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.
Hydrochlorothiazide is an example of a thiazide like
diuretic which is available as a combination product.
Which of the following is the most appropriate MHRA
advice?
A. Increase risk of osteoporosis
B. Risk of non-melanoma skin cancer
C. Hypokalaemia risk
D. Arrhythmia risk
E. Risk of severe diarrhoea
Hydrochlorothiazide and other thiazide diuretics have been associated with an increased risk of non-melanoma skin cancer (NMSC), particularly with long-term use. The MHRA has issued warnings regarding this risk, as exposure to sunlight while taking these medications may increase the risk of developing NMSC.
A patient’s eGFR is measured whilst admitted in hospital.
At what eGFR should thiazide diuretics be avoided?
A.
<45ml/min/1.73m2
B.
<30ml/min/1.73m2
C.
<20ml/min/1.73m2
D.
<35ml/min/1.73m2
E.
<25ml/min/1.73m2
<30ml/min/1.73m2
You have a trainee pharmacist working with you. You are
teaching them all about ACE inhibitors.
Which of the following ACE inhibitors would be most
appropriate to take 30-60 mins before food?
A. Ramipril
B. Captopril
C. Perindopril
D. Lisinopril
E. Enalapril
perindopril should be taken 30-60 minutes before food for optimal absorption.
Which electrolyte disturbance is most likely to occur with
ACE inhibitors
A. Hyperkalaemia
B. Hypokalaemia
C. Hyponatraemia
D. Hypermagnesemia
E. Hypercalcaemia
Hyperkalemia
You are a locum pharmacist working at your regular
store. You are checking a prescription with the following
medications and decide to contact the GP.
What would be the most appropriate reason for
contacting the GP?
Amlodipine 10mg - One to be taken daily
Losartan 50mg - One to be taken daily
Simvastatin 80mg - One to be taken at night
Cyanocobalamin 50mcg - One to be taken three times a
day
A. Interaction between Amlodipine and Losartan
B. Query the Losartan dose as it is an inappropriate dose
C. Query the Simvastatin dose as it is too high as the
patient is also on Amlodipine
D. Patient has been inappropriately prescribed
Cyanocobalamin
E. The directions for simvastatin is incorrect on the
prescription
Query the Simvastatin dose as it is too high as the
patient is also on Amlodipine
Nicorandil can be used in the treatment of angina as it
works as a vasodilator.
Which of the following side effects would require
stopping nicorandil?
A. Mouth ulcers
B. Dizziness
C. Headache
D. Haemorrhage
E. Angioedema
Mouth ulcers
Which of the following anti-epileptic medications does
not need to be brand prescribed?
A. Carbamazepine
B. Lamotrigine
C. Phenobarbital
D. Phenytoin
E. Primidone
Lamotrigine is one of the anti-epileptic drugs (AEDs) that does not require brand prescribing. Unlike other AEDs such as phenytoin, carbamazepine, or phenobarbital, which may have significant variations between brands in terms of bioavailability, lamotrigine is generally considered to be less prone to such issues. Therefore, generic versions of lamotrigine are usually considered to be equivalent to the branded product, and it is often safe to prescribe generic versions without needing to specify a particular brand.
Patient Y has had epilepsy since he was 11 years old and
since has been on anti-epileptic medication thus has
well-controlled epilepsy. He has passed his driving test
and is going to be driving a car from next week which
was gifted to him.
Which of the following is the most appropriate DVLA
recommendation regarding driving with epilepsy?
A. Patients should not drive during medication changes
or withdrawal of anti-epileptic drugs, and for 6 months
after their last dose
B. Patients do not need to take extra precautions when
driving
C. Patients who have had a first unprovoked epileptic
seizure or a single isolated seizure must not drive for 6
months.
D. If a driver has a seizure they must stop driving and
immediately notify DVLA
E. Patients are able to drive 30 minutes after a seizure
D. If a driver has a seizure they must stop driving and
immediately notify DVLA
Carbamazepine is an anti-epileptic which has many
indications, one being for the treatment of generalised
tonic clonic seizures.
Which of the following is the most appropriate target
level for carbamazepine?
A. 10-20mg/L
B. 1.5-3mcg/L
C. 4-12mcg/L
D. 3-10mcg/L
E. 5-7mcg/L
4-12 mcg/L
A patient has been initiated on Carbamazepine, as you
are handing out the prescription you provide some
advice regarding his medication.
Which of the following is the most appropriate advice to
provide?
A. Take it on an empty stomach 2 hours before food
B. Advise him to see a GP in 4 months for a review
C. Advise him to seek immediate medical attention if he
gets any visual disturbances
D. Advise him to seek immediate medical attention if a
fever, rash, mouth ulcers, bruising or bleeding develops
E. Advise him to stop taking his medication if he starts
vomiting
The most appropriate advice is D. Advise him to seek immediate medical attention if a fever, rash, mouth ulcers, bruising, or bleeding develops.
Explanation: Carbamazepine is known to potentially cause serious adverse effects such as severe skin reactions, blood disorders (e.g., agranulocytosis, thrombocytopenia), and liver toxicity. Symptoms like fever, rash, mouth ulcers, bruising, or bleeding can be signs of a potentially serious reaction, such as Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN), and the patient should seek immediate medical attention.
You are providing a lunchtime teaching session at the
hospital regarding anti-epileptic medication as there
have been numerous prescribing and administration
errors being reported on the hospital reporting system.
Which of the following is the most appropriate advice
regarding phenytoin?
A. Phenytoin should not be given intramuscularly due to
the absorption being slow and erratic
B. Patients who are being enteral fed, feeding should be
interrupted 1 hour before and after a phenytoin dose
C. Injection solution is acidic and is therefore irritant to
tissues
D. The total plasma phenytoin concentrations should be
between 15-20mg/L for adults.
E. Patients can be prescribed different brands of
phenytoin
Phenytoin should not be given intramuscularly due to
the absorption being slow and erratic
Miss E, has been prescribed Sodium Valproate.
Which of the following indications would be most
appropriate to prescribe Sodium Valproate to Miss E?
A. Migraine prophylaxis
B. Bipolar prophylaxis
C. Epilepsy
D. Depression
E. Schizophrenia
Epilepsy
A prescription from the hospital for Concerta XL has been
received by the pharmacy for a 12 year old boy. The
patient is a regular patient and you recognise his mum
very well when she comes in to collect the prescription.
The prescription states
“Concerta XL 18mg once daily in
the morning, supply 56 days
”.
Which of the following would be the most appropriate
reason for not dispensing this medication and querying
the prescription?
A. Dosage is incorrect
B. Prescription has exceeded maximum supply
C. The medication is not suitable for the patient
D. Direction are incomplete
E. Modified release preparations of methylphenidate do
not need to be brand prescribed and you do not have
this brand in stock as there is a current stock issue so
would require another prescription
Explanation: Concerta XL (a modified-release form of methylphenidate) is typically prescribed with a maximum supply of 30 days at a time for safety and regulatory reasons. In this case, the prescription for 56 days exceeds the usual supply limit for a controlled substance like methylphenidate, which is often prescribed in monthly quantities.
Mr F is 60years old and has been on lithium for 4 years
now for the treatment of bipolar disorder. He has been
having no problems with his medication and has no
other medical conditions.
Which of the following would be the most appropriate
monitoring requirements?
A. Monitoring of BMI, eGFR, electrolytes, and thyroid
function every 6 months
B. Monitor BMI, renal, cardiac and electrolytes every 6
months
C. Monitor BMI, thyroid, cardiac and electrolytes every 6
months
D. Monitor BMI, eGFR, electrolytes, and thyroid function
every year
E. Monitor BMI, renal, ECG, and electrolytes every 6
months
Monitoring of BMI, eGFR, electrolytes, and thyroid
function every 6 months
Which of the following would be a contraindication for
lithium carbonate?
A. Concomitant diuretic treatment
B. Untreated hypothyroidism
C. Elderly
D. Epilepsy
E. Myasthenia gravis
Explanation: Lithium carbonate is commonly used to treat bipolar disorder, but it can affect thyroid function. Untreated hypothyroidism is a contraindication for lithium use because lithium can exacerbate hypothyroidism or worsen existing thyroid problems, especially in patients with untreated thyroid conditions.
You are working in a GP surgery where you are looking at
medicine shortages. There is a limited stock issue with
Lithium Carbonate and there are multiple patients at the
surgery who are on this medication.
What would be the most appropriate advice to provide in
regards to the stock issues?
QUESTION 40
A. Patients are fine to be switched to alternatives
antipsychotics
B. The dose should be reduced gradually over 2 weeks
C. Advice changing therapy to an atypical antipsychotic
or sodium valproate
D. Evaluate whether patients need to be on lithium
therapy
E. Patient can be switched to carbamazepine
Advice changing therapy to an atypical antipsychotic
or sodium valproate
Miss H is currently on Sertraline. She has been initiated on
Diclofenac for pain she has been experiencing for the
past couple of weeks.
Which of the following electrolyte imbalance is most
likely to occur?
A. Hyperkalaemia
B. Hypomagnesemia
C. Hypernatremia
D. Hypercalcaemia
E. Hyponatraemia
Explanation: Both sertraline (a selective serotonin reuptake inhibitor, SSRI) and diclofenac (a non-steroidal anti-inflammatory drug, NSAID) can contribute to the development of hyponatraemia.
Sertraline (SSRI) can cause hyponatraemia, particularly in elderly patients or those taking diuretics. This occurs due to the drug’s potential to increase the secretion of antidiuretic hormone (ADH), leading to water retention and dilution of sodium in the blood.
Diclofenac (NSAID) can cause fluid retention and reduce kidney function, which may exacerbate or contribute to the risk of hyponatraemia
Mr W suffers from Parkinson
s disease and has been
drooling Saliva more than normal recently.
What would be the most appropriate first line treatment?
A. Refer him to the speech and language therapist
B. There is no treatment for this side effect
C. Glycopyrronium bromide
D. Salivix pastilles
E. Botulinum toxin type A
Refer to speech and language
According to the MHRA advice for Metoclopramide.
What would be the most appropriate dose to prescribe?
A. 10mg repeated up to four times a day for seven days
B. 10mg repeated up to three times a day for five days
C. 10mg repeated up to three times a day for seven days
D. 10mg repeated up to four times a day for five days
E. 10mg repeated up to three times a day for ten days
Explanation: According to MHRA advice, metoclopramide should be prescribed as follows:
10mg up to three times a day, and this should not be continued for more than 5 days due to the risk of serious side effects, such as tardive dyskinesia.
A patient comes in explaining he has been binge eating
for the past two weeks and he just cannot seem to stop
and he is a bit concerned because he has gained a lot of
weight in the past two weeks.
Which of the following medications is most likely to
cause this?
A. Co-careldopa
B. Risperidone
C. Sertraline
D. Bromocriptine
E. Selegiline
Co-careldopa - impulse control
Which of the following antidepressants are the most
sedative?
A. Clomipramine
B. Imipramine
C. Lofepramine
D. Nortriptyline
E. Sertraline
Clomipramine
How many weeks should you wait before starting
Tranylcypromine for a patient previously on Mirtazapine?
A. 1 week
B. 2 weeks
C. 4 weeks
D. 3 days
E. 5 weeks
1 week
Which of the following is a symptom of serotonin
syndrome?
A. Tachycardia
B. Bradycardia
C. Constipation
D. Hypothermia
E. Hyperkalaemia
Tacycardia
Which of the following is best described as an extra
pyramidal side effect?
A. Tardive dyskinesia
B. Weight gain
C. Hyperglycaemia
D. QT interval prolongation
E. Sexual dysfunction
Tardive dyskinesia
For how long should patients be monitored for relapse
after withdrawing from antipsychotic medication?
A. 1 month
B. 1 year
C. 2 years
D. 6 months
E. 3 years
2 years
As part of a teaching session on antipsychotics you
produce a presentation regarding first and second
generation antipsychotics. Both generations can be used
in treating schizophrenia.
However, they have different side effect profiles. Which of
the following antipsychotics would have the most
extrapyramidal side effects?
A. Chlorpromazine
B. Periciazine
C. Prochlorperazine
D. Sulpiride
E. Pimozide
Chlorpromazine
Mrs P comes in to collect her son’s repeat prescription.
She explains how she requested another spacer device
which has been dispensed.
She asks if cleaning it once a week is enough. What is the
most appropriate advice?
A. Explain that once a week cleaning is find to do
B. Explain that the spacer device does not need cleaning
C. Explain that the spacer should be cleaned once a
month with detergent and water
D. Explain that the spacer should be cleaned once a
month with detergent and water and air dry
E. Explain that the spacer should be cleaned once every
two months with detergent and water and air dry
Explain that the spacer should be cleaned once a
month with detergent and water and air dry
A pre registration pharmacist is sitting in on an asthma
clinic with an asthma nurse. A patient comes in who is
currently taking salbutamol two puffs when required,
Qvar inhaler two puffs twice a day.
However, the patient explains he is waking up at night
and has to use their salbutamol inhaler every day. What
would be the most appropriate next step according to
the NICE guidelines?
A. Montelukast
B. Salmeterol
C. Theophylline
D. Tiotropium
E. Prednisolone
According to the NICE guidelines for the management of asthma, the most appropriate next step for a patient who is using their salbutamol inhaler more frequently, particularly at night, would be to add a long-acting beta agonist (LABA), such as Salmeterol.
Salmeterol is recommended when asthma is not well controlled with a short-acting beta agonist (like salbutamol) and an inhaled corticosteroid (such as Qvar) alone. It is important to note that LABAs should be prescribed in combination with an inhaled corticosteroid to avoid potential risks of monotherapy with LABA.
Ipratropium bromide can be used in the treatment of
asthma.
Which of the following would be the most appropriate
advice to provide a patient?
A. Diarrhoea is a common side effect of ipratropium
B. Counsel patients on administration of ipratropium
ensuring patients are made aware of accidental contact
with the eye
C. No specific advice is needed
D. Patients should not use this inhaler if they have
glaucoma
E. Inhale fast and deep when using this inhaler
Counsel patients on administration of ipratropium
ensuring patients are made aware of accidental contact
with the eye
Montelukast is an example of a leukotriene receptor
antagonist which is used in the treatment of asthma. Mrs
S has been newly prescribed Montelukast at a dose of
10mg in the evening.
What would be the most appropriate counselling advice
to provide when handing out medication?
A. Patients should be counselled on neuropsychiatric
reactions and should seek immediate medical attention
if any changes to speech and behaviour occur.
B. It should be taken 30 mins before bed
C. Vomiting and diarrhoea are common side effects
D. Crush the tablet before taking it
E. It can be crushed and mixed with orange juice if
needed
Patients should be counselled on neuropsychiatric
reactions and should seek immediate medical attention
if any changes to speech and behaviour occur.
Antimuscarinics can be used in the treatment of asthma
and COPD.
Which of the following are common side effects of
antimuscarinics?
A. Dry mouth
B. Constipation
C. Skin reactions
D. Blurred vision
E. Urinary disorders
Dry mouth
A patient has newly been prescribed a QVAR inhaler as
her symptoms were not being controlled from
salbutamol alone.
You gain consent for her to participate in the new
medicine service the pharmacy provides and you counsel
her on the correct inhaler technique.
Which of the following would be the most appropriate
technique for her new QVAR pMDI inhaler?
A. Inhale fast and deep
B. Inhale slow and steady
C. Breathe into the inhaler before you take a dose
D. Do not shake the inhaler before use
E. Hold your breath for one minute before exhaling
Inhale slow and steady
Which of the following MHRA advice is associated with
corticosteroid use?
A. Visual disturbances as there is a risk of serous
chorioretinopathy
B. Candidiasis
C. Diabetes
D. Osteoporosis
E. Hypernatraemia
Visual disturbances as there is a risk of serous
chorioretinopathy
Miss T has been using a salbutamol inhaler for the past
year. She has been getting on with it fine and has rarely
needed to use it. But she comes in to collect a new
prescription of a low dose inhaled corticosteroid.
Which of the following reasons would Miss T need an
addition of a corticosteroid inhaler?
A. Using her salbutamol inhaler once a week
B. Symptomatic three times a week or more
C. Not waking up at least one night a week
D. Never using her Salbutamol inhaler
E. Her Salbutamol inhaler has finished
Symptomatic three times a week or more
As part of a lunchtime teaching session on asthma at
your GP practice. You are running through the signs of an
asthma attack.
Which of the following would NOT be a sign of an acute
severe asthma attack?
A. PEF of 33-50%
B. Unable to complete one sentence
C. PEF >50-75%
D. Respiratory rate of >25/min
E. Arterial oxygen saturation of >92%
C. PEF >50-75%
Inhaled corticosteroids are a cause of oral candidiasis and
there are ways to prevent this.
Which of the following would be the most appropriate
advice?
A. Advise her to rinse her mouth after using her
corticosteroid inhaler
B. Use her inhaler after food
C. Advise her to rinse her mouth before using her
corticosteroid inhaler
D. Advise her to take the doses every other day to reduce
the risk of candidiasis
E. Use her inhaler 30 mins before food
A. Advise her to rinse her mouth after using her
corticosteroid inhaler
