OTC sales Flashcards
TRUE OR FALSE
liquid antacid preparations are more effective than tablets
true
which antibiotics have impaired absorption when taken with antacids
tetracyclines
e.g doxycycline, lymecycline, tetracyline
when is sumatriptan NOT suitable for OTC migraine treatment
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
which class of antidepressants have a severe interaction with pseudoephedrine
MAOI (e.g phenelzine, meclobemide, isocarboxazid, Tranylcypromine). Interaction causes hypertensive crisis
avoid pseudoephedrine whilst taking MAOI and for 14 days after stopping the MAOI
what are the contraindications for the OTC sale of Urlipristal (ella one)
- patient has already taken Ellaone in the same menstrual cycle
- breast/cervical/ovarian/uterine cancer
- unexplained vaginal bleeding
- severe asthma controlled by oral glucocorticoids
which OTC medication should NOT be sold to a patient taking phenytoin
fluconazole
note: Fluconazole increases the concentration of phenytoin
what is the first line emergency contraception for all women who have had unprotected sex within 5 days
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
what should you NOT sell ibuprofen to a patient taking ciprofloxacin
interaction between ibuprofen + ciprofloxacin:
ibuprofen increases the risk of seizures when given with ciprofloxacin
what is a demulcent (found in cough medicines)
name some examples
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
what is the age where children can have OTC cough syrups containing pholcodine
must be 6 years or older for OTC pholcodine
what is the guidance around duration + quantity of OTC cough medicines in children
- 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
when would you refer a patient who wants to buy OTC chloramphenicol
- pain in the eye
- rash on the face or scalp
- swelling around eye or face
- glaucoma
- recent eye infection or new infection during treatment
what is the first line treatment for allergic rhinitis
saline nasal irrigation
then if it is moderate- to severe, nasal corticosteroid
how long can topical salicylic acid (15-50%) be applied for for warts
up to 12 weeks
what is the maximum dosage for Naproxen OTC
one 250mg tablet three times a day
what are the common side effects of sildenafil
hot flushes, GI discomfort, alopecia, cough, headaches
describe to use benzoyl peroxide for acne (counselling points)
- 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.
when do you need to urgently refer a patient with Dyspepsia
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.
can patients over 60 buy OTC treatment for thrush
no - over 60s need to be referred to GP
if a patient is using 2 different eye drops, how long should they wait in between using each product
should leave 5 minutes between using each product
what OTC treatment can be used for SCALP ringworm
none- should refer to GP
what OTC treatment can be used for SKIN ringworm
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
what side effects may a person experience with nicotine patches
- Headaches
- Skin irritation
- Upset stomach
- Vivid dreams
what are the symptoms of blepharitis
- 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
what is the weekly alcohol limit for men AND women
- no more than 14 units a week (for both men + women)
describe how to use permethrin 5% cream for scabies
- 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
what are the contraindications for OTC sale of Sildenafil
- 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
why can’t you sell sildenafil to a patient taking erythromycin antibiotics
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
why can’t you give orlistat to patients taking levothyroxine
taking orlistat + levothyroxine = reduced control of hypothyroidism
why may additional precautions be used in patients taking Orlistat + oral contraceptives
Orlistat may indirectly reduce the availability of oral contraceptives and lead to unexpected pregnancies in some individual cases - if severe diarrhoea occurs
which OTC medication is contraindicated in patients with parkinson’s disease
Prochlorperazine 3 mg OTC is contraindicated in patients who have Parkinson’s Disease.
which medication might a patient be taking which mean that you cannot supply orlistat
- 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
what is the OTC age to sell amorolfine 5% medicated lacquer for fungal nail infections
must be 18 years
note: this cannot be sold to pregnant women + max 2 nails can be infected to buy
can chloramphenicol be sold to pregnant/ breastfeeding women
no
which desogestrel brand can be sold OTC to adolescents
- Lavima (can be sold to adults + adolescents)
* note: Hana is not licensed to be sold in adolescents*
what is the age to buy mometasone 0.05\5 nasal spray OTC
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
can a patient taking ciclosporin also take levonorgestrel (levonelle)
no
levonelle inhibits ciclosporin metabolism leading to increased risk of toxicity
which OTC meds does ciclosporin interact with
- NSAIDs e.g ibuprofen, naproxen, indometacin
- levonorgestrel (levonelle)
- orlistat
which EHC can reduce the efficacy of hormonal contraceptives
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
which PPIs can be bought OTC
- 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
what is the dose for OTC sale of tranexamic acid for heavy periods
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
