OfB 2022

Question 1

Medicine A has a plasma elimination half-life of 9 hours.
How long will it take for the plasma concentration to drop to 25% of the
peak level?
(1 Point)
A 2.25 hours
B 4.5 hours
C 9 hours
D 18 hours
E 27 hours

Answer 1

• D 18 hours
• after 9hr = 50%
  after 18hr = 25%

Question 2

max age to sell sildenafil as OTC

Answer 2

no max age

Question 3

It is Tuesday morning, a 15-year-old girl presents at the pharmacy, requesting
the morning after pill. On questioning she tells you that she had unprotected
sexual intercourse Sunday night but has been embarrassed to come in for
advice. During the consultation it is clear that she doesn’t want to see another
healthcare professional or become pregnant. She is competent in making
decisions regarding her treatment.
What would be the best action to take for this patient?
(1 Point)
A do not supply and contact the Local Safeguarding team as she is under 16
B sell her one pack of Levonelle One Step (levonorgestrel) over the counter to take straight
away.
C sell her one pack of EllaOne (ulipristal acetate) over the counter to take straight away.
D send her to see her GP straight away to have a copper IUD fitted.
E signpost her to a family planning clinic for a consultation regarding future contraception.

Answer 3

C sell her one pack of EllaOne (ulipristal acetate) over the counter to take straight away.

Question 4

A 64-year-old patient with rheumatoid arthritis is
taking hydroxychloroquine. Co-administration of certain drugs is associated
with an increased risk of cardiovascular events (including angina or chest pain
and heart failure) and cardiovascular mortality.
Which of the following drugs does this apply to?
(1 Point)
A amoxicillin
B azithromycin
C ciprofloxacin
D flucloxacillin
E metronidazole

Answer 4

B azithromycin

Question 5

Which of the following long-acting beta 2 agonist/long-acting muscarinic
agonist combinations is available in a Respimat inhaler device?
(1 Point)
A aclidinium/formoterol
B glycopyyronium/indacaterol
C glycopyyronium/formoterol
D umeclidinium/vilanterol
E tiotroprium/olodaterol

Answer 5

E tiotroprium/olodaterol

Question 6

Which of the following statements is FALSE in relation to the ‘off-label’ use
of a medicine?
(1 Point)
A ‘Off-label’ use means that the medicine is being used in a way that is different to that
described in the license
B An example of using a medicine ‘Off-label’ would be to prescribe a medicine for an age
group outside the licensed range
C An ‘off-label’ medicine would have a license in other countries but not in the UK
D When using medicines ‘Off-label’, Patient Information Leaflets (PILs) may not contain
information on the use of the medicine for the ‘Off-label’ indication
E The use of metformin in polycystic ovary syndrome is ‘off-label

Answer 6

C An ‘off-label’ medicine would have a license in other countries but not in the UK

Question 7

A dose of medicine is made by diluting one part of concentrate to five parts of
water.
How much of the concentrate will there be in a 30 mL dose?
(1 Point)
A 4 mL
B 5 mL
C 6 mL
D 7 mL
E 8 mL

Answer 7

B 5 mL

Question 8

A 76-year-old man presents with jaundice. His liver function tests reveal a raised
bilirubin and alkaline phosphatase.
Which antibiotic is most likely to have been a significant factor in
the following scenario?
(1 Point)
A co-amoxiclav
B trimethoprim
C doxycycline
D amoxicillin
E clindamycin

Answer 8

A co-amoxiclav

Question 9

Which of the following cautionary and advisory labels /recommended
label wording for dispensed medicines applies to phenoxymethylpenicillin
tablets?
(1 Point)
A … an hour before food or on an empty stomach
B Avoid exposure of skin to direct sunlight or sun lamps
C Do not take indigestion remedies or medicines containing iron or zinc at the same time of
day as this medicine
D … sucked or chewed
E … with or after food

Answer 9

A … an hour before food or on an empty stomach

Question 10

Which of the following statements about OTC desogestrel is correct?
(1 Point)
A it is licensed from 16 years
B the first tablet should be taken on the first day after menstrual bleeding.
C it should be taken for 21 days followed by a 7 day break
D it can be started or restarted on the same day as emergency contraception containing
levonorgestrel
E if the user is less than 24 hours late from her usual time of taking any tablet, she should take
the missed tablet as soon as she remembers and take the next tablet at the usual time, even if
it leads to taking two tablets in one day.

Answer 10

D it can be started or restarted on the same day as emergency contraception containing

Question 11

Fexofenadine 120 mg is available OTC as GSL
From what age is it licensed?
(1 Point)
A 10
B 12
C 14
D 16
E 18

Answer 11

B 12

Question 12

A new drug has been developed which undergoes extensive first pass
metabolism.
Which would be the most appropriate dosage form for systemic drug
delivery to avoid this problem?
(1 Point)
A enteric coated tablet
B immediate release tablet
C modified release capsule
D modified release tablet
E sublingual tablet

Answer 12

E sublingual tablet

Question 13

Which of the following is the most appropriate ear drop to recommend a
GP prescribe for a child with Otitis Media?
(1 Point)
A dexamethasone/framycetin/graicidin (Sofradex)
B dexamethasone/glacial acetic acid/neomycin sulfate (Otomize)
C flumetasone/clioquinol
D gentamicin/hydrocortisone
E lidocaine hydrochloride/phenazone (Otigo)

Answer 13

E lidocaine hydrochloride/phenazone (Otigo)

Question 14

Mr B, a 19-year-old, has recently joined a running club “to try and get fit”. He
comes to the pharmacy for advice on a “personal problem”. Once inside the
consultation room, Mr B tells you that he has developed “soreness on the skin
in the groin of his legs” and that “the area is wet and itchy and smells a little”.
Which of the following treatment options is most appropriate for Mr B?
(1 Point)
A encourage regular washing of the area, morning and night and after exercising.
B apply miconazole cream, three times a day for up to fourteen days.
C apply clotrimazole/hydrocortisone cream for up to seven days.
D refer to the GP for further investigation and a prescription if necessary.
E suggest he use an aerosol deodorant around his groin area.

Answer 14

C apply clotrimazole/hydrocortisone cream for up to seven days.

Question 15

Of the following antidepressants, for which one is it essential you counsel
the patient on the possibility of a hypertensive crisis?
(1 Point)
A lofepramine
B phenelzine
C sertraline
D trazadone
E venlafaxine

Answer 15

B phenelzine

Question 16

A 37-year-old woman is admitted to hospital for treatment of possible
diverticulitis. Her notes state that she is allergic to penicillin; the nature of the
reaction is gastrointestinal disturbance and diarrhoea. On further questioning,
she says she gets an “upset stomach” and diarrhoea when taking oral penicillins
and will not ingest these medicines. She says she does not experience any
itchiness, rash, swelling or other symptoms when taking penicillin.
What is the most appropriate antibiotic(s) to recommend?
(1 Point)
A amoxicillin 500 mg three times a day for 5 days
B co-amoxiclav 500/125 mg three times a day for 5 days
C cefalexin 500 mg twice a day for 5 days with Metronidazole: 400 mg three times a day for 5
days
D cefalexin 500 mg twice a day with trimethoprim: 200 mg twice a day for 5 days

Answer 16

B co-amoxiclav 500/125 mg three times a day for 5 days

Question 17

A breastfeeding woman presents with a swollen area on her breast that is feel
hot and painful to touch. The area is red and there is a burning pain in her
breast that is constant. This started one hour ago.
What is the most appropriate advice to give?
(1 Point)
A A & E
B give appropriate advice
C no action necessary
D see GP for routine appointment
E see GP for urgent appointment

Answer 17

B give appropriate advice

Question 18

Which of the following is the most appropriate to use to assess bleeding
risk?
(1 Point)
A ORBIT
B CHADSVASC2
C HASBLED
D CENTOR CRITERIA
E FEVERPAIN

Answer 18

A ORBIT

Question 19

Fournier’s gangrene is a rare but serious and potentially life-threatening
infection.
Which of the following medicines can it occur with?
(1 Point)
A ertugliflozin
B glimepiride
C exenatide
D linagliptin
E pioglitazone

Answer 19

A ertugliflozin

Question 20

Which of the following diuretics may cause urine to look slightly blue in
some lights?
(1 Point)
A amiloride
B bendroflumethiazide
C bumetanide
D furosemide
E triamterene

Answer 20

E triamterene

Question 21

There is an increased risk of infantile hypertrophic pyloric stenosis following
exposure to this drug and the risk is particularly increased in the first 14 days
after birth.
Which of the following does this apply to?
(1 Point)
A amoxicillin
B ciprofloxacin
C erythromycin
D metronidazole
E trimethoprim

Answer 21

C erythromycin

Question 22

You are discussing OTC naproxen with your counter assistant.
The maximum duration of continuous treatment in any one cycle (period)
is:
(1 Point)
A 2 days
B 3 days
C 5 days
D 6 days
E 7 days

Answer 22

B 3 days

Question 23

A 32-year-old woman asks you for advice as she feels like she may be suffering
with mild depression. She asks if she can buy St John’s Wort over the counter as
she has heard that it is good for depression. The only medication she takes is
Cilest (combined oral contraceptive pill). You tell her that these two medications
should not be taken together.
What is the mechanism of the interaction?
(1 Point)
A St John’s Wort chelates with the combined oral contraceptive in the stomach, reducing
absorption and increasing the risk of pregnancy
B St John’s Wort induces the enzyme that metabolises the combined oral contraceptive and so
there is an increased risk of pregnancy
C The combined oral contraceptive increases the rate of stomach emptying leading to a
reduced antidepressant effect of St John’s Wort
D The combined oral contraceptive induces the enzyme that metabolises St John’s Wort
leading to a reduced antidepressant effect
E The combined oral contraceptive inhibits the enzyme that metabolises St John’s Wort and so
there is an increased risk of serotonin syndrome

Answer 23

B St John’s Wort induces the enzyme that metabolises the combined oral contraceptive and so

Question 24

A patient presents in your pharmacy with a unilateral deep red eye, the redness
is most intense around the ciliary flush (circumcorneal). The patient is
complaining of pain, deep within the eye which is worse when looking at a light
source. The pupil of the affected eye is smaller than that of the normal eye.
Which of the following is the most likely diagnosis?
(1 Point)
A Anterior Uveitis
B Bacterial conjunctivitis
C Keratitis
D Scleritis
E Sub-conjunctival haemorrhage

Answer 24

A Anterior Uveitis

Question 25

A 56-year-old patient is prescribed phenobarbital 30 mg tablets and your
dispenser orders it from your wholesaler as you have none in stock.
Which of the following is the best summary of the legal restrictions that
apply?
(1 Point)
A No register entry required, safe custody required, 28 days prescription validity
B No register entry required, no safe custody required, 28 days prescription validity
C No register entry required, no safe custody required, 6 months prescription validity

Answer 25

B No register entry required, no safe custody required, 28 days prescription validity

Question 26

Documentation is an important part of the Quality Assurance Process.
Which of the following is correct when making alterations to the entry on
a Standard Operating Procedure document?
(1 Point)
A the reason for the alteration does not need to be recorded.
B the alteration does not need to be signed.
C alteration does not need to be dated.
D alteration should permit the reading of the original information.
E you are allowed to cross out the original information

Answer 26

D alteration should permit the reading of the original information.

Question 27

You receive a private prescription for Dronabinol.
Which of the following statements is correct?
(1 Point)
A dronabinol is a licensed product
B dronabinol is a schedule 4 CD
C the prescription should be on a FP10PCD or equivalent
D it is used for morning sickness
E it can be prescribed by any GP

Answer 27

C the prescription should be on a FP10PCD or equivalent

Question 28

A 42-year-old man with chronic heart failure is prescribed metformin and
his HbA1c is not controlled below his agreed threshold.
What is the most appropriate drug that should be prescribed next?
(1 Point)
A dapagliflozin
B gliclizade
C pioglitazone
D sitagliptin
E tolbutamide

Answer 28

A dapagliflozin

Question 29

A 45-year-old man is using digoxin for for atrial fibrillation.
His next digoxin dose should be omitted if the heart rate drops below:
(1 Point)
A 60 beats per minute
B 70 beats per minute
C 80 beats per minute
D 90 beats per minute
E 100 beats per minute

Answer 29

A 60 beats per minute

Question 30

Which of the following drugs is an intermediate-acting insulin?
(1 Point)
A isophane insulin
B insulin aspart
C insulin lispro
D insulin glulisine
E insulin detemir

Answer 30

A isophane insulin

Question 31

carbimazole s/e common

Answer 31

sore throat

Question 32

A patient on digoxin for heart failure should not be given this drug without
considering a reduction in the dose of digoxin.
(1 Point)
A atenolol
B atorvastatin
C bendroflumethiazide
D captopril
E losartan
F milrinone
G simvastatin
H verapamil

Terms of use

Answer 32

H verapamil

Question 33

You are a community pharmacist. A 30-year-old woman presents one day in
August with a blocked, itchy nose. She has been sneezing; her nasal discharge
is runny and clear. She has had the symptoms for the past few weeks. She has
been taking cetirizine tablets daily for the past week or so but she is still
experiencing symptoms. She has no other significant medical conditions.
(1 Point)
A aciclovir
B amoxicillin
C cetirizine
D clotrimazole
E fluticasone
F Reassure patient, no treatment necessary
G Refer to Accident & Emergency department

Answer 33

E fluticasone

Question 34

Mrs DL presents with a 2 week history of excessive facial sweating and dizziness
on standing.
(1 Point)
A Acute kidney injury
B Autonomic neuropathy
C Chronic kidney disease
D Hypoglycaemia
E Ketoacidosis
F Hyperosmolar hyperglycaemic state (HHS)
G Peripheral neuropathy

Answer 34

B Autonomic neuropathy

Question 35

Mr TG presents with a 4 week history of reduced urine output, tiredness and
itching.
(1 Point)
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A Acute kidney injury
B Autonomic neuropathy
C Chronic kidney disease
D Hypoglycaemia
E Ketoacidosis

Answer 35

C Chronic kidney disease

Question 36

Mrs GH presents with hyperventilation and vomiting.
(1 Point)
A Acute kidney injury
B Autonomic neuropathy
C Chronic kidney disease
D Hypoglycaemia
E Ketoacidosis
F Hyperosmolar hyperglycaemic state (HHS)
G Peripheral neuropathy
H Retinopathy

Answer 36

E Ketoacidosis

Question 37

Simvastatin (drug A) and clarithromycin (drug B)
(1 Point)
A change dosing regimen of drug B
B increase dose of drug A
C monitor plasma levels of drug A
D monitor plasma levels of drug B
E reduce dose of drug A
F stop drug A temporarily
G stop drug A and recommend a drug from a different class
H stop drug B and recommend a drug from a different class

Answer 37

F stop drug A temporarily

Question 38

levonorgestrel/ethinylestradiol (drug A) and carbamazepine (drug B)
(1 Point)
A change dosing regimen of drug B
B increase dose of drug A
C monitor plasma levels of drug A
D monitor plasma levels of drug B
E reduce dose of drug A
F stop drug A temporarily
G stop drug A and recommend a drug from a different class

Answer 38

B increase dose of drug A

Question 39

A 28-year-old pregnant woman presenting with a red eye which feels gritty and
is producing sticky discharge.
(1 Point)
A aciclovir
B amorolfine
C amoxicillin
D chloramphenicol
E ciprofloxacin
F clotrimazole
G flucloxacillin
H fusidic acid

Answer 39

H fusidic acid

Question 40

A 67-year-old man presents with symptoms suggestive of prostatitis. There is
no blood in his urine, and renal function is normal.
(1 Point)
A aciclovir
B amorolfine
C amoxicillin
D chloramphenicol
E ciprofloxacin
F clotrimazole

Answer 40

E ciprofloxacin

Question 41

Patient A is 4-months-old and has been prescribed paracetamol 120 mg/5 mL.
(1 Point)
A one 2.5 mL spoonful up to twice a day
B one 2.5 mL spoonful up to four times a day
C one 5 mL spoonful up to four times a day
D one 5 mL spoonful and a one 2.5 ml spoonful up to four times a day
E two 5 mL spoonfuls up to four times a day
F two 5 mL spoonfuls and one 2.5ml spoonful up to four times a day
G three 5 mL spoonfuls up to four times a day
H four 5 mL spoonfuls up to four times a day

Answer 41

B one 2.5 mL spoonful up to four times a day

Question 42

Patient B is 12-years-old and has been prescribed paracetamol 250 mg/5 mL
(1 Point)
A one 2.5 mL spoonful up to twice a day
B one 2.5 mL spoonful up to four times a day
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C one 5 mL spoonful up to four times a day
D one 5 mL spoonful and a one 2.5 ml spoonful up to four times a day
E two 5 mL spoonfuls up to four times a day
F two 5 mL spoonfuls and one 2.5ml spoonful up to four times a day
G three 5 mL spoonfuls up to four times a day
H four 5 mL spoonfuls up to four times a day

Answer 42

E two 5 mL spoonfuls up to four times a day

Question 43

Patient C is 48-months-old and has been prescribed paracetamol 120 mg/5 mL
(1 Point)
A one 2.5 mL spoonful up to twice a day
B one 2.5 mL spoonful up to four times a day
C one 5 mL spoonful up to four times a day
D one 5 mL spoonful and a one 2.5 ml spoonful up to four times a day
E two 5 mL spoonfuls up to four times a day
F two 5 mL spoonfuls and one 2.5ml spoonful up to four times a day
G three 5 mL spoonfuls up to four times a day
H four 5 mL spoonfuls up to four times a day

Answer 43

E two 5 mL spoonfuls up to four times a day

Question 44

A 45-year-old, who has hyperkalaemia
(1 Point)
A alendronate
B atorvastatin
C clarithromycin
D gentamicin
E naproxen
F propranolol
G ramipril
H spironalactone

Answer 44

H spironalactone

Question 45

A 35-year-old with myasthenia gravis
(1 Point)
A alendronate
B atorvastatin
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C clarithromycin
D gentamicin
E naproxen
F propranolol
G ramipril
H spironalactone

Answer 45

D gentamicin

Question 46

A 77-year-old with uncontrolled heart failure
(1 Point)
A alendronate
B atorvastatin
C clarithromycin
D gentamicin
E naproxen
F propranolol
G ramipril
H spironalactone

Answer 46

F propranolol

Question 47

This should not be combined with a starch-based thickener as the two
compounds can counteract the thickening action and result in a thin watery
liquid — patients with swallowing difficulties (dysphagia) are potentially at
greater risk of aspiration of the thinner liquid.
(1 Point)
A cinchocaine
B glycerol
C loperamide
D macrogol
E misoprostol
F pancreatin
G prednisolone
H senna

Answer 47

D macrogol