Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

2021 Pre-registration > OTC: General > Flashcards

OTC: General Flashcards

1
Q

3 types of conjunctivitis?

A

Bacterial: OE then BE, Sticky purulent discharge, gritty feeling

Viral: BE due to cold/flu, Watery eyes with redness and gritty feeling - self limiting or aciclovir POM

Allergic: BE, watery, red, itchy- due to hayfever/pollen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Referral criteria for conjunctivitis?

A
  • Closed angle closure glaucoma symptoms (n/v, blurred/hazy vision, rainbow rings, photophobia, intense eye pain and headache): can cause blindness
  • Previous laser /surgery within 6 months
  • Eye inflammation with rash on face
  • Foreign body in the eye
  • Eye/head trauma
  • Keratitis (esp with contact lens)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Immediate referral in those with conjunctivitis (3)?

A

Glaucoma symptoms

  • Sudden severe eye pain
  • N/V
  • Cloudy eye
  • blurred/halo vision
  • headache

Keratitis (corneal ulcers)
- severe eye pain, loss of vision, photophobia, redness around eyes

Uveitis
- irregular pupil shape with no response to light and photophobia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

OTC treatment for conjunctivits

A

1) Chloramphenicol eye drops or oint: 2yrs +
2) Brolene: propamidine isoetionate

Refer if no improvement in 48hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Chloramphenicol eye drops dosage OTC?

A

1-2 drops every 2 hrs for 1st two days whilst awake
then every 4hrs next 3 days ( 5 day course)

Fridge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Chloramphenicol eye ointment dosage OTC?

A

TDS/QDS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Contraindications for chloramphenicol?

A

Myelosuppression

Blood dyscrasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Conjunctitivits lifestyle advice?

A 
Wash hands before and after use
Dispose tissue after use
Avoid sharing pillows
Bathe eyelids 
No lens before or 24hrs after use
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What causes vaginal thrush?

A

Candida albicans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Symptoms of vaginal thrush?

A

Itching and sore
Cottage-cheese like discharge (cream and curd like)
No smell

Pain during sex
Stinging skin when urinating due to scratching

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

OTC referral ages for thrush?

A

<16yrs
>60yrs
OTC failure >7days
Recurrent attacks (>2 episodes within 6 months - underlying cause)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

OTC referral criteria for thrush?

A

<16yrs
>60yrs
OTC failure >7days
- Recurrent attacks (>2 episodes within 6 months - underlying cause)
- Smell and colour: grey, watery, fishy - BV
- Yellow/green, frothy, foul - vaginal trichomoniasis
- Vag spotting, abd. pain, dysuria - gonnorrhoea/chlamydia
- sores ulcers blisters - herpes
- STI (inform partner)
- Vaginal bleeding - cancer?
- Med ADR? antibiotics, SGLT2 inhibitors (gliflozins)
- Pregnant/diabetic/immunocompromised

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Treatment options OTC for thrush?

A

Fluconazole 150mg STAT PO: 12-24hrs for symptom relief - treat systemically

Clotrimazole pessary/cream - internal/external (pessary at night, immediate relief)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Which OTC formulation would not be suitable for pregnant women?

A

Antifungal cream with applicator

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Lifestyle advice for vulvovaginal thrush?

A 
Cotton underwear
Wipe front to back
Avoid soap/douching
Change clothes and wash after physical activity
Refrain from sex due to spread
moisturise with emollient
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How would you treat severe infection of candidiasis?

A

Either two doses of oral fluconazole 150 mg (taken 3 days apart) or, if oral treatment is contraindicated, two doses of clotrimazole 500 mg vaginal pessary (used 3 days apart).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How would you treat candidiasis in pregnancy?

A

Intravaginal clotrimazole or miconazole should be prescribed for at least 7 days.
Oral antifungals should not be used.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What drugs can antifungals used for candidiasis interact with?

A

Anticoagulants like warfarin as antifungals are enzyme inhibitors CYP 3A4, CYP 2CP

Statins, CCBs, Phenytoin

Tacrolimus/Sarolimus: increased levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What can EHC be used for?

A

Unprotected sex
Contraceptive failure
Advance supply e.g. going on holiday

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Referral criteria for EHC?

A
  • Severe liver impairment
  • unprotected sex >5days: needs copper IUD
  • Period changes: late/light/heavy
  • Interacting medicines: enzyme inducers (carbamazepine, phenytoin, rifampicin, st johns wart, griseofulvin) - needs double dose but unlicensed OTC
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the two EHC options?

A

Levonorgestrel - 3 days, 72hrs (16+)

Ulipristal - 5 days, 120hrs (No age)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Which EHC can you take more than once in the same cycle?

A

Levonorgestrel - can

Ulipristal - contra indicated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

EHC should be avoided in?

A

Severe liver impairment
Ectopic pregnancy risk
Chrons disease
Asthma treated with steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Which EHC has to be stopped in breastfeeding?

A

Levonorgestrel OK avoid nurding 8hrs

Ulipristal - Not recommended for 1 week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Regular contraception with EHC?

A

Levonorgestrel - OK, start stat and barrier for 7 days

Ulipristal - use condom until next period (5days after and barrier for 2 days)

Barrier for prog - 2 days
Barrier for combined - 7 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Advice for EHC?

A

Take asap.
If vomit within 3 hrs, take a double dose
Barrier method until next period
ulipristal reduced effectiveness of current contraception so use barrier methods
Abnormal bleeding at period - see gp
delayed period - see gp: levo >5days, uli >7days
Severe abdominal pain: ectopic pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Significant interactions with EHC?

A

Rifampicin, ciclosporin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

How many missed pills of regular contraception would prompt to get EHC?

A

Combined: 2pills (week 1 day 1-7 EHC/week2 day 8 -14 but barriers or 3 day 15-21 no need ehc but precautions for 7 days)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Legal age of consent for sex in the UK?

A

16yrs, IF <16YRS: Use fraser

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Offences are considered statutory rape in those under

A

13yrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is cystitis?

A

Infection caused by e.coli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Symptoms of cystitis?

A

Dysuria, haematuria, foul smell, polyuria, dark/cloudy urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Referral criteria for cystitis?

A

<16, >70
Men and children
Recurrent: >2 episodes in 6 months or 3 in a year
Duration: >48hrs
Severe symptoms
Lower back/flank pain
Systemic symptoms e.g. fever, n/v (pyelo?)
Haematuria - inflammation/stones, if not painful it can be cancer
Abnormal discharge
Medication ADR: allopurinol/cyclophosphamide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Which patient groups are predisposed to UTI?

A

Immunocompromised
pregnant
diabetic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Treat UTI OTC?

A

Sodium/potassium sachets - 1 sachet TDS for 2 days - neutralises urine and provides symptomatic relief

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Interaction for sodium/potassium sachets?

A

Contraind in hyperkalaemia/hypertension/heart disease/pregnancy/kidney disease/salt restricted diet (eg on lithium)

Interact with: ACEi, spironolactone, potassium sparing, lithium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Lifestyle advice for UTI?

A 
lots of water 
pee after sex
wipe front to back
cranberry juice 
avoid douching
cotton underwear
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What are the OTC supply criteria for sumatriptan?

A

1) Must first be diagnosed by a dr or pharmacist
2) Established pattern: 5 attacks per year (approx)
3) Simple analgesia ineffective

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Describe the different types of headaches

A

1) intense eye pain: cluster headache
2) Sinus headache: runny nose
3) aura/no aura/ n/v / unilateraly throbbing / photosensitivity / triggers- migraine
4) tight band pulsating around head - tension headache

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

When would you refer headache?

A
  • OTC analgesia failure >1 day
  • Oral contraceptive
  • Recurring
  • <12
  • Severe headache >4hrs
  • Trauma/injury
  • inc severity and frequency
  • severe deep pain when lying down
  • stiff neck (meningitis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

When would you refer after that pt has been on sumatriptan?

A
  • 1st time migraine and >50yrs
  • > 4 attacks/month
  • > 24hr headache
  • Migraine symtpoms have changed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What conditions should sumatriptan be avoided in?

A 
severe renal/liver impairment
CVS disease (recent tia/stroke/mi) and epilepsy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Give some oTC remedies for migraine.

A

1) Co-codamol: max 3 days and can cause rebound headaches
2) Migraleve pink (with anti emetic buclizine)
3) Syndol: para codeine caffeine
4) n/v with migraine: buccal buccastem prochloprerazine
5) nurofen: ibuprofen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

How to counsel a patient on the use of sumatriptan?

A

OTC: max 2 doses of 50mg and POM is max 6 x 50mg.

Take one dose stat on onset of symptoms. Then do not take another unless its for another attack. (Leave 2 hrs gap) should work within 30mins.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What is insomnia?

A

Inability to maintain sleep.
Inability to go to sleep.
Poor quality and duration of sleep.
Early awakening from sleep.

46
Q

OTC products for insomnia are suitable for those over the age of ____

A

16yrs

47
Q

What OTC treatments are available OTC for insomnia?

A

1) Sleep hygiene
2) Nytol: diphenhydramine
3) Sominex/phenergen: promethazine

48
Q

The maximum duration you can use phenergen/sominex (promethazine) OTC for insomnia?

A

1 week

49
Q

The maximum duration you can use nytol (diphenhydramine) OTC for insomnia?

A

2 weeks

20mins before bedtime

50
Q

OTC insomnia preparations are contra-indicated/cautioned in _______

A

Epilepsy

Myasthenia gravis

51
Q

Give examples of sleep hygiene advice.

A

Avoid blue light
Have a consistent routine
Read before bed/meditation/bath
Avoid drugs/alcohol/exercise before bed (stimulant)

52
Q

What are the symptoms of motion sickness?

A

Pale skin
Dizzy
N/V
Cold sweats

Triggers: sea, car, air

53
Q

Three point criteria when recommending products for motion sickness?

A

1) Age
2) Journey duration
3) Drowsiness

54
Q

Hyoscine hydrobromide is an antimuscuranic which can be used for motion sickness. What are the contra indications?

A

Glaucoma
Prostate enlargement
60yrs+

55
Q

Referral criteria for motion sickness?

A

If symptoms last after travel and if on TCA/phenothiazines.

56
Q

What non-drug options are available for motion sickness?

A

Sea band/garlic herbal capsules: ok for pregnancy and in those that have contraindications

57
Q

OTC options for motion sickness?

A 
Hyoscine hydrobromide:
1) kwells kids 150mcg 4yrs+
 joyride 3yrs+
2) kwells 300mcg 10yrs+
3) Scopoderm 1.5mg patch (72hrs)

4) Cinnarizine - Stugeron 15mg:
5) Phenergen (promethazine) 5mg/5ml or 10mg/25mg tablets

58
Q

For journeys <4hrs what are the treatment options and doses?

A

Hyoscine hydrobromide (150mcg kids or 300mcg adults) - 30mins before travel then, 1 tab q6hrs max TDS

59
Q

For journeys >4hrs what are the treatment options and doses?

A

Scopoderm - hyoscine hydrobromide 1.5mg patch: to apply behind the ear on the evening before or 5/6hrs before - lasts 72hrs

60
Q

For journeys 4-8hrs what are the treatment options and doses?

A

Stugeron cinnarizine 15mg - 5yrs+: 1 tab 2 hrs before then TDS (half in 5-12yrs)

phenergen (promethazine) 2yrs+: take the night before (6-8hr duration)

61
Q

Age for kwells kids and joy ride (hyoscine hydro bromide)?

A

Kwells kids: 4yrs+

Joy ride: 3yrs+

62
Q

Age for Kwells adult?

A

10+

63
Q

Age for scopoderm patch?

A

10+

64
Q

Age for stugeron?

A

5+

65
Q

Age for phenergen?

A

2+

66
Q

Lifestyle advice for motion sickness?

A

Stare at a still object
Relax with music
Open windows - fresh air
Stay still

67
Q

Symptoms of BPH?

A

Chronic urinary retention
Urgency
Weak stream
Difficulty passing urine/fully completing bladder

68
Q

Symptoms of BPH that require referral?

A
  • <3months (new)
  • cloudy urine / haematuria / dysuria
  • fever - undiagnosed UTI

(UTI symptoms - refer stat)

69
Q

Interactions with BPH?

A

a-blockers or any other hypotensive drugs

70
Q

Conditions with BPH that require referral?

A
  • prostate surgery
  • uncontrolled diabetes
  • urinary incontinence
  • blurred/cloudy vision
  • scheduled surgery for glaucoma/cataract
71
Q

What is BPH?

A

prostate gland enlargement = pressure on the urethra = symptoms

72
Q

BPH complications?

A

Can cause a UTI - refer to GP

Inability to urinate - Urgent A+E: may need catheter to drain (severe pain + bladder swelling)

73
Q

Tamsulosin 400mcg supply criteria OTC?

A
  • Symptoms present for min3 months
  • 45-75yrs
  • 2 week supply initially then a further 4 weeks if improvement in those two weeks - after that must be diagnosed by a dr for further supplies
74
Q

Tamsulosin dose?

A

400mcg ON or evening with meals (initially postural hypotension so take while sitting down and rarely SJS)

75
Q

Tamsulosin is cautioned in

A

those taking CYP inhibitors e.g. antifungals

76
Q

how long after tamsulosin use should a patient see a dr?

A

6 weeks

77
Q

How often should tamsulosin be reviewed?

A

annually

78
Q

Tamsulosin counselling?

A 
Swallow whole do not chew or crush 
With meals 
6weeks - gp
12 months - review
SE: drowsy/dizzy - driving, postural hypotension
79
Q

Tamsulosin has an enhanced hypotensive effect with the following drugs:

A

other a-blockers

  • indoramin
  • doxazosin
80
Q

Tamsulosin interacts with the following drugs:

A 
Enzyme inhibitors e.g. antifungals 
warfarin 
verapamil
diclofenac
PDE5 inhibitors e.g. sildenafil: excessive hypotension
81
Q

What is orlistat used for?

A

To help weight loss in conjunction with a low fat diet
Inhibits dietary absorption of fats
BMI >28kg/m2

82
Q

Requirements for the use of orlistat?

A

BMI >28kg/m2

Age 18yrs+

83
Q

When would you need to refer those on orlistat?

A

1) Conditions: hypertension, hyperlipidaemia, diabetes: may require dose changes, kidney disease, malabsorption, rectal bleeds
2) Drugs: levothyroxin, amiodarone and ciclosprin (reduces levels), warfarin (vit k and inr), contraindicated with acarbose, antiepileptic drugs (increases seizure risk)
3) no weight loss in 3 months
4) max 6 months use
5) preg/bf

84
Q

orlistat should be cautioned in:

A

those with vitamin deficency especially fat soluble vitamins ADEK - recommend supplements at night or 2hrs after orlistat

+ contraception as severe diarrhoea can reduce the effectiveness: use additional precautions

85
Q

Talk about orlistat OTC.

A
  • Alli - 60mg capsules - max 180mg per day
  • 60mg TDS before with or upto an hour after main meals
  • omit doses if missed meals or no fat in meals
  • SE: oily stools and faecal incontinence
86
Q

Lifestyle advice with orlistat/constipation?

A 
5 x fruit/veg per day
2.5L fluid
18-30g fibre 
30mins/day exercise for 5 days 
alcohol 2-3units a day max 14 units and alc free days in between
87
Q

What is constipation?

A

small, hard stools passes less frequently than normal (NICE: < 3x a week)

  • straining
  • incomplete defeacation
  • abd pain/bloating
  • nausea
88
Q

When to refer constipation?

A
  • blood in stools
  • unexplained weight loss
  • > 40yrs and sudden
  • hypothyroid symptoms: weight gain, cold intolerance, thin hair, fatigue
  • obstruction
  • laxative abuse
  • constipation > 2 weeks
89
Q

Drugs that can cause constipation?

A

opioids/iron/TCA/ aluminium/ CCB - verapamil /diuretics/antimuscuranics/antihistamines

90
Q

1st line for constipation?

A

Lifestyle. Fibre intake around 30g, increase fluid intake, fruit and veg x5, alcohol within limit (14 units weekly), do not hold in faeces, exercise 30mins/5days

91
Q

2nd line for constipation?

A

Bulk forming - methylcellulose, isphagula husk 6+, sterculia 6+: 2-3days to work, SE oesophageal and intestinal obstruction, swallow whole and not just before bed

Osmotic - movicol 2-11yrs paeds or 12+ adults, lactulose 3months +, magnesium sulphate 12+: increases water in colon, works in 2-3days, se: discomfort flatulence cramps

Stimulant - senna 6+ POM/12+ GSL, docusate (also a stool softener) 18+, bisacodyl 10+, sodium picosulfate 10+ - increases GI motility and works in 6-12hrs so take ON

^ glycerin suppositories: work in 15-30mins 4g adults, 2g children <12 and 1g infants

Stool softeners - liquid paraffin 3yrs+: not recommended as causes anal seepage, lipoid pneumonia and malabsorption of ADEK

92
Q

Laxatives suitable for pregnancy?

A

1) Bulk forming - isphagula husk but few days to work
2) Osmotic: lactulose
3) Stimulant senna but not at term or birth - induces contractions

93
Q

Laxatives unsuitable for elderly

A

bulk forming as can cause obstruction

94
Q

LAXATIVES SUITABLE FOR CHILDREN

A

1ST LINE = LACTULOSE (OSMOTIC)

95
Q

Laxatives suitable for opioid-induced constipation?

A

1) Osmotic - lactulose/movicol
2) Stimulant - senna

NO BULK FORMING: RISK OF OBSTRUCTION

96
Q

Age category for bulk forming laxatives - isphagula and sterculia?

A

6yrs +

97
Q

Age category for osmotic laxatives?

A

Movicol paeds 2yrs+
Movicol adult 12yrs+
Magnesium sulphate 12yrs+
Lactulose 3months +

98
Q

Age category for stimulant laxatives?

A

Bisacodyl - 10+
Sodium picosulfate - 10+
Senna - 12+
Docusate - 18+

99
Q

if a patient makes lifestyle changes for their constipation, how long will it take to work?

A

atleast 2 weeks

100
Q

What is dyspepsia?

A

heartburn, reflux, GORD, indigestion, ulcers - upper abdominal symptoms

101
Q

Symptoms of dyspepsia?

A 
Reflux
GORD
heartburn
burning sensation/pain above stomach
n/v/abd pain/bloating
feeling 'full'
102
Q

Referal criteria for dyspepsia?

A
  • New onset in >55yrs
  • ALARM symptoms: anorexia, loss of weight, anaemia, recurrent n/v, malaise/blood in stool
  • used >4weeks
  • no relief >2weeks
  • Ulcer risk e.g. pain after eating food (gastric) or pain on empty stomach around 2-3hrs after food and interferes with sleep (duodenal)
  • CVS: if HF, liver/kidney failure, risk of MI (radiating) or angina (worse on exertion)
  • endoscopy within 14 days - false negative
  • ADR
103
Q

OTC treatment for dyspepsia?

A

1) Antacids/alginates: gaviscon
2) H2 rec antagonists - cimetidine
3) PPI - omeprazole/esomeprazole, pantoprazole

104
Q

Lifestyle advice for dyspepsia?

A 
smaller meals
fluid intake 
fruit and veg 
weight loss
smoking cessation
105
Q

What drugs can cause dyspepsia?

A 
NSAIDS
Warfarin
Aspirin
Theophylline
Steroids
Bisphosphonates
Iron
Abx
SSRI
Nitrates
106
Q

Cautions with OTC dyspepsia treatment?

A

anyone with heart failure, hypertension, kidney/liver failure

volume depletion states

high potassium and sodium content

malabsorption of other drugs so 2hrs gap

107
Q

Which antacids have low NA?

A

mucogel

maalox

108
Q

Age range for OTC dyspepsia tx?

A

18+

109
Q

Which h2 receptor antagonist is available for dyspepsia?

A

cimetidine but POM (enzyme inhibitor)

ranitidine - cancerogenic

110
Q

PPis can be used for dyspepsia, what is the criteria?

A

omeprazole 10mg available OTC and pantop 20mg available otc and esomeprazole 20mg available

1-3 days to work

enzyme inhibitor

max 2 week supply

can cause hypomag/hyponat/fractures/osteoporosis

interactions:
warfarin - inc bleeding
clopidogrel - reduced antiplatelet effect use lansop
phenytoin - inc toxicity

2021 Pre-registration (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions