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Pharmacy > OTC 2 > Flashcards

OTC 2 Flashcards

1
Q

what are the symptoms of colic?

A

excessive high pitched crying
(Rule of 3s: at least 3 hours/ day, 3 days/ week for 3 weeks)
red in the face
clenched fists
knees drawn up to stomach
excessive gas/ trouble passing stool

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2
Q

when should you refer colic?

A

inconsolable crying
failure to put on weight

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3
Q

what OTC options are available for colic?

A

infacol (simethicone)
colief (lactase enzyme)

lack of clinical evidence but can trial for 1 week

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4
Q

what other advice can you give regarding colic?

A

reassure parent
could trial removing cows milk for 1 week
massage the tummy in circular motions
hold baby during crying episodes, rock them, warm baths, burp them, hold upright during feed

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5
Q

what age range is colic most prevalent in?

A

starts in infancy and can last until 6 months

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6
Q

what are the symptoms of cradle cap?

A

greasy yellow scales on scalp

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7
Q

what age range is cradle cap most prevalent in?

A

starts in infancy before 6 months

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8
Q

is cradle cap self limiting?

A

yes,

clears up after a few weeks/ months
as scales flake off, skin underneath may appear red

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9
Q

when should cradle cap be referred?

A

severe cradle cap on face/ body
swelling, scratching, bleeding
infected, inflammed

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10
Q

what OTC products can be used for cradle cap?

A

baby shampoo (use soft brush and apply as daily routine)
olive oil BP (apply overnight to loosen scales, gently brush following morning)

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11
Q

can you use capasal shampoo for cradle cap?

A

no, contains salicylic acid

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12
Q

can you use nizoral dandruff shampoo for cradle cap?

A

no, contains ketoconazole

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13
Q

what advice should be given to parents with a child with cradle cap?

A

don’t pick the scales - can cause infection

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14
Q

what are the symptoms of meningitis?

A

non-blanching rash (pale, blotchy skin with widespread bruises which do not fade when pressed against a glass)
stiff neck
headache
cold hands and feet
confusion/ drowsiness
photophobia
seizures
flu-like symptoms
high fever
muscle ache
N&V

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15
Q

what are the symptoms of meningitis in infants?

A

floppiness/ unresponsiveness
dislike being handled
refusing feeds
difficult to wake
rapid breathing/ grunting
unusual cry or moan
bugling fontanelle

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16
Q

what should you do if an infant presents to the pharmacy with symptoms indicative of meningitis?

A

A&E

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17
Q

how should you treat viral meningitis?

A

symptomatic relief (paracetamol, ibuprofen)

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18
Q

what are the symptoms of measles?

A

koplik spots
conjunctivitis
cold-like symptoms
fever

rash starts behind ears, spreading to face, trunks, limbs
red-brown confluent and blotchy rash

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19
Q

what are the symptoms of mumps?

A

fever
headache
malaise

swelling on one or both sides of face (inflammation of the parotid glands)

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20
Q

what are the symptoms of rubella?

A

lymphadenopathy

rash starts on face, the spreads to trunk/ limbs
pink-red macular non-confluent rash

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21
Q

when should you refer measles, mumps or rubella?

A

all cases

(notifiable diaseases)

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22
Q

how could you manage MMR OTC?

A

symptomatic relief (paracetamol/ ibuprofen)

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23
Q

what advice can you give for children suffering with MMR?

A

bed rest
hydration
contagious (off school)
avoid acidic drinks in mumps (irritates parotid gland)
children with rubella should avoid pregnant women

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24
Q

how long is MMR contagious for?

A

measles - 4 days after rash
mumps - 5 days after swelling
rubella - 6 days after rash

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25
Q

what complications can mumps cause in adults?

A

meningitis and sterility

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26
Q

what are the two types of nappy rash?

A

irritant and fungal

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27
Q

when should nappy rash be referred?

A

broken skin, severe nappy rash
yellow crust/ weeping
other body areas affected
OTC failure > 1 week

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28
Q

what OTC options are available for irritant nappy rash?

A

barrier preparations:
bepanthen, drapolene, sudocrem, metanium

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29
Q

what OTC options are available for fungal nappy rash?

A

clotrimazole
miconazole

apply for 7 days after clearing to prevent returning

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30
Q

should babies with oral thrush be referred or treated OTC?

A

treated OTC, common in babies

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31
Q

what OTC product can be used for oral thrush in infants?

A

daktarin SF oral gel

(> 4 mnths)

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32
Q

how often should daktarin SF oral gel be applied and what is the duration?

A

QDS after meals

continue for 1 week after symptoms disappear

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33
Q

what are the symptoms of slapped cheek?

A

bright red rash on cheeks
light pink, lace like, itchy rash on trunk and limbs
initial cold like symptoms (most contagious)

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34
Q

when should you refer slapped cheeK?

A

pregnant women (miscarriage/ still birth)
blood disorders
anaemia

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35
Q

what OTC products can be used for slapped cheek?

A

symptomatic relief (paracetamol or ibuprofen)
antihistamines for itchy rash

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36
Q

what advice can be given for slapped cheek?

A

rest
fluids
once rash appears no longer contagious

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37
Q

what are the symptoms of whooping cough?

A

initial catarrhal symptoms (runny nose, watery eyes, fever)
intense coughing bouts (between coughs there is a whoop)

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38
Q

when should you refer whooping cough?

A

all cases
A&E if significant breathing difficulties

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39
Q

what OTC products can be given for whooping cough?

A

fever (paracetamol or ibuprofen)

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40
Q

what advice can be given for whooping cough?

A

very contagious (stay away from school 5 days after abx started or 3 weeks after coughing started)
cover child’s mouth/ nose when coughing/ sneezing

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41
Q

what are the symptoms of chicken pox?

A

small red spots, very itchy and infectious blisters leading to crusts

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42
Q

when should you refer chicken pox?

A

adults
pregnant women
weakened immune system
infants under 4 weeks old
shingles

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43
Q

what OTC products can be used for chicken pox?

A

calamine lotion
crotamiton (eurax)
>1 chlorphenamine (piriton)
paracetamol

AVOID ibuprofen (serious skin infection)

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44
Q

what advice can be given for chicken pox?

A

do not scratch lesions (infection)
contagious until lesions crusted over

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45
Q

what is classed as a high temperature?

A

> 38

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46
Q

what is classed as a high grade fever?

A

> 39

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47
Q

what are the symptoms of scarlet fever?

A

pink-red itchy sandpaper rash (appears on chest/ stomach first)
sore throat
headache
strawberry tongue
flushed cheeks

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48
Q

how long should children stay off school with scarlet fever?

A

24 hours after starting abx

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49
Q

what are the symptoms of cluster headache?

A

occurs in clusters
intense pain in/ behind one eye

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50
Q

what are the symptoms of sinus headache?

A

blocked/ congestion caused from blocked sinuses

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51
Q

what are the symptoms of tension headache?

A

constant ache that feels like a tight band around the head

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52
Q

what are the symptoms of migraine?

A

unilateral throbbing pain
N&V
photosensitivity/ sound sensitivity
migraine with/ without aura
acute triggers

53
Q

when should you refer a headache?

A

unresponsive to analgesia within 1 day
taking COC with migraine type headache
recurring headache
neck stiffness
children < 12
severe headache lasting > 4 hours
recent trauma injury
increasing severity/ frequency
sever deep pain (worse when lying down)

54
Q

when are you unable to sell sumatriptan for migraine?

A

1st migraine attack in >50
4 attacks a month
> 24 hours
liver and renal impairment
CVD
epilepsy

55
Q

what OTC products can be used for headaches?

A

simple analgesics
analgesics with codeine and dihydrocodeine

56
Q

what OTC products can be used for migraines?

A

sumatriptan
antiemetics:
prochlorperazine (buccastem)
buclizine (migraleve pink)

57
Q

what is the licensing for OTC sumatriptan?

A

18-65 yrs
previously tried simple analgesia
established pattern (5 attacks in past year needed)
previously diagnosed

58
Q

how do you take sumatriptan?

A

one 50mg tablet ASAP after onset
do not take a second for the same attack
second dose can be taken after 2 hours if migraine recurs only if response to first
max 2 in 24 hours

59
Q

when should insomnia be referred?

A

chronic insomnia (> 3 weeks)
suspected depression
< 16 years
medication ADR

60
Q

what OTC products can be used for insomnia?

A

diphenydramine (nytol)
promethazine (sominex, phenergan)

61
Q

what is age restriction for diphenydramine?

A

> 16 years

62
Q

what is the age restriction for promethazine?

A

> 16 years

63
Q

what OTC products are available for travel sickness?

A

hyoscine hydrobromide
cinnarizine
promethazine

64
Q

what formulations of hyoscine hydrobromide are available OTC for travel sickness?

A

tablets (journeys lasting up to 4 hours)
patches (journeys over 24 hours)

65
Q

what is hyoscine hydrobromide contraindicated in?

A

glaucoma and prostatic enlargement

66
Q

what brands of hyoscine hydrobromide are there for travel sickness?

A

kwells
kwells kids
joyride

67
Q

what is the age restriction of kwells?

A

> 10 years

68
Q

what is the age restriction of kwells kids?

A

> 4 years

69
Q

what is the age restriction of joyride?

A

> 3 years

70
Q

what is the age restriction of scopaderm (hyoscine hydrobromide) patches?

A

> 10 years

71
Q

how long do hyoscine hydrobromide tablets last? and how long before the journey should they be taken?

A

for journeys lasting up to 4 hours
take 30 mins before
last 6 hours

72
Q

how long do hyoscine hydrobromide patches last? and how long before the journey should they be taken?

A

for journeys lasting over 24 hours
take night before
last 72 hours

73
Q

cinnarizine and promethazine can be used for travel sickness for journeys lasting how long?

A

4-8 hours

74
Q

what is the age restriction for cinnarizine (sturgeron)?

A

> 5 years

75
Q

what is the age restriction for promethazine (phenergan)?

A

> 2 years

76
Q

what non-drug treatment options are there for travel sickness?

A

acupressure wristbands
ginger herbal supplements

limited evidence, only for patients unsuitable for medication

77
Q

what OTC options are available for otitis externa?

A

earcalm spray

78
Q

what is the age restriction for earcalm spray?

A

> 12 years

79
Q

when should you refer BPH?

A

symptoms < 3 months
dysuria, haematuria, cloudy urine past 3 months
fever
concomitant alpha blockers

80
Q

what is the age licensing of tamsulosin for BPH?

A

45-75

81
Q

how do you supply tamsulosin for BPH?

A

initially give 2 week supply
give further 4 week supply if improvement

82
Q

after 6 weeks of taking tamsulosin, what should be done?

A

see the dr - appropriate to continue

83
Q

what is the age restriction of mebeverine?

A

> 18 years

84
Q

what is the age restriction of alverine?

A

> 12 years

85
Q

what is the age restriction of peppermint oil?

A

> 18 years

86
Q

what is the age restriction of buscopan?

A

> 12 years

87
Q

what is the age restriction of loperamide?

A

> 18 years

88
Q

what are the symptoms of scabies?

A

itching (worse at night)
pimple like rash
small thread like grey lines

89
Q

what are the OTC options for scabies?

A

permethrin (lyclear)
malathion (derbac-M)

90
Q

how should you treat scabies?

A

apply treatment twice, 7 days apart
apply to entire body
treat all close contacts

91
Q

what OTC options are there for threadworm?

A

mebendazole (ovex)

92
Q

what is the age restriction of mebendazole?

A

> 2 years

93
Q

which patient group is mebendazole contraindicated in?

A

pregnant women

94
Q

how should you treat threadworm?

A

mebendazole 100mg stat dose
repeated after 2 weeks to prevent recurrence
treat all family members

95
Q

for pregnant and breastfeeding patients, who cannot use mebendazole, what advice can be given to manage threadworm?

A

strict hygiene measures for at least 6 weeks:

96
Q

what are the different types of ulcer?

A

minor apthous (<5mm size and regular shaped)
major apthous (>10mm size and regular shaped)
trauma (irregular shape)

97
Q

when should an ulcer be referred?

A

> 3 weeks
painless
10mm
5 ulcers

98
Q

what OTC products can be used for ulcers?

A

chlorhexidine (prevents bacterial infection)
local analgesics: benzydamine, choline salicylate
local anaesthetics: lidocaine, benzocaine
topical corticosteroids: hydrocortisone buccal pellets

99
Q

what is the age restriction of corsodyl mouthwash (chlorhexidine)?

A

> 12 years

100
Q

what is the age restriction of difflam oral rinse (benzydamine)?

A

> 12 years

101
Q

what is the age restriction of bonjela adult (choline salicylate)?

A

> 16 years

102
Q

what are pseudoephedrine, phenylephrine, xylometazoline and oxymetazoline?

A

decongestants

103
Q

why should you not use nasal spray decongestants for longer than 7 days?

A

risk of rebound congestion

104
Q

what conditions are decongestants contraindicated in?

A

HTN
hyperthyroidism
diabetes
CVD
glaucoma
prostatic enlargement

105
Q

what should be used first line in patients with congestion who are < 3 months?

A

saline spray/ drops

106
Q

what should be used first line in patients with nasal congestion who are over 3 months and 12 years?

A

steam inhalation

107
Q

what is dextromethorphan?

A

anti-tussive

108
Q

what are guaifenesin and ipecacuanha?

A

expectorants

109
Q

what is the age restriction of dextromethorphan?

A

> 6 years

110
Q

what are the side effects of dextromethorphan?

A

sedation and constipation

111
Q

cough medication containing what is best for children under 6 years?

A

glycerol
simple linctus

112
Q

what is the age restriction of cetirizine?

A

> 6 years
2 years (liquid)

113
Q

what is the age restriction of loratadine?

A

> 2 years

114
Q

what is the age restriction of acrivastine?

A

> 12 years

115
Q

what is the age restriction of chlorphenamine?

A

> 6 years
1 year (liquid)

116
Q

what is the age restriction of promethazine?

A

> 5 years
2 years (liquid)

117
Q

what is the age restriction of steroid nasal sprays?

A

> 18 years

118
Q

what steroids are available as nasal sprays?

A

fluticasone & beclometasone

119
Q

what OTC eye drops are available for hay fever related watery, itchy eyes?

A

sodium cromoglicate (opticrom)
xylometazoline/ antazoline (otrivine antistin)

120
Q

what is the age restriction of covonia throat spray (lidocaine)?

A

> 12 years

121
Q

what is the age restriction of tyrozet lozenges (benzocaine)?

A

> 3 years

122
Q

when should you refer a fungal infection?

A

facial/ scalp involvement
toenails also affected in athletes foot
large area affected
broken skin
diabetic/ immunocompromised

123
Q

clotrimazole (canesten) and miconazole (daktarin) are licensed in what age range?

A

all ages

124
Q

what OTC option is there for acne vulgaris?

A

benzoyl peroxide

125
Q

how should you treat acne with benzoyl peroxide?

A

start at a low strength, increase
wash skin before applying
takes 8 weeks for improvement, continue for 4-6 months

126
Q

what age range is tranexamic acid licensed in?

A

18-45 years

127
Q

what is the dose of tranexamic acid for menorrhagia?

A

two tablets TDS (QDS if severe) for max 4 days

128
Q

what is the age restriction of naproxen for dysmenorrhoea?

A

18-50 years

129
Q

what is the dose of naproxen for dysmenorrhoea?

A

two tablets initially, one further tablet 6-8 hours later if needed
max 3 tablets/ per
max 3 days/ month

Pharmacy (20 decks)

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