OTC Flashcards
H2 antagonists e.g. ranitidine. What age can you sell them to OTC? Can you sell them to pregnant and breastfeeding women?
Over 16 years No
What is max dose of ranitidine OTC?
75 mg tablets Do not take more than 2 in 24 hours
True or false: Being overweight can contribute to dyspepsia
True
True or false: Smoking can contribute to dyspepsia
True
In what group of patients is orlistat licensed for OTC?
> 18 years BMI > 28
What is the OTC omeprazole dose and how long can they be used for and when would you refer?
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
What age can you sell OTC omeprazole to?
>18 years
What age can you sell esomeprazole to?
>18 years
What age can you sell OTC esomeprazole to?
>18 years
What is the dose of OTC esomeprazole, and what is the max time it can be used for?
20mg OD 2 weeks maximum
What is colic?
When a baby cries with no obvious cause Linked to disorder of GI tract, post partum depression, anxious parents Affects babies < 6 months old
How can you treat colic OTC?
Anti-foaming agents e.g. simethicone (Dentinox, infacol) Gripe water Effectiveness is lacking however and it should resolve by itself in time
What are symptoms of colic?
High pitched crying Often at same time of day Drawing knees up to stomach
When would you refer with colic?
Failure to put on weight OTC treatment failure Danger symptoms Over anxious parents Symptoms have not resolved past 4 months of age
What is 1st line for constipation?
Lifestyle measures
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?
If straining would exacerbate a condition e.g. angina Or increase bleeding risk e.g. haemorrhoids
Why must bulk forming laxatives be taken with adequate fluids?
To avoid intestinal obstruction
Frequent use of stimulant laxatives can lead to what?
Fluid and electrolyte imbalance
How long does it take for glycerol suppositories to work?
Within 30 mins
What are the preferred type of laxative in children?
Osmotic Bulk forming
What are the safest laxatives to use in pregnancy and breastfeeding?
Bulk forming and osmotic
Why are stimulant laxatives not really recommended in breastfeeding and pregnancy?
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.
At what point is constipation classed as chronic?
Lasting 6 weeks or more
If a patient has constipation along with tiredness, what could be underlying causes?
Hypothyroidism Anaemia
How long does it take for bulk forming laxatives to work?
12- 72 hours
What age can you sell Senna OTC to?
>12 years
What age can you sell Sodium picosulphate (Dulcolax pico liquid) OTC to?
> 10 years
What age can you sell ispaghula husk OTC to?
>6 years
Is Movicol is licensed for acute, chronic or both types of constipation?
Chronic
What are danger symptoms in a diarrhoea patient that prompts a referral?
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
What is the difference between Diarolyte and Diarolyte Relief?
Relief contains rice power and normal diarolyte is glucose based
What age can you sell loperamide OTC to?
12 years and over
What is the maximum dose of GSL loperamide a day?
What is the maximum dose of P medicine loperamide a day?
12mg (6 caps a day) for GSL
16mg (8 caps a day) for P
Does rectal bleeding from haemorrhoids need to be referred?
No unless excessive bleeding occurs or has occurred for more than 3 weeks
What kind of laxative should be used for IBS?
Bulk forming
What age can you sell mebeverine OTC?
> 18 years
What age can you sell Buscopan OTC?
12 years and over
What age can you sell Colpermin IBS relief capsules OTC? (peppermint oil)
15 years and over
What are the symptoms of haemorrhoids?
Bleeding, perianal itching, mucus discharge and pain
How many days max should you use Anusol HC plus ointment OTC?
7 days max (contains hydrocortisone)
Can you use anusol HC plus ointment OTC in pregnancy and breastfeeding?
No
A cough for how many weeks would prompt a referral?
Longer than 3 weeks
What is croup?
Croup in children is caused typically by the parainfluenza virus. It often starts with a cold and develops into a characteristic barking cough
What time of the day are symptoms of croup the worst?
At night
How can you treat croup?
No medical treatment as it is viral but can offer antipyretic treatment if fever is present
Systemic decongestants should be used with caution in what group of patients?
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.
Systemic decongestants are contraindicated in patients taking what medicine class?
MAOIs Risk of hypotensive crisis
What is a purpuric rash?
One which does not blanch white on pressure
Bonjela preparations containing choline salicylate is unsuitable for which age group?
Under 16 years
What is the licensed age range for sumatriptan OTC?
18-65
What is the maximum dose of OTC sumatriptan?
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
What groups of patients is sumatriptan OTC unsuitable for?
- Previous myocardial infarction - Ischaemic heart disease, e.g. angina - Peripheral vascular disease - Cardiac arrhythmias (including Wolff-Parkinson-White syndrome)
What is 1st line for pregnancy in threadworm?
Strict hygiene measures Refer if this has not worked
What is the dosing instructions for mebendazole in threadworm?
Once only dose Can be repeated after 2 weeks if it has not cleared up Everyone in the house should be treated
What age group is mebendazole not suitable for?
<2 years
What is recommended as first line for head lice treatment in pregnancy and BF?
Wet combing If treatment needed, Dimeticone e.g. Hedrin
What is recommended as first line for head lice treatment in asthma and eczema?
Wet combing If treatment needed, Dimeticone e.g. Hedrin
How many times should you apply head lice treatment and how many days should you leave between each treatment course?
Twice At least 7 days between
What is first line for scabies?
Permethrin 5% w/w cream (Lyclear®)
What is first line for scabies in pregnancy and BF?
Permethrin 5% w/w cream (Lyclear®)
Where should you apply scabies lotion?
All over the body
What is 1st line for athlete’s foot in pregnancy and breastfeeding?
Topical imidazoles e.g. Daktarin Gold
What is the minimum age for Lamisil OTC (terbinafine) for athelete’s foot (tinea pedis)?
> 16 years
What is the maximum number of nails you can treat OTC for fungal nail infection?
2 If more than this, need to refer
Amorolfine lacquer is licensed OTC for what condition and what is the age restriction?
Fungal nail infection 18 years and over
How can ringworm (tinea corpis) and jock itch (tinea cruris) be treated OTC?
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.
How can sweat rashes be treated OTC?
Topical imidazoles e.g. Daktarin
What should you do if someone comes into the pharmacy with impetigo?
Usually needs a prescription to treat it so refer
What age groups should be referred in vaginal thrush?
<16 years >60 years
True or false: Poorly controlled diabetes is linked with thrush
True
Women who have had more than how many episodes of thrush in 6 months- when should you refer to GP?
More than 2 episodes in last 6 months
Can you treat a pregnant person OTC for thrush?
No- refer
What NSAID (stronger than ibuprofen) is available OTC for primary dysmenorrhoea?
Feminax ultra 250mg naproxen
What age range is Feminax ultra licensed for?
15-50 years
What age would you refer for bacterial conjunctivitis?
<2 years
Can you treat bacterial conjunctivitis OTC for pregnancy and breastfeeding?
No- refer
An ulcer lasting than more than how many weeks should be referred?
More than 3 weeks- exclude oral cancer
What is the minimum age to use Difflam mouthwash?
12 years
What is the minimum age to use Difflam spray?
6 years
What is a common side effect on the teeth if a patient is having chlorhexidine mouthwash?
Stains teeth brown
What is the minimum age to use miconazole 2% oral gel for oral thrush?
>4 months
Should miconazole oral gel be applied before or after meals?
After and held in the mouth as long as possible
What anticoagulation interacts with miconazole oral thrush gel and prompts a referral?
Warfarin
If a patient has diabetes and presents to the pharmacy with oral thrush, what should you do?
Refer
What is angular stomatitis?
Cracked fissures in the corners of the mouth
What can you offer OTC for angular stomatitis?
Clotrimazole 1% cream
True or false: Diuretics can cause dry eyes
True
What is the minimum age to use hydrocortisone 1% cream OTC?
10 years
What is the maximum number of days to use OTC steroid cream?
7 days
What steroid creams are available OTC?
Hydrocortisone 1% and clobetasone butyrate 0.05%
What areas can you not put OTC steroid cream?
Facial skin, broken skin, genitals You can put it on ears as this does not count as your face
Can you give steroid creams OTC to pregnant women?
No