Medicines 38 Flashcards
If mebendazole cant be given for threadworm what is the advice?
🪱 Threadworm Treatment – Hygiene Measures Only
When?
✅ Consider hygiene measures alone when:
Drug treatment is not wanted
Drug treatment is not recommended (e.g. during pregnancy)
How?
Follow strict hygiene measures (see “Practical Tips”) for 6 weeks:
🧼 Wash hands and nails regularly
🧺 Wash bedding, towels, and clothes frequently
🚽 Clean bathrooms and toilets daily
👕 Wear tight-fitting underwear at night
🛑 Avoid nail biting and thumb-sucking
Why?
➡️ After 6 weeks, all intestinal worms die naturally
➡️ No new eggs ingested = no reinfection
What do the following words mean?
Orthopnoea
Apnoea
Orthopnoea 🛏️ – Shortness of breath when lying flat
Apnoea 😴 – Temporary cessation of breathing, especially during sleep
Which antimalarial can be bought OTC as a P medicine
Maloff Protect: Contains atovaquone 250 mg and proguanil hydrochloride 100 mg.
Which vaccines do people with splenectomy need (NHS)
People without a fully working spleen should also have the following extra immunisations:
pneumococcal vaccine
meningococcal ACWY conjugate vaccine (MenACWY)
meningococcal B vaccine (MenB)
influenza vaccine (flu) every year
What are the steps to take if someone is having anaphylaxis in the community pharmacy?
📞 Step 1:
Instruct another staff member to call 999 immediately — report a suspected anaphylaxis.
💉 Step 2:
Locate and administer adrenaline (e.g. EpiPen) right away.
‼️ Why This Order Matters:
MEP guidance: If a pharmacist gives adrenaline, they must ensure an ambulance is called.
Speed matters: Calling 999 ASAP ensures rapid medical support.
Delegation avoids delays in both treatment and emergency response.
What is the proper name for slapped cheek syndrome and the typical symptoms?
Erythema infectiosum
Often presents with cold-like symptoms initially (fever, runny nose).
Followed by a bright red rash on the cheeks – the “slapped cheek” appearance.
Caused by Parvovirus B19.
💊 What is Clonidine?
Clonidine is a centrally acting alpha-2 adrenergic agonist.
🔄 How it Works:
Reduces sympathetic outflow from the brain
Causes vasodilation and lowers heart rate
Leads to reduced blood pressure
🩺 Uses:
Hypertension (especially resistant hypertension)
ADHD (as a non-stimulant option)
Withdrawal symptoms (opioids, alcohol, nicotine)
Menopausal flushing
Migraine prophylaxis (off-label)
What class of drugs does theophylline belong to?
Xanthines
If someone has bad adherence on oral antipsychotic medications, what is the recommended treatment?
Depot Injections of the antipsychotic ( usually one that has previously been effective orally for them)
Which two antipsychotics cause the most weight gain ?
“COW”
CLOZAPINE
OLANZAPINE
WEIGHT GAIN
What can be given to try and help with parkonsonium like symptoms with 1st generation antipsychotics?
Procyclidine
Antimuscarinic that helps combat EPS
All Wales ACB score of 3
When should clozapine be given as an antipsychotic?
Clozapine is generally offered to people who do not respond adequately to two other antipsychotics and is always initiated and monitored in secondary care. (NICE)
What does Onchomycosis?
Onycho- 👉 Greek: “onyx” = nail
-myc- 👉 Greek: “mykes” = fungus
-osis 👉 Suffix meaning: condition or disease
💡 Put Together:
Onycho + myc + osis
= Condition of fungal infection of the nails
What does chronic lithium use lead to
Chronic kidney damage
Can also cause hypothyroidism
Can increase calcium
What are the signs and symptoms to look out for with lithium use ?
⚠️ What to Report Immediately
Patients & carers should seek medical attention if any of the following occur:
🚨 Signs of lithium toxicity (e.g. tremor, confusion, ataxia)
🦋 Hypothyroidism symptoms (e.g. fatigue, weight gain, cold intolerance)
🛁 Renal dysfunction – especially polyuria & polydipsia
😵💫 Benign intracranial hypertension – persistent headache & visual disturbances
🔁 Signs of relapse (of bipolar disorder)
💧 Fluid & Diet Advice
Maintain adequate fluid intake
Avoid major sodium intake changes
Watch out for dehydration risks:
Excessive alcohol
Vomiting/diarrhoea 🤢
Hot climates ☀️
What do the lithium treatment packs include?
Lithium Treatment Pack Includes:
📘 Patient information booklet
💳 Lithium alert card
📈 Serum lithium level record book
What is zuclopentixol acetate?
A type of antipsychotic (less used now due to dangers)
used for managing schizophrenia and acute psychotic episodes, as well as agitation or violent behavior in some conditions.
Reaches peak effect 12 hours after dose
No more effective than haloperidol, only benefit over haloperidol is length of time of acting
By which route will the soluble insulin be administered for DKA treatment? (NICE)
Intravenous infusion
What is DKA charecterised by ?
Hyperglycaemia:
Blood glucose above 11 mmol/L or known diabetes mellitus.
Ketonaemia:
Capillary or blood ketone level above 3 mmol/L.
Significant ketonuria (2+ or more).
Acidosis:
Bicarbonate level less than 15 mmol/L.
Venous pH less than 7.3.
⚠️ Common Signs & Symptoms:
Dehydration (due to polydipsia & polyuria)
Weight loss
Excessive tiredness
Nausea & vomiting
Abdominal pain
Kussmaul respiration (rapid & deep breathing)
Acetone breath (fruity smell)
Reduced consciousness
What are the main acetylcholinesterase (AChE) inhibitors used in dementia?
AChE inhibitors include donepezil, rivastigmine and galantamine.
Remember by “GRANDMA DOESNT REMEMBER”
NOT AChE but
memantine is now recommended as an option for managing moderate Alzheimer’s disease for people who cannot take AChE inhibitors, and
as an option for managing severe Alzheimer’s disease
note that memantine may be used in combination an AChE inhibitor (1)
Whats the difference between Menorrhagia & Dysmenorrhoea?
🔹 Dysmenorrhoea = Painful Periods
“DYS” = Discomfort
Think: “DYS = Discomfort with Your Stomach”
It’s all about cramping, lower abdominal pain, often just before or during menstruation.
🔹 Menorrhagia = Heavy Bleeding
“MENOR” sounds like “More”
Think: “Menorrhagia = More blood”
Defined as excessive or prolonged menstrual bleeding (e.g., soaking through pads/tampons, periods lasting >7 days).
WHat are the risk factors for heart disease?
Your risk of developing atherosclerosis is significantly increased if you:
smoke
have high blood pressure (hypertension)
have high cholesterol
have high levels of lipoprotein (a)
do not exercise regularly
have diabetes
Other risk factors for developing atherosclerosis include:
being obese or overweight
having a family history of CHD
Why are Beta-2 agonists cautioned in diabetes?
Beta-2 agonists (e.g. salbutamol) can:
Increase blood glucose levels
Mask signs of hypoglycaemia
⚠️ Intravenous salbutamol can lead to ketoacidosis
→ Especially in insulin-dependent diabetics
What is the guidance for malaria prophylaxis in pregnancy?
🚫 Travel Advice
Avoid travel to malarious areas during pregnancy where possible.
If unavoidable, counsel on risks vs benefits of effective prophylaxis.
✅ Antimalarial Options in Pregnancy
🔹 Chloroquine
✔️ Safe in all trimesters
❌ Often not effective due to widespread resistance
🔹 Mefloquine
✔️ Can be used in 2nd and 3rd trimesters
⚠️ May be considered in 1st trimester only if benefits outweigh risks
🔹 Doxycycline
❌ Contraindicated in pregnancy
⚠️ May be used if essential, only if completed before 15 weeks’ gestation (unlicensed use)
🔹 Atovaquone + Proguanil (Malarone)
❌ Avoid in pregnancy
✔️ Consider in 2nd or 3rd trimester if no suitable alternatives
🧬 Supplement with high-dose folic acid (5 mg daily) due to neural tube defect risk
