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GPhC BNF > GPhC Qs > Flashcards

GPhC Qs Flashcards

1
Q

How long do you retain signed orders for?

A

2 years from date of supply

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2
Q

EMERGENCY SUPPLY

PATIENT REQUEST?

A

immediate need
previously prescribed
appropriate dose
5 days- phenobarbital/schedule 4/5

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3
Q

EMERGENCY SUPPLY
EEA ES
NOT ALLOWED?

A

SCHEDULE 1/2/3

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4
Q

EMERGENCY SUPPLY PATIENT

ENTRY?

A

DATE
NAME/QUANTITY/FORM/SRENGTH
NAME+ADDY OF PATIENT
NATURE

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5
Q

EMERGENCY SUPPLY

PATIENT LABELLING?

A 
DATE
NAME/QUANTITY/FORM/STRENGTH
ANME OF PATIENT
NAME+ADDY OF PHARMACY
'EMERGENCY SUPPLY'

VET
‘KEEP OUT OF REACH OF CHILDREN’ ‘must’ lol

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6
Q

EMERGENCY SUPPLY PRESCRIBER

REQUIREMENTS

A

PROVIDE SCRIPT IN 72HOURS

NO CDS 1/2/3 (except pheno)

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7
Q

EMERGENCY SUPPLY PRESCRIBER REQUEST

ENTRY?

A 
DATE
NAME/QUANTITY/FORM/STRENGTH
NAME+ADDY OF PRACTITIONER
NAME+ADDY OF PATIENT
DATE PRESCRIPTION
AMEND ENTRY, INCLUDE DATE PRESCRIPTION RECEIVED
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8
Q

WHAT CDs REQUIRE DENATURING?

A

RETURNED/EXPIRED/OBSOLTE

SCHEDULE 2/3/4 (part 1)

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9
Q

SCH 2/3/4 RETURNED

AUTHORISED WITNESS NEEDED?

A

NO,

just witness to see is preferred, myna

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10
Q

EXPIERD CD

AUTHORISED WITNESS REQUIRED?

A

YES, ONLY IF SCHEDULE 2!

3? Good practice, etc…

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11
Q

patient returned cd entry?

A

NO, KEEP it separate, but record destruction yes

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12
Q

EXPIRED STOCK ENTRY?

A

RECORD FOR SCHEDULE 2 CDs

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13
Q

CDs, bank holiday coming up, prescription wording wag1?

A

Instalments due on days when the pharmacy is closed should be dispensed on the day immediately
prior to closure

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14
Q

Methadone+contraceptive pill?

A

Should be calm

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15
Q

Fluclo, breastfeeding?

A

Ery preferred

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16
Q

Warfarin+miconazole?

A

Inhibitor, INR increases, bleed

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17
Q

Theophylline, patient stopped smoking?

A

Reduce dose

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18
Q

Ibuprofen dose 3 year?

A

100mg TDS

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19
Q

Paracetamol dose 7 year old?

A

240-250mg QDS

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20
Q

Vaginal thrush treatment?

A

Fluconazole/itraconazole/clotrimazole/minconazole

Etc

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21
Q

Bacterial vaginosis treatment?

A

Metronidazole

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22
Q

Fungal nail infection?

A

2 nails max, tips/sides only
1-2 times a week amorofline, 18+
yellow/distored, crumblish

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23
Q

Fever+chicken pox?

A

Give paracetamol, not ibuprofen

infection risk L

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24
Q

dabigatran labelling?

A

read additional info!

swallow whole, do not chew or crush!

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25
Q

topiramate labelling?

A

sleepy, don’t drive/use tools/machines

do not stop taking this med!!!! (anti-epileptic)

+kidney stones? cool

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26
Q

alendronic acid dosing?

A

10mg OD or 70MG WEEKLY

70MG OD is an L

risk, osteonecrosis, fractures, auditory canal

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27
Q

metformin+next intensification

bladder L, takes trimethoprim UTI, needs to lose weight?

A

Pioglitazone L bladder
Flozin L urine
Sulphonylurea L weight gain
GLP-1? HMMM

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28
Q

Child

Clenil+SABA+next up?

A

LTRA

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29
Q

Under 16, UPSI 2 days, best contraceptive, doesn’t wnna see anyone?

A

Ulipristal, any child bearing age (but IUD probs best)

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30
Q

Trimethoprim+Methotrexate?

A

bone marrow suppression L, anti-folate, blood counts

teratogenic btw, avoid in pregnancy, UTI no!

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31
Q

How often do you clean spacers?

A

Once a month
mild detergent
air dry, no rinse

DO NOT USE A CLOTH INSIDE!

Wipe detergent off mouthpiece obvs

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32
Q

How often do you replace spacers?

A

6-12 months

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33
Q

END OF LIFE

Diamorphine, preferred, route?

A

Syringe driver

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34
Q

Meds contraindicated syringe route?

A

Chlorpromazine
Prochlorperazine
Diazepam

Cyclizine
Levomepromazine

skin reactions L

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35
Q

Animal bite?

A

Co-amoxiclav

OR

Doxy+metro (allergy)

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36
Q

Animal scratch?

A

Flucloxacillin

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37
Q

Cyclophosphamide/alkylating agents

BIG BOY RISK?

A

Neutropenia

contraception during+3 months after

Cisplatin- during+6 months after

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38
Q

Sespsis in children symptoms?

A

dry nappies
Crying
clinging
mute :|

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39
Q

profound bradycardia?

A

bisoprolol? really?

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40
Q

stage 1 hypertension, <55, >10% cvd risk?

A

ACE/arb gogo

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41
Q

Vincristine route?

A

IV, neurotoxicity risk otherwise

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42
Q

VET prescription years?

A

5 years

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43
Q

Ring worm, yute arm, treatment?

A

Clotrimazole

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44
Q

What drugs cause hypercalcaemia?

A

Hydrochlorthiazide
Thiazide-like
Lithium
Excess vitamin A/d/calcium

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45
Q

palpitations+feeling faint, sign of?

A

HYPOKALAEMIA

SALBUTAMOL+CORTICOSTEROIDS

ABCDE

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46
Q

SSRI, hypo?

A

hyponatraemia

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47
Q

signs of hyponataraemia?

A

nausea
headache
irritability
seizures

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48
Q

HIGH TSH, LOW T3/T4, WHAT IS THAT? TREATMENT?

A

hypothyroidism

levothyroxine

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49
Q

C diff. treatment order?

Relapse in 12 weeks of resolution?

Relapse after 12 weeks?

Life threatening?

A

Oral vanc

Oral fidaxo

Relapse in 12 weeks of resolution?
fidaxomicin

Relapse after 12 weeks?
vancomycin/fidaxomicin

Life threatening?

vanc+ IV metro

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50
Q

PYELONEPHRITIS, AVOID?

A

RENALLY CLEARED DRUGS PROBS

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51
Q

COPD exacerbation, penicillin allergy? purulent sputum

A

Doxy 200mg first day, 100mg OD +4 days

+ prednisolone 30mg 5 days

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52
Q

Animal scratch?

A

Fluclo apparently

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53
Q

Apixaban

DVT/PE general treatment?

A

10mg BD 7 days, 5mg BD maintain

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54
Q

Apixaban

VTE prophylaxis after knee surgery?

A

2.5mg BD 10-14 days

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55
Q

APIXABAN

VTE prophylaxis after hip surgery?

A

2.5mg BD 32-38 days

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56
Q

APIXABAN 2.5MG BD DOSING CRITERIA?

A

> /= 133 creatinine

> /= 80 years

= 60kg

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57
Q

Boostrix, pertussis, protects you from?

A

WHOOOOOOOOOOOOOPING

COUGH

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58
Q

CHLAMYDIA TREATMENT?

A 
AZITHROMYCIN 1G STAT
OR
DOXYCYCLINE 7 DAYS
OR
ERYTHROMYCIN 14 DAYS
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59
Q

antibiotic myna penicillin allergy, thrush?

A

fluclo, might as well give it :|

be a MAN! (or woman)

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60
Q

SICK DAY RULES?

SADMAN

A 
SGLT
ACE
DIURETICS
METFORMIN
ARBS
NSAIDS
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61
Q

SICK DAY RULES diabetes

SICK?

A

SUGAR- increase bgm, (some anti-diab drugs dose increase)
INSULIN- NEVER STOP! (bar SADMAN) (possible dose increase)
CARBS- adequate hydration+carbs
KETONES- type 1, check every 2-4hrs, EXTRA rapid acting insulin dose! wow

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62
Q

gap between 2 different eye drops?

A

5mins

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63
Q

CARER, ONCE DAILY INSULIN?

A

Determir (OD/BD)
Degludec
Glargine

isophane?

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64
Q

insulin the mixes?

A

Biphasic, multiple, with meals, duh!

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65
Q

swollen ankles?

A

CCBs!

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66
Q

CLOZAPINE MONITORING?

A

leukocytes, blood counts
weekly first 18 weeks, then fortnighly till year, then monthly

look out for intestinal obstruction/constipation!

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67
Q

MUSCLE ACHE STATINS?

A

creatine kinase?

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68
Q

STATINS HEPATIC L?

A

ALT levels

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69
Q

STROKE PREVENTION

CHA2-DS2-VAS SCORE?

WHEN DO YOU TREAT?

A 
C congestive HF
Hypertension
Age 75+ (2)
Diabetic
Stroke/TIA (2)
Vascular disease- dvt, aneurysm, etc
Age 65-74
Sex- female

When is thromboprophylaxis NOT needed?
Men= 0
Women= 1

TREAT?
>/= 2,

men 1? consider…

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70
Q

MHRA

only report the serious, adverse effects?

A

is codeine constipation established? yes

DKA, FLOZIN, REPORT TO MHRA

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71
Q

DKA, SLGT, REPORT?

A

YEAH PROBS :z

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72
Q

Lithium+antidepressants risk?

A

Serotonin syndrome

C
A
N

ikykyk

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73
Q

breakthrough pain?

A

1/10th to 1/6th

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74
Q

MORPHINE dose increase?

A

1/3 to 1/2

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75
Q

QUNINE INDICATION

A

NOCTURNAL LEG CRAMPS 200-300 mg ON
MALARIA

Not the best, side-effects, tinnitus, QT prolongation

Can take 4 weeks to work, review every 3 months

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76
Q

amiodarone+digoxin interaction?

A

bradycardia risk

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77
Q

what is duty of candour?

A

being honest when things go wrong

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78
Q

How long do you retain private scripts?

A

2 years, date of supply!

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79
Q

BISOPROLOL CAUTIONARY LABEL?

A

Do not stop taking this medicine unless your doctor tells you to stop

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80
Q

RIVAROXABAN CAUTIONARY LABEL?

A

Take with or just after food, or a meal

Warning: Read the additional information given with this medicine

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81
Q

digoxin yellow vision, toxicity, mangement?

A

withdraw. specalist, a&E?

digoxin specific antibody

K+ sparing diuretic also helps, as hypokalaemia potentiates toxicity :(

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82
Q

Hypoglycaemia treatment?

A

15-20g sucrose/glose
3-4 heaped spoons sugar (in water?)
150-200ml juice

NOT diet coke lol

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83
Q

HYPOGLYCAEMIA- SYMPTOMS?

A 
SWEATING
LETHARGIC
DIZZINESS
HUNGER
TREMOR
TINGLING LIPS
PALPITATIONS
EXTREME MOODS
PALE
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84
Q

MASTITIS TREATMENT?

A

Flucloxacillin 10-14 days

Erythromycin 10-14 days

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85
Q

EVIDENCE HIERARCHY ORDER?

A 
SYSTEMATIC REVIEW/META-ANALYSIS
RCT
COHORT
CASE-CONTROL
CASE SERIES/REPORTS
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86
Q

Methotrexate, what drug to avoid?

A

Trimethoprim, bone marrow L

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87
Q

METHOTREXATE+NSAIDs?

A

reduces mtx clearance, but just monitor more, calm

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88
Q

methotrexate contraception monitoring?

A

during+ 6 months

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89
Q

What is the 6-in-1 vaccine?

DTPHPHs

A 
DIPTHERIA
TETANUS
PERTUSSIS
HEPATITIS B
POLIO
HAEMOPHILIUS INFLUENZA B
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90
Q

emergency supply insulin, brand not in stock, action?

A

other pharmacies?

any brand? :O

Some are by brand, eg. glargine, careful

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91
Q

insulin prescribing?

A

UNITS PLEASE TY

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92
Q

PRIVATE CDs?

A

Use standardised form (vet excluded)
Send to NHS
Prescribe POMs separately (so you can retain 2 years)

needs ‘prescriber ID number’ not reg hmm

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93
Q

pom REGISTER?

A

2 YEARS FROM LAST ENTRY

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94
Q

private prescriptions?

A

repeatable, not NHS

repeat, repeat once, dispense total twice

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95
Q

private prescription, oral contraceptive?

A

can repeat 5 times, dispense total 6 tiems

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96
Q

private script, dispense within?

A

6 months, rest repeats doesn’t matter

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97
Q

private script schedule 4, dispense within?de

A

28 days, rest repeats no limit

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98
Q

desogesterl depression?

A

side-effect

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99
Q

desogestrel+phenytoin?

A

L

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100
Q

SCHIZO

HALOPERIDOL+RISPERIDONE TRIED, L, WHAT’S NEXT?

A

CLOZAPINE!

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101
Q

WARFARIN+CLARITHROMYCIN INTERACTION?

A

Increases INR, adjust dose, monitor

MACROLIDE BRUH

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102
Q

ibuprofen 3 year old?

A

100mg TDS

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103
Q

PARACETAMOL DOSE 10 YEAR OLD?

A

480-500MG QDS

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104
Q

WHAT IS THIS?

A

VERRUCA

Pressure areas, sole of feet, painful, black spos

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105
Q

WHAT IS THIS?

A

Warts
smooth, raised, hands

refer if wart on face/genitalia

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106
Q

WARTS/VERRUCA TREATMENT?

A

SALICYLIC ACID
GLUTARALDEHYDE
LACTIC ACID
CRYOTHERAPY

FILE W/ EMERY BOARD

WATERPROOF PLASTER+SOCKS TO STOP SPREAD

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107
Q

symptoms of candidiasis?

A

white patches easily wiped off
bleeding, red area
loss of taste
cracks

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108
Q

oral thrush treatment?

A

miconazole
after food, hold in mouth, swirl,
continue 7 days after lesions healed

breastfeeding/nipples calm but wash remove? same with permethrin

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109
Q

phenelzine+pseudoephedrine interaction?

A

hypertensive crisis

avoid+for 14 days after stopping MAOI, phenelzine

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110
Q

Longtec OD, shortec PRN, CDs

A
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111
Q

flucloxacillin counselling?

A

Take this medicine when your stomach is empty. This means an hour before food or 2 hours after food

space doses evenly, complete course

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112
Q

enoxaparin+rivaroxaban?

A

risk of bleed :(

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113
Q

enoxaparin thrombocytopenia MHRA?

A
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114
Q

risedronate dosing
treatment osteoporosis

female?

male?

A

female?
5MG OD
35MG ONCE A WEEK

male?
35MG ONCE A WEEK

prevent females 5mg od btw

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115
Q

patient, candidiasis, steroid, advice?

A

spacer

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116
Q

stage 1 hypertension, cvd risk>10%, diabetic?

A

ACE/ARB?

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117
Q

ACTIVITIES NOT REALLY NEEDING RP PRESENCE? STILL NEED TO SIGN IN!

A 
ASSEMBLY
ACCURACY CHECKING
DISPENSING
GSL MEDS?
WASTE STOCK PROCESS?
ORDERING
RECEIVING (excluding CDs)
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118
Q

NAPPY RASH TREATMENT?

A

BARRIER PREPS
CLOTRMIAZOLE/MICONAZOLE (+7 days after rash has gone)
HYDROCORTISONE 1% CREAM POM
FLUCLO/ERY IF BACTERIAL INFECTION

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119
Q

ALLERGIC DERMATITIS TREATMENT?

A

EMOLLIENTS
STEROIDS
CALAM ITCHINESS RELIEF

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120
Q

URTICARIA TREATMENT?

A

cetirizine (non-sedating)
oral L?

IV/IM chlorphenamine

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121
Q

Morphine MR instead of IR issue?

A

delayed pain relief

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122
Q

Patient w/
low HB+folate
treatment?????

A

Hydroxycobalamin injections (probs)

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123
Q

birth prevent bleeding?

A

vitamin k antagonist!

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124
Q

TB INITIAL?

A 
RIPE
rifampicin
isoniazide (+pyridoxine b6)
pyrazinamide
ethambutol

2 months

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125
Q

TB CONTINUOUS?

A

RIFAMPICIN
ISONIAZID
4 months

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126
Q

SSRI+sodium valproate interaction, electrolyte?

A

hyponatraemia

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127
Q

spironolactone electrolyte?

A

hyperkalaemia, SPARES POTASSIUM!

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128
Q

AKI, drugs to stop?

A

renally cleared drugs, ace/arb/nsaids,

metformin, lactic acidosis!!!!

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129
Q

VET label requirements?

A 
expiry (when human, under cascade)
name+addy of owner
name+addy of pharmacy
name of VET
id+species of animal
for animal treatment only
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130
Q

VET PRESCRIPTION LEGAL REQUIREMENTS?

A

NAME/ADDY/TELEPHONE NUMBER/QUALI/SIG OF PRESCRIBER (schedule 2/3, need RCVS registration number as well)

NAME+ADDRESS OF OWNER

ID/SPECIES/ADDY OF ANIMAL

DATE- 6 MONTHS VALIDITY | SCH 2/3/4- 28 DAYS

NAME/QUANTITIY/DOSE/ADMINISTRATION- ‘as directed’ is poor

ANY WARNINGS/WITHDRAWAL PERIODS?

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131
Q

SIGNED ORDER REQUIREMENTS?

A 
NAME OF SCHOOL
PRODUCT DETAILS (+ spacer)
STRENGTH (if relevant)
PURPOSE OF PRODUCT
TOTAL QUANTITY
SIGNATURE OF PRINCIPAL/HEAD TEACHER
headed paper not a legal requirement
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132
Q

patient, thorn, cellulitis? staph?

treatment?

A

add in IV
vancomycin
teicoplanin
linezolid

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133
Q

eye drop+eye ointment gap?

A

5 minutes, same same

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134
Q

CURB65 SCORE INDICATORS?

A

CONFUSIONt
UREA NITROGEN>7mmol/L
RAISED RESP. RATE>/= 30breaths/min
low bp systolic <90, dyastolic /=65 years

1 point each

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135
Q

diabetes uti medication?

A

flozins, proximal tubule, excretes glucose in urine

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136
Q

meds falls?

A

risepirdone….

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137
Q

amiodarone warning label?

A

Protect your skin from sunlight—even on a bright but cloudy day. Do not use sunbeds

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138
Q

GLARGINE HAS TO BE BY BRAND!!!

A
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139
Q

Ciclosporin patient has H pylori?

A

PPI+AMOXI+

METRO, not clari, interaction

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140
Q

stool softener?

A

docusate

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141
Q

EMERGENCY SUPPLY, RX, PRESCRIBER?

A

72 HOURS

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142
Q

COELIAC DISEASE, AVOID?

A

GLUTEN
WHEAT
BARLEY
RYE

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143
Q

REASON FOR CHEMOTHERAPY BREAK?

A

LET BLOOD CELL LEVELS RECOVER, WE GO AGAIN

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144
Q

PATIENT 60+

AMLODIPINE+RAMIPRIL, what’s next step?

A

INDAPAMIDE!

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145
Q

Child

fever, cold-like symptoms, white spots?

A

Measles

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146
Q

alufozin+sildenafil?

A

big hypotension risk!

stabilse on alfuzosin first, THEN add sildenafil lowest dose

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147
Q

Orange book?

A

aseptic stuff
manufacture and distribution of human medicines

good manufacturing practice

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148
Q

Green book?

A

broader distribution of human medicines

DSITRIBUTE!

good dstributing practice!

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149
Q

Memantine maximum daily dose, dementia?

A

20mg OD

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150
Q

GOUT

Patient on diuretic+antihypertensive, treatment?

A

COLCHICINE

Avoid NSAID cos hyperkalaemia/renal impairment L

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151
Q

resuscitation adult

ompression:breath ratio?

A

30:2

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152
Q

babies resuscitate?

A

5 rescue breaths before starting chest compression :(

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153
Q

Fluoxetine+St John’s wart interaction?

A

serotonin syndrome

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154
Q

Methylphenidate PR advice?

A

Do not crush/chew

equasym/medikinet- can sprinkle on apple sauce/yoghurt, then swallow

6+, CD2 BTW

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155
Q

PATIENT UTI

METHOTREXATE, PEN ALLERGY?

A

Nitro calm

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156
Q

Private prescription, HRT, menopause symptoms, record in POM register?

A

Prescriptions for oral contraceptives are exempt
from record keeping

:/

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157
Q

EMERGENCY SUPPLY FUN FACTS TREATMENT LENGTHS!
CDs 4/5?
POM?

A

If the emergency supply is for a CD (i.e.
phenobarbital or Schedule 4 or 5 CD), the maximum
quantity that can be supplied is for five days’
treatment. For any other POM, no more than 30
days can be supplied except in the following
circumstances:
• If the POM is insulin, an ointment, a cream,
or an inhaler for asthma (i.e. the packs cannot
be broken), the smallest pack available in the
pharmacy should be supplied
• If the POM is an oral contraceptive,
a full treatment cycle should be supplied

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158
Q

validity
schedule
4 part 1/2?
5?

A

4 part 1/2? 28 days

5? 6 months

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159
Q

Atorvastain muscle pain, monitor?

A

creatine kinase >x5 upper limit L :(

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160
Q

ATORVASTATIN LFT MONITORING?

A

BEFORE
AT 3 MONTHS
AT 12 MONTHS

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161
Q

Patient using OTC co-codamol, 3 days, still in pain, next step?

A

co-codamol POM? but 3 days

tramadol? step up?

even up morphine? :o

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162
Q

Co-codamol 8/500 max OTC pack size?

A

32 units, but 3 days use only max

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163
Q

co-codamol label?

A

Do not take more than 2 at any one time. Do not take more than 8 in 24 hours

Contains paracetamol. Do not take anything else containing paracetamol while taking this medicine. Talk to a doctor at once if you take too much of this medicine, even if you feel well

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164
Q

OTC pain arthritis, tried co-codamol, what’s next?

A

Capsaicin, topical? Idk

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165
Q

CITALOPRAM/ESCITALOPRAM/DOMPERIDONE/ERYTHROMYCIN/FLUCONAZOLE/QUININE

BIG BOY RISK?

A

QT prolongation

SPECIFIC EXAMPLES BTW

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166
Q

ETANERCEPT PRESCRIBING?

A

BRAND PLEASE TY

biological drugs!!

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167
Q

brand prescribing?

A 
CP3
qvar/clenil inhalers potency
ciclosporin
tacrolimus
etanercept
glargine

NOT fentanyl? hmm

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168
Q

WHAT IS THIS?

A 
STYE
excessively watery
swelling
eyelish lid/follicle
small yellow-pus
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169
Q

STYE advice?

A

1month+

self-limiting
warm compress 2-4x a day 5-10mins till stye drains
avoid makeup, contact lenses

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170
Q

DABIGATRAN REVERSAL AGENT?

A

IDARUCIZUMAB

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171
Q

peak expiratory flow?

A

blow out hard+fast

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172
Q

cellulitis minor allergy?

A

jus give the fluclo

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173
Q

numb, cramp?

A

treat hypocalcaemia

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174
Q

Potentially life-threatening hypertensive crisis can develop in those taking MAOIs who eat tyramine-rich food (such as mature cheese, salami, pickled herring, Bovril®, Oxo®, Marmite® or any similar meat or yeast extract or fermented soya bean extract, and some beers, lagers or wines) or foods containing dopa (such as broad bean pods). Avoid tyramine-rich or dopa-rich food or drinks with, or for 2 to 3 weeks after stopping, the MAOI.

A
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175
Q

hba1c 46?

A

diet advice

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176
Q

VET LABEL REQUIREMENTS

A

Name of the prescribing veterinary surgeon
• Name and address of the animal owner
• Name and address of the pharmacy
• Identification and species of the animal
• Date of supply
• Expiry date of the product
• The name or description of the product
or its active ingredients and content quantity
• Dosage and administration instructions
• If appropriate, special storage instructions
• Any necessary warnings for the user (e.g.
relating to administration, disposal, target
species, etc)
• Any applicable withdrawal period (i.e. the time
between when an animal receives a medicine
and when it can safely be used for food)
• The words: ‘For animal treatment only’
• The words: ‘Keep out of reach of children

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177
Q

SATIVEX VALIDITY?

A

28 DAYS

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178
Q

SERETIDE?

A

fluticasone w/ salmeterol

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179
Q

kid,

Seretide+ICS, next step up?

A

increase ICS dose or change to SABA

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180
Q

lady on seretide, next step?

A

increase ICS dose or add LTRA

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181
Q

COPD, had, green sputum, prescribe?

A

AMOXI,DOXY,CLARI

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182
Q

DRUGS THAT CAUSE HYPONATRAEMIA?

A 
CERTAIN DRUGS DITCH SALT
Carbamazepine
Diuretics
Desmopressin/Vasporessin
SSRIs
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183
Q

DRUGS THAT CAUSE HYPERNATRAEMIA?

A 
SALTY CEO
Sodium Bicarbonate/Chloride
Corticosteroids
Effervescent Formulations
Oestrogens/Androgens
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184
Q

what patch is 7 days?

A

BUPRENORPHINE
BUTRANS
Manufacturer advises apply patch to dry, non-irritated, non-hairy skin on upper torso, removing after 7 days and siting replacement patch on a different area (avoid same area for at least 3 weeks).

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185
Q

STYE FIRST LINE?

A

HOT COMPRESS

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186
Q

chickenpox

A

no ibu

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187
Q

WHAT’S THIS?

A

IMPETIGO

HYDROGEN peroxide
fusidic acid
mupirocin
fluclo
clari/ery
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188
Q

WHAT IS THIS?

A

molluscum contagiosum

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189
Q

s&S molluscum?

A

all over the body

small/raised/smooth/pink/papules, sometimes black dots

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190
Q

how do u manage molluscum?

A

self-limiting

don't share towels
don't scratch
can go school
wear waterproof bandages
lesions r contagious :(

paracetamol calm!

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191
Q

ENZYME INDUCING ANTI EPILEPTICS?

A

CP3T

Carbamazepine.
Eslicarbazepine acetate.
Oxcarbazepine.
Perampanel (at a dose of 12 mg daily or more).
Phenobarbital.
Phenytoin.
Primidone.
Rufinamide.
Topiramate (at a dose of 200 mg daily or more).
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192
Q

valproate, non-enzyme inducer, cu iud still?

A
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193
Q

chest pain?

A

nitroglycerin/GTN

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194
Q

SUBCONJUNC, NO PAIN ,ETC?

A

CALM, REASSURE

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195
Q

POSSIBLE SIGNS OF STROKE?

A

CALL 999

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196
Q

Patient

slurred speech, can’t raise arm

A

Call 999

can’t give aspirin 300 cos it might be haemorrhagic, bp+statins ;)

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197
Q

HYPOGLYCAEMIA- SYMPTOMS?

A 
SWEATING
LETHARGIC
DIZZINESS
HUNGER
TREMOR
TINGLING LIPS
PALPITATIONS
EXTREME MOODS
PALE
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198
Q

travel sickness, 4 year old?

A

kwells
hyoscine hydrobromide

joy ride 3+

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199
Q

‘CASCADE’ IS FOR?

A

THE VET PRESCRIPTION, NOT THE LABEL

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200
Q

‘FOR ANIMAL TREATMENT ONLY’

A

THAT’S FOR THE LABEL BRUH

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201
Q

VET PRX MEETS CASCADE YEAH BUT ALWAYS

GO FOR SPECIES LICENSE FIRST

A
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202
Q

CASCADE ORDER?

A
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203
Q

EXPIRY 10/21?

A

31/10/21!

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204
Q

mr ISNTEAD OF IR?

A

DELAYED PAIN RELEIEF

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205
Q

ES NOT ALLOWED?

A

SCHEDULE 3, TRAMADOL, L

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206
Q

TAMSULOSIN OTC?

A

45 and 75 years
Symptoms of BPH present for a minimum of three months
A two week supply of tamsulosin can be supplied initially
If there has been an improvement in urinary symptoms within the initial two weeks, a further supply of four weeks can be made
After six weeks, a further supply can be made only where the patient confirms that the doctor has carried out a clinical assessment and agreed further supplies are appropriate.

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207
Q

MTX+FOLIC ACID SEPARATE DAYS?

A

Give folic acid to reduce side-effects. Folic acid decreases mucosal and gastrointestinal side-effects of methotrexate and may prevent hepatotoxicity; there is no evidence of a reduction in haematological side-effects.

Withdraw treatment if ulcerative stomatitis develops—may be first sign of gastro-intestinal toxicity.

Treatment with folinic acid (as calcium folinate) may be required in acute toxicity.

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208
Q

UPPER UTI?

A

Oral first line (upper UTI symptoms):

Cefalexin, ciprofloxacin, co-amoxiclav (if culture susceptible), or trimethoprim (if

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209
Q

trimethoprim uti dose?

A

Manufacturer advises dose reduction to half normal dose after 3 days if eGFR 15–30 mL/minute/1.73 m2.

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210
Q

TRI UTI DOSE?

A

Adult

200 mg twice daily for 3 days (7 days in males).

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211
Q

short-term prednisolone side-effect?

A

increased appetite, mood changes and difficulty sleeping

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212
Q

metallic taste abx/dabetic?

A

metronidazole

metformin

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213
Q

methadone and driving?

A

as long as it’s not impaired

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214
Q

zolpidem elderly?

A

risk of falls

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215
Q

zolpidem schedule?

A

4

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216
Q

elderly PK?

A

decreased renal function?

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217
Q

LITHIUM+
ANTIPSYHCO
SSRI
MAOI

A

ANTIPSYCHOTICS- QT prolongation
SSRI/MAOI- serotonin syndrome

L

MAYBE just clozapine?

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218
Q

chemotherapy break?

A

recover from myelosuppression?

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219
Q

trimethoprim duration uti?

A

females 3, men 7

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220
Q

TEETHING MANAGEMENT ORDER?

A 
GUM RUBBING
RING
CUDDLING
WIPE AWAY SALIVA
PARACETAMOL/IBUPROFEN (3MONTHS+ and/or really?)
LIDOCAINE, 5MONTHS+
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221
Q

15 year old UPSI? dlow

A

ULI

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222
Q

13 year old lithium, period pain?

A

Can’t do NSAIDS, age, interaction!

Give dihydrocodeine w/ parcetamol
paramol

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223
Q

pharmacy record?

A

5 years

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224
Q

cd register from date of entry?

A

2 years

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225
Q

You need minimum 75 people in each arm. You have 3 arms at a ratio of 1:2:2

A
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226
Q

STATIN MONITORING?

A

Before starting treatment with statins, at least one full lipid profile (non-fasting) should be measured, including total cholesterol, HDL-cholesterol, non-HDL-cholesterol (calculated as total cholesterol minus HDL-cholesterol), and triglyceride concentrations, thyroid-stimulating hormone, and renal function should also be assessed.

Liver function
There is little information available on a rational approach to liver-function monitoring; however, NICE suggests that liver enzymes should be measured before treatment, and repeated within 3 months and at 12 months of starting treatment, unless indicated at other times by signs or symptoms suggestive of hepatotoxicity (NICE clinical guideline 181 (July 2014). Lipid Modification—Cardiovascular risk assessment and the modification of blood lipids for the primary and secondary prevention of cardiovascular disease).

Those with serum transaminases that are raised, but less than 3 times the upper limit of the reference range, should not be routinely excluded from statin therapy. Those with serum transaminases of more than 3 times the upper limit of the reference range should discontinue statin therapy.

Creatine kinase
Before initiation of statin treatment, creatine kinase concentration should be measured in patients who have had persistent, generalised, unexplained muscle pain (whether associated or not with previous lipid-regulating drugs); if the concentration is more than 5 times the upper limit of normal, a repeat measurement should be taken after 7 days. If the repeat concentration remains above 5 times the upper limit, statin treatment should not be started; if concentrations are still raised but less than 5 times the upper limit, the statin should be started at a lower dose.

Diabetes
Patients at high risk of diabetes mellitus should have fasting blood-glucose concentration or HbA1C checked before starting statin treatment, and then repeated after 3 months.

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227
Q

H PYLORI

MACROLIDES OR AMOXI L?

A

A proton pump inhibitor, plus bismuth subsalicylate [unlicensed], plus metronidazole, and tetracycline [unlicensed].

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228
Q

HYPERTENSION
57 YEAR OLD+BLACK
CAN’T TAKE CCB?

A

ARB!!!

SARTANNNNN

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229
Q

lansoprazole GR label directions?

A

Do not take indigestion remedies 2 hours before or after you take this medicine

Take 30 to 60 minutes before food

Swallow this medicine whole. Do not chew or crush

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230
Q

OMEPRAZOLE long-term side-effect?in

A

may reduce absorption of vitamin B12 with long-term treatment

C diff risk btw

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231
Q

key aspect of audit?

A

investigating and comparing to gold standard

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232
Q

ciclosporin, cyp induce/inhibit interaction?

A

doxy calm?

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233
Q

rivaroxaban dosing?

A

15mg BD 21 days, then 20mg OD

2.5mg BD too low

15-49mL/min? 15mg OD

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234
Q

RIVAROXABAN DOSE ADJUSTMENTS?

A

When used for Treatment of deep-vein thrombosis or pulmonary embolism:
Following the first 21 days of treatment for deep-vein thrombosis or pulmonary embolism, the usual dose of 20 mg once daily can be given, but consider reducing to 15 mg once daily if creatinine clearance 15–49 mL/minute and the risk of bleeding outweighs the risk of recurrent deep-vein thrombosis or pulmonary embolism.

When used for Prophylaxis of recurrent deep-vein thrombosis or pulmonary embolism:
When the recommended dose is 20 mg once daily, consider reducing to 15 mg once daily if creatinine clearance 15–49 mL/minute and the risk of bleeding outweighs the risk of recurrent deep-vein thrombosis or pulmonary embolism.

When used for Prophylaxis of stroke and systemic embolism in patients with non-valvular atrial fibrillation:
Reduce dose to 15 mg once daily if creatinine clearance 15–49 mL/minute.

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235
Q

mebendazole advice?

A

wear underwear, don’t scratch, silly

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236
Q

DRUG BREAST PAIN/CHANGES

A

spironolactone

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237
Q

Levofloxacin seizures?

A

lowers threshold

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238
Q

statin, 3 months, 12 months?

A

LFTs

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239
Q

tamsulosin+sildenafil?

A

hypotension risk

Tamsulosin causes significant hypotensive effects when given with Sildenafil – patient should be stabilised on first drug then second drug at lowest recommended dose

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240
Q

tamsulosin+amlodipine?

A

hypotension again

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241
Q

Adults should eat no more than 6g of salt a day (2.4g sodium) – that’s around 1 teaspoon. Children aged: 1 to 3 years should eat no more than 2g salt a day (0.8g sodium) 4 to 6 years should eat no more than 3g salt a day (1.2g sodium)

A
242
Q

Ulcer 5 weeks?

A

Refer, cancerous

243
Q

Meropenem+valproate?

A

Concentration decreased

Valp

244
Q

EEA CDs?

A

Not buprenorphine

245
Q

methadone, citalopram, QT avoid

A
246
Q

fluclo, breastfeeding, calm mastitis

A
247
Q

miconazole, warfarin, inhibitor, conc berzerk

A
248
Q

recurrent UTIs, trimethoprim, now diabetes, first drug????

A
249
Q

under 16, UPSI, dlow?

A

ulipristal 30mg
(levo 1.5mg)

5mg is fibroids!!

250
Q

trimethoprim, methotrexate?

A

anti folate, renal L, nephrotoxicity risk

251
Q

Route in palliative care?

End of life adding hyoscine + diamorphine hydrobromide always give it

A

SYRINGE DRIVER

252
Q

NEUTROPENIC SEPSIS TREATMENT?

A

beta lactam (fluclo etc) monotherapy with piperacillin with tazobactam

X aminoglycoside or glycopeptides

253
Q

Lady was shopping and fell and has profound bradycardia

A

Bisoprolol, B for bradycardia!

254
Q

stage 1 hypertension, CVD>10%, FIRST LINE?

A

TREAT WITH GUIDELINE

255
Q

Pharmacist signed in, not present, what can HCA do?

A

Dispense+Accuracy check

256
Q

ARM, ringworm, OTC?

A

miconazole, clotrimazole, etc

257
Q

hypercalcaemia, POM vitamin supplement treatment?

but if malignancy?

A

dehydration iv sodium chloride

pamidronate sodium

but if malignancy? calcitonin, pamid best still

258
Q

high tsh, low t3 t4, is? treatment?

A

HYPOTHYROIDISM

GIVE LEVOTHYROXINE

259
Q

Prescribed medication 50mcg/kg and the drug was 250mg per 5ml. (4) doses of tinzaparin.
Patient had surgery and are on amlodipine and have a respiratory rate of 18 and BP was
100/58 and it was 70 beats per minute. What drug modification do you recommend?

A

Hypotensive, stop the CCB? Hmmm

260
Q

Mania, first-line antipsychotic, no regular testing?

A

LORAZEPAM?

ROQ?

Etc

261
Q

pertussis, whooping cough calm

A
262
Q

citalopram+valproica cid?

A

hyponatraemia!

263
Q

LITHIUM+ANTIDEPRESSANTS?

A

SERTRALINE- SEROTONIN SYNDROME

CITALOPRAM- QT PROLONGATION

264
Q

MED, MOST LIKELY TO CAUSE FALLS?

INDAPAMIDE/METFORMIN/FERROUS/VALSARTAN/CHOLECALCIFEROL?

A

Valsartan

hyperkalaemia, persistent postural hypotension- falls

265
Q

Where a product states ‘Use by’ or ‘Use before’,
this means that the product should be used before
the end of the previous month. For example,
‘Use by 06/2022’ means that the product should
not be used after 31 May 2022.

A
266
Q

STATIN+MACROLIDE?

A

exposure statin, myopathy

267
Q

cough for someone who wants to snooze?

A

pholcodiene linctus, 12+ generally
children 6-12 5 days only ok

diphenhydrdamine?

268
Q

sildenafil+tamsulosin?

A

hypotension

269
Q

INSULIN ONCE DAILY?

A

isophane
or
DDG? Hmmm

270
Q

malaria, pregnancy?

A

Chloroquine and Proguanil can both be used at normal doses in pregnancy as benefit of malaria prophylaxis outweighs any risk

BUT recommend FOLIC ACID 5mg to be taken with proguanil

271
Q

short-term contraception, wants to get pregnant later?

A

pill- 2 weeks calm

desogrestel- 2months (smoking)

272
Q

long-acting, doesn’t want kids anymore

A

SURGERY
ETONORGESTREL- 5 YEARS
IUD PRO DEVICE, MIRENA 5 YEARS^

273
Q

ALWAYS DOUBLE CHECK INPUTTED ANSWER! FUMING :D

A
274
Q

q19 september 2019 alternative

A
275
Q

What is it? What you doing?

A

Chickenpox, paracetamol, calm

276
Q
A

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

277
Q

QT PROLONGATION DRUGS

Long hearts make vets cut animals - lithium /Haloperidol /Macrolides /Venlafaxine /Citalopram /Amiadorone

A
278
Q

BACK PAIN?

A

NSAID, lowest dose

codeine with/without paracetamol

279
Q
A
280
Q

Drug, dry cough, help sleeping?

A
281
Q

vancomycin, c diff, oral,?

A

licensed

282
Q

Olanzapine issue, diabetes?

A

weight gain

hyperglycaemia

283
Q

osteoporosis+prednisolone L

A
284
Q

BABY NO URINATION refer?

A
285
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

286
Q

vaccine that sets offever?

A

menb

287
Q

MALARIA MEDS WHILST ON CONTRACEPTION?

A

NO INTERACTION!

288
Q

med to stop diarrhoea, sick?

A

SADMAN!

289
Q

burnt hand,HIL

A 
run water
don't use ice
cover burns with cling film, 
X wet dressings, topical creams
elevate, avoid oedema
pain relief

REFER KIDS UNDER 5!

290
Q

BURNS REFERRAL?

A

CHILDREN UNDER 10

291
Q

SECRETIONS IN PALLIATIVE CARE?

A

hyoscine hydrobromide/butylbromide

glycopyrroinum bromide

292
Q

LAXATIVE+CONSTIPATION? Hmmm

A
293
Q

Subconjunctival haemorrhage?

A

self-limiting, dw, calm

294
Q

slapped cheek maangement?

A

paracetamol
nsaid
etc

295
Q

formoterol, next stepup?

A

Add LTRA, if not already MART?

296
Q

spacer technique?

A 
Breathe in through your
mouth, slowly and
steadily over 4 to 5
seconds or,
breathe in and out
through your mouth,
slowly and steadily
297
Q

UTI, women, penicillin allergy, sensitive to trim and ntiro?

A
298
Q

EHC, uli, childbearing age

A
299
Q

TEMAZEPAM?

A

Temazepam is schedule 3 but subject to safe custody and special Rx requirements – same with Butec

300
Q

fentanyl patch return?

A

Remove the backing and fold the patch over on itself. Place into a waste disposal
bin or a CD denaturing kit.

denature, witness good practice, boss doesn’t care

301
Q

VET CD?

A

ANIMAL UNDER MY CARE

302
Q

P<0.05

A
303
Q

megaloblastic anaemia?

A

vitamin b12

Megaloblastic anaemia
– one cause is pernicious anaemia which is down to vitamin b12 deficiency. Can give oral hydroxocobalamin or if it is due malabsorption IM hydroxocobalamin
If folate deficiency – Folic Acid OD for 4 months. Never give alone if undiagnosed = neuropathy of spinal cord

304
Q

folic acid dosing?

A

5mg, 400mcg certain, sickle?

305
Q

VET label needed?

A

animal treatment only

out of reach of children

306
Q

ACEI+ccs?

A

HYPERKALAEMIA :/

307
Q

afro carib?a

A

ARB»> candesartan

308
Q

levothyroxine hair loss?

A

can contribute :/

309
Q

methotrexate adr?

A

mucositis

myelosuppression

310
Q

patient adr, wrong med, wat do u do?

A

NRLS report? yellow card? manager? idk

311
Q

insulin before/after meal?

A

before usually

312
Q

metallic taste?

A

metformin

metronidazole

313
Q

b2 agonist+prednisolone?

A

hypokalaemia

314
Q

REVALIDATION SUBMIT?

A

4 CPDs
1 peer discussion
1 reflective

315
Q

sore throat, can’t have amoxicillin?

A

order
phenoxy
clary/ery

316
Q

FLOZINS, dry cough?

A

dry mouth yes, but cough?

UPPER respiratory tract infection, really?

317
Q

plans to stop smoking?

A

preparation

318
Q

stopped smoking, came, what can i take?

A

action?

319
Q

alcohol units Q

A

answer 15 units

ABV x
ml of alcohol/ 1000

320
Q

gaviscon feeds, not in the same line?

A
321
Q

CD cupboard?

A

morhpine 13mg/ml mad strength

322
Q

ampoules? cocain?

A

For liquid containing ampoules, open the ampoule and empty the contents into
a CD denaturing kit, or dispose of in the same manner as liquid dose formulations above. Dispose
of the ampoule as sharps pharmaceutical waste

cocain?e big boys

323
Q

bets evidence?

A

systematic
then meta
then etc

324
Q

osteoporosis vitamin needed?

A

vitamin d- calciferol etc

325
Q

folic acid methotrexate dose?

A

5mg weekly g

326
Q

‘animal use only’?

A

not needed on prescription

327
Q

“animal under my care”?

A

not needed on label lol

328
Q

private POM years?

A

2

329
Q

es REQUEST prescriber?

A

72 hrs

330
Q

insulin hypoglycaemia risk?

A

long acting glibenc prosb

331
Q

stimulates insulin secretion?

A

sulphonylureas

meglitis?

332
Q

once weekly insulin?

A

GLP-1s, dulaglulatides, etc

333
Q

RI, maintenance, 4 months

A
334
Q

valproate in pregnancy?

A

lowest effective dose etc

335
Q

anticoagulant in blister pack?

A

apixaban/rivaroxaban/edoxaban

NOT dabigatran

336
Q

annual flu vac?

A

immunocompurosemise

337
Q

migraine, contraceptive?

A

COC calm

338
Q

nasal congestion, CVD, avoid ephed?

A

give inhalation

339
Q

what is clinical governance?

A

Clinical Audit, Risk Management, Education + CPD, Evidence based care and effectiveness, patient + carer experience and involvement, staffing arrangement

clinical governancea system through which NHS organisations are accountable for continuously improving the quality of their services

340
Q

tramadol advice?

A

Warning: This medicine may make you sleepy. If this happens, do not drive or use tools or machines. Do not drink alcohol

Dissolve or mix with water before taking

341
Q

shingles treatment?

A

aciclo, refer, etc

342
Q

treatment of diabetes, pt has renal and heart failure, egfr is 25, can’t take SGLT-2, their BMI is
overweight?

A

linagltiptin FTW

343
Q

cyclophosphamide?

A

neutropenia

344
Q

oxycodone?

A

less s-e, better in renal

345
Q

rivaroxaban stroke?

A

20mg od with food

346
Q

aripiprazole s-e?

A 
hyperglycaemia
hyperprolactinaemia
weight gain
qt
ED
Fatigue
347
Q

CD LEGAL REQUIREMENTS?

A

Patient name and address
Drug name
Dose (‘as directed’ on its own is not permitted)
Formulation
Strength (where appropriate)
Total quantity/dosage units of the preparation in both words and figures (for liquids, total volume in ml)
Prescriber signature and address
Date of issue
For instalment prescriptions, specify the instalment amount AND instalment interval
The words “for dental treatment only” written on it if issued by a dentist

348
Q

dystonia, procyclidine?

A

It is used to treat symptomatic Parkinsonism and extrapyramidal dysfunction caused by antipsychotic agents. The mechanism of action is unknown. It is thought that Procyclidine acts by blocking central cholinergic receptors, and thus balancing cholinergic and dopaminergic activity in the basal ganglia.

349
Q

56 year old omeprazole, heart burn?

A

refer, 55+!

but constipation 50+ refer

350
Q

parenteral guidance, paediactric drug administration?

A

medusa? green book?

351
Q

azathioprine?

A

inhibits purine synthesis

352
Q

girl on COC and had missed one pill what to do ?
Missed pill = >24 hours for COC
Take one pill ASAP and next dose normal time even if it means taking 2 together. No extra precautions
Whereas – if it was POP, missed pill = >3 hours (Desogestrel >12 hours). Take ASAP and use condom for 2 days

A
353
Q

someone was on levo and baclofen and was suffering hypothyroid symtoms - is it DDI or is it just baclofen causing them
Baclofen: drowsy, dizzy, weak, tired, nausea, constipatedVet surgery details, N & A, Qualification – RCVS no. for CD2 or CD3
Animal: Name + Species (inc. address if different from owner)
Medication: Name, strength, form, dosage
Admin instructions, NOT “as directed”
Warnings e.g. withdrawal period
If repeat, state no.
If human/unlicensed = “FOR ADMINISTRATION UNDER THE VETINARY CASCADE”
If CD2/CD3 = “THIS ITEM HAS BEEN PRESCRIBED FOR AN ANIMAL OR HERD UNDER CARE OF VET”
Vet signature
Date: 6-month expiry and 28 day expiry for CD2,3,4

A
354
Q

VET RX?

A

Vet surgery details, N & A, Qualification – RCVS no. for CD2 or CD3
Animal: Name + Species (inc. address if different from owner)
Medication: Name, strength, form, dosage
Admin instructions, NOT “as directed”
Warnings e.g. withdrawal period
If repeat, state no.
If human/unlicensed = “FOR ADMINISTRATION UNDER THE VETINARY CASCADE”
If CD2/CD3 = “THIS ITEM HAS BEEN PRESCRIBED FOR AN ANIMAL OR HERD UNDER CARE OF VET”
Vet signature
Date: 6-month expiry and 28 day expiry for CD2,3,4

355
Q

vet label

A 
Name of prescribing veterinary surgeon 
Name + Address of owner
Medication: Name, Strength, Dosage and administration
Any special storage instructions
“FOR ANIMAL TREATMENT ONLY”
Name and Species of animal 
Pharmacy Name and Address
Expiry and Date of Supply
KOROC
356
Q

buprenorphine?

A

cd3 no reg
but
safe custdoy

357
Q

dose for allopruionol and colchicije and ibuprofen in GOUT

A

allo 100mg mild

300-600mg moderate severe

358
Q

GOUT DOSING?

A

Gout: Acute
1st Line: NSAIDs e.g. Diclofenac, Naproxen
Ibuprofen: initially 300-400mg TDS-QDS
Diclofenac: 75-150mg OD in 2-3 divided doses
Alt: Colchicine: max 500mcg BD-QDS max 6mg per course and do not repeat course in 3 days
Gout: Prevention
1st Line: Allopurinol: Initially 100mg OD
2nd Line: Feboxust
Alt: Sulfinpyrazone (initiation may precipitate an acute attack)

359
Q

CHLORAMPHENICOL DOSING?

A

Drops: Every 2 hours for the first 48 hours then every 4 hours during waking hours for 5 days
Ointment: Apply 3-4 times OD for 5 days
Refer if not improving >48 hours
C/I: FH of blood dyscrasias, history of myelosuppression

360
Q

VERRUCA?

A

SALICY

361
Q

MICONAZOLE AGE?

A

4MONTHs+

362
Q

patients with COPD give oxygen at 88-92 % in acute asthma or COPD because of the risk of sending them into hypercapnic drive (normal patients it’s usually 98% o2 I think something quite high)
Exacerbations of COPD: Target = 88-92%
Acute asthma: Target = 94-98% (if not at risk of hypercapnic respiratory failure)Digoxin
Monitor: K+, Mg2+, Ca2+. Toxicity increased by hypokalaemia, hypomagnesaemia and hypercalcaemia, RF, plasma digoxin.
Cardiac arrhythmias, weakness, lethargy, dizzy, headache, confusion, nausea, anorexia, diarrhoea, blurred or yellow vision
Overdose: more likely 1.5-3 mcg/litre

A
363
Q

DIGOXIN?

A

Digoxin
Monitor: K+, Mg2+, Ca2+. Toxicity increased by hypokalaemia, hypomagnesaemia and hypercalcaemia, RF, plasma digoxin.
Cardiac arrhythmias, weakness, lethargy, dizzy, headache, confusion, nausea, anorexia, diarrhoea, blurred or yellow vision
Overdose: more likely 1.5-3 mcg/litre

364
Q

PD, LEVODOPA

A

“On” state = may feel energetic and able to move more easily
“Off” state = very stiff slow
Occurs as an end of dose, “weaning” off – worsening of motor function
Means shorter length of benefit
M/R preps may help of Levodopa or take at specific times of the day to avoid off periods
Advanced PD: can use Apomorphine for refractory motor fluctuations “OFF” episodes

365
Q

BACK PAIN?

A

Offer NSAID if no C/I (otherwise codeine with or without paracetamol)

366
Q

. Patient on b2 agonist, corticosteroids, and is currently on a 9 month relegeous fast. What
electyolyte disturbaces do you see. She breaks her fast daily to injest her meds. what electrolyte
disturbance are they at risk of ?

A
367
Q

WHOOPING COUGH MANAGEMENT?

A

Prescribe clarithromycin for infants less than 1 month of age.
Prescribe azithromycin or clarithromycin for children aged 1 month or older, and non-pregnant adults.
Prescribe erythromycin for pregnant women.
From 36 weeks’ gestation, this is recommended to reduce the risk of transmission to the newborn baby.
Prior to this, it is likely to be of clinical benefit for the woman only if administered within the first 21 days of the illness, or may be advised if she is likely to come into close contact with a person from a vulnerable group.
Prescribe co-trimoxazole if macrolides are contraindicated or not tolerated (off-label indication). However, co-trimoxazole is contraindicated during pregnancy, and is not licensed for use in infants younger than six weeks of age.
For full information on dosing regimens, contraindications, and adverse effects of antibiotics, see the section on Prescribing information.

368
Q

SATIVEX?

A

just records, not safe custody

369
Q

Child 4 years old with cough which was chesty now its dry it’s been 10 days?

A
370
Q

pholcodine linctus age?

A

16+

371
Q

med increase neutrophils?

A

filgrastim

372
Q 
sativex
nabilone
epidyolex
dronabinol
?
A

schedule 4 cd
pom
schedule 5 cd
schedule 2 d

373
Q

GI surgery past 5 days?

A

metoclopramide contraindicated

374
Q

mentronidazole inhibits, careful, clary ery

A
375
Q

CO-BENELDOPA WHEN?

A

EMPTY STOMACH
1 HOUR BEFORE/2 HOURS AFTER
COLOURS URINE, HARMLESS

376
Q

n&v in migraines?

A

bucclizien, buccastem

377
Q

NAUSEA IN RADIOTHERAPY?

A

DEXAMETHASONE

378
Q

SUBARROCHNOID HAEMORRHAGE TREATMENT?

A

NIMODIPINE

379
Q

drug to avoid in gout?

A

bendroflumethiazide

380
Q

caffeine+bp?

A

L

381
Q

verapamil side-ef?

A

constipation

382
Q

NSAIDS lowest CVD risk?

A

naproxen+ibu 1.2

383
Q

pink sputum?

A

HF

384
Q

osteomyelitis treatment?

A

fluclo (6 weeks)
w/
fusidic acid/rifampicin (2 weeks)

385
Q

septicaemia?

A

tazobacta+piperacillin

386
Q

isotretinoin+vitamin A, cod liver?

A

avoid in pregnant!

387
Q

SET INTERACTION?

A

SILDENAFIL
ERYTHROMYCIN
TADALAFIL

388
Q

DISULFIRAM, DRINK ALCOHOL?>

A

FULL BODY RASH!

389
Q

IBANDRONIC ACID OSTEOPOROSIS?

A

150mg monthly

390
Q

HBA1C TARGETS?

A

48 IF NO hypoyglycaemia drugs

53 IF HYPOYGLYCAEMIA DRUGS

391
Q

RECURRENT VAGINAL THRUSH DOSE?

A

moetronidazole

150MG every third day for 3 doses+150mg ONCE weekly for 6 months

392
Q

ulipristal BF?

A

1 WEEK GAP

393
Q

BMI>30?

A

OBESE

394
Q

ORAL VACCINE?

A

ROTAVIRUS

395
Q

EXCRETE 1 UNIT OF ALCOHOL?

A

1HOUR

396
Q

OT?

A

PATIENT DISABILITY LIFE

397
Q

SPEECH AND LANGUAGE?

A

SWALLOWING DIFFICULTIES

398
Q

ISOTRETINOIN BLOOD DONATION?

A

AVOID DURING+1 MONTH AFTER

399
Q

BEST BOOK FOR VACCINE INFO?

A

GREEN BOOK, KO

400
Q

VAC IN PREGN?

A

INFLUENXA? OK

401
Q

oral thrush yeah but nystatin is POM REFER

A
402
Q

Patient, ace, diabetic, HF?

A

indapamide!

403
Q

over 65, hypertension, ccb, next?

A

increase dose

404
Q

methotrexate common?

A

fever hm

405
Q

chadvas 2 female?

A

start treatmetn

406
Q

impulse drug?

A

levodopa, non-erogt prami the worst

407
Q

mefanamic acid+naproxen?

A

both same class!

408
Q

low hb/folate?

A 
Give hydroxocobalamin (vitamin B12) at intervals of up to 3 months
Frequent IM injections to replenish stores- then maintenance
409
Q

HYDROXOCOBALAMIN DOSING?

A

Initially 1 mg 3 times a week for 2 weeks, then 1 mg every 2–3 months

410
Q

statin lfts monitor?

A

before
3m
12m

411
Q

COPD fev1<50

laba+ics, enxt?

A

lama

412
Q

zopiclone shcedule?

A

4, no words fiugres

413
Q

CIPROFLOXACIN?

A

Do not take milk, indigestion remedies, or medicines containing iron or zinc, 2 hours before or after you take this medicine

Space the doses evenly throughout the day. Keep taking this medicine until the course is finished, unless you are told to stop

Swallow this medicine whole. Do not chew or crush

414
Q

clari+statin?

A

jus withold 7 days? contact?

415
Q

hives, urticaria?

A

chlorphenamine gwarn

416
Q

diabetic patient
low egfr
HF
?

A

glipti

417
Q

letrozole+hrt?

A

avoid

418
Q

denosumab risk?

A

hypocalcaemia

419
Q

Pow ferritin?

A

Give ferrous sulphate

420
Q

FOSTAIR LOWER DOSE THAN BECLO?

A

POTENCY!

421
Q

METHOTREXATE, BREATHING, TOXIC

A
422
Q

gentamicin bacteria?

A

MRSA

423
Q

CICLOSPORIN- SIDE-EFFECTS?

bit longer start

A 
HYPER- glycaemia/uricemia/kalaemia/lipidaemia/tension
HYPO- magnesaemia
Renal/Liver Impairment
Skin Reactions
Gingival Hyperplasia
Hair changes (hirsutism)
Eye inflammation/vision Ls (topical)
424
Q

CICLOSPORIN- INTERACTIONS

Increases exposure? GPOM

Decreases exposure? PG

Can mix with?

A

GRAPEFRUIT+POMELO juice-> increased ciclosporin exposure

PURPLE GRAPE JUICE-> decreased ciclosporin exposure

BUT…
Can mix with orange/apple juice to improve taste

425
Q

TACROLIMUS- SIDE-EFFECTS?

A 
HYPER-glycaemia+uricaemia/kalaemia
HYPO/HYPERtension
RENAL/LIVER IMPAIRMENT
SKIN REACTIONS
VISUAL DISTURBANCES
BLOOD DYSCRASIA
CVD (QT prolongation/cardiomyopathy in children)
Nervous system disorder/peripheral neuropathy
426
Q

TACROLIMUS- INTERACTIONS? GP^2

Patient has hypersensitivity to macrolide?

A

GRAPEFRUIT/POMEGRANATE/POMELO juice- INCREASES tacrolimus levels

Patient has hypersensitivity to macrolide? DO NOT USE

427
Q

drug pre-screen TB?

A

Etanercept

428
Q

palliative care

bowel colic/secretions?

A

hyoscine
glyc

BITYL??

429
Q

4 YEAR OLD NAUSEA?

A

HYOSCINE
JOY RIDE 3+
KWELLS KIDS 4+

430
Q

hives?

A

iv chlorphenamine!

431
Q

methotrexate likely?

A

fever

432
Q

Know hypertension guidelines inside out. Pt was on ACE and diabetic, I chose thiazide as had heart failure too

A
433
Q

Patient over 65 hyper tension on amlodipine 10mg, either add next step, I chose increase to max 20mg dose first??????????????????????????/

A
434
Q

Where the CD prescription is written by
a dentist, the words ‘for dental treatment
only’ must be presen

A
435
Q

RL for vet on label- what is not a LR I put ‘under cascade’ as this is LR under prescription only

A
436
Q

zopiclone, sch 4, no need words n figures

A
437
Q

Do not take letrozole with HRT as it may interfere with letrozole effectiveness?

A
438
Q

HYPOCALCAEMIA- depressed, forgetful muscle cramp confusion

A
439
Q

isotretinoin suicidal?

A

gp asap!

440
Q

myelosuppression monitoring?

A

full blood count

441
Q

Diabetic pt, what is first step. I chose gliptin, as had an eGFR of lower than 30 and had heart failure

A
442
Q

Breastfeeding

Paroxetine – present but not known to be harmful

A
443
Q

Advice if immunosuppressed and taking influenza vaccine – IM inactivated version

A

INJECTION

NOT NASAL!!!

444
Q

Carbamazepine – increased risk of major congenital malformations

A
445
Q
A

Labetolol doses – same as for HT 100mg BD initially

446
Q

clozapine monitiring?

A

weekly, 18 weeks, 1 year, monthly

447
Q

osmotic?

A

lactulose+macrogol

448
Q

carbamazepine vitamin

A

d

449
Q

neutropenia side-effect

A

Diarrhea. Vomiting. Burning or pain with urination. Unusual vaginal discharge or irritation

450
Q

neutropenia side-effects

A 
Chills, with or without a fever.
Body aches.
Extreme fatigue.
Sore throat.
Mouth sores.
Runny nose.
New or worsening cough
451
Q

gums?

A

gingival

452
Q

colchicine+azithromycin?

A

Azithromycin is predicted to increase the exposure to Colchicine. Manufacturer advises avoid P-glycoprotein inhibitors or adjust Colchicine dose.

453
Q

Three pictures of prescriptions saying what’s wrong: one was epinephrine and
phenalizine interaction serious
3. Another was a duplication of same medicine of mst it was wrong dose coz longtec given
less frequently than shortec

A
454
Q

LITHIUM, PERIOD, PAIN/

A

dihydro+parace

455
Q

renal L?

A

calcium

456
Q

MEASLES

A
457
Q

CONTACT DERMATITIS

A
458
Q

SHINGLES

A
459
Q

MOLLUSCUM

A
460
Q

NAPPY RASH?

A

CLOTRIMAZOLE 1%

461
Q

headlice,med, doesn’t smell?

A

dimeticione 1% lotion?

462
Q

dabigatran MOA?

A

direct thrombin (factor IIa) inhibitor

463
Q

rivaroxaban stroke?

A

20mg od

464
Q

butrans?

A

7 days

465
Q

lithium+depression?

A

fluox and olanzapine, olanzapine, quetiapine or lamotrigine

466
Q

methotr+trim?

A

anti folate, myelo

467
Q

lady falls give?

A

vitamin d

468
Q

neutropenia leads to?

A

sepsis

469
Q

quetiapine, antibiotic chocie?

A

doxycycline!

470
Q

rate control af?

A

beta blocker

471
Q

low ferrtin+hb?

A

give ferrous sulp

472
Q

fluclo

A

jaundice

473
Q

mesalazin report or na blodo dyscrasia?

A
474
Q

zolpidem sch 4 ES?

A

5 DAYS

475
Q

grey circle inhaler?

A

handihaler?

476
Q

kid, asthma, add?

A

ltra probs

477
Q

h pylori amox allergy?

A

pcm

478
Q

finasteridepc

A

moodbs

479
Q

fludricort storage?

A

check spc

480
Q

euresis kid ,water swallow?

A

hypernatraemia

481
Q 
Very common	greater than 1 in 10
Common	1 in 100 to 1 in 10
Uncommon [formerly 'less commonly' in BNF publications]	1 in 1000 to 1 in 100
Rare	1 in 10 000 to 1 in 1000
Very rare	less than 1 in 10 000
A 
Very common	greater than 1 in 10
Common	1 in 100 to 1 in 10
Uncommon [formerly 'less commonly' in BNF publications]	1 in 1000 to 1 in 100
Rare	1 in 10 000 to 1 in 1000
Very rare	less than 1 in 10 000
482
Q

naproxen age?

A

15-50

483
Q

tranexamic acid age?

A

18-45

484
Q

clari+statin?

A

omit statin 7 days?

485
Q

statin, muscle pain, test?

A

creatinien kinase

486
Q

CHADVASC
ORBIT
HASBLED

A
487
Q

HPV VAC?

A

CERVICAL PREVENT

488
Q

COC+AMOX

A

CALM

489
Q

Seizure medicine for an 8 week year old oromucosal tabs put under tongue or yogurt -
buccual midazolam

A
490
Q

co-codamol max?

A

240mg/day, 4-6hrs

491
Q

isotretinoin 7 days

A
492
Q

ssri valp?

A

hyponatraemia

493
Q

amiodarone, weight, tired?

A

thyroid

494
Q

yellow eyes, nausea?

A

fluclo

495
Q

neutropenia symptoms?

A

sore throat

496
Q

RINGWORM

A
497
Q

RASH

A
498
Q

WHITE SPOTS MOUTH

A
499
Q

GREY EGG INHALER?

A

TRELEGY ELIPTA

500
Q

heart failure, drug to stop?

A

amlodipine

501
Q

BASAL-BOLUS REGIME!

A
502
Q

apix dvt?

A

10mg bd 7 days, 5mg bd

503
Q

MHRA REPORTING?

A

We are particularly interested in receiving Yellow Card reports of suspected ADRs:

in children
in patients that are over 65
to biological medicines and vaccines
associated with delayed drug effects and interactions
to complementary remedies such as homeopathic and herbal products

504
Q
A
505
Q

Permethrin once weekly for 2 doses – apply to whole body including face and wash off after 8-12 hours

A
506
Q

Morphine patient and one some IV randomcaine – why do you contact the prescriber about the morphine? This is for spine surgery? HELP

A
507
Q

signed order?

A

he reason for requesting inhalers was missing

508
Q

Paracetamol kid dose for a 2 month baby

A

30–60 mg every 8 hours as required, maximum daily dose to be given in divided doses; maximum 60 mg/kg per day.

509
Q

HAP+PEN ALLERGY?Usually give co-amoxiclav for 5 days but pen allergic so doxycycline + metronidazole

A

Non severe: usually Co-amoxiclav but pen allergic so alt: doxycycline
Severe HAP: IV Pip/Taz, cephalosporins, meropenem or levofloxacin

510
Q

BITE+PEN ALELRGY?

A

Usually give co-amoxiclav for 5 days but pen allergic so doxycycline + metronidazole

511
Q

EPILEPSY AFTER CARE?

A

Recovery position

512
Q

HIGH TSH, LOW T3T4?

A

hypothyroidism

513
Q

Woman’s arms and legs hurt she’s on simvastin what blood test does she need - serum creatinine

A
514
Q

saba uncuntrolled ,40?

A

beclo, celnil

515
Q

factor no dvt?

A

exercise

516
Q

seizure, 8 week?

A

buccal midazolam

517
Q

drugs, driving, methadone, driving?

A

it impairs

518
Q

naproxen days max?

A

3 days, pack of 9

519
Q

lansop?

A

Take 30 to 60 minutes before food

Do not take indigestion remedies 2 hours before or after you take this medicine

520
Q

metro+statin?

A

calm

521
Q

only chc, oestrogen stopped pre- srugery, not proges

A
522
Q

emergency supply cd?

A

refer

out of hours

523
Q

pom register?

A

POM Register (private rx):
Supply date, Rx date
Medicine details (name, qty, form, strength)
Rx’er details and Pt details

524
Q

confidential?

A

20 days normally and has to be a written request

525
Q

VET SCRIPT?

A

et surgery details, qualification (RCVS if CD 2/3)
Animal name and species
Owner
Med details
Admin instructions
Repeatable rx – write no.
If human med/unlicensed: for admin under vet cascade
If CD2/3: Item has been rx’d under care of vet etc
Vet signature
Date: 6 month expiry (inc. repeats) and 28 day expiry for CD2/3/4
Good practice: 28 days’ supply

526
Q

SCHD 2, SAFE STORAGE, THEN DISPOSE?

A

Sch 2 e.g. diamorphine, methadone, oxycodone, ketamine

527
Q

PHENYTOIN INTERACTION?

A 
Sodium Valproate
Isoniazid/Itraconazole
Cimetidine
Ketoconazole
Fluconazole, Fluoxetine, Amiodarone, Diltiazem, Verapamil 
Alcohol
Chloramphenicol
Erythromycin/Clarithromycin
Sulphonamide (sulfadiazine/co-trimoxazole)
Ciprofloxacin
Omeprazole
Metronidazole/Miconazole
528
Q

ASPIRIN+NAPRO?

A

BLEED

529
Q

HEADACHE REFER?

A

LIGHTS+VOMIT

530
Q

whooping cough) Pertussis, Infranix or Boosterix

A
531
Q

OPIOID INDUCED?

A

STIMULANT+OSMOTIC

532
Q

ALREADY TRIED BULK LAXATIVE?

A

Chronic constipation: bulk-forming, then osmotic and can try stimulant after (or after – prucalopride)

533
Q

ASTHMA

A

Adult: (SABA as required)
Low-dose ICS Trial
Regular preventer: Low-dose ICS regular
Initial add-on: LABA 🡪 MART therapy
Additional: Medium-dose ICS OR LTRA
Child (SABA as required)
Very low-dose ICS trial e.g. Clenil modulate 50mcg TT BD
Regular preventer: Very low-dose ICS or 5 add LABA or LTRA and if <5 LTRA
Additional: Increase to low dose, >5 add LABA or LTRA and if no response to LABA, discontinue

534
Q

patient was 4 had nocturnal asthma what inhaler should be prescribed
most likely add LTRA

A
535
Q

patient was on salbutamol but badly controlled what is the next treatment
If adult, put on low dose ICS

A
536
Q

patient was on salbutamol but badly controlled what is the next treatment
If adult, put on low dose ICS

A
537
Q

BECLO

A

800BD AMXXX

538
Q

Clinical Audit, Risk Management, Education + CPD, Evidence based care and effectiveness, patient + carer experience and involvement, staffing arrangement

A
539
Q

OWNER-STANDARDS

A
540
Q

lithium monitor?

A

weekly till stable
3 months
6 months

3months, 65+, elderly peak etc

541
Q

citalopram?

A

taste disturbed

542
Q

omeprazole L LONG-TERM?

A

VITAMIN B12 DOWN

543
Q

hydrocortisone?

A

apply sparingly TWICE A DAY maximum for 7 days

544
Q

post-herpetic neuralgia

A

paracetamol mild

amitripyline serious

545
Q

breastfeeding?

A

Levonorgestrel – wait 8 hours and for Ulipristal wait one week

546
Q

Person is smoking and would like quit sometime in the future but not now, at what stage is this in the change cycle

A

contemp

547
Q

tests

A

Rhabdomyolysis CK
Agranulocytosis WBC
liver dysfunction LFTS

548
Q

IMBALANCES SYMPTOMS
K+
, Na+
, Ca2+, Mg2+

A
549
Q

HYPOKALAEMIA vs HYPERKALAEMIA?

A

HYPOKALAEMIA- muscle cramps, arrhythmias
HYPERKALAEMIA- numbness, nausea, SOB, chest pain

both palpitations- heart rate

550
Q

HYPONATRAEMIA vs HYPERNATRAEMIA?

A

HYPONATRAEMIA- nausea, headache, irritability, seizures

HYPERNATRAEMIA- thirst, fatigue, confusion

551
Q

HYPOCALCAEMIA vs HYPERCALCAEMIA?

A

HYPOCALCAEMIA- depressed, forgetful
HYPERCALCAEMIA- nausea, lethargy, arrhythmias

both muscle cramp/confusion

552
Q

mouth ulcer order?

A 
hydrocortisone
lidocaine
benzydamine
chlorhexidine
doxycycline
?
553
Q

subconjuntival?

A

myna

554
Q

subarrochnoid?

A

serious

555
Q

phenytoin+doxy?

A

less doxy

556
Q

paclitaxel class?

A

taxane

557
Q

myelosupp?

A

7-10daysafter

558
Q
A
559
Q

SPC Qs?

A

There’s always a contradiction!

560
Q

DIABETIC KETOACIDOSIS?

A

soluble insulin such as Actrapid (insulin soluble human) given intravenously

561
Q

HYPO?

A

For adults with hypoglycaemia, give 15–20 g glucose, repeated after 15 minutes if necessary.

15–20 g is available from 60–80 mL oral glucose liquid, 4–5 glucose tablets, or 1.5–2 tubes of glucose 40% oral gel.

If oral glucose formulations are not available, the dose may be given using another fast-acting carbohydrate; 15–20 g is available from approximately 3–4 teaspoonfuls of sugar dissolved in an appropriate volume of water, or 150–200 mL of pure fruit juice.

562
Q

READ THE Q, LEAST APPROPRIATE?!!! CHILD, RINGING BELLS

A

DOXYCYCLINE!

563
Q
A

ALL HAVE QT RISK BAR CCB!!!

564
Q

DOXY+WARFARIN?

A

INR ROCKET

565
Q

Chlorthalidone is a diuretic

A

SICK DAY

566
Q

Ranolazine is a treatment for angina. Dehydration is an uncommon side effect, however there are no sick day rules for it. It isn’t widely recognised as a medicine to be withheld during dehydrating illness.

A

DON’T STOP!

567
Q

what drugs cause gord?

A

alpha-blockers, anticholinergics, benzodiazepines, beta-blockers, bisphosphonates, calcium-channel blockers, corticosteroids, non-steroidal anti-inflammatory drugs (NSAIDs), nitrates, theophyllines, and tricyclic antidepressants should be reviewed

NOT INDAPAMIDE!!!!

567
Q

what drugs cause gord?

A

Drugs that may cause or exacerbate the symptoms of GORD, such as alpha-blockers, anticholinergics, benzodiazepines, beta-blockers, bisphosphonates, calcium-channel blockers, corticosteroids, non-steroidal anti-inflammatory drugs (NSAIDs), nitrates, theophyllines, and tricyclic antidepressants should be reviewed

568
Q

Mirtazapine is a presynaptic alpha2-adrenoreceptor antagonist. It is given at bedtime due to its sedating effect.

Citalopram, fluoxetine, paroxetine and sertraline are all SSRI drugs. They are not usually associated with sedating effects.

A
569
Q

Mrs R is taking the DMARD sulfasalazine, which acts as an immunosuppressant. Yellow fever is a live vaccine and should therefore be avoided in all patients taking DMARDS due to the increased risk of possibly life-threatening generalised infections. Specialist advice must always be sought in such situations.

  • Hepatitis A, DTP, meningitis ACWY and rabies are all inactivated vaccines and are therefore safe for Mrs R
A
570
Q

PPI LONG-TERM?

A

B12!

571
Q

FUNGAL SKIN?

A

apply twice daily continuing for 10 days after lesions have healed

572
Q

A 72-year-old patient who is required to start an intermediate acting insulin regimen which can be administered by her carers.i

A

INSULATARD INTERMEDIATE!!

573
Q

A 45-year-old patient with type 2 diabetes who wants to change from his current basal-bolus insulin regimen to a biphasic insulin regimen to reduce his number of daily injections.

A

NovoMix 30 (insulin aspart) twice daily

MIX!!!

574
Q

ISOPHANE IS?

A

INTERMEDIATE ACTING!!

575
Q

Mrs L presents in the pharmacy with yellow skin. You explain this is likely the result of high bilirubin levels in her blood due to one of her medicines.

A

Patients should be told how to recognise signs of liver disorder and advised to seek prompt medical attention if symptoms such as anorexia, nausea, vomiting, fatigue, abdominal pain, jaundice, dark urine, or pruritus develop.
The correct answer is:
propylthiouracil

576
Q

LIVER DISORDER, YELLOW SKIN, DIFERENT TO PANCREATITIS, ABDDOMINAL PAIN!

A
577
Q

PD/ASTHMA exacerbations + ABX

Amoxicillin 500mg TDS for 5 days

200mg stat doxy and then 100mg OD for 7 days

200mg BD clarithromycin for 7 days

Prednisolone:

40mg OD for asthma for 5 days

30 OD for COPD for 7-14 days

If prophylaxis then Azithromycin Three times per week

A
578
Q

VERAPAMIL CCB IN AF, NOT DILTIAZEM!

A

VERAPAMIL CCB IN AF, NOT DILTIAZEM!

579
Q

warfarin

A

Isolated calf-vein DVT = 6 wks
Provoked VTE = 3 months
Unprovoked DVT or PE = at least 3 months (long-term possibly)

580
Q

analgesia

pains/strains?

A

Paracetamol or topical NSAID
+ codeine adjuvant
48hrs post injury PO NSAID

PRICE – what to do
HARM – what to avoid

Seek medical advice 5-7 days or worsening Sx

581
Q

analgesia

Effervescent preparations = high salt content. Avoid espec if HT

A
582
Q

Routes:
INTRATHECALLY
= methotrexate, cytarabine and hydrocortisone
VINKA alkaloids
= INTRAVENOUSLY or orally
If IV for adults to be in 50ml mini-bag
If IV for paeds can be in 10 or 20ml syringe

A
583
Q

toujeo high strength 300 units

A
584
Q

Oral agents plus basal insulin
Type 2 only

Basal bolus
Rapid acting with meals (bolus)
Long acting once daily (basal)
or
Long-acting:
	or
Twice daily mixture
Mix of short and intermediate acting
A
585
Q

number needed to treat (NNT) the number of patients that we would need to treat with ‘drug’ to prevent event.
1 / ARR => 1/ 0.02 = 50
i.e. 50 people have to be treated before 1 outcome is achieved.
Higher number = less efficacious

A
586
Q

Systematic Review
collection of studies asking same Q & basing conclusions on the cumulated results
Meta-analysis is the statistical process of combining the results
Only as good as source
Retrospective
RCT
Participants (individuals or groups) randomly allocated to receive either the new intervention or a control treatment (usually the standard treatment or a placebo).
Prospective
Qualitative study
Examines the experiences and beliefs of people from their own perspective e.g. interviews
Cohort study
Follow-up or longitudinal study, is a type of observational study
At the end of the period of observation the incidence of disease or frequency of health outcome in the exposed group is compared to that in the unexposed group.
prospective as it looks forward from potential cause to consequence.
Case-Control study
Observational group of studies
Got disease = case. Not = controls
retrospective because it looks backwards in time to the earlier exposures of individuals.

A
587
Q

DEPRESCRIBING

A
588
Q
A
589
Q

when to NOT use depot?

A

quick result needed
skin
allergy

590
Q
A
591
Q
A
592
Q
A
593
Q
A
594
Q
A
595
Q
A
596
Q
A
597
Q
A
598
Q
A
599
Q
A
600
Q

VERAPAMIL CCB IN AF, NOT DILTIAZEM!

A

GPhC BNF (48 decks)

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