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Pre-reg Exam > OTC > Flashcards

OTC Flashcards

1
Q

Paracetamol dose child 1-2 months?

A

30-60mg TDS

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2
Q

Paracetamol dose child 3-5 months?

A

60mg every 4-6 hours

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3
Q

Paracetamol dose child 6-23 months?

A

120 mg every 4–6 hours

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4
Q

Paracetamol dose child 2-3 years?

A

180mg every 4-6 hours

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5
Q

Paracetamol dose child 4-5 years?

A

240mg every 4-6 hours

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6
Q

Paracetamol dose child 6-7 years?

A

240-250mg every 4-6 hours

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7
Q

Paracetamol dose child 8-9 years?

A

360-375mg every 4-6 hours

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8
Q

Paracetamol dose child 10-11 years?

A

480-500mg every 4-6 hours

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9
Q

Paracetamol dose child 12-15 years?

A

480- 750mg every 4-6 hours

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10
Q

Paracetamol dose child 16-17 years?

A

0.5-1g every 4-6 hours

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11
Q

What is the age restriction for paracetamol 250mg/5ml liquid?

A

Cant be sold for children under 6.

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12
Q

Ibuprofen dose child 1-2 months?

A

5mg/kg TDS - QDS

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13
Q

Ibuprofen dose child 3-5 months?

A

50mg TDS

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14
Q

Ibuprofen dose child 6-11 months?

A

50mg TDS- QDS

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15
Q

Ibuprofen dose child 1-3 years?

A

100mg TDS

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16
Q

Ibuprofen dose child 4-6 years?

A

150mg TDS

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17
Q

Ibuprofen dose child 7-9 years?

A

200mg TDS

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18
Q

Ibuprofen dose child 10-11 years?

A

300mg TDS

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19
Q

Ibuprofen dose child 12-17 years?

A

300-400mg TDS initially- up to 600mg TDS

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20
Q

What is the dose of ibuprofen used for post immunisation fever?

A

2.5ml (50mg). Can be repeated after 6 hours if needed.

Do not exceed 2 doses in 24 hours.

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21
Q

What is the dose of paracetamol used for post immunisation fever?

A

2.5ml (60mg). can be repeated every 4 hours up to QDS.

Max 2 days.

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22
Q

What is the youngest age you can sell paracetamol 120mg/5ml liquid?

A

2 months

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23
Q

What is the youngest age you can sell ibuprofen 100mg/5ml liquid?

A

3 months

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24
Q

What is the youngest age you can sell piriton liquid?

A

1 year

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25
Q

What is the youngest age you can sell Hedrin lotion or derbac M (malathion) liquid?

A

6 months

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26
Q

What is the age restriction for sale of mebendazole?

A

2 years

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27
Q

What is the age restriction on sales of cough and cold preparations? e.g pholcodeine, guianfenesin.

How long should treatment last generally?

A

6 years

Treat for 5- 7 days (max 5 days for children 6-12)

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28
Q

What is the age restriction on sales of cetirizine?

A

liquid- 2 years (max. 5mg OD)

tablets- 6 years (10mg OD)

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29
Q

What is the age restriction on sales of topical hydrocortisone?
How long can it be used for?

A

10 years

7 days.

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30
Q

What is the age restriction on sales of codeine containing products?

A

12 years

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31
Q

What is the age restriction on sales of feminax ultra (naproxen)

A

15- 50 years

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32
Q

What is the age restriction on sales of canesten thrush products?

A

16-60 years

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33
Q 
What class is oral lidocaine? 
Are there any restrictions?
A

P medicine
5 months +
Pack sizes restricted to 10g

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34
Q 
What class of drug is amorolfine 5% nail lacquer? 
Are there any restrictions?
A

P medicine

For FUNGAL nail infections
Maximum 2 nails at a time
Patients 18 +

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35
Q

What is chloramphenicol indicated in?
What is the referral criteria?
Which strengths are P medicines?

A

P medicines:
chloramphenicol 0.5% eyedrops
chloramphenicol 1% ointment

Acute bacterial congunctivitis
Maximum 5 days treatment

Refer if: eye surgery in last 6 months, vision affected, aged <2 years, history of bone marrow suppresion.

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36
Q

What are the key points about levorogestrel for EHC?

A

Levonelle 1500 micro grams
72 hours
Age 16 years and older
Less effective if overweight- give 2 tablets
Vommiting within 3 hours, take another one ASAP
Double dose if patient also taking CYP3A4 enzyme inducers (st johns wort, carbamazepine, phenytoin)

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37
Q

What are the key points about ulipristal for EHC?

A

Ellaone 30mg
120 hours (5 days)
No age restriction
Vommiting within 3 hours, take another one ASAP

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38
Q

Which is the most effective EHC?

A

Copper IUD within 5 days

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39
Q

What strength of orlistat classifies as a P medicine?

A

60mg

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40
Q

What are the restrictions around sale of orlistat?

What is the dose?

What is the refferal criteria/ other considerations?

When should it be stopped?

A

Patients 18 and over with BMI >28kg/m2
60mg TDS WITH MEALS (low fat diet)
Reduces absorption of fat soluble vitamins (ADEK) and some drugs notably antiepileptics, oral contraception.

Refer if: diabetic, epileptic (increased seizures)
It is contraindicated if: pt on anticoagulants (affects vitamin K), amiodarone, levothyroxine

STOP if no weight loss after 12 weeks

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41
Q

Which PPIs are available OTC?

When should you see a doctor if symptoms don’t improve?

When do you refer and why?

A 
Omeprazole 10mg (max 20mg OD)
Pantoprazole 20mg (max 20mg OD)
Nexium (esomeprazole) 20mg

Patients aged 18 and over only.
See Dr if no improvement after 2 weeks on omeprazole and 4 weeks on pantoprazole

Refer if over 55- could be gastric cancer

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42
Q

What is the MHRA alert regarding PPIs?

A

Low risk of subacute cutaneous lupus erythematosus (SCLE)- lesions on sun exposed skin + arthralgia (joint pain)

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43
Q

What are the key points about viagra connect sale?

When would you refer?

A

Sildenafil 50mg tabs (max 50mg a day)
P medicine
ED in men 18 and over
cycling over 3 hours a week can contribute to ED
See dr wihin 6 months- sign of CV disease
severe side effects priapism (>4 hours) + visual defects

Refer if: recent ACS (6 months), stroke, severe HF, hypotension

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44
Q

What are the key points about maloff protect sale?

A

Atovaquone 250mg + proguanil 100mg
P medicine
One tablet OD 2 days before trip + 7 days after
18 years and over
Prevention of malaria (falciparum) for up to 12 weeks

Refer in: depression, seizures, <40kg, renal and hepatic probs.

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45
Q

What are the key points about sumatriptan sale?

A

Sumatriptan 50mg (1 stat can be repeated once if another attack within 24 hours)
P medicine
18- 65 years with diagnosed migraine (>4 attacks/ year)

Refer if: 1st migraine, 3 or more CV risk factors, seizures history, headache >24 hours, >4 attacks a month.

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46
Q

What are the key points about tamsulosin sale?

A

400microgram P medicine
Aged 45-75 with BPH symptoms for over 3 months

  • 2 week supply initially if no improvement STOP
  • If improvement further 4 weeks (6 weeks total)
  • Pt must see GP at 6 weeks before further supplies can be made if doctor says its OK.
  • Must see doctor annually to continue further supply

Refer if: eye surgery scheduled (floppy iris syndrome), hypotension, heart, kidney, liver disease, on erythromycin/ ketoconazole.

47
Q

What are the key points about tranexamic acid sale?

A

500mg tabs P medicne
Women aged 18- 45 with regular cycles (21-35 days) for reduction of heavy menstrual bleeds.
1g TDS (can increase to 8 tabs / 4g a day) max 4 days.

Refer if: antioagulants, irregular perios, on the pill/HRT.

48
Q

What is the indication and age restriction on the sale of dovonex?

A

calcipotriol 50mcg/g
previously diagnosed mild to mod plaque psoriasis
18 and over

49
Q

Which medicines for nasal congestion have been recently changed from POM to P?

A

Otrivine extra dual relief
ipratroprium 0.6mg/ml xylometazoline 0.5mg/ml
18 years and over nasal congestion and runny nose

Clarinaze allergy & Nasonex allegy control
mometasone 0.05% nasal spray
18 years and over for allergic rhinitis (hayfever)
maximum 3 months

50
Q

What do WWHAM, ENCORE and SITDOWNSIR stand for?

A

WWHAM
Who, what symptoms, how long, action taken, other medication

ENCORE
explore, no medication, care, observe, refer, explain

SITDOWNSIR
site, intensity, type, duration, onset, with (other symptoms), aggravating factors?, spread/radiation, incidence/ frequency pattern, relieved by?

51
Q

What are the main sections of consultation skills?

A
  1. Initiating the session
  2. Gathering information
  3. Building the relationship
  4. explanation and planning
  5. closing the session
52
Q

What sputum colour is often associated with cough in heart failure?

A

pink sputum

53
Q

What sputum colour is associated with cough in pneumonia?

A

red/ rust

54
Q

What are some referral criteria for patients presenting with cough?

A

Cough > 3-4 weeks

SOB, chest pin, pain when breathing in, blood in sputum,

55
Q

What is the age restriction for simple linctus?

A

1 month

56
Q

What is the age restriction for preparations containing honey?

A

1 year

57
Q

What could middle ear pain be a sign of?

A

Otitis media- refer may need abx

58
Q

What are the maximum doses of ephedrine and pseudoephedrine?

What additional items would concern you if requested with these drugs.

A

ephedrine- 180mg
pseudoephedrine (eg sudafed) 720mg
can’t be sold together.

due to risk of methamphetamine (crystal meth) manufacture. esp. if want lithium batteries and acetone.

59
Q

Are sympathomimmetics (e.g pseudoephedrine) compatible with MAOIs (e.g phenelzine, isocarboxazid)

A

No- cause hypertensive crisis

Avoid sympathomimmetics within 14 days of stopping MAOI therapy

NOTE: pseudoephedrine is cautioned in hypertension and diabetes.

60
Q

What is the standard treatment for tonsillitis?

What are the signs that it is bacterial infection rather than viral?

A

Penicillin 500mg TDS 10 days
OR (pen allergic clarith 500mg BD 5 days/ erythromycin.)

Swollen glands with possible exudate and usually NO cough present

61
Q

What is the kissing disease?

A

Glandular fever

62
Q

Which medicines are known to cause agranulocytosis and may present as sore throat?

A 
Immunosuppressants
carbimazole
captopril
sulfasalazine
penicillamine
gold
cytotoxics
neuroleptics (e.g clozapine)
co-trimethoprim
carbamazepine, phenytoin, ethosuximide
co-trimoxazole
63
Q

What do you do if a patient presents with dysphhagia?

A

Always refer- sign of cancer

64
Q

After how long should you refer a sore throat?

A

2 weeks

65
Q

Can an advance supply of EHC be supplied?

A

Yes to be used if contraception fails as long as patient is competent to use it appropriately.

66
Q

What should be done if a child under 13 requested EHC?

A
  • Too young to consent to any sexual activity

- Treat seriously, should be reported to social services

67
Q

What is the max quantity to paracetamol and aspirin that can be sold OTC?

A

100 tablets non-effervescent

No limit on effervescent

68
Q

What is the age restriction for OTC sales of loratadine?

What is the recommended dosing?

A

children over 2 (must weigh over 30kg) 5mg OD

children over 12 and adults - 10mg OD

69
Q

What is the age restriction on sales of chlorphenamine?

What is the recommended dosing in adults?

A

1 year old upwards

4mg every 4-6 hours in adults

70
Q

Which nasal product should be avoided in patients with glaucoma?

A

nasal corticosteroids (e.g fluticasone)

71
Q

Which part of the eye is the sclera?

A

The white bit of the eye

72
Q

What red flag symptoms with the eye that require referral?

A 
Photophobia
visual changes (halos around lights)
Eye pain ( true pain not irritation when its described as gritty or foreign body in the eye)
73
Q

What are the signs of blepharitis?

How is it treated?

A

Red, swolen, itchy eyes, typically bilateral, accompanied with crustydebris or skin flakes around the lashes

No treatment needed- goes away on its own

74
Q

What are red flag symptoms with headaches that require refferal?

A

Recent trauma (haemorrhage)
Children < 12 who have a fever and a rash (meningitis)
New headache in patients >50

75
Q

What age groups should be referred if they present to the pharmacy with thrush?

A

Under 16s and over 60s

76
Q

What ages can lactulose and docusate be used from?

A

lactulose- infant

docusate- 6 months

77
Q

What is pain in the upper left quadrant of the abdomen likely to be?

A

spleen pain

78
Q

What is pain in the upper right quadrant of the abdomen likely to be?

A

Hepatitis (liver associated pain)

gall stones causing cholecystisis

79
Q

What is pain in the lower left quadrant of the abdomen radiating to the groin likely to be?

A

renal stones

80
Q

What is deep crushing chest pain that radiates to the neck, jaw and inner left arm likely to be?

A

MI

81
Q

What is a pain that originates near the navel and migrates to the lower right quadrant of the abdomen likely to be?

A

Apendicitis

82
Q

What products are available OTC for androgenetic alopecia?

A

Minoxidil 2% and 5%
Men aged 18-50 years old
Any hair growth achieved is lose 6-8 weeks after treatment cessation.

83
Q

How is permethrin (Lyclear) used in the treatment of scabies?

What age is it licensed for?

A

Apply to the entire body
Treat all members of the household simultaneously
Wash away after 8-12 hours
Repeat treatment after 7 days

Licensed for adults and children over 2 years old

84
Q

How is malathion (Derbac M) used for the treatment of scabies?

What age is it licensed for?

A

Apply to the entire body
Treat all members of the household simultaneously
Wash away after 24 hours
Repeat treatment after 7 days

Licensed for adults and children over 6 months old

85
Q

What is the recommended OTC first line treatment for acne?

A

Benzoyl peroxide (Acnecide) 2.5% or 5%

86
Q

Hoiw is impetigo described?
What are the infecting species?
What is the treatment?

A

Red itchy inflamed, burst vesicles leave brown yellow sticky crust on face around nose and mouth.
s. aureous streptococcus pyogenes
Need referral for a prescription for antibiotics- topical fusidic acid or systemic flucloxacillin.

87
Q

What is the ABCDE rule of malignant melanoma diagnosis?

A

First signs: changes in size, shape, colour of a mole.

Asymetry of mole
Border  irregular/ jagged
Colour- non-uniform
Diameter  >7mm (back of a pencil)
Evolution (change in mole over time)
88
Q

What factor of sun screen is recommended for skin protection? How often should it be applied?

A

At least factor 30. Apply at least 20 minutes before sun exposure and reapply every 2 hours.

89
Q

How should malathion (derbac M), dimeticone (hedrin), isopropyl mystirate (full marks), permethrin (lyclear) be used for head lice?

What is the age restriction?

A

derbac M- apply to dry hair and leave for 12 hours before washing off.

hedrin- apply to dry hair and leave for 8 hours. wash out with shampoo afterwards.

lyclear and full marks- only need 10 minute contact time

6 months and over except full marks which is 2 years

90
Q

What age can mebendazole (ovex) be used for? can it be used when pregnant or breastfeeding?

A

2 years +
No for pregnant
yes for breastfeeding

91
Q

How can molluscum contagiosum be described? How i it treated?

A

Pink pearl- like spots with a white center usually on the face and armpits.
Treatment often just freezing spots with nitrogen.

92
Q

What are erythema infectiosum or fifth disease?

A

slapped cheek disease

93
Q

How can measles be described? How is it treated?

A

1-2 weeks before symptoms
Fever, small greyish-white spots in the mouth, blotchy red skin around ears and eyes, rash.
Self limiting - goes away itself in 7-10 days. just give pain relief.

94
Q

How is mumps described? How is it treated?

A

2-3 weeks before symptoms
Swelling of the parotid glands near the mouth leading to fever, loss of appetite.
Self limiting - goes away itself in 7-10 days. just give pain relief.

95
Q

What is german measles?

A

rubella

96
Q

How is rubella described? How is it treated?

When is rubella of particular concern?

A

2-3 weeks before symptoms.
Of concern in pregnant women- can harm foetus.
Red or pink spotty rash starting from behind ear to face.
Self limiting - goes away itself in 7-10 days. just give pain relief.

97
Q

How is motion sickness managed?

A

Antihistamines- cyclizine (ages 6+), cinnarazine, promethazine (ages 5+ )
antimuscarinics - hyoscine (ages 3+)

Take tabs 2 hours before travel (20-30 mins for hyoscine)

98
Q

What are the rules if someone misses a pill of their combined oral contraceptive?

Which pills does this not apply to?

A

If ONE pill missed (24 hours+) take the missed pill then continue taking the rest as normal, no additional contraception is needed

If TWO pills missed (48 hours+) take the latest missed pill then continue taking the rest as normal, use extra contraception for the next 7 days.
If pill is missed in the first week, not protected- EHC may be needed if sex occurred.
If pill is missed in third week (pills 15-21) omit the pill free interval. start new pack right after.

Doesnt apply to :
Zoely (not protected after 24 hours of missed dose)
Qlaira (not protected after 12 hours of missed dose)
Eloine (not protected after 24 hours of missed dose)
Daylette

99
Q

What are the rules if someone misses a pill of their progestogen- only oral contraceptive (minipill)?

A

If less than 3 hours late (12 hours for desogestrel):
take the missed pill asap. take the next pill at the usual time. You are protected- no extra precautions.

If more than 3 hours late (12 hours for desogestrel):
take one pill as soon as you remember, take next pill at usual time. You are not protected for the next 2 days (48 hours) use condoms and EHC needed if sex occurs.

100
Q

EHC should be repeated if vomiting occurs before which timeframe?

A

3 hours

101
Q

What are the stages of the cyclical transtheoretical model of change?

What stage are most patients who present to pharmacy to buy NRT

A

Relapse
Pre-contemplation- some patients may be here
Comtemplation
Preparation- most patients who ask for NRT are here
Action
Maintanace

102
Q

What is the maximum number of nicotine gum that can be chewed in 24 hours?

A

15 pieces

103
Q

What is the maximum number of sprays o nicotine nasal sprays and mouth sprays in 24 hours?

A

64 sprays

104
Q

What is the maximum number of nicotine lozenges in 24 hours?

A

15

105
Q

What are the clinical symptoms of malaria?

A

Fever, N+V, headache

general malaise within 3 months of travel to endemic area (p.vivax malaria can take up to a year)

106
Q

What does the 50%, 30% and 20% in DEET mean?

A

50%- protection for up to 12 hours
30%- protection for up to 6 hours
20%- protection for 1-3 hours

107
Q

What can DEET reduce the effectiveness of?

A

sunblock.

NOTE: the effectiveness of DEET is nt reduced by sunblock.

108
Q

When should chloroquine for malaria prophylaxis be avoided?

What are notable drug interactions?

A

Patients with epilepsy

Amiodarone, ciclosporin, digoxin, cimetidine

109
Q

What BMI classes as overweight? What about obese?

A

25 is overweight

30 is obese

110
Q

What OTC treatment is available for chlamydia?

Any restrictions?

A

Azithromycin 1g stat

Men and women over 16 who have tested positive and are asymptomatic

111
Q

What is the first line treatment for chlamydia in a clinic setting

A

Adults and children >13

1st line: Doxycycline 100mg BD for 7 days
2nd line: Azithromycin 1g on day one then 500mg for 2 days.

Avoid sex until treatment is complete (or 7 days after if azithromycin used)

112
Q

After how long should a patient with a mouth ulcer be reffered to a dentist to exclude oral cancer?

A

2-3 weeks

113
Q

What is the minimum age for pseudoephedrine and ephedrine sale?

A

12 years

114
Q

What medicines commonly cause oral thrush?

What is the minimum age for selling Miconazole gel for it?

A

Inhales steroids
cytotoxics
broad spectrum antibiotics

4 months

Pre-reg Exam (15 decks)

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