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OTC Flashcards

1
Q

H2 antagonists e.g. ranitidine. What age can you sell them to OTC? Can you sell them to pregnant and breastfeeding women?

A

Over 16 years No

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2
Q

What is max dose of ranitidine OTC?

A

75 mg tablets Do not take more than 2 in 24 hours

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3
Q

True or false: Being overweight can contribute to dyspepsia

A

True

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4
Q

True or false: Smoking can contribute to dyspepsia

A

True

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5
Q

In what group of patients is orlistat licensed for OTC?

A

> 18 years BMI > 28

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6
Q

What is the OTC omeprazole dose and how long can they be used for and when would you refer?

A

10mg/20mg OD 4 weeks maximum However, if symptoms have not resolved in 2 weeks, refer Any danger symptoms e.g. unexplained weight loss, refer

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7
Q

What age can you sell OTC omeprazole to?

A

>18 years

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8
Q

What age can you sell esomeprazole to?

A

>18 years

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9
Q

What age can you sell OTC esomeprazole to?

A

>18 years

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10
Q

What is the dose of OTC esomeprazole, and what is the max time it can be used for?

A

20mg OD 2 weeks maximum

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11
Q

What is colic?

A

When a baby cries with no obvious cause Linked to disorder of GI tract, post partum depression, anxious parents Affects babies < 6 months old

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12
Q

How can you treat colic OTC?

A

Anti-foaming agents e.g. simethicone (Dentinox, infacol) Gripe water Effectiveness is lacking however and it should resolve by itself in time

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13
Q

What are symptoms of colic?

A

High pitched crying Often at same time of day Drawing knees up to stomach

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14
Q

When would you refer with colic?

A

Failure to put on weight OTC treatment failure Danger symptoms Over anxious parents Symptoms have not resolved past 4 months of age

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15
Q

What is 1st line for constipation?

A

Lifestyle measures

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16
Q

Generally, laxatives should be avoided in constipation as first line and lifestyle measures should be tried. What exemptions would you want to treat with laxatives?

A

If straining would exacerbate a condition e.g. angina Or increase bleeding risk e.g. haemorrhoids

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17
Q

Why must bulk forming laxatives be taken with adequate fluids?

A

To avoid intestinal obstruction

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18
Q

Frequent use of stimulant laxatives can lead to what?

A

Fluid and electrolyte imbalance

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19
Q

How long does it take for glycerol suppositories to work?

A

Within 30 mins

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20
Q

What are the preferred type of laxative in children?

A

Osmotic Bulk forming

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21
Q

What are the safest laxatives to use in pregnancy and breastfeeding?

A

Bulk forming and osmotic

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22
Q

Why are stimulant laxatives not really recommended in breastfeeding and pregnancy?

A

Not advisable in the third trimester as it may induce uterine contractions. Senna enters the breast milk, so may cause colic and diarrhoea in the infant.

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23
Q

At what point is constipation classed as chronic?

A

Lasting 6 weeks or more

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24
Q

If a patient has constipation along with tiredness, what could be underlying causes?

A

Hypothyroidism Anaemia

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25
Q

How long does it take for bulk forming laxatives to work?

A

12- 72 hours

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26
Q

What age can you sell Senna OTC to?

A

>12 years

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27
Q

What age can you sell Sodium picosulphate (Dulcolax pico liquid) OTC to?

A

> 10 years

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28
Q

What age can you sell ispaghula husk OTC to?

A

>6 years

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29
Q

Is Movicol is licensed for acute, chronic or both types of constipation?

A

Chronic

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30
Q

What are danger symptoms in a diarrhoea patient that prompts a referral?

A

Confusion Drowsiness Passing little urine Dry mouth Sunken eyes Duration of 3 days or longer in adults >24 hours in babies >48 hours in young chuldren

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31
Q

What is the difference between Diarolyte and Diarolyte Relief?

A

Relief contains rice power and normal diarolyte is glucose based

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32
Q

What age can you sell loperamide OTC to?

A

12 years and over

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33
Q

What is the maximum dose of GSL loperamide a day?

What is the maximum dose of P medicine loperamide a day?

A

12mg (6 caps a day) for GSL

16mg (8 caps a day) for P

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34
Q

Does rectal bleeding from haemorrhoids need to be referred?

A

No unless excessive bleeding occurs or has occurred for more than 3 weeks

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35
Q

What kind of laxative should be used for IBS?

A

Bulk forming

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36
Q

What age can you sell mebeverine OTC?

A

> 18 years

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37
Q

What age can you sell Buscopan OTC?

A

12 years and over

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38
Q

What age can you sell Colpermin IBS relief capsules OTC? (peppermint oil)

A

15 years and over

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39
Q

What are the symptoms of haemorrhoids?

A

Bleeding, perianal itching, mucus discharge and pain

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40
Q

How many days max should you use Anusol HC plus ointment OTC?

A

7 days max (contains hydrocortisone)

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41
Q

Can you use anusol HC plus ointment OTC in pregnancy and breastfeeding?

A

No

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42
Q

A cough for how many weeks would prompt a referral?

A

Longer than 3 weeks

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43
Q

What is croup?

A

Croup in children is caused typically by the parainfluenza virus. It often starts with a cold and develops into a characteristic barking cough

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44
Q

What time of the day are symptoms of croup the worst?

A

At night

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45
Q

How can you treat croup?

A

No medical treatment as it is viral but can offer antipyretic treatment if fever is present

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46
Q

Systemic decongestants should be used with caution in what group of patients?

A

They should be used with caution in people with diabetes, hypertension, hyperthyroidism, raised intraocular pressure, prostatic hypertrophy, hepatic or renal impairment, or ischaemic heart disease.

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47
Q

Systemic decongestants are contraindicated in patients taking what medicine class?

A

MAOIs Risk of hypotensive crisis

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48
Q

What is a purpuric rash?

A

One which does not blanch white on pressure

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49
Q

Bonjela preparations containing choline salicylate is unsuitable for which age group?

A

Under 16 years

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50
Q

What is the licensed age range for sumatriptan OTC?

A

18-65

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51
Q

What is the maximum dose of OTC sumatriptan?

A

Single 50mg dose stat

Can take another 50mg tablet but has to be at least 2 hours after taking the first tablet

Max 100mg in 24 hours for the same attack BUT symptoms have to have improved after taking the first tablet

If there is NO response to the first tablet, should not take a second tablet

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52
Q

What groups of patients is sumatriptan OTC unsuitable for?

A
  • Previous myocardial infarction - Ischaemic heart disease, e.g. angina - Peripheral vascular disease - Cardiac arrhythmias (including Wolff-Parkinson-White syndrome)
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53
Q

What is 1st line for pregnancy in threadworm?

A

Strict hygiene measures Refer if this has not worked

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54
Q

What is the dosing instructions for mebendazole in threadworm?

A

Once only dose Can be repeated after 2 weeks if it has not cleared up Everyone in the house should be treated

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55
Q

What age group is mebendazole not suitable for?

A

<2 years

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56
Q

What is recommended as first line for head lice treatment in pregnancy and BF?

A

Wet combing If treatment needed, Dimeticone e.g. Hedrin

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57
Q

What is recommended as first line for head lice treatment in asthma and eczema?

A

Wet combing If treatment needed, Dimeticone e.g. Hedrin

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58
Q

How many times should you apply head lice treatment and how many days should you leave between each treatment course?

A

Twice At least 7 days between

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59
Q

What is first line for scabies?

A

Permethrin 5% w/w cream (Lyclear®)

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60
Q

What is first line for scabies in pregnancy and BF?

A

Permethrin 5% w/w cream (Lyclear®)

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61
Q

Where should you apply scabies lotion?

A

All over the body

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62
Q

What is 1st line for athlete’s foot in pregnancy and breastfeeding?

A

Topical imidazoles e.g. Daktarin Gold

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63
Q

What is the minimum age for Lamisil OTC (terbinafine) for athelete’s foot (tinea pedis)?

A

> 16 years

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64
Q

What is the maximum number of nails you can treat OTC for fungal nail infection?

A

2 If more than this, need to refer

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65
Q

Amorolfine lacquer is licensed OTC for what condition and what is the age restriction?

A

Fungal nail infection 18 years and over

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66
Q

How can ringworm (tinea corpis) and jock itch (tinea cruris) be treated OTC?

A

Most local infections can be treated adequately with topical antifungal preparations. Imidazoles (clotrimazole, econazole, miconazole) or terbinafine are suitable first-line treatments for groin infections and skin ringworm.

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67
Q

How can sweat rashes be treated OTC?

A

Topical imidazoles e.g. Daktarin

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68
Q

What should you do if someone comes into the pharmacy with impetigo?

A

Usually needs a prescription to treat it so refer

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69
Q

What age groups should be referred in vaginal thrush?

A

<16 years >60 years

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70
Q

True or false: Poorly controlled diabetes is linked with thrush

A

True

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71
Q

Women who have had more than how many episodes of thrush in 6 months- when should you refer to GP?

A

More than 2 episodes in last 6 months

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72
Q

Can you treat a pregnant person OTC for thrush?

A

No- refer

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73
Q

What NSAID (stronger than ibuprofen) is available OTC for primary dysmenorrhoea?

A

Feminax ultra 250mg naproxen

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74
Q

What age range is Feminax ultra licensed for?

A

15-50 years

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75
Q

What age would you refer for bacterial conjunctivitis?

A

<2 years

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76
Q

Can you treat bacterial conjunctivitis OTC for pregnancy and breastfeeding?

A

No- refer

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77
Q

An ulcer lasting than more than how many weeks should be referred?

A

More than 3 weeks- exclude oral cancer

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78
Q

What is the minimum age to use Difflam mouthwash?

A

12 years

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79
Q

What is the minimum age to use Difflam spray?

A

6 years

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80
Q

What is a common side effect on the teeth if a patient is having chlorhexidine mouthwash?

A

Stains teeth brown

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81
Q

What is the minimum age to use miconazole 2% oral gel for oral thrush?

A

>4 months

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82
Q

Should miconazole oral gel be applied before or after meals?

A

After and held in the mouth as long as possible

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83
Q

What anticoagulation interacts with miconazole oral thrush gel and prompts a referral?

A

Warfarin

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84
Q

If a patient has diabetes and presents to the pharmacy with oral thrush, what should you do?

A

Refer

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85
Q

What is angular stomatitis?

A

Cracked fissures in the corners of the mouth

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86
Q

What can you offer OTC for angular stomatitis?

A

Clotrimazole 1% cream

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87
Q

True or false: Diuretics can cause dry eyes

A

True

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88
Q

What is the minimum age to use hydrocortisone 1% cream OTC?

A

10 years

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89
Q

What is the maximum number of days to use OTC steroid cream?

A

7 days

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90
Q

What steroid creams are available OTC?

A

Hydrocortisone 1% and clobetasone butyrate 0.05%

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91
Q

What areas can you not put OTC steroid cream?

A

Facial skin, broken skin, genitals You can put it on ears as this does not count as your face

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92
Q

Can you give steroid creams OTC to pregnant women?

A

No

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93
Q

Are OTC steroid creams licensed for psoriasis flare ups?

A

No

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94
Q

What age range is OTC tranexamic acid licensed for in heavy periods?

A

18-45 year olds

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95
Q

At what age are you eligible for the free flu vaccine?

A

65 years and older

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96
Q

Coughing up thin and frothy mucous can suggest what?

A

Left ventricular failure

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97
Q

What age can you sell OTC guaifenesin cough syrup?

A

>6 years (Benylin chesty cough for children)

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98
Q

What age can you sell OTC diphenhydramine cough syrup?

A

> 6 years (Benylin children’s night cough)

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99
Q

What age is otrivine child nasal drops licensed in?

A

6-12 years Contains xylometazoline

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100
Q

What age are Tyrozets (benzocaine) lozenges licensed in?

A

> 3 years

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101
Q

Is Ella One recommended in a patient with severe uncontrolled asthma?

A

No, especially if being treated with an oral glucocorticoid

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102
Q

Tamsulosin 400mcg capsules can be sold to what group of patients over the counter? How long can they take this before assessment is needed by a doctor?

A

Treatment of functional symptoms of benign prostate hyperplasia in men ages 45-75 years Can be taken for up to 6 weeks before clinical assessment by a doctor

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103
Q

What is the patient advice surrounding sunlight and cold sores?

A

Sunlight can trigger cold sores so direct sunlight should be avoided and sun screen should be applied.

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104
Q

Is oral lidocaine for children (Anbesol, Bonjela): - P medicine - GSL - POM?

A

P medicine Changed from GSL in late 2018 Max pack size 10g

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105
Q

What is the MHRA advice surrounding the sale of oral lidocaine for children?

A
  • Gone from GSL to P medicine - Restriction of pack size of 10g - Moved to second line after non-pharmacological management
106
Q

What advice would you give to breastfeeding women being treated for scabies?

A

Breastfeeding women should remove the treatment from the nipples before feeding, and reapply afterwards.

107
Q

Buccastem is licensed for what age OTC?

A

18 years

108
Q

Anusol Plus HC is licensed for what age OTC?

A

18 years

109
Q

Corticosteroid nasal sprays are licensed for what age OTC?

A

18 years

110
Q

Tranexemic acid is licensed for what age OTC?

A

18 years

111
Q

Canesten thrush cream is licensed for what age range OTC?

A

16-60 years

112
Q

Azithromycin (OTC for chlamydia) is licensed for what age?

A

16 years

113
Q

Nytol is licensed for what age OTC?

A

16 years

114
Q

Feminax ultra OTC is licensed for what age?

A

15-50 years

115
Q

Voltarol gels OTC are licensed for what age?

A

14 years

116
Q

Rennie is licensed for what age OTC?

A

12 years

117
Q

Gaviscon is licensed for what age OTC?

A

12 years

118
Q

Woodwards Gripe water OTC is licensed for what age range?

A

1 month- 1 year

119
Q

Calpol OTC is licensed from what age?

A

2 months

120
Q

Nurofen OTC is licensed from what age?

A

3 months

121
Q

Daktarin 2% oral gel is licensed from what age otc?

A

4 months

122
Q

Hedrin and Derbac liquid is licensed from what age OTC?

A

6 months

123
Q

Piriton OTC (chlorphenamine) is licensed from what age?

A

1 year

124
Q

What age is Diarolyte relief OTC licensed for?

A

1 year (Under this age needs medical advice)

125
Q

OTC choramphenicol is licensed for what age?

A

2 years

126
Q

Mebendazole OTC is licensed for what age?

A

2 years

127
Q

Lyclear cream OTC is licensed for what age?

A

2 years (Under this age needs medical advice)

128
Q

Loratadine OTC is licensed what from age?

A

2 years (as long as they weigh more than 30 kg)

129
Q

Phenergan OTC is licensed from what age?

A

2 years

130
Q

What is the active ingredient in Joy Rides?

A

Hyoscine hydrobromide

131
Q

Joy Rides OTC is licensed from what age?

A

3 years

132
Q

Kwells OTC is licensed from what age?

A

4 years

133
Q

Sturgeon (cinnarizine) is licensed from what age?

A

5 years

134
Q

What are the 6 stages of transtheoretical model of change?

A
  1. Pre-contemplation 2. Contemplation 3. Preparation 4. Active 5. Maintenance 6. Relapse
135
Q

Is evaluation a stage in the transtheoretical model of change?

A

No

136
Q

What is tranexamic acid licensed for?

A

Heavy menstrual bleeding over several cycles with regular cycles

137
Q

What are the dosing instructions for tranexamic acid OTC?

A

Taken only once heavy bleeding has started 2 500mg tablets TDS until symptoms are alleviated (Can be increased to 8 tablets a day 4g for heavier periods) It will not work properly if taken before menstruation It should not be taken for more than 4 consecutive days

138
Q

What is the max number of days you should use tranexamic acid OTC for?

A

4 days

139
Q

If a patient comes in asking for tranexamic acid OTC for heavy periods, but is on warfarin/DOAC, what should you do?

A

Refer Heavy period may be due to anticoagulation

140
Q

What is the supply criteria for sumatriptan OTC?

A
  • >18 years - Needs to have a migraine diagnosis by doctor/pharmacist - Established pattern of migraine - history of 5 or more attacks over a period of at least a year - Have tried simple analgesia and it hasn’t worked
141
Q

If a patient comes in asking for sumatriptan but is on an SSRI/TCA, what should you do?

A

Refer Risk of serotonin syndrome if used together

142
Q

If a patient comes in asking for sumatriptan but is on an a MAOI, what should you do?

A

Refer

143
Q

Can sumatriptan be used as a prophylactic for migraines?

A

No- it is for acute attacks

144
Q

What is the supply criteria for tamsulosin OTC?

A

Male patients 45-75 years - Had symptoms for a minimum of 3 months - 2 weeks supplied initially and then if there is an improvement in symptoms, a further 4 weeks can be supplied

145
Q

How many weeks of tamsulosin is supplied initially?

A

2 weeks

146
Q

After how many weeks of tamsulosin OTC does the patient have to get assessed by a doctor?

A

6 weeks and they can agree whether further supplies are appropriate Then an annual review after this

147
Q

If a male patient asks for tamsulosin OTC but mentions he suffers from postural hypotension, what should you do?

A

Refer Can cause postural hypotension

148
Q

What are the dosing instructions for chloramphenicol eye drops?

A

Total 5 days One drop into affected eye every 2 hours for the first 48 hours and every 4 hours after

149
Q

What are the dosing instructions for chloramphenicol ointment? What about if used with the eye drops?

A

Apply 3-4 times a day for 5 days Eye drops during the day, and the ointment just one application at night

150
Q

What are the storage requirements for chloramphenicol i) Eye drops ii) Ointment

A

Store eye drops in the fridge Ointment does not need to be in the fridge but store at no more than 25°C

151
Q

If a patient presents to the pharmacy with bacterial conjunctivitis, but wears contact lenses, what should you do?

A

Refer - needs to be advised chloramphenicol on the advice of a doctor / contact lens practitioner Hard contact lens users and disposable contact lens users can start using their lenses again after successfully completing a course of treatment. Soft contact lens wearers should wait 24 hours after completing a course of treatment before starting to use their lenses again.

152
Q

Is it recommended that a child with bacterial conjunctivitis does not go to school?

A

No - should still go to school

153
Q

What is the minimum age for pantoprazole OTC?

A

18 years

154
Q

What is the dose for pantoprazole OTC?

A

20mg OD

155
Q

Do PPIs provide immediate relief?

A

No- start to work after a day or so If a patient needs immediate relief, an antacid or alginate is more appropriate

156
Q

At what age would you refer a patient if they requested a PPI for first time dyspepsia symptoms?

A

55 years (Refer those over 45 years of age who suffer from long term recurrent symptoms of indigestion or heartburn)

157
Q

What is Onychomycosis?

A

Fungal nail infection

158
Q

What is the dosing instruction for amorolfine for fungal nail infections? What time scale for toenails and fingernails?

A

Apply to the nail once weekly Has to be applied regularly until all the affected nail has grown out 6 months for fingernails 9-12 months for toenails

159
Q

A non blanching rash can be a symptom of what?

A

Meningitis The rash does not fade when pressed with a glass

160
Q

How long before symptom onset is chickenpox contagious for?

A

Usually from 2 days before spots appear Until the spots have crusted over- considered contagious until no new lesions have appeared for 24 hours

161
Q

How soon do you get symptoms after coming into contact with chickenpox?

A

1-3 weeks

162
Q

Can you catch shingles from someone with chickenpox?

A

No

163
Q

Can you catch chickenpox from someone with shingles?

A

Yes if you have not had chickenpox before

164
Q

How may hours after unprotected sex is Ulipristal Acetate licensed for?

A

120 hours (5 days)

165
Q

How may hours after unprotected sex is Levonorgestrel licensed for?

A

72 hours (3 days)

166
Q

What age is levonorgestrel licensed for OTC?

A

16 years and over

167
Q

What is the dose of ulipristal acetate for EHC?

A

30mg

168
Q

What is the dose of levonorgestrel for EHC?

A

1500 micrograms

169
Q

True or false: Ulipristal EHC is not recommended for patients who have taken CYP3A4 enzyme inducing medicines or herbal products in the last 4 weeks

A

True

170
Q

If a patient has taken CYP3A4 enzyme inducing medicines or herbal products in the last 4 weeks, and an IUD is not suitable, what EHC and what dose should they have?

A

2 tablets of levonorgestrel 1500 micrograms should be taken within 72 hours of unprotected sex

171
Q

Levonorgestrel is less effective in women with a BMI over what?

A

26 - may need a double dose as per FSRH advice

172
Q

What is the advice surrounding EHC levonorgestrel and vomiting?

A

If the patient vomits within 3 hours of taking levonorgestrel, she should repeat the same dose she took previously.

173
Q

Can you take a second dose of levonorgestrel within the same cycle?

A

EMC does not advise it as it can disturb the woman’s period

174
Q

If a patient has taken EHC, after how any days of an overdue period must they do a pregnancy test?

A

More than 5 days overdue

175
Q

What is the advice surrounding EHC ulipristal and vomiting?

A

If vomiting occurs within 3 hours another tablet should be taken as soon as possible

176
Q

In what clinical conditions is the use of EHC ulipristal not recommended?

A

Severe hepatic impairment Asthma which is being treated by oral glucocorticoids

177
Q

In what clinical conditions is the use of EHC levonorgestrel not recommended?

A

Severe malabsorption syndrome e.g. Crohn’s Severe hepatic impairment

178
Q

What is the advice regarding ulipristal EHC and breastfeeding?

A

After using ulipristal breast feeding is not recommended for a week because it is present in breast milk. During this time expressing and discarding the milk is advised to maintain lactation.

179
Q

What is the advice regarding levonorgestrel EHC and breastfeeding?

A

Potential exposure of an infant to levonorgestrel can be reduced if the breast-feeding woman takes the tablet immediately after feeding and avoids nursing at least 8 hours following Levonelle

180
Q

Children under what age are legally too young to consent to sexual activity?

A

13 years

181
Q

What is the dosing instruction for naproxen OTC for painful periods?

A

On the first day 2 tablets (500 mg) should be taken initially and then one tablet (250 mg) after 6 to 8 hours if needed. Max 3 tablets in a day Max number of days for treatment is 3 days

182
Q

What is the max duration of days is licensed for OTC naproxen for painful periods?

A

3 days

183
Q

Viagra OTC is licensed from what age?

A

18 years

184
Q

What is the dosing instruction for Viagra?

A

One 50 mg tablet taken with water approximately one hour before sexual activity - max of one tablet in 24 hours If Viagra Connect is taken with food, the onset of activity may be delayed compared to the fasted state

185
Q

If a patient presents to the pharmacy with subconjuctival haemorrhage, what you recommend?? What would warrant a referral?

A

There should be no pain and the patient should be reassured that symptoms will resolve in 10 to 14 days without treatment. However, a patient with a history of trauma should be referred to exclude ocular injury.

186
Q

Psuedoephedrine is cautioned in what conditions?

A

Diabetes Hypertension Heart disease Angle-closure glaucoma

187
Q

Miss W is a 19 year old patient who has developed several painful red lumps and patches (that measure 1-5 cm) on her lower legs What advice should you give?

A

These lumps are characteristic of erythema nodosum. Treatment is usually rest and painkillers such as NSAIDs. - The bumps and patches last about two weeks before fading like a bruise.

188
Q

How many levels of healthy living pharmacy is there?

A

Level 1, 2 and 3 Need to be on the HLP register

189
Q

What does Level 1, 2 and 3 healthy living pharmacies entail?

A

Level 1- Promoting health, wellbeing and self-care (profession-led) Level 2 - Providing services (commissioner-led) Level 3 - Providing treatment (commissioner-led)

190
Q

What is the dose of paracetamol for a 2 month old?

A

30-60mg TDS

191
Q

What is the dose of paracetamol for 3-5 months?

A

60mg QDS

192
Q

What is the dose of paracetamol for 6 months-2 years?

A

120mg QDS

193
Q

What is the dose of paracetamol for 2-3 years?

A

180mg QDS

194
Q

What is the dose of paracetamol for 4-5 years?

A

240mg QDS

195
Q

What is the dose of paracetamol for 6-7 years?

A

250mg QDS

196
Q

What is the dose of paracetamol for 8-9 years?

A

375mg QDS

197
Q

What is the dose of paracetamol for 10-11 years?

A

500g QDS

198
Q

What is the dose of paracetamol for 12-15 years?

A

480-750mg QDS

199
Q

Discharge coming out the ear can indicate what?

A

Ear infection- refer

200
Q

A patient has severe itchy hands, particularly at night. You notice silver lines with a dot at the end in the webs of her fingers. What is this?

A

Scabies

201
Q

Which illness is characterised by white spots surrounded by a red ring on the inner cheek and gums?

A

Measles

202
Q

Rubella is also known as what?

A

German measles

203
Q

The difference between German measles and measles (morbilli) is what?

A

Measles manifests itself with white spots in the mouth.

204
Q

What are the symptoms of Reye’s Syndrome?

A
  • Vomiting repeatedly - Tiredness and lack of interest or enthusiasm - Rapid breathing - Seizures As the condition progresses, the symptoms may get more severe and more wide-ranging, and can include: -Irritability, or irrational or aggressive behaviour -Severe anxiety and confusion that’s sometimes associated with hallucinations - Coma (loss of consciousness)
205
Q

Apart from if the child is very young, after how many days should a child see their GP with a fever?

A

If it hasn’t reduced after 5 days Any other warning signs e.g. if it isn’t reduced by paracetamol, if they have a rash etc

206
Q

Should Hedrin (dimeticone) be applied to wet or dry hair?

A

Dry

207
Q

Scarlet fever is caused by what?

A

Group A strep

208
Q

What are the symptoms of scarlet fever?

A

Sore throat, fever, extensive red rash (sandpaper like as it is rough) The rash usually starts on the trunk before spreading. NO rash on the face but cheeks can be flushed Strawberry tongue - red papillae and white coating

209
Q

What is the likely diagnosis and what would you do if a child presented with this in community pharmacy?

A

Scarlet Fever
Refer as it is caused by Strep A and need antibiotics

210
Q

A rash like this indicates what?

A

Chicken pox

211
Q

A rash like this indicates what?

A

Scarlet fever - refer

212
Q

How long does acute otitis media usually last?

When would antibiotics be indicated?

A

3 days (can be up to a week)

If symptoms do not improve by themself after 3 days or if patient is systemically unwell, consider antibiotics (amoxicillin)

213
Q

In patients with blepharitis, can their eyelids stick together?

A

Yes, can also be itchy and have a build up of debris

214
Q

What is the advice for patients with blepharitis?

A

Maintain good eyelid hygiene (BD then OD)
Remove debris from eyelids, can use baby shampoo to do this
Warm compress
Eye make up can make the condition worse

215
Q

What is this?

A

Blepharitis

216
Q

What is this?

A

Bacterial conjuctivitis

217
Q

What is this?

A

Allergic conjuctivitis

218
Q

Is allergic conjuctivitis contagious?

A

No

219
Q

What are the main differences of presentation for viral and allergic conjuctivitis?

A

Viral can be bilateral or unilateral
Allergic is bilateral, red and gritty

220
Q

What age is acetic acid (EarCalm) licensed in?

A

12+

221
Q

When should you stop using EarCalm and what is the maximum number of days you can use it OTC?

A

Treatment should be continued until two days after symptoms have disappeared but no longer than 7 days

222
Q

Constipation lasting how long with no identifiable cause prompts a referral?|

A

2 weeks

223
Q

What age should you refer someone with constipation?

A

<18 to rule out underlying causes

224
Q

How does the afe licensing of OTC loperamide differ in the following indications:

i) Acute diarrhoea
ii) Acute diarrhoea associated with IBS

A

i) 12 years and older
ii) 18 years and older if associated with IBS, and need to have diagnosis by the doctor

225
Q

What is this?

A

Angular stomatitis

226
Q

What are the symptoms of oral thrush?

A

Patches of curd-like, white or yellowish plaques that can occur anywhere in the mouth, especially the cheeks, gums, palate, and tongue. These are easily removed, revealing an underlying red base that is not usually painful.

227
Q

True or false:
In oral thrush, white patches cannot be removed easily from the tongue

A

False- they can be removed easily leaving a red base

228
Q

What should you recommend if a pregnant or breastfeeding lady comes in with oral thrush?

A

Refer

229
Q

What would be first line for a sprain?

What is second line?

A

Paracetamol or TOPICAL NSAID

If no improvement after 48 hours of injury, use an oral NSAID

230
Q

What does Otrivine Extra Dual Relief nasal spray contain and what is it used for?

What is the age licensing for OTC?

A

Symptomatic treatment of nasal congestion and rhinorrhea in connection with common colds.

Ipratropium bromide

xylometazoline hydrochloride

> 18 years

231
Q

What would be first line for period pains (primary dysmenorrhoea)?

A

NSAID

Can offer paracetamol as well or if NSAID contraindicated

232
Q

How long should daktarin gel be applied for?

A

During symptomatic period and for 7 days after symptoms have cleared up

233
Q

What drug should be avoided in chicken pox and why?🐓

A

IBUPROFEN

Increased risk of serious skin infection - necrotising fasciitis

234
Q

How much pseudoephedrine OR ephedrine can you legally sell at a given time?

A

720mg of pseudoephedrine

OR

180mg of Ephedrine

235
Q

What drugs contain Archas Oil?

Archas oil = Peanut oil

A

Ceromol (for ear wax)

Naseptin (nasal cream)

Colpamin (peppermint oil)

Salmeterol (LABA - only generic versions?)

236
Q

Chloramphenicol counselling points?

A

5-day course of ABx

1 drop every 2 hours (during awake hours) for 2 days
1 drop every 4 hours for 3 days for 3 days

Don’t touch eye with dispenser/bottle
Take contacts out - not preservative free (or refer?)
Store in fridge is drops

chloramphenicol eye drops/eye ointment age >2yrs

237
Q

What is the API of viagra connect and what must be done after 6 months?

A

Sildenifil 50mg

Must have a doctors appointment after 6 months

238
Q

What’s the minimum age of aspirin use and why?

A

> 16 years

Risk of Rayes syndrome in younger than 16

Rayes syndrome: rare but serious condition that causes swelling in the liver and brain

239
Q

Counselling points for Hedrin (dimeticone 4%)?

A

Leave on hair for a minimum of 8hrs/can be left overnight

Wash out with normal shampoo

Repeat after 7 days

Use nit comb alongside?

240
Q

Ovex (Mebendazole) counselling?

A

> 2 years

Can repeat after 14 days if reinfected

Hygiene advice

241
Q

Minimum age to buy Clamelle (azthromycin for chlamydia) OTC?

A

16 years

242
Q

Hydrocortisone (hc45) 1 % cream min age otc?

A

10 years

Max 15g tube

243
Q

Eurax HC (hydrocortisone 0.25%) cream min age?

Clobetasone (eumovate) 0.05% cream?

A

10yrs

12 yrs

244
Q

Tamsulosin 400mcg tablets (FloMax)?
Age range

A

45 years - 75 years

245
Q

Naproxen 250mg tablets (Feminax Ultra)?
Age range

A

15 - 50 years

246
Q

Any cough/ cold remedy containing actives like antihistamines, expectorants, suppressants and stimulants should not be used in under

A

Any cough/ cold remedy containing actives like antihistamines, expectorants, suppressants and stimulants should not be used in under 6 years, and never first line in 6- 12 years, if used then maximum 5 days

247
Q

Tranexamic acid? For menorrhagia (heavy bleeds) age

A

18y

248
Q

sumatriptan age

A

18 - 65y

249
Q

age range for

  • paracetamol
  • cetirizine
  • loratadine
A

2 months

2 yrs

2 yrs

250
Q

Levornorgestrel age

amorolfine age

simple linctus paed age

A

16

18

1

251
Q

Co-codamol age

A

12 years
But guidance states codeine containing products for pain relief should only be used in over 12’s when ibuprofen and paracetamol have failed.

Codeine containing cough remedies should only be used in over 18 years as risks (of respiratory problems/ dependence) outweigh benefits

252
Q

Steroid nasal sprays (beconase, flixonase)

Esomeprazole, Pantoprazole, Omeprazole?

age?

A

18y

253
Q

Cough cold remedies containing chlorphenamine, promethazine, diphenylhydramine, tripolidine (antihistamines)?

A

6 years

(Any cough/ cold remedy containing actives like antihistamines, expectorants, suppressants and stimulants should not be used in under 6 years, and never first line in 6- 12 years, if used then maximum 5 days)

254
Q

Clotrimazole 2% cream? what else can clotrimazole be used for?

Fluconazole capsule 150mg?

Age range?

A

16 - 60 years when used for thrush all:

Clotrimazole 2% cream
Clotrimazole 10% internal cream
Clotrimazole pessary

Fluconazole 150mg capsule

Clotrimazole 1% cream For fungal skin infections (e.g. ring worm)
Can be used in adults and children (no licensed age mentioned)

255
Q

Antihistamines:
Chlorphenamine liquid? (piriton syrup)

A

Liquid: over 1 years (safest choice for young children)

Chlorphenamine Tablets: 6 years

256
Q

Acrivastine? (antihistamine) Age range

A

12 - 65 years

257
Q

age use for

  • senna
  • isphagula husk fybogel
A
  • senna 12 yrs
  • isphagula husk 6 yrs
258
Q

Minoxidil 2% + 5%? (Regain)
Age range

A

18 years- 65 years

OTC Hair loss treatment

259
Q

Daktarin oral gel (Miconazole) age

A

licenced for 3 months

260
Q

Minimum age Benzoyl Peroxide can be used in?

A

12 years

Acne treatment

261
Q

ullipristal acetate age

A

Licensed for any girl of child bearing age

262
Q

POM to P switch mometasone nasal spray Clarinaze Allergy Control 0.05%
Which statement is correct?
A. The nasal spray can be sold to a 16yo boy with perennial allergy and has had corticosteroid nasal spray on rx before
B. can be used for up to 4 months before seeing a GP as long as symptoms are improving
C. a common SE of use is nosebleeds
D. no need to prime nasal spray before use

A

C. common SE is nosebeeds

Under-18s can only use mometasone nasal spray if their doctor prescribes it.

If you’re using a new bottle, it may not work first time. Pump the spray a few times until a fine mist comes out. You’ll also need to do this if the bottle has not been used for a few days.

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