly used in dental infections due to its activity against anaerobic bacteria?

A

Metronidazole

76
Q

Which antibiotic can cause severe optic neuropathy?

77
Q

Which drug use for DVT is a direct thrombin inhibitor and has a rapid onset of action?

A

Dabigatran

78
Q

Which international patients would be eligible for emergency supply at patient’s request?

A

EEA and Swiss

79
Q

Which drug can be used in the treatment of alcohol dependency and works by causing acute sensitivity to alcohol?

A

Disulfiram

80
Q

Can standard NHS prescriptions be repeated?

A

No, in England there is the repeat dispensing service

81
Q

Can private prescriptions be repeated?

A

Yes, they can be repeated as many times as the prescriber has written (e.g. repeat x3 = repeat dispense 3 times)

If the prescription just says “repeat” it can only be repeat dispensed once

82
Q

What are symptoms of alcohol overdose?

A

Ataxia
Nystagmus
Dysarthria (difficulty speaking)

83
Q

What are the symptoms of TCA overdose?

A

Dry mouth
Urinary retention
Dilated pupils

84
Q

What drug is indicated for maintaining abstinence in alcohol-dependent patients and works by reducing cravings?

A

Acamprosate

85
Q

What are the symptoms of thiamine deficiency?

A

Acute confusion, leg tremors, droopy eyelids

86
Q

Which anti-hypertensive can cause menstrual disturbance?

A

Spironolactone

87
Q

Which antihypertensives can cause sleep disturbances?

88
Q

What are the signs of carbamazepine toxicity?

A

Blurred vision
Ataxia
Dizziness
N&V

89
Q

What are the signs of theophylline toxicity?

A 
Haematemesis/vomiting
Hyperglycaemia
Dilated pupils
Tachycardia
Arrythmias
Agitation
Restlessness
Convulsions
90
Q

What conditions is pseudoephedrine cautioned in?

A

Diabetes

Hypertension

91
Q

When can aspirin be used in under 16s?

A

Treatment of Kawasaki disease

92
Q

What are the BNF recommendations for avoiding methotrexate dosing errors?

A

Use one strength of tablet
Ensure the label clearly states the dose and regimen
Advise the patient to report any signs of blood/liver/pulmonary disorders (sore throat, bleeding, bruising
Advise the patient of the dose and reason for taking

93
Q

What is the age license for hydrocortisone 1% cream?

94
Q

Which beta blocker usually has to be given more than once daily?

A

Propranolol

95
Q

What is the shelf-life of GTN s/l tablets after opening?

96
Q

What are the symptoms of seborrhoeic dermatitis?

A

Red rash affecting central regions of the face

97
Q

Symptoms of sinus headaches?

A

Dull, throbbing headache in upper half of face

Made worse by bending down

98
Q

How should CD3 private prescriptions be processed?

A

Submit to relevant NHS agency

99
Q

How should CD3 requisitions from a prescriber be processed?

A

Submit to relevant NHS agency

100
Q

How does tax affect processing of CD3 invoices?

A

Should be kept for 6 years

101
Q

How long should you wait for before giving blood after stopping isotretinoin and why?

A

4 weeks, risk of teratogenicity to pregnant women receiving transfusion

102
Q

Which diuretic has little effect in patients with CrCL <30ml/min?

A

Bendroflumethiazide

103
Q

What are the five MHRA recommended check points for reducing prescribing errors?

A 
Right patient
Right medicine
Right route
Right dose
Right time
104
Q

Which anticoagulant should be dose reduced when used concomitantly with verapamil?

A

Dabigatran

105
Q

What are the symptoms of glandular fever and what is the causative virus?

A

Swollen neck glands
Sore throat
Tiredness
Fever

Epstein Barr

106
Q

Which age group does glandular fever affect the most?

A

Teenagers and young adults

107
Q

Which drug class interacts with quinolones, increasing the risk of convulsions?

108
Q

Which antisecretory medication can cause severe diarrhoea that may require withdrawal of the medication?

A

Misoprostol

109
Q

Why is phenytoin prescribed more commonly as oral preparations instead of IV?

A

More error-prone, increasing risk of death

110
Q

What schedule CD is buprenorphine?

111
Q

How long should hygiene measures be continued for with threadworm infections in pregnancy?

112
Q

MHRA alert regarding finasteride?

A

Risk of depression, stop finasteride and seek medical attention

Pharmacy Pre-Reg (8 decks)

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