Lanc Flashcards by Simon Evans

r AB a 55yr old African male who suffers from hypertension. He was once taking Amlodipine 5mg tablets alongside his angiotensin II receptor blocker. The calcium channel blocker could not be tolerated because of oedema.
A. Spironolactone B. Bisoprolol
C. Methyldopa D. Felodipine
E. Losartan
F. Lisinopril G. Verapamil H. Indapamide

Indapamide

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Mrs AB has been diagnosed with pre-eclampsia having previously having an allergic reaction to calcium channel blockers. She was also not able to tale labetalol or nifedipine.
A. Spironolactone B. Bisoprolol
C. Methyldopa D. Felodipine
E. Losartan
F. Lisinopril G. Verapamil H. Indapamide

Methyldopa

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Mr RM has recently been discharged from hospital after suffering from hypokalaemia for a few days. The letter stated Mr RMs potassium levels have reached normal range since stopping the thiazide like diuretic.
Which drug from the list above would the letter be referring to?
A. Spironolactone B. Bisoprolol
C. Methyldopa D. Felodipine
E. Losartan
F. Lisinopril G. Verapamil H. Indapamide

Indapamide

Hypokalaemia can occur with thiazide and related diuretics.

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Mr AJ a 55 year old Caucasian diabetic comes into your pharmacy explaining he has to been started on a new hypertensive drug and needs to repeat his U&Es in 7-14 days.
A. Spironolactone B. Bisoprolol
C. Methyldopa D. Felodipine
E. Losartan
F. Lisinopril G. Verapamil H. Indapamide

Lisinopril

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local GP asks if there is a drug that is both a stimulant laxative and a faecal softener that he can prescribe. The patient is on multiple medicines and so the clinician would
like to reduce the pill burden for the patient.
A. Bisacodyl
B. Sodium Picosulfate C. Senna
D. Co-danthramer
E. Co-danthrusate
F. Docusate
G. Ispaghula husk
H. Macrogol

Explanation: While Docusate is primarily known as a faecal softener, it may also have a mild stimulant effect. It works by decreasing the surface tension of the stool, allowing water to penetrate and soften it. This dual action distinguishes it from other options listed, such as Bisacodyl (primarily a stimulant), Sodium Picosulfate (a stimulant), Senna (a stimulant), Co- danthramer (a stool softener combined with a stimulant), and Co-Danthrusate (a combination of a stimulant and a stool softener).

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The local prescribing nurse asks you to recommend a laxative which decreases surface tension and increases penetration of intestinal fluid into the faecal mass.
A. Bisacodyl
B. Sodium Picosulfate C. Senna
D. Co-danthramer
E. Co-danthrusate
F. Docusate
G. Ispaghula husk
H. Macrogol

Faecal so,eners are claimed to act by decreasing surface tension and increasing penetra7on of intes7nal fluid into the faecal mass. Docusate sodium and glycerol suppositories have so,ening proper7es.

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Mr SP a 34yr old male comes into your pharmacy with a prescription for chronic constipation. When handing out the medication you explain to the patient to take 1-3 sachets daily in divided doses and that the osmotic laxative increases the amount of water in the large bowel.
A. Bisacodyl
B. Sodium Picosulfate C. Senna
D. Co-danthramer
E. Co-danthrusate
F. Docusate
G. Ispaghula husk
H. Macrogol

Osmotic laxatives increase the amount of water in the large bowel, either by drawing fluid from the body into the bowel or by retaining the fluid they were administered with
Dose for chronic constipation

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You advise a patient on his choice of laxative for his constipation. You discuss that bulk forming laxatives are of value in adults with small hard stools if fibre cannot be increased in the diet.
A. Bisacodyl
B. Sodium Picosulfate C. Senna
D. Co-danthramer
E. Co-danthrusate
F. Docusate
G. Ispaghula husk
H. Macrogol

Bulk-forming laxatives include bran, ispaghula husk, methylcellulose and sterculia. They are of particular value in adults with small hard stools if fibre cannot be increased in the diet. Onset of action is up to 72 hours. Symptoms of flatulence, bloating, and cramping may be exacerbated. Adequate fluid intake must be maintained to avoid intestinal obstruction

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Mrs LM visits your pharmacy having given birth a few months back. Her GP recommends if dietary measures fail she buys an over the counter laxative that is suitable for breastfeeding mothers
A. Bisacodyl
B. Sodium Picosulfate C. Senna
D. Co-danthramer
E. Co-danthrusate
F. Docusate
G. Ispaghula husk
H. Macrogol

A bulk-forming laxative is the first choice during breast-feeding, if dietary measures
fail. Lactulose or a macrogol may be used if stools remain hard. As an alternative, a short course of a stimulant laxative such as bisacodyl or senna can be considered.

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Mr AB comes in to collect his acute prescription for antibiotics. When handing out the prescription you advise him he should not take milk, indigestion remedies, or medicines containing iron or zinc, 2 hours before or after you take this medicine. Mr AB states he is allergic to cephalosporins and you confirm this is not part of that drug class.
A. Tetracycline
B. Phenoxymethylpenicillin C. Erythromycin
D. Azithromycin
E. Doxycycline
F. Clarithromycin
G. Ciprofloxacin
H. Nitrofurantoin

Tetracycline

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Mrs DL comes into collect her acute prescription for antibiotics. When handing out the prescription you advise her do not take indigestion remedies 2 hours before or after you take this medicine.
A. Tetracycline
B. Phenoxymethylpenicillin C. Erythromycin
D. Azithromycin
E. Doxycycline
F. Clarithromycin
G. Ciprofloxacin
H. Nitrofurantoin

Azithromycin

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Mrs AB comes into collect her acute prescription for antibiotics. When handing out the prescription you advise her Protect your skin from sunlight—even on a bright but cloudy day. Do not use sunbeds.
A. Tetracycline
B. Phenoxymethylpenicillin C. Erythromycin
D. Azithromycin
E. Doxycycline
F. Clarithromycin
G. Ciprofloxacin
H. Nitrofurantoin

Doxycycline

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Mrs BD comes into collect her acute prescription for antibiotics. When handing out the prescription you advise her this medicine may colour your urine and this is harmless.
A. Tetracycline
B. Phenoxymethylpenicillin C. Erythromycin
D. Azithromycin
E. Doxycycline
F. Clarithromycin
G. Ciprofloxacin
H. Nitrofurantoin

Nitro

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Mrs BD comes into collect her acute prescription for antibiotics. When handing out the prescription you advise her not to take milk, indigestion remedies, or medicines containing iron or zinc, 2 hours before or after you take this medicine. Swallow this medicine whole. Do not chew or crush. Space the doses evenly throughout the day. Keep taking this medicine until the course is finished, unless you are told to stop.
A. Tetracycline
B. Phenoxymethylpenicillin C. Erythromycin
D. Azithromycin
E. Doxycycline
F. Clarithromycin
G. Ciprofloxacin
H. Nitrofurantoin

Cipro

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You are called by a patient who is worried about his urine being a reddish-brown colour. You reassure the patient its most likely one of the side effects of the new tablet he has started.
A. Nefopam
B. Propranolol
C. Rifampicin
D. Ferrous Sulphate E. Nitrofurantoin
F. Triamterene
G. Senna
H. Phenindione

Senna

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You are called by a patient who is worried about his urine being a yellow-brown colour. You reassure the patient its most likely one of the side effects of the new tablet he has started.
A. Nefopam
B. Propranolol
C. Rifampicin
D. Ferrous Sulphate E. Nitrofurantoin
F. Triamterene
G. Senna
H. Phenindione

nitro- yellow/brown

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. You are called by a patient who is worried about his urine being red in colour and his contact lenses have a red tint too. You reassure the patient its most likely one of the side effects of the new tablet he has started.
A. Nefopam
B. Propranolol
C. Rifampicin
D. Ferrous Sulphate E. Nitrofurantoin
F. Triamterene
G. Senna
H. Phenindione

Rifampicin

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You are called by a patients mother who is worried about her daughters stools being a dark colour since starting a new tablet. You reassure the patient its most likely one of the side effects of the new tablet he she has started.
A. Nefopam
B. Propranolol
C. Rifampicin
D. Ferrous Sulphate E. Nitrofurantoin
F. Triamterene
G. Senna
H. Phenindione

Ferrous sulphate

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You are called by a patient who is worried about his urine being a blue colour. You reassure the patient its most likely one of the side effects of the new tablet he she has started.
A. Nefopam
B. Propranolol
C. Rifampicin
D. Ferrous Sulphate E. Nitrofurantoin
F. Triamterene
G. Senna
H. Phenindione

Triamterene

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Mrs Jones comes into your pharmacy after being diagnosed with scurvy. She has muscle aches, joint pain, bleeding gums and has developed blue spots under her skin.
A. Vitamin C B. Vitamin A C. Vitamin B D. Vitamin K E. Vitamin D F. Calcium G. Iodine
H. Iron

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Mr AW comes into your pharmacy stating he would like to supplicate his diet with a retinol top up. He mentions he has started to include cheeses, egg, oily fish and liver pate. You mention a good amount of retinol is 700 micrograms a day.
What vitamin would you sell Mr AW using the options given above?
A. Vitamin C B. Vitamin A C. Vitamin B D. Vitamin K E. Vitamin D F. Calcium G. Iodine
H. Iron

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Miss GM brings into your pharmacy a multivitamin tablet. She states she has just been advised to reduce her pyridoxine levels as she has started to get a loss of feeling in arm and the legs. You take a look at the pack and find the pyridoxine present.
A. Vitamin C B. Vitamin A C. Vitamin B D. Vitamin K E. Vitamin D F. Calcium G. Iodine
H. Iron

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You are asked by a customer for a group of vitamins that include essential nutrients like thiamine, riboflavin, niacin, and folic acid, playing a crucial role in energy metabolism and DNA synthesis
A. Vitamin C B. Vitamin A C. Vitamin B D. Vitamin K E. Vitamin D F. Calcium G. Iodine
H. Iron

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Mr DJ visits your pharmacy and enquires into the difference between ergocalciferol and cholecalciferol. You discuss how ergocalciferol comes from plant based sources and cholecalciferol comes from plant based sources. Both supplements are processed by the liver.
A. Vitamin C B. Vitamin A C. Vitamin B D. Vitamin K E. Vitamin D F. Calcium G. Iodine
H. Iron

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ou carry out a medication review for Mr JK who has multiple clinical issues. He has been started a new anti-diabetic agent to be taken once weekly. You explain the important side effect of acute pancreatitis. A. Sitagliptin B. Dulaglutide C. Empagliflozin D. Insulin Glargine E. Gliclazide F. Pioglitazone G. Metformin H. Humulin Mix

Dulaglutide

You carry out a medication review for Mrs MK who has recently been prescribe an intensification of anti-diabetic medication. During the medication review you realise that Mrs MK suffers from brittle bones disease and the new agent has a caution against bone fractures especially in women. A. Sitagliptin B. Dulaglutide C. Empagliflozin D. Insulin Glargine E. Gliclazide F. Pioglitazone G. Metformin H. Humulin Mix

Concomitant use with insulin (risk of heart failure); elderly (increased risk of heart failure, fractures, and bladder cancer); increased risk of bone fractures, particularly in women; risk factors for bladder cancer; risk factors for heart failure

You carry out a medication review for Mrs HD who tells you she has been experiencing sharp shooting pain in the abdomen radiating into the back. You recognise Mrs HD has a tablet that could be causing this side effect. A. Sitagliptin B. Dulaglutide C. Empagliflozin D. Insulin Glargine E. Gliclazide F. Pioglitazone G. Metformin H. Humulin Mix

Symptom of acute pancreatitis - Sitagliptin

You carry out a medication review for Mr SP who has low levels of B12 in his recent blood investigations. The GP has prescribed him some B12 injections but did not that one of the anti-diabetic medication A. Sitagliptin B. Dulaglutide C. Empagliflozin D. Insulin Glargine E. Gliclazide F. Pioglitazone G. Metformin H. Humulin Mix

Metformin

You are carrying out a medication review for the GP practice. One of the anti- diabetic drugs requires advising the patient on Fournier’s gangrene. A rare but potentially life-threatening infection that requires urgent medical attention. A. Sitagliptin B. Dulaglutide C. Empagliflozin D. Insulin Glargine E. Gliclazide F. Pioglitazone G. Metformin H. Humulin Mix

Empaglifozin

You are called by your local GP for some advice on prescribing a medication for a neonate. You ask the GP for a weight and calculate the dose accordingly. How old is a patient when categorised as a neonate? A. 0-56 days B. 0-6 months C. 0-12 months D. 0-28 days months E. 0-14 days

0-28 days

Patients should be advised that unused, unwanted medicines should be returned to a pharmacy for safe disposal. Which option below is incorrect with regards to waste reduction? A. Waste medicines can be received at a pharmacy as long as waste exemptions are complied with. B. Blister strips can be removed from their inert outer packaging but tablets and capsules C. Waste containers must be kept in secure waste containers in a designated area preferably away from medicines that are fit for use. D. Ensure that all patient identifiable information is destroyed or totally obscured. E. The whole bottle including empty bottles with residue should be placed into pharmaceutical waste containers.

You are visited by the GPhC inspector for an audit. He takes out some a control drug requisition. The introduction of an approved mandatory requisition form is a remaining Shipman inquiry recommendation aimed at ensuring purchases of CDs can be monitored. From the options below what is not a legal requirement for a controlled drug requisition? A. Signature of the recipient B. Name of the recipient C. Address of the recipient D. Purpose of the requisition E. Date of birth of the recipient

You are visited by the GPhC inspector for an audit. The inspector takes out some control drug prescriptions and questions you on examples of doses that are not legally acceptable for schedule 2 and 3 controlled drugs. From the options below which is an example of a dose which is legally acceptable? A. One PRN B. Twiceaday C. Decrease dose by 3.5ml every 4 days D. Titration dose E. As per chart

One prn MEP 3.6.7 Pg 112

You are visited by the internal auditors at your pharmacy. The superintendent states the company must go through a safe custody audit after a recent incident had been filed. The area manager asks you what controlled drugs are exempt from being kept in a controlled drugs cabinet. Choose the correct answer from the list below. A. Buprenorphine 2mg s/l tablets B. Fentanyl 5cg patches C. Midazolam 10mg/2ml ampoules D. Oxycodone 10mg/5ml solution E. Morphine 1mg ampoules

Midazolam 10mg/2ml ampoules

You have been asked by the dispenser to confirm the quantity of prednisolone 5mg tablets to be dispensed after receiving a hospital prescription. The directions are: 40 mg once daily for 5 days, then reduced in steps of 5 mg every 7days until stop. What is the total quantity of prednisolone 5mg tablets to be dispensed? A. 208 B. 215 C. 222 D. 236 E. 243

236

You are asked to call the Toxbase team by your colleague after an incident at your workplace. Which of the following statements regarding Toxbase, a clinical toxicology database is incorrect? A) Toxbase provides information on the management of poisoning and toxicological emergencies. B) It is accessible only to healthcare professionals with appropriate credentials. C) Toxbase offers guidance on the antidotes, decontamination procedures, and supportive care for different toxic substances. D) The information on Toxbase is regularly updated by a team of toxicology experts. E) Toxbase is primarily used for patient diagnosis and treatment of infectious diseases.

Vincristine is a commonly used chemotherapy medication in the treatment of various malignancies. Choose the correct statement regarding vincristine below? A. Vincristine is classified as an alkylating agent. B. Vincristine acts by inhibiting topoisomerase II enzyme. C. Vincristine is primarily eliminated by renal excretion. D. Vincristine can cause peripheral neuropathy as a notable side effect. E. All of the above are correct.

Vincristine is a commonly used chemotherapy medication in the treatment of various malignancies. The form in which it is given can be a matter of life or death if given incorrectly. Choose the correct statement regarding vincristine below? A. Vincristine should be given as a S/C injection only. B. Vincristine should be given as a IM injection only. C. Vincristine should be given as a IV injection only. D. Vincristine should be intrathecal administration only. E. All of the above are correct.

You are clinically checking a prescription for Nitrofurantoin capsules for Mrs FR. She is pregnant and has a lower UTI. You check the dosage and contact the GP to highlight a potential error. What is the correct dose for this patient? A. 100mg BD for 7 days B. 100mg BD for 3 days C. 50mg BD for 3 days D. 50mg QDS for 3 days E. 500mg TDS for 7 days

100mg BD 7 days

You have a patient who is currently unwell with a fever. The mother tells you her child is 4 years old. What is the correct dose for paracetamol 120mg/5ml suspension when bought over the counter? A. 5 ml Up to 4 times a day B. 2.5ml Up to 4 times a day C. 2.5ml Up to 3 times a day D. 7.5ml Up to 4 times a day E. 10ml Up to 3 times a day

10ml up to 4 times a day

Miss KK a 20-year-old female visits your pharmacy seeking emergency contraception. She had unprotected intercourse with her partner last night and is concerned about the risk of pregnancy. The pharmacist provides her with information about Levonelle, a commonly used emergency contraceptive pill, including its effectiveness, dosage, and possible side effects. Regarding the use of Levonelle as an emergency contraceptive, which of the following statements is incorrect? A. Levonelle can be sold to women over 16, when supplying emergency contraception pharmacists should refer to guidance issued by the Royal Pharmaceutical Society B. Higher dose option for emergency contraception in patients with body weight over 70 kg or BMI over 26 kg/m2 C. Levonelle is a short-term contraceptive method. D. Levonelle can be taken up to 72hrs after unprotected intercourse. E. If started after day 5 additional contraceptive precautions are required for 3 days.

You have a professional legal and moral duty to protect children from abuse and neglect. The HCA has come to talk to you in confidence regarding a child, who she feels is suffering from potential physical abuse. From the options below what would be a sign of physical abuse? A. Poor Growth B. Evidence of self harm/self mutilation C. Indication of a STD D. Injuries blamed on siblings E. Poor Weight

You have a professional legal and moral duty to protect children from abuse and neglect. The HCA has come to talk to you in confidence regarding a child, who she feels is suffering from potential neglect? From the options below what would be a sign of neglect? A. Poor Growth B. Evidence of self harm/self-mutilation C. Indication of a STD D. Injuries blamed on siblings. E. Bite Marks

You are performing a medication review for a patient and believe there is room for medicines optimisation. What is the primary goal of medicines optimisation? A. Increase the number of prescribed medicines for patients. B. Encourage people to take ownership of their treatment. C. Minimize the consideration of lifestyle changes in patient care. D. Promote the unnecessary use of medicines. E. Ignore opportunities for non-medical therapies in the treatment plan.

. The HCA advises you that a patient is asking for OTC pseudoephedrine who has already been into the pharmacy a few days ago. Pseudoephedrine and Ephedrine are widely used as decongestants but also can be abused. Choose the correct advice from the options listed below? A. It is unlawful to supply a product or combination of products that contain more than 720mg pseudoephedrine or 120mg of ephedrine at any one time. B. It is unlawful to supply a product or combination of products that contain more than 720mg pseudoephedrine or 180mg of ephedrine at any one time. C. It is unlawful to supply a product or combination of products that contain more than 700mg pseudoephedrine or 120mg of ephedrine at any one time. D. It is unlawful to supply a product or combination of products that contain more than 780mg pseudoephedrine or 180mg of ephedrine at any one time. E. It is unlawful to supply a product or combination of products that contain more than 780mg pseudoephedrine or 160mg of ephedrine at any one time.

Paracetamol and Aspirin are legal products that are available in different ranges and formulations. A patient comes into your pharmacy asking to buy some paracetamol effervescent tablets. He would like to purchase multiple packs due to multiple packs on his repeat medication have not arrived. What is the maximum supply you can sell to the patient? A. 100 B. 96 C. There are no legal limits on the quantity of the OTC effervescent tablets. D. 112 E. 32

Mr GH a 16yr old patient brings in a prescription for some antibiotics. You have a new pre-registration trainee. You ask the trainee to go through the legal requirements for the prescription. Using the options below which is not a prescription requirement? A. Signature by an appropriate practitioner B. Address of the prescriber. C. Date prescription is valid for up to 6 months from the appropriate date. D. Age of the patient E. Particulars of prescriber

Age of pt

You are entering your control drug prescriptions at the end of the day and come across a private prescription for a POM that was dispensed a day earlier. You enter it as soon as possible. What is the record keeping advise for entering a private POM prescription? A. Record should be made on the day of the sale or supply. B. Record should be made on the day of the sale up to 3 days after. C. Record should be made on the day of the sale or the next following day. D. Record should be made on the day of the sale or up to 5 days. E. Records can be made for up to 28 days.

You are undergoing an internal audit with the area manager of your pharmacy. You are asked by your area manager how long a POM register must be retained for. Choose the correct answer from the options below? A. 6 months B. 1 year C .5 years D. 3 years E. 2 year

2 years

You get a call from a local clinician whilst on call, he requests an emergency supply as it’s the weekend and is unable to send over a electronic or physical copy. From the options below which is not a relevant prescriber able to request the above? A. Dentist B. Nurse independent prescriber C. Podiatrist independent prescriber D. Supplementary prescriber E. Physiotherapist independent prescriber

Advances in biotechnology have increased the number of biological molecules and materials. You explain to your pre-registration trainee the importance of brands and generics. What is a biosimilar in the context of biologic medicines? A. A biosimilar is a completely different type of medication with no similarity to existing biologics. B. A biosimilar is a biologic medicine that is only licensed for different diseases than the original innovator product. C. A biosimilar is a term used for generic versions of biologic medicines. D. A biosimilar is a biologic medicine developed to treat the same disease(s) as the original innovator product, with similar quality, safety, and efficacy. E. A biosimilar can be marketed at any time, regardless of the patent status of the originator product.

d- a BIOSIMILAR is a biologic medicine developed to treat the same disease(s) as the original innovator product with similar quality, safety and efficacy

What information should be included in Signed Orders when record-keeping for Patient-Owned Medicines (POM)? From the options below what option is incorrect? A. Date the POM was supplied. B. Name, quantity, and, where it is not apparent, formulation and strength of the POM supplied. C. Name and address, trade, business, or profession of the person to whom the medicine was supplied. D. Purpose for which it was sold or supplied. E. Time of day the POM was supplied.

You are handed a veterinary prescription. It is for a Mrs DTs dog who has been unwell for a few days. The prescription is legal and clinically correct. What is the correct protocol regarding the retention and submission of veterinary prescriptions and private prescriptions for Schedule 2 and 3 Controlled Drugs (CDs)? A. Veterinary prescriptions should be submitted to the relevant NHS agency. B. Original human private prescriptions for Schedule 2 and 3 CDs should be retained for three years. C. Veterinary prescriptions should be retained for two years and then submitted to the relevant NHS agency. D. Original human private prescriptions for Schedule 2 and 3 CDs must be retained for five years and not submitted to the relevant NHS agency. E. Original human private prescriptions for Schedule 2 and 3 CDs must be submitted to the relevant NHS agency.

You have finished a controlled drug destruction register and start a new book. The pre-registration trainee asks you how long must you keep it until it can be destroyed. Choose the correct answer from the options given below? A. 7 years B. 3 year C. 5 years D. 1 years E. 2 years

7 YEARS ??

You have just come across a patient who has in Adjunct to oral anticoagulation for prophylaxis of thromboembolism associated with prosthetic heart valves has been started on dipyridamole 200mg tablets twice a day. A. Take with a full glass of water standing up. B. Take 30-60mins before food. C. Take with or just after food. D. Do not take indigestion remedies 2hrs before or after this medicine. E. Take with orange juice.

tAKE 30-60 mins before food

Dipyridamole capsules are a slow-release formulation that should be dispensed in an original container (packs containing desiccant) and any capsule remaining should be discarded after a period of time. What is the correct answer using the options below. A. any capsules remaining should be discarded 6 weeks after opening. B. any capsules remaining should be discarded 8 weeks after opening. C. any capsules remaining should be discarded 12 weeks after opening. D. any capsules remaining should be discarded 4 weeks after opening. E. any capsules remaining should be discarded 56 days after opening.

Mr GS has had a recent diabetic review with one of the issues identified as erectile dysfunction. You check Mr GS’s repeats to find a severe contraindication. Which medicine from the list below would be contraindicated for Mr GS? A. Aspirin B. Warfarin C. Atorvastatin D. Isosorbide Dinitrate E. Ramipril

D Isosorbide dinitrate potentially increases the risk of hypotension when given with sildenafil - manufacturer advises avoid

Beta-adrenoceptor blocking drugs (beta- blockers) block the beta-adrenoceptors in the heart, peripheral vasculature, bronchi, pancreas, and liver. Your pre-registration trainee discusses cardio selective, water soluble and lipid soluble profiles of beta blockers. Using the options below which is the incorrect statement regarding beta-blockers? A. Renal secretion of water-soluble beta blockers occurs therefore it would mean a reduced the dose in CKD patients. B. Beta blockers contraindicated in 2-3rd degree heart block and worsening HF. C. Beta blockers mask hypoglycaemia. D. Use cardio selective B-blockers in Asthmatics if needed also in diabetics. E. All Beta blockers are to be used in pregnancy.

One of your patients Mr DA has been prescribed procyclidine for his Parkinson’s disease. Since starting the drug Mr DA has been experiencing some extrapyramidal side effects associated with levodopa therapy. Which of the following is least likely to be a side effect of the procyclidine? A. Constipation B. Dry mouth C. Urinary retention D. Blurred vision E. Acute pancreatitis

Acute pancreatitis

The medicines and healthcare products regulatory agency has classified antiepileptic drugs into 3 categories to help with continuity of a specific brands if required. Mr KJ comes into you pharmacy with a prescription for the 1st line treatment of partial (focal) seizures. Using the options below which option is used in 1st line treatment for Mr KJ? A. Clobazam B. Lamotrigine C. Gabapentin D. Levetiracetam E. Pregabalin

Lamotrigine

Mr KJ Has recently had his anti-epileptic mediation changed. He asks you if he has to keep to the same brand of his medication. He was told some anti-epileptic medication should have brand continuity always. Using the options below which anti-epileptic medication requires brand continuity? A. Phenobarbital B. Lacosamide C. Levetiracetam D. Ethosuximide E. Vigabatrin

Phenobarbital

Mr KJ Has recently had his anti-epileptic mediation changed. He asks you if he has to keep to the same brand of his medication as he was told some anti-epileptic medication should have brand continuity. Using the options below which anti-epileptic medication does not require brand continuity? A. Phenobarbital B. Primidone C. Carbamazepine D. Phenytoin E. Lacosamide

Lacosamide

. Replacing an Anti-epileptic drugs (AED) should be done slowly and cautiously WITH older drugs only withdrawn after a new regimen has been established. Abrupt withdrawal increases the risk of rebound seizures. Interactions with other AEDs is very common. They also interact with each other often resulting in an increased toxicity without any added anti-seizure effect. From this list below choose the enzyme inducing anti-epileptic drug? A. Phenytoin B. Lacosamide C. Levetiracetam D. Ethosuximide E. Clobazam

Phenytoin

9-year-old child Ms ET had started a new drug for a newly diagnosed condition. After a few weeks of taking the medication, Ms ET began to develop a rash on her face and trunk, accompanied by fever and blistering of the skin. Concerned parents rushed her to the hospital, where she was diagnosed with Stevens-Johnson Syndrome (SJS), a severe and potentially life-threatening skin reaction. Which medication is most likely to have triggered ETs Stevens-Johnson Syndrome (SJS) based on the scenario? Choose the correct option from the list below. A.Phenobarbital B. Tramadol C. Sertraline D. Lamotrigine E. Phenoxymethylpenicillin

Lamotrigine

35-year-old female Mrs PH has been diagnosed with schizophrenia and prescribed antipsychotic medication to manage her symptoms. She has been taking the medication for the past few months under the supervision of her psychiatrist. Mrs PH has noticed a significant increase in her weight despite maintaining her usual diet and exercise routine. Concerned about her weight gain, she schedules an appointment with her pharmacist to discuss her medication. Which antipsychotic medication is most associated with weight gain? A. Amisulpride B. Aripiprazole C. Olanzapine D. Sulpride E. Haloperidol

Olanzapine

While rotating through the renal ward, you've been assigned the responsibility of reviewing a patient's repeat medication. Recognising the fragility of individuals with chronic kidney disease, you understand the critical significance of maintaining electrolyte balance in these patients . Which adverse effect is commonly associated with the use of Selective Serotonin Reuptake Inhibitors (SSRIs)? A. Hyperglycaemia B. Hypokalaemia C. Hyponatraemia D. Hypernatraemia E. Hypercalcaemia

Hyponatraemia

Mr TY, a 45-year-old man, has been experiencing symptoms of depression for several months, including persistent sadness, loss of interest in activities, and difficulty sleeping. Concerned about his mental health, John decides to seek help from his pharmacist who signposts to the GP. After a thorough evaluation, his diagnoses him with depression and prescribes citalopram, a selective serotonin reuptake inhibitor (SSRI), to help manage his symptoms. Which of the following side effects are commonly associated with the use of citalopram as described in Mr TY’s scenario? A. Weight gain and increased appetite B. Hypertension and tachycardia C. Increased libido and sexual dysfunction D. Dry mouth, constipation, urinary retention, blurred vision E. Muscle stiffness and extrapyramidal symptoms (EPS)

Dry mouth, constipation, urinary retention, blurred vision

Hypothyroidism is a condition characterized by an underactive thyroid gland, resulting in insufficient production of thyroid hormones. Which of the following signs and symptoms is commonly associated with hypothyroidism? A. Weight loss and increased appetite B. Heat intolerance and excessive sweating C. Tachycardia and palpitation D. Fatigue, weight gain, cold intolerance, and constipation E. Anxiety, restlessness, and tremors

patient comes into your pharmacy with symptoms of thrush over the past few days. She feels itching in the PV region and has a white coloured discharge. She is taking multiple repeat medicines for multiple illnesses. Using the list below what drug could be the cause of her thrush symptoms? A. Finasteride B. Clotrimazole C. Nitrofurantoin D. Empagliflozin E. Allopurinol

Empaglifozin

65yr old Mr CW with type 2 diabetes mellitus is being discharged from the renal ward. You notice him still being on Metformin Below what levels of eGFR is metformin to be avoided in? A. Avoid Metformin in patients who have a eGFR being below 60 mL/min/1.73m2. B. Avoid Metformin in patients who have a eGFR being below 15 mL/min/1.73m2. C. Avoid Metformin in patients who have a eGFR being below 40 mL/min/1.73m2. D. Avoid Metformin in patients who have a eGFR being below 30 mL/min/1.73m2. E. Avoid Metformin in patients who have a eGFR being below 20 mL/min/1.73m2.

Below 30

Mrs HA has a history of asthma. She has been prescribed oral corticosteroids for the management of an acute exacerbation. During counselling you explain the potential side effects associated with prolonged or excessive use of corticosteroids. Which of the following is a mineralocorticoid side effect that the pharmacist should mention to the patient? A. Muscle weakness B. Weight gain C. Hypotension D. Sodium retention E. Raised Potassium

Sodium retention

mode of action for Gentamycin? A. Inhibit protein synthesis bind to 30s ribosomes B. Inhibitcellwallsynthesis. C. Inhibit cell wall synthesis inhibiting B-lactamase. D. Inhibit cell wall synthesis, peptidoglycan in cell walls.

Aminoglycosides inhibit protein synthesis by binding to the 30s ribosomes

Mrs HF rushes into your pharmacy very worried that the recent antibiotic started for her son has caused staining of his teeth. Which of the following antibiotics is associated with the risk of staining teeth? A. Ciprofloxacin B. Tetracycline C. Erythromycin D. Clarithromycin E. Penicillin V

Mr JP who suffers from rheumatoid arthritis experiences persistent fatigue and bruising. Upon further investigation, it is discovered that the patient is suffering from bone marrow suppression, leading to decreased production of red blood cells, white blood cells, and platelets. Immediate medical intervention is necessary to mitigate the risk of severe complications. After reviewing his medication you realise the methotrexates anti-folate effect has been increased due to a newly started antibiotic. From the options listed below anti-biotic is most likely the cause of the above interaction. A. Ciprofloxacin B. Tetracycline C. Metronidazole D. Clarithromycin E. Trimethoprim

Bone marrow suppression can occur abruptly; factors likely to increase toxicity include advanced age, renal impairment, and concomitant use with another anti-folate drug (e.g. trimethoprim). Manufacturer advises a clinically significant drop in white cell count or platelet count calls for immediate withdrawal of methotrexate and introduction of supportive therapy.

Mr DS has a history of chronic obstructive pulmonary disease presents to the pharmacy for a refill of his respiratory medications. Upon reviewing his medical history, the pharmacist notes that the patient also has a history of narrow-angle glaucoma. Which of the following respiratory medications should be used with caution or avoided in this patient due to the risk of exacerbating narrow-angle glaucoma? A. Salbutamol B. Ipratropium C. Fluticasone D. Montelukast E. Budesonide-formoterol

Ipratropium, an anticholinergic medication commonly used in the management of COPD, can cause pupillary dilation and increase intraocular pressure, potentially exacerbating narrow- angle glaucoma. Therefore, it should be used with caution or avoided in patients with a history of narrow-angle glaucoma

You are carrying out an asthma review for Mr GL who has recently been diagnosed with having chronic migraines. Since starting the new medication, he feels his chest has become tight and feels this occurred suddenly as soon as he had taken the anti- migraine tablets. Choose the drug most likely causing this from the options below. A. Topiramate B. Candesartan C. Amitriptyline D. Propranolol E. Paracetamol

propanolol

One of your patients has had intensification of his Asthma treatment. You explain plasma-theophylline concentration are measured 5 days after starting oral treatment and at least 3 days after any dose adjustment. A blood sample should usually be taken 4–6 hours after an oral dose of a modified-release preparation according the local guidelines. From the options listed below what is the plasma concentration level required for satisfactory bronchodilation? A. plasma-theophylline concentration of 10–20 mg/litre B. plasma-theophylline concentration of 10–50 mg/litre C. plasma-theophylline concentration of 20–25 mg/litre D. plasma-theophylline concentration of 25–50 mg/litre E. plasma-theophylline concentration of 10-15 mg/litre

10-20

A 52-year-old woman visits her local pharmacy seeking information about hormone replacement therapy (HRT). She explains to the pharmacist that she has been experiencing bothersome symptoms of menopause, including hot flashes, night sweats, and mood swings, which are impacting her quality of life. 91. Using the options given below choose the incorrect statement regarding HRT. C. The likelihood of HRT affecting the risk of dementia is unknown. A. Combined HRT with oestrogen and progestogen is associated with a decreased risk of breast cancer that is dependent on duration of treatment, which reduces after stopping HRT. B. Combined HRT with oestrogen and progestogen is associated with little or no increase in the risk of CHD. D. HRT with oestrogen alone is associated with little or no increase in the risk of breast cancer.

A is incorrect

A 60-year-old male patient with benign prostatic hyperplasia (BPH) visits the pharmacy to pick up his prescription for alfuzosin. During counselling, the pharmacist emphasizes the importance of its side effects. Which of the following adverse effects is the patient most likely to experience if he fails to follow instructions? A. Hyperglycaemia B. Hyperkalaemia C. First dose hypotension D. Tachycardia E. Hypoglycaemia

First dose may cause collapse due to hypotensive effect (therefore should be taken on retiring to bed). Patient should be warned to lie down if symptoms such as dizziness, fatigue or sweating develop, and to remain lying down until they abate completely.

Mr YM brings his 10 yr old daughter to be reviewed by the pharmacist. His daughter states a painful left ear, no fever or discharge however she has a feeling of it being blocked. She has recently been swimming with her school and has been having symptoms for 2 days. You inspect the ear it is an outer ear infection and recommend OTC ear spray. From the list below choose the correct option on the above scenario. A. Keeping the affected ear dry and avoiding swimming or submerging the ear in water until the infection resolves. B. Using over-the-counter acetic acid ear drops to help restore the normal acidic environment of the ear canal and inhibit bacterial or fungal growth. C. Avoiding inserting anything into the ear canal, such as cotton swabs, which can exacerbate irritation or injury. D. Taking over-the-counter pain relievers, such as ibuprofen or acetaminophen, to alleviate discomfort. E. All the above.

Mrs H and her 7-year-old daughter visit your pharmacy requesting for advice about a skin rash that has developed recently on Mrs H. Mrs H explains that the rash initially appeared as red itchy spots which have now developed into fluid- filled intensely itchy blisters that crust over and scab. They have appeared on her face, on the chest and abdomen, and on the arms and legs. She has no other symptoms and does not suffer from any other medical conditions. Which of the following is the most likely cause of Miss H’s symptoms? 97. 98. A. An allergic reaction B. Cytomegalovirus C. Measles virus D. Tinea corporis E. Varicella-zoster virus

A patient presents to the pharmacy with complaints of scaling and itching on one foot, primarily between the 4th and 5th toes. The skin appears soggy, and there are areas of dry, scaly skin on the soles of the feet. Based on the provided information, which of the following conditions is the most likely diagnosis? A. Athlete's foot B. Eczema C. Psoriasis D. Cellulitis E. Plantar warts

atHLETE FOOT

A 5-year-old child is brought to the pharmacy with symptoms of anaphylaxis. Based on the provided dosing recommendations for adrenaline in the paediatric population, what is the appropriate dose of adrenaline 1/1000 solution to administer intramuscularly to this child? A) 0.01 mg IM (0.01ml 1:1000 solution) B) 0.03 mg IM (0.03ml 1:1000 solution) C) 0.15 mg IM (0.15ml 1:1000 solution) D) 0.3 mg IM (0.3ml 1:1000 solution) E) 0.5 mg IM (0.5ml 1:1000 solution)

3 -year-old child presents to the pharmacy with symptoms of a barking cough and difficulty breathing, particularly at night. Upon examination, you observe the child displaying inspiratory stridor. Based on the provided information, what is the most likely diagnosis for this child's condition? A. Bronchiolitis B. Pneumonia C. Asthma D. Croup E. Pertussis

Croup

A patient presents to the pharmacy with a burn injury. According to the provided information, which of the following conditions would warrant an urgent referral to a healthcare professional? A) A superficial burn covering an area smaller than the size of the patient's hand. B) A mild burn with minimal blistering and mild pain. C) A chemical burn with no respiratory symptoms. D) A burn that is small in size. E) A deep burn that appears charred, painless, and causes shortness of breath.

A regular patient of yours is taking hyoscine butyl bromide three times a day to treat her abdominal cramps. Upon returning to your pharmacy, she complains of specific side effects related to the hyoscine butyl bromide tablets. Which one of the following side effects is least likely to be caused by hyoscine butyl bromide? A. Increased bronchial secretions B. Constipation C. Pupil dilatation D. Dry mouth E. Urinary retention

You are undergoing a diabetic review for Mr AD whose HbA1C has been fluctuating over the last few years. He asks when administering his rapid-acting insulin analogues, at which time should they be ideally administered in relation to food intake? A. At least 60 minutes before a meal B. 2hrs before the meal C. At night D. At least 2 hours after a meal E. Just before or just after food

Just before or just after food

The next question Mr AD asks is the onset and peak duration for his rapid acting insulin. Using the list below choose the correct option. A. Onset 10-23mins and peaks 1-3hrs B. Onset 10-20mins and peaks 1-3hrs C. Onset 30-60mins and peaks 2-4hrs D. Onset 1-2hrs and peaks 4-6hrs

B - Onset 10-20 mins and peaks 1-3 hrs

A 7-year-old child presents to the pharmacy with symptoms of chickenpox, including fever and itchy skin lesions. The child's parent asks for advice on managing their symptoms. Which of the following over-the-counter medications is not recommended for managing symptoms of chickenpox due to the risk of developing Reye's syndrome? A. Ibuprofen B. Piriton C. Paracetamol D. Calamine lotion E. Alovera gel

Ibuprofen

Mr PJ has just had a heart valve replacement. The maintenance dose of warfarin depends on the international normalized ratio (INR) during monitoring. There is a wide variation of Warfarin daily dosing ranging from 1-15mg. What is the recommended target value INR for someone who is being treated for atrial fibrillation. A. 1.0 B. 3.0 C. 2.0 D. 2.5 E. 3.5

2.5

You have a concerned mother who has brought her infant into your pharmacy with symptoms of a barking cough and a mild fever. What is the recommended management in children with croup? A. Administer oral antibiotics B. Administer oral corticosteroids C. Administer inhaled bronchodilators D. Apply a hot steam mist to the child's face. E. Administer a cough suppressan