OTC Flashcards
1
Q
Paracetamol dose child 1-2 months?
A
30-60mg TDS
2
Q
Paracetamol dose child 3-5 months?
A
60mg every 4-6 hours
3
Q
Paracetamol dose child 6-23 months?
A
120 mg every 4–6 hours
4
Q
Paracetamol dose child 2-3 years?
A
180mg every 4-6 hours
5
Q
Paracetamol dose child 4-5 years?
A
240mg every 4-6 hours
6
Q
Paracetamol dose child 6-7 years?
A
240-250mg every 4-6 hours
7
Q
Paracetamol dose child 8-9 years?
A
360-375mg every 4-6 hours
8
Q
Paracetamol dose child 10-11 years?
A
480-500mg every 4-6 hours
9
Q
Paracetamol dose child 12-15 years?
A
480- 750mg every 4-6 hours
10
Q
Paracetamol dose child 16-17 years?
A
0.5-1g every 4-6 hours
11
Q
What is the age restriction for paracetamol 250mg/5ml liquid?
A
Cant be sold for children under 6.
12
Q
Ibuprofen dose child 1-2 months?
A
5mg/kg TDS - QDS
13
Q
Ibuprofen dose child 3-5 months?
A
50mg TDS
14
Q
Ibuprofen dose child 6-11 months?
A
50mg TDS- QDS
15
Q
Ibuprofen dose child 1-3 years?
A
100mg TDS
16
Q
Ibuprofen dose child 4-6 years?
A
150mg TDS
17
Q
Ibuprofen dose child 7-9 years?
A
200mg TDS
18
Q
Ibuprofen dose child 10-11 years?
A
300mg TDS
19
Q
Ibuprofen dose child 12-17 years?
A
300-400mg TDS initially- up to 600mg TDS
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.
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.
22
Q
What is the youngest age you can sell paracetamol 120mg/5ml liquid?
A
2 months
23
Q
What is the youngest age you can sell ibuprofen 100mg/5ml liquid?
A
3 months
24
Q
What is the youngest age you can sell piriton liquid?
A
1 year
25
What is the youngest age you can sell Hedrin lotion or derbac M (malathion) liquid?
6 months
26
What is the age restriction for sale of mebendazole?
2 years
27
What is the age restriction on sales of cough and cold preparations? e.g pholcodeine, guianfenesin.
How long should treatment last generally?
6 years
Treat for 5- 7 days (max 5 days for children 6-12)
28
What is the age restriction on sales of cetirizine?
liquid- 2 years (max. 5mg OD)
tablets- 6 years (10mg OD)
29
What is the age restriction on sales of topical hydrocortisone?
How long can it be used for?
10 years
7 days.
30
What is the age restriction on sales of codeine containing products?
12 years
31
What is the age restriction on sales of feminax ultra (naproxen)
15- 50 years
32
What is the age restriction on sales of canesten thrush products?
16-60 years
33
```
What class is oral lidocaine?
Are there any restrictions?
```
P medicine
5 months +
Pack sizes restricted to 10g
34
```
What class of drug is amorolfine 5% nail lacquer?
Are there any restrictions?
```
P medicine
For FUNGAL nail infections
Maximum 2 nails at a time
Patients 18 +
35
What is chloramphenicol indicated in?
What is the referral criteria?
Which strengths are P medicines?
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.
36
What are the key points about levorogestrel for EHC?
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)
37
What are the key points about ulipristal for EHC?
Ellaone 30mg
120 hours (5 days)
No age restriction
Vommiting within 3 hours, take another one ASAP
38
Which is the most effective EHC?
Copper IUD within 5 days
39
What strength of orlistat classifies as a P medicine?
60mg
40
What are the restrictions around sale of orlistat?
What is the dose?
What is the refferal criteria/ other considerations?
When should it be stopped?
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
41
Which PPIs are available OTC?
When should you see a doctor if symptoms don't improve?
When do you refer and why?
```
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
42
What is the MHRA alert regarding PPIs?
Low risk of subacute cutaneous lupus erythematosus (SCLE)- lesions on sun exposed skin + arthralgia (joint pain)
43
What are the key points about viagra connect sale?
When would you refer?
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
44
What are the key points about maloff protect sale?
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.
45
What are the key points about sumatriptan sale?
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.
46
What are the key points about tamsulosin sale?
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
What are the key points about tranexamic acid sale?
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
What is the indication and age restriction on the sale of dovonex?
calcipotriol 50mcg/g
previously diagnosed mild to mod plaque psoriasis
18 and over
49
Which medicines for nasal congestion have been recently changed from POM to P?
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
What do WWHAM, ENCORE and SITDOWNSIR stand for?
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
What are the main sections of consultation skills?
1. Initiating the session
2. Gathering information
3. Building the relationship
4. explanation and planning
5. closing the session
52
What sputum colour is often associated with cough in heart failure?
pink sputum
53
What sputum colour is associated with cough in pneumonia?
red/ rust
54
What are some referral criteria for patients presenting with cough?
Cough > 3-4 weeks
| SOB, chest pin, pain when breathing in, blood in sputum,
55
What is the age restriction for simple linctus?
1 month
56
What is the age restriction for preparations containing honey?
1 year
57
What could middle ear pain be a sign of?
Otitis media- refer may need abx
58
What are the maximum doses of ephedrine and pseudoephedrine?
What additional items would concern you if requested with these drugs.
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
Are sympathomimmetics (e.g pseudoephedrine) compatible with MAOIs (e.g phenelzine, isocarboxazid)
No- cause hypertensive crisis
Avoid sympathomimmetics within 14 days of stopping MAOI therapy
NOTE: pseudoephedrine is cautioned in hypertension and diabetes.
60
What is the standard treatment for tonsillitis?
What are the signs that it is bacterial infection rather than viral?
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
What is the kissing disease?
Glandular fever
62
Which medicines are known to cause agranulocytosis and may present as sore throat?
```
Immunosuppressants
carbimazole
captopril
sulfasalazine
penicillamine
gold
cytotoxics
neuroleptics (e.g clozapine)
co-trimethoprim
carbamazepine, phenytoin, ethosuximide
co-trimoxazole
```
63
What do you do if a patient presents with dysphhagia?
Always refer- sign of cancer
64
After how long should you refer a sore throat?
2 weeks
65
Can an advance supply of EHC be supplied?
Yes to be used if contraception fails as long as patient is competent to use it appropriately.
66
What should be done if a child under 13 requested EHC?
- Too young to consent to any sexual activity
| - Treat seriously, should be reported to social services
67
What is the max quantity to paracetamol and aspirin that can be sold OTC?
100 tablets non-effervescent
| No limit on effervescent
68
What is the age restriction for OTC sales of loratadine?
What is the recommended dosing?
children over 2 (must weigh over 30kg) 5mg OD
children over 12 and adults - 10mg OD
69
What is the age restriction on sales of chlorphenamine?
What is the recommended dosing in adults?
1 year old upwards
4mg every 4-6 hours in adults
70
Which nasal product should be avoided in patients with glaucoma?
nasal corticosteroids (e.g fluticasone)
71
Which part of the eye is the sclera?
The white bit of the eye
72
What red flag symptoms with the eye that require referral?
```
Photophobia
visual changes (halos around lights)
Eye pain ( true pain not irritation when its described as gritty or foreign body in the eye)
```
73
What are the signs of blepharitis?
How is it treated?
Red, swolen, itchy eyes, typically bilateral, accompanied with crustydebris or skin flakes around the lashes
No treatment needed- goes away on its own
74
What are red flag symptoms with headaches that require refferal?
Recent trauma (haemorrhage)
Children < 12 who have a fever and a rash (meningitis)
New headache in patients >50
75
What age groups should be referred if they present to the pharmacy with thrush?
Under 16s and over 60s
76
What ages can lactulose and docusate be used from?
lactulose- infant
| docusate- 6 months
77
What is pain in the upper left quadrant of the abdomen likely to be?
spleen pain
78
What is pain in the upper right quadrant of the abdomen likely to be?
Hepatitis (liver associated pain)
| gall stones causing cholecystisis
79
What is pain in the lower left quadrant of the abdomen radiating to the groin likely to be?
renal stones
80
What is deep crushing chest pain that radiates to the neck, jaw and inner left arm likely to be?
MI
81
What is a pain that originates near the navel and migrates to the lower right quadrant of the abdomen likely to be?
Apendicitis
82
What products are available OTC for androgenetic alopecia?
Minoxidil 2% and 5%
Men aged 18-50 years old
Any hair growth achieved is lose 6-8 weeks after treatment cessation.
83
How is permethrin (Lyclear) used in the treatment of scabies?
What age is it licensed for?
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
How is malathion (Derbac M) used for the treatment of scabies?
What age is it licensed for?
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
What is the recommended OTC first line treatment for acne?
Benzoyl peroxide (Acnecide) 2.5% or 5%
86
Hoiw is impetigo described?
What are the infecting species?
What is the treatment?
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
What is the ABCDE rule of malignant melanoma diagnosis?
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
What factor of sun screen is recommended for skin protection? How often should it be applied?
At least factor 30. Apply at least 20 minutes before sun exposure and reapply every 2 hours.
89
How should malathion (derbac M), dimeticone (hedrin), isopropyl mystirate (full marks), permethrin (lyclear) be used for head lice?
What is the age restriction?
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
What age can mebendazole (ovex) be used for? can it be used when pregnant or breastfeeding?
2 years +
No for pregnant
yes for breastfeeding
91
How can molluscum contagiosum be described? How i it treated?
Pink pearl- like spots with a white center usually on the face and armpits.
Treatment often just freezing spots with nitrogen.
92
What are erythema infectiosum or fifth disease?
slapped cheek disease
93
How can measles be described? How is it treated?
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
How is mumps described? How is it treated?
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
What is german measles?
rubella
96
How is rubella described? How is it treated?
When is rubella of particular concern?
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
How is motion sickness managed?
Antihistamines- cyclizine (ages 6+), cinnarazine, promethazine (ages 5+ )
antimuscarinics - hyoscine (ages 3+)
Take tabs 2 hours before travel (20-30 mins for hyoscine)
98
What are the rules if someone misses a pill of their combined oral contraceptive?
Which pills does this not apply to?
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
What are the rules if someone misses a pill of their progestogen- only oral contraceptive (minipill)?
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
EHC should be repeated if vomiting occurs before which timeframe?
3 hours
101
What are the stages of the cyclical transtheoretical model of change?
What stage are most patients who present to pharmacy to buy NRT
Relapse
Pre-contemplation- some patients may be here
Comtemplation
Preparation- most patients who ask for NRT are here
Action
Maintanace
102
What is the maximum number of nicotine gum that can be chewed in 24 hours?
15 pieces
103
What is the maximum number of sprays o nicotine nasal sprays and mouth sprays in 24 hours?
64 sprays
104
What is the maximum number of nicotine lozenges in 24 hours?
15
105
What are the clinical symptoms of malaria?
Fever, N+V, headache
| general malaise within 3 months of travel to endemic area (p.vivax malaria can take up to a year)
106
What does the 50%, 30% and 20% in DEET mean?
50%- protection for up to 12 hours
30%- protection for up to 6 hours
20%- protection for 1-3 hours
107
What can DEET reduce the effectiveness of?
sunblock.
| NOTE: the effectiveness of DEET is nt reduced by sunblock.
108
When should chloroquine for malaria prophylaxis be avoided?
What are notable drug interactions?
Patients with epilepsy
Amiodarone, ciclosporin, digoxin, cimetidine
109
What BMI classes as overweight? What about obese?
25 is overweight
| 30 is obese
110
What OTC treatment is available for chlamydia?
Any restrictions?
Azithromycin 1g stat
Men and women over 16 who have tested positive and are asymptomatic
111
What is the first line treatment for chlamydia in a clinic setting
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
After how long should a patient with a mouth ulcer be reffered to a dentist to exclude oral cancer?
2-3 weeks
113
What is the minimum age for pseudoephedrine and ephedrine sale?
12 years
114
What medicines commonly cause oral thrush?
What is the minimum age for selling Miconazole gel for it?
Inhales steroids
cytotoxics
broad spectrum antibiotics
4 months
