M2 Flashcards
A patient is due to start a statin, and has been prescribed
simvastatin. What would be the most appropriate
counselling advice to provide the patient?
A. Take the statin in the morning
B. Take the statin one hour before breakfast
C. Crush the tablet before taking it
D. Take the statin at night
E. Take the statin with a glass of orange juice
Take the statin at night
A lady comes into the pharmacy explaining she is
thinking about starting a family. However, she has some
concerns because of her current medications. What
would be the most appropriate advice to provide?
Below are her current repeat medication list:
Rosuvastatin 5mg
Ramipril 10mg
Amlodipine 5mg
A. Advise the patient to arrange an appointment with her GP
because she would need to stop taking her rosuvastatin
three months before planning to conceive.
B. She can continue to take her medication as normal
C. Refer to A&E
D. Advise her to stop all her medication and see the GP as
soon as possible
E. Advice the patient to stop taking her Ramipril three
months before planning to conceive
A. Advise the patient to arrange an appointment with her GP
because she would need to stop taking her rosuvastatin
three months before planning to conceive.
Which blood pressure target would be most appropriate
for an 84 year old Caucasian lady?
A. <140/90mmHg
B. <150/90mmHg
C. <130/80mmHg
D. <135/85mmHg
E. <160/90mmHg
<150/90 mmHg
A patient has recently started taking Ramipril 5mg for
high blood pressure. However, for the past few weeks he
has noticed a cough which has been keeping him up at
night. What would be the most appropriate action?
A. Explain that it is a common side effect and should
disappear
B. Switch his medication to a diuretic
C. Refer him to the urgent care centre
D. Refer him to his GP as a switch in his medication to
Losartan would need to be considered
E. Sell him an over the counter cough syrup
D. Refer him to his GP as a switch in his medication to
Losartan would need to be considered
What dose of Atorvastatin would be expected to be
prescribed for secondary prevention of heart disease?
A. 80mg
B. 40mg
C. 20mg
D. 7.5mg
E. 5mg
80mg
A patient has newly been prescribed Amiodarone for the
treatment of arrhythmias. He is to initially take 200mg
three times a day for 1 week.
Which of the following side effects would require
discontinuation of Amiodarone?
A. Weight loss
B. Impaired vision
C. Nausea
D. Skin reactions
E. Confusion
Amiodarone is an antiarrhythmic medication that has several serious side effects. One of the most concerning is optic neuropathy/neuritis, which can cause progressive vision loss. If a patient experiences impaired vision while on amiodarone, the medication should be discontinued immediately and an ophthalmology referral is required.
Mr X visits the pharmacy to collect his repeat medication.
Whilst there, he asks for some advice about one of his
medications; Amiodarone which he has been taking for
about three months which was started in hospital.
He is going on holiday to Spain next week and he
remembers the doctor telling him lots of new
information about his medication. He asks if there are any
precautions he should take whilst on holiday.
What would be the most appropriate advice?
QUESTION 7
A. No further advice is needed. He should take his
medication as normal
B. Advise him to cancel his holiday as it is not appropriate
to travel whilst on this medication
C. Advise Mr X that he should use a wide spectrum sun
cream to protect his skin from the light whilst on holiday
and you show him the range of sun creams available
D. Whilst on holiday, he should keep his medication in
the fridge
E. Advise him to make sure he has enough medication
whilst travelling
Amiodarone is associated with photosensitivity, meaning it increases the risk of severe sunburn and skin reactions when exposed to sunlight. Patients taking amiodarone should:
Use a high-SPF (broad-spectrum) sunscreen (SPF 30 or higher).
Wear protective clothing (hats, long sleeves, sunglasses).
Avoid prolonged sun exposure, especially during peak hours.
Be cautious with artificial UV light (e.g., tanning beds), which can also cause severe reactions.
Patients who have low potassium and magnesium
should ensure these are within range before starting
which of the following medications?
A. Digoxin
B. Ramipril
C. Simvastatin
D. Flecainide
E. Sotalol
Digoxin also requires potassium and magnesium levels to be within range before starting, as hypokalaemia increases the risk of digoxin toxicity.
How many hours after a dose of digoxin should a blood
sample be taken?
A. 2 hours
B. 1 hour
C. 6 hours
D. 24 hours
E. 12 hours
6 hrs
A patient has been admitted to hospital due to a possible
overdose of digoxin. Which of the following is an overdose
sign?
A. Yellow vision
B. Diarrhoea
C. Dizziness
D. Vomiting
E. Depression
One of the classic signs of digoxin toxicity is yellow or blurred vision, sometimes with a halo effect around lights (xanthopsia). This is due to digoxin’s effects on the optic nerve and retinal cells
Tranexamic acid can be used in the treatment of
menorrhagia. What is the maximum duration that it can
be used for?
QUESTION 11
A. 2 days
B. 3 days
C. 14 days
D. 4 days
E. 7 days
Tranexamic acid is an antifibrinolytic used to reduce heavy menstrual bleeding (menorrhagia). The recommended maximum duration of use for menorrhagia is 4 days per menstrual cycle.
A woman comes into the pharmacy explaining she has
been experiencing heavy bleeding and would like
something for it.
Having had a consultation with her, there are no red flags
and find it appropriate to make the sale of Tranexamic
acid to her.
What age range can tranexamic acid be sold to over-the-
counter?
A. 18-45
B. 16-80
C. 25-50
D. 18-40
E. 18-50
18-45
A risk assessment for venous thromboembolism has been
carried out on Mrs Y who has been admitted into hospital
due to falling down the stairs.
Within how many hours should thromboprophylaxis for
Mrs Y begin?
QUESTION 13
A. 10 hours
B. 5 hours
C. 1 hour
D. 14 hours
E. 24 hours
According to NICE guidelines, thromboprophylaxis should be initiated within 14 hours of hospital admission, provided there are no contraindications (e.g., active bleeding, high bleeding risk).
A patient is being treated for deep vein thrombosis with
warfarin.
What would be the most appropriate INR target?
A. 2.5
B. 3.5
C. 1.5
D. 6
E. 5
2.5
Dipyridamole can be used as secondary prevention of
ischaemic stroke not associated with atrial fibrillation. It is
given by mouth using modified-release medicines at a dose
of 200mg twice daily.
Which of the following is the most appropriate advice
regarding the storage of modified release dipyridamole
A. The original pack can be split to make up a
prescription
B. It can be stored up until the expiry date
C. No special advice is needed regarding storage
D. It should be dispensed in the original container and
any remaining capsules should be appropriately
discarded 6 weeks after opening
E. It should be dispensed in the original container and
any remaining capsules should be appropriately
discarded 8 weeks after opening
D
Rivaroxaban is a direct inhibitor of factor X which can be
used for the treatment of venous thromboembolism. Mr
Z has been newly prescribed rivaroxaban at a dose of
20mg daily for a while now where he is due for a
medicine use review at the pharmacy.
When he comes in to collect his medication you have a
review with him in the consultation room about all his
medications. Which of the following is an appropriate
reminder for Mr Z about rivaroxaban?
A. He should take rivaroxaban with food
B. He should take it on an empty stomach
C. He should take it before bed
D. He should take it 1 hour before breakfast
E. He should take rivaroxaban while standing up only
Rivaroxaban 15mg and 20mg doses should be taken with food to enhance absorption and ensure optimal anticoagulant effect.
Lower doses (e.g., 2.5mg, 10mg) can be taken with or without food.
Mr Z explains he has recently been finding it hard to
swallow his rivaroxaban tablets and if there is something
he could do about it.
Which of the following would be appropriate to give
advice?
A.There is nothing he can do, and he should not miss his
medications so should take it whole
B. Refer him to his GP for an alternative medicinal form
C. Advise him that he can crush his tablets and mix it with
either apple puree or water just before he is due to take his
medication and should immediately eat food after taking
Rivaroxaban.
D. Advise him that he can crush his tablets and mix it with
either apple puree or water just before he is due to take his
medication.
E. Advise him he can crush the tablets and mix it with
orange juice
Advise him that he can crush his tablets and mix it with
either apple puree or water just before he is due to take his
medication and should immediately eat food after taking
Rivaroxaban.
A few weeks later, Mr Z is admitted to hospital due to
falling. His creatinine clearance is measured whilst in
hospital. Which of the following creatinine clearance
levels would require Mr Z stopping his rivaroxaban
temporarily?
A.
<15ml/min
B.
<45ml/min
C.
<30ml/min
D.
<25ml/min
E.
<50ml/min
<15ml/min
Which of the following is an appropriate antidote for
rivaroxaban?
A. Idarucizumab
B. Andexanet alfa
C. Vitamin K
D. Digifab
E. Penicillamine
Andexanet alfa is a specific reversal agent for factor Xa inhibitors like rivaroxaban and apixaban. It works by binding to and sequestering the factor Xa inhibitors, thereby reversing their anticoagulant effects.
Mrs S has been treated for high blood pressure for the
past few months. However, her blood pressure still
remains high despite stepping up her anti-hypertensive
medications.
The doctor has decided to initiate her on Spironolactone,
but would need to take a potassium level first to check if
this is appropriate. Which of the following levels of
potassium would be appropriate to initiate
spironolactone?
A.
<4.5mmol/L
B.
<10mmol/L
C.
<7mmol/L
D.
<5mmol/L
E.
<8mmol/L
<4.5mmol/l
Following potassium levels being checked, it is
appropriate to initiate Spironolactone to Mrs S. The
doctor has asked her to come back within a month.
Which of the following would be most appropriate to
monitor in one month?
QUESTION 21
A. Renal function, magnesium levels and liver function
B. Renal function, potassium and sodium levels
C. Renal function, potassium and magnesium levels
D. Liver function, potassium and sodium levels
E. Liver function, potassium and calcium levels
Renal function, potassium, sodium levels
Why should beta blockers not be stopped suddenly in
patients being treated for ischaemic heart disease?
A. It can cause electrolyte disturbances
B. It can cause bronchospasms
C. It can cause rebound worsening of myocardial ischaemia
D. It can cause liver function to deteriorate
E. It can cause osteomyelitis
It can cause rebound worsening go Myocardial ischaemia
As a primary care pharmacist, you are working today on
telephoning patients for medication reviews. Whilst on
the phone to Mr E he explains how he has been getting a
lot of nightmares recently which means he wakes up
during the night.
Which of the following medications would be better for
him to help with this?
A. Atenolol
B. Propranolol
C. Acebutalol
D. Nebivolol
E. Labetalol
Atenolol
Mr S, a 50-year-old male, has had asthma since he was 10
years old. He has been using inhalers since then and has
well controlled asthma. He also has type 2 diabetes in
which he takes metformin 500mg twice a day.
He suffers from angina and is newly prescribed a beta
blocker to treat it. Which of the following would be the
most appropriate to prescribe?
A. Celiprolol
B. Carvedilol
C. Bisoprolol
D. Nadolol
E. Pindolol
Bisoprolol is a beta-1 selective blocker, which makes it a good choice for patients with asthma, as it has less potential to cause bronchoconstriction compared to non-selective beta-blockers. It also effectively treats angina and is commonly prescribed for patients with both cardiovascular conditions and asthma.
