OTC Flashcards

Question

Answer 1

A

E
RATIONALE: SENNOSIDE TABLETS ARE LICENSED FOR
PURCHASE FOR INDIVIDUALS ABOVE THE AGE OF 12

Answer 2

A

D
RATIONALE: LACTULOSE IS NOT RECOMMENDED IN
PATIENTS WITH IBS DUE TO ITS BLOATING EFFECT THAT
IS OFTEN EXPERIENCED IN PATIENTS WITH IBS.

Answer 3

A

A
RATIONALE: CETIRIZINE, LORATADINE AND DESLORATADINE
ARE ALL ONCE DAILY DOSING. CHLORPHENAMINE IS TAKEN
EVERY 4 TO 6 HOURS. ACRIVASTINE IS TAKEN THREE TIMES
DAILY.

Answer 4

A

D
RATIONALE: SILDENAFIL CANNOT BE SOLD OVER THE COUNTER IN
PATIENTS WITH HYPOTENSION, PATIENTS WHO HAVE RECENTLY HAD A
CARDIAC COMPLICATION, HAVE SICKLE CELL ANAEMIA (AN
ABNORMALITY OF RED BLOOD CELLS), LEUKAEMIA (CANCER OF BLOOD
CELLS) OR MULTIPLE MYELOMA (CANCER OF BONE MARROW). WHILST
OPTION B IS ALREADY TAKEN SILDENAFIL, THAT DOSING IS NOT FOR
ERECTILE DYSFUNCTION, RATHER FOR PULMONARY HYPERTENSION.

Answer 5

A

B
RATIONALE: ASKING FOR SPECIFIC PRODUCTS MAY INDICATE
ABUSE, HOWEVER IT COULD ALSO BE INDICATIVE OF A
PATIENT WHO HAS BENEFITED FROM A SPECIFIC ACTIVE
INGREDIENT AND WANTS HELP IN FINDING THE SAME ONE.
ALL OF THE OTHER OPTIONS ARE MORE LIKELY TO BE
INDICATIVE OF MEDICATION ABUSE - REMEMBER THAT THIS
IS ALL CONTEXTUAL, AND AS A PHARMACIST, YOU CANNOT
RELY ON GENERALISATIONS.

Answer 6

A

D
RATIONALE: WHILST COUGH REMEDIES MAY PROVE USEFUL,
IN THIS CONTEXT, THE COUGH IS LIKELY CAUSED BY THE
PATIENT’S RAMIPRIL WHICH CAUSES A COUGH THROUGH THE
BUILD UP OF BRADYKININ. NO OTHER COUGH SYRUP WILL
ADDRESS THIS MECHANISM OF ACTION - A REFERRAL TO THE
GP TO SWITCH MEDICATIONS WOULD BE MORE APPROPRIATE.

Answer 7

A

A
RATIONALE: CLOTRIMAZOLE TENDS TO BE USED AS AN
ANTIFUNGAL. ALL THE OTHER OPTIONS ARE EITHER NOT
AVAILABLE OVER THE COUNTER OR ARE STEROIDS.

Answer 8

A

D
RATIONALE: APART FROM FEXOFENADINE, ALL OF THE OTHER
ANTIHISTAMINES ARE OLD GENERATION WITH ANTICHOLINERGIC SIDE
EFFECTS WHICH ARE CONTRAINDICATED IN GLAUCOMA.

Answer 9

A

C
RATIONALE: THE LEGAL RESTRICTION FOR PARACETAMOL
STIPULATES THAT NO MORE THAN 100 NON EFFERVESCENT
TABLETS OR CAPSULES CAN BE SOLD TO A PERSON AT ANY
ONE TIME. HOWEVER, THERE ARE NO LEGAL LIMITS ON THE
QUANTITY OF OVER THE COUNTER EFFERVESCENT TABLETS,
GRANULES OR LIQUIDS THAT CAN BE SOLD; PROFESSIONAL
JUDGEMENT SHOULD BE USED TO DEDICE THE APPROPRIATE
QUANTITY TO SUPPLY AND WHAT LIMITS TO IMPOSE.

Answer 10

A

A
RATIONALE: WHILST IRRITIBLE BEHAVIOUR AND IMPATIENCE
ARE BOTH POTENTIAL INDICIATORS OF SUBSTANCE MISUSE,
THIS WOULD NOT BE LEGAL GROUNDS TO REFUSE SUPPLY,
THIS WOULD FALL UNDER PROFESSIONAL JUDGEMENT. AGE
AND GENDER ARE ALSO NEVER A REASON TO ASSUME ONE
MAY BE USING OTC PRODUCTS ILLEGALLY. THE PRODUCTS IN
QUESTION CONTAIN PSEUDOEPHEDRINE RATHER THAN
EPHEDRINE, SO OPTION B IS NOT RELEVANT.

Answer 11

A

A
RATIONALE: BENZOCAINE (A LOCAL ANAESTHETIC) AND
MENTHOL TEND TO BE ACTIVE INGREDIENTS IN COUGH DROPS
AND SORE THROAT LOZENGES

Answer 12

A

B
RATIONALE: NSAIDS AREN’T A HARD CONTRAINDICATION IN
ASTHMA, BUT THEY ARE ADVISED AGAINST; IN THIS CASE,
SYSTEMIC NSAIDS ARE THE LEAST APPROPRIATE. TOPICAL
NSAIDS HAVE VERY LITTLE SYSTEMIC ABSORPTION SO THIS
WOULD BE ACCEPTABLE FOR LOCAL ACTION.

Answer 13

A

C
RATIONALE: HYOSCINE BUTYLBROMIDE, OR BUSCOPAN, HAS
ANTICHOLINERGIC SIDE EFFECTS I.E. BLURRED VISION,
CONSTIPATION, DRY MOUTH AND URINARY RETENTION.
DIARRHOEA IS NOT AN ANTICHOLINERGIC SIDE EFFECT.

Answer 14

A

D
RATIONALE: CIALIS TOGETHER (OR TADALAFIL) IS CLASSED
AS A “P” MEDICINE, WHICH CAN BE BOUGHT FROM A
PHARMACY, BUT NOT FROM A REGULAR STORE (GSL).

Answer 15

A

E
RATIONALE: NONE OF THE OTHER OPTIONS WOULD BE
APPROPRIATE. SELF CARE IS THE MOST APPROPRIATE
OPTION.

Answer 16

A

B
RATIONALE: A SORE THROAT COULD BE INDICATIVE OF
THROMBOCYTOPENIA, OR ANOTHER BLOOD DYSCRASIA. A
REFERAL TO THE GP URGENTLY WOULD BE MOST
APPROPRIATE FOR A BLOOD TEST AND THEN FURTHER
MANAGEMENT.

Answer 17

A

B
RATIONALE: BACTERIAL INFECTION IS THE MOST COMMON
CAUSE AND IS THOUGHT TO ACCOUNT FOR 80–90% OF
CASES OF TRAVELLERS’ DIARRHOEA. THE CLINICAL PICTURE
MAY VARY DEPENDING ON THE INFECTING PATHOGEN.
REFERRAL WOULD BE THE MOST APPROPRIATE OPTION.

Answer 18

A

Five times daily

Answer 19

A

C
RATIONALE: CHLORPHENAMINE IS A FIRST GENERATION
ANTIHISTAMINE AND IS CONSEQUENTLY FAIRLY SEDATING.
THIS WOULD BE THE LEAST APPROPRIATE CHOICE.

Answer 20

A

E
RATIONALE: ALL OF THE OTHER OPTIONS ARE CONTRAINDICATED DUE
TO THEIR CONTAINING OF STIMULANTS WHICH WOULD INCREASE
THIS PATIENT’S BLOOD PRESSURE. STEAM INHALATION WITH
PARACETAMOL AND MENTHOL CRYSTALS WOULD BE THE MOST
APPROPRIATE CHOICE.

Answer 21

A

E
RATIONALE: PHOLCODINE-CONTAINING COUGH AND COLD MEDICINES
ARE BEING WITHDRAWN FROM THE UK MARKET AS A PRECAUTION
FOLLOWING A REVIEW WHICH FOUND THAT THEIR BENEFITS DO NOT
OUTWEIGH THE INCREASED RISK OF THE VERY RARE EVENT OF
ANAPHYLAXIS TO NEUROMUSCULAR BLOCKING AGENTS (NMBAS) USED
IN GENERAL ANAESTHESIA

Answer 22

A

B
RATIONALE: GLYCEROL SUPPOSITORIES ARE THE FASTEST ACTING
CHOICE ON THIS LIST. DOCUSATE SODIUM AND MACROGOL SACHETS
CAN TAKE 24-48 HOURS TO REACH FULL EFFECT. LACTULOSE CAN
TAKE 72 HOURS TO REACH FULL EFFECT. SENNA TAKES ROUGHLY 8
HOURS TO TAKE EFFECT

Answer 23

A

A
RATIONALE: CLOTRIMAZOLE 1% IS THE ONLY CHOICE HERE
THAT IS LICENSED FOR THE USE OF RINGWORM.
CLOTRIMAZOLE 2% IS NOT LICENSED FOR THIS INDICATION.

Answer 24

A

D
RATIONALE: HYDROCORTISONE 1% CREAM IS ONLY SUITABLE
FOR THOSE OVER THE AGE OF 10. OPTION C IS NOT
APPROPRIATE AS A SHAVING RASH COULD SUGGEST AN
OPEN WOUND, ON WHICH STEROIDS SHOULD NOT BE USED.
A VULVAL RASH MAY BE INDICATIVE OF AN STI, WHICH
WOULD REQUIRE FURTHER INVESTIGATION.