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learning from past papers > OTC sales > Flashcards

OTC sales Flashcards

1
Q

TRUE OR FALSE

liquid antacid preparations are more effective than tablets

A

true

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2
Q

which antibiotics have impaired absorption when taken with antacids

A

tetracyclines

e.g doxycycline, lymecycline, tetracyline

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3
Q

when is sumatriptan NOT suitable for OTC migraine treatment

A

sumatriptan is less suitable for patients who have more than four migraine attacks a month

note: to buy pt must have been previously diagnosed with migraines + tried simple analgesics

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4
Q

which class of antidepressants have a severe interaction with pseudoephedrine

A

MAOI (e.g phenelzine, meclobemide, isocarboxazid, Tranylcypromine). Interaction causes hypertensive crisis

avoid pseudoephedrine whilst taking MAOI and for 14 days after stopping the MAOI

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5
Q

what are the contraindications for the OTC sale of Urlipristal (ella one)

A
  • patient has already taken Ellaone in the same menstrual cycle
  • breast/cervical/ovarian/uterine cancer
  • unexplained vaginal bleeding
  • severe asthma controlled by oral glucocorticoids
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6
Q

which OTC medication should NOT be sold to a patient taking phenytoin

A

fluconazole

note: Fluconazole increases the concentration of phenytoin

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7
Q

what is the first line emergency contraception for all women who have had unprotected sex within 5 days

A

Ellaone

note: levonelle is considered instead of Ellaone, if the patient is taking regular combined hormonal contraceptive + has missed contraception within the first week of restarting their contraceptive

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8
Q

what should you NOT sell ibuprofen to a patient taking ciprofloxacin

A

interaction between ibuprofen + ciprofloxacin:

ibuprofen increases the risk of seizures when given with ciprofloxacin

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9
Q

what is a demulcent (found in cough medicines)

name some examples

A

demulcent = a substance that relieves irritation of the mucous membranes in the mouth by forming a protective film

examples: pectin, glycerin, honey, syrup, simple linctus, methylcellulose, propylene glyco

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10
Q

what is the age where children can have OTC cough syrups containing pholcodine

A

must be 6 years or older for OTC pholcodine

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11
Q

what is the guidance around duration + quantity of OTC cough medicines in children

A
  • treatment with cough + cold remedies should be restricted to 5 days or less
  • children should not be given more than 1 cough or cold preparation at a time because different brands may contain the same active ingredient
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12
Q

when would you refer a patient who wants to buy OTC chloramphenicol

A
  • pain in the eye
  • rash on the face or scalp
  • swelling around eye or face
  • glaucoma
  • recent eye infection or new infection during treatment
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13
Q

what is the first line treatment for allergic rhinitis

A

saline nasal irrigation

then if it is moderate- to severe, nasal corticosteroid

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14
Q

how long can topical salicylic acid (15-50%) be applied for for warts

A

up to 12 weeks

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15
Q

what is the maximum dosage for Naproxen OTC

A

one 250mg tablet three times a day

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16
Q

what are the common side effects of sildenafil

A

hot flushes, GI discomfort, alopecia, cough, headaches

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17
Q

describe to use benzoyl peroxide for acne (counselling points)

A
  • Benzoyl peroxide prevents new lesions rather than shrinking existing ones, and therefore should be applied not just to active lesions (whole face)
  • The face should be washed and left to dry for 20 minutes before applying treatment
  • Treatment should start with the lower strength product to allow the skin time to adjust to the medication.
  • Acne is notoriously slow to respond to treatment and it can take months to see the maximum
    benefit.
18
Q

when do you need to urgently refer a patient with Dyspepsia

A

Urgent endoscopic investigation is required for patients if Dyspepsia if they have:

  • dysphagia (difficulty swallowing)
  • significant acute gastrointestinal bleeding
  • in those aged 55 years and over with unexplained weight loss and symptoms of upper abdominal pain, reflux or dyspepsia.
19
Q

can patients over 60 buy OTC treatment for thrush

A

no - over 60s need to be referred to GP

20
Q

if a patient is using 2 different eye drops, how long should they wait in between using each product

A

should leave 5 minutes between using each product

21
Q

what OTC treatment can be used for SCALP ringworm

A

none- should refer to GP

22
Q

what OTC treatment can be used for SKIN ringworm

A

topical antifungal preparations e.g

  • Imidazoles (clotrimazole, econazole, miconazole) or
  • terbinafine

note: topical clotrimazole and miconazole is considered to be safe for use in pregnancy and breastfeeding

23
Q

what side effects may a person experience with nicotine patches

A
  • Headaches
  • Skin irritation
  • Upset stomach
  • Vivid dreams
24
Q

what are the symptoms of blepharitis

A
  • sore eyelids
  • itchy eyes
  • a gritty feeling in the eyes
  • flakes or crusts around the roots of the eyelashes
  • eyelids sticking together in the morning when you wake up

note: this is commonly confused with conjunctivitis but conjunctivitis does not involve eyelids

25
Q

what is the weekly alcohol limit for men AND women

A
  • no more than 14 units a week (for both men + women)
26
Q

describe how to use permethrin 5% cream for scabies

A
  • Apply the cream over the whole body but NOT the head and face. Should be applied to cool skin
  • leave cream on for 8-12 hrs
  • Reapply the cream to the hands if they are washed within 8 hours of treatment
  • treatment repeated after 1 week
27
Q

what are the contraindications for OTC sale of Sildenafil

A
  • severe cardiovascular disorder such as recent (6 months) acute myocardial infarction (AMI) or stroke
  • unstable angina
  • severe cardiac failure
  • sexual activity may be inadvisable

note: max one 50mg tablet per day

28
Q

why can’t you sell sildenafil to a patient taking erythromycin antibiotics

A

because both sildenafil and erythromycin prolong the QT interval - severe interaction

note: most manufacturers advise avoiding the use of two or more drugs that are associated with QT prolongation

29
Q

why can’t you give orlistat to patients taking levothyroxine

A

taking orlistat + levothyroxine = reduced control of hypothyroidism

30
Q

why may additional precautions be used in patients taking Orlistat + oral contraceptives

A

Orlistat may indirectly reduce the availability of oral contraceptives and lead to unexpected pregnancies in some individual cases - if severe diarrhoea occurs

31
Q

which OTC medication is contraindicated in patients with parkinson’s disease

A

Prochlorperazine 3 mg OTC is contraindicated in patients who have Parkinson’s Disease.

32
Q

which medication might a patient be taking which mean that you cannot supply orlistat

A
  • ciclosporin
  • oral anticoagulants + warfarin
  • amiodarone
  • antiepileptics
  • levothyroxine
  • acarbose

note: can buy 60mg orlistat OTC but patient must be at least 18 and have a BMI 28 or over

33
Q

what is the OTC age to sell amorolfine 5% medicated lacquer for fungal nail infections

A

must be 18 years

note: this cannot be sold to pregnant women + max 2 nails can be infected to buy

34
Q

can chloramphenicol be sold to pregnant/ breastfeeding women

A

no

35
Q

which desogestrel brand can be sold OTC to adolescents

A
  • Lavima (can be sold to adults + adolescents)

* note: Hana is not licensed to be sold in adolescents*

36
Q

what is the age to buy mometasone 0.05\5 nasal spray OTC

A

must be 18+ (adults)

note: this should not be used for more than 3 months or if a person has an untreated nasal infection or recent nasal trauma/surgery. if symptoms have not improved within 14 days, refer

37
Q

can a patient taking ciclosporin also take levonorgestrel (levonelle)

A

no

levonelle inhibits ciclosporin metabolism leading to increased risk of toxicity

38
Q

which OTC meds does ciclosporin interact with

A
  • NSAIDs e.g ibuprofen, naproxen, indometacin
  • levonorgestrel (levonelle)
  • orlistat
39
Q

which EHC can reduce the efficacy of hormonal contraceptives

A

Ulipristal (Ellaone) it can reduce the efficacy of combined oral contraceptives and progestogen only contraceptives

note: if taking POP, wait 5 days after ellaone to restart

40
Q

which PPIs can be bought OTC

A
  • omeprazole 10mg once daily
  • pantoprazole 20mg once daily

note: patients must be 18+ but do not sell to over 45. do not supply if patients are taking nelfinavir or atazanavir. if symptoms don’t improve after 2 weeks, refer to GP

41
Q

what is the dose for OTC sale of tranexamic acid for heavy periods

A

It should be taken only once heavy bleeding has started at a dose of two 500mg tablets three times a day until the symptoms are alleviated

note: do not take before period starts + do not take for more than 4 days in a row

learning from past papers (21 decks)

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