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Inori Pre Reg > P Meds > Flashcards

P Meds Flashcards

1
Q

What is amorolfine 5%?

A

A Topical antimtcotic (antifungal) agent

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2
Q

License age of amorolfine?

A

Over 18

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3
Q

How many infected nails need to be referred?

A

More than 2

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4
Q

How long does it take for amorolfine to work?

A

9-12 months for toenails

6months for finger nails

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5
Q

Dose of amorolfine?

A

Apply once a week

Before applying, file down the nail

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6
Q

When to review amorolfine treatment?

A

Approximately in 3 months. If symptoms worsen or have not improved by then, referral to doctor or prescriber

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7
Q

Additional counselling points on amorolfine?

A

Wear impermeable gloves
Do Not use any nail vanish or artificial nails
Keep nails short and filed down

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8
Q

When to refer pts for amorolfine?

A 
Under 18
Preganacy and lactation
Diabetes
Immunocompromisrd
More than 2 infected nails
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9
Q

Chloramphenicol eye drops strength and ointment?

A 
Drops = 0.5%
Ointment = 1%
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10
Q

Symptoms of conjunctivitis?

A
  1. Yellow purulent discharge and eyelids stuck together in the morning
  2. Swelling of the eyelids
  3. Irritated, itchy, red or watery eye and/or burning or gritty sensation in eye
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11
Q

Dose of chloramphenicol eye drops?

A

1 drop into the eye every 2hrs for the first 48hrs then decrease dose to every 4hrs
Total of 5 days treatment
But if no improvement within 2 days, refer

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12
Q

Dose of chloramphenicol ointment?

A

Apply approximately 1cm of ointment between the lower eyelid and the eye TDS to QDS

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13
Q

When to refer pts when selling chloramphenicol?

A 
Under 2
Using bone marrow depressant drugs
Eye pain
Glaucoma
Recent eye infection
Pregnancy and bf
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14
Q

When to refer pts urgently when selling chloramphenicol?

A

Contact lens wearer (tends to be a different bacteria causing the infection so urgent referral) esp if came into contact with water

Clody looking eye
Unusual pupil
Affected vision
Ohotophobia
Eye surgery or laser treatment within the last 6 months
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15
Q

Advice for contact lens wearer who are using chloramphenicol?

A

Don’t wear whilst using or for at least 24hrs after use
Don’t reuse old contact lens
Replace containers

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16
Q

What’s the strength of ulpristal acetate?

A

30mg

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17
Q

What’s the strength of levonorgestrel?

A

1500mcg

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18
Q

Licensing age of levonorgestrel?

A

Over 16s

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19
Q

What to do if pts wants levonorgestrel but is also taking enzyme inducers?

A

First refer for an IUD if can’t

Give 2 tabs

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20
Q

Levonorgestrel is less effective in pts?

A

Who are over 70jg or with a BMI of over 26

Pts need to be informed of the risk

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21
Q

What to do if pt wants ulpristal but also takes enzyme inducers?

A

Refer

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22
Q

Administration advice on ulpristal and levonorgestrel?

A

If vomiting occurs within 3hrs, another tab should be taken as soon as possiblr

Both can be taken with food or without at any point in the Menstural cycle

With levonorgestrel, pts can take more than 1 tab within the same menstrual cycle but should be advice about possible cycle disruption

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23
Q

Which condition needs to be referred when selling ulpristal?

A

Severe liver impairment

Severe asthma who are in oral glucocorticoid

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24
Q

Which condition needs to be referred when selling levonorgestrel?

A

Severe liver dysfunction
Pts at risk of ectopic pregnancy
Severe malabsorption syndrome

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25
Q

Breast feeding advice and ulpristal?

A

Not recommend for a week after taking the dose

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26
Q

Breast feeding advice and levonorgestrel?

A

Appears in the milk but not harmful

Just try to take the dose after giving BF

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27
Q

Contraception advice and ulpristal?

A

Can reduce the efficcacy of of COC and progesterone only contraception
The efficacy of ulpristal can be also reduced by progesterone

Restart progesterone containing contraception 5 days after dose and use a barrier method till then

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28
Q

Contraception and levonorgestrel?

A

Continue regular contraception

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29
Q

What age can you sell mometasone 0.05% nasal spray?

A

18 plus

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30
Q

How long can you use mometasone nasal spray?

A

Up to 3 months treatment

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31
Q

Indication of mometasone nasal spray?

A

For the treatment of the symptoms of seasonal hay fever or perennial allergic rhinitis for over 18

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32
Q

Dose of mometasone nasal spray?

A

2 sprays into each nostril od until symptoms are controlled, then one spray into each nostril daily

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33
Q

Direction for use of mometasone nasal spray?

A

Shake container well before use
Prime the spray (pump the spray 10 times until a fine mist is obtained, reprime with 2 sprays if the pump has not been used for 14 days)
Blow nose gently
Breath in slowly through nose, breath out through mouth
Wipe the nozzle with a clean tissue

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34
Q

When to discard mometasone nasal spray?

A

After 2 months of first opening

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35
Q

Common side effects of mometasone nasal spray

A

Nose bleed (epistaxis)
Headache
Pharyngitis
URTI

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36
Q

When to refer pts when selling mometasone nasal spray?

A 
Nose infection
Recent nasal surgery ot trauma
No improvement within 14 days
Symptoms persist more than 3 months
Under 18
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37
Q

What’s first line for teething?

A

Non pharmaceutical option, gentle running of the gum with a clean finger and allowing the child to bite on a clean and cool object

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38
Q

Second line for teething?

A

Paracetamol or ibuprofen

Lidocaine containing teething gel

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39
Q

How to apply Lidocaine containing teething gels?

A

Apply a pea sized blob to a clean fingertip and spread gently into the sore area of the gum. If necessary, repeat dose after 3hrs.
Max 6times/day

40
Q

Orlistat p med dose?

A

60mg

41
Q

Orlistat licensing age?

A

18 plus who are overweight or obese (BMI over 28)

42
Q

What diet is advised when taking orlistat?

A

A lower fat, mildly hypocaloric diet to aid weight loss and minimise GI side effect

43
Q

Who to refer when selling orlistat?

A

Pt taking antidiabetic meds esp acarbose
Pts taking antihypertensive meds
Pts taking anti Hypercholestrrolaemia meds
Pts taking amiodarone
Pts taking levothyroxine
Pts taking anti epileptic drugs (increased risk of convulsion when Co administered)
Pts who were unable to lose weight after 12 wks
Pts who experience rectal bleeding
Pts with kidney disease

44
Q

Orlistat treatment duration?

A

Should not exceed 6 months

45
Q

What to do when salleing orlistat?

A

Always check the pts BMI

46
Q

Mode of action of orlistat?

A

Lonf acting inhibitor of GI lipase, blocks the absorption

47
Q

Dose of orlistat?

A

120mg up to 3 times a day, dose to be taken immediately before, during, or up to 1 hour after each main meal

48
Q

How to take orlistat?

A

Take with water immediately before, during it up to one hour after each mean
If a meal doesn’t contain fat, omit dose

49
Q

When to refer pts when selling orlistat?

A

Pts taking ciclosporin or warfarin
Pt has chronic malabsorption sgndorme
Cholestasis
Preganant or bf

50
Q

Interaction of orlistat?

A

Reduces oral contraception

Impairs absorption if fat soluble vitamins (A, D, E & K) so take multivitamin supplements at bedtime

51
Q

Side effects of orlistat?

A

Oily leakage from rectum
Flatulence
Faecal urgency
Fatty oily stools

52
Q

Which PPIs are available as OTC?

A

Omeprazole 10mg tavs

Pantoprazole 20mg

53
Q

Mode of action of PPI?

A

Inhibits gastric acid secretion by blocking the hydrogen potassium adenosine triphophatase enzyme system

54
Q

Dose of p omeprazole?

A

10mg OD

Swallowed whole with plenty of water before a meal. Should not be crushed or chewed

55
Q

Dose of P pantoprazole?

A

20mg OD

Swallowed whole with plenty of water before a meal. Should not be chwed or crushed

56
Q

Licensing age for P omeprazole and pamtoprazole?

A

Over 18

57
Q

When to refer pt when seeing omeprazole pantoprazole?

A

If pts taking nelfinavir for omeprazole, atazanavir for pantoprazole
If symptoms do not improve after 2wks
Pts over 55 who present with these symptoms for the first time or worsened
Over 45s who experience recurrent
Pregnancy or bf
ALARM SYMPTOMS

58
Q

MHRA warning on PPIs?

A

Very low risk of subacute cutaneous lupus eythematosus

Lesions tend to develop in sun exposed area of the skin

59
Q

Action time of PPIs?

A

Relief after a day or so and efficacy increases after 3 or 4 days
Pts requiring immediate relief may take Simple antacids or antacid alginate combo for fee days along side PPIs until it takes effect

60
Q

Licensing age for sildenafil?

A

Plus 18

61
Q

What drugs have the potential to cause erectile dysfunction?

A 
Antihypertensive
Antidepressants
Antipsychotics 
cytotoxics
Recreational drugs
Diuretics
Fibrates
H2 antagonists
62
Q

Erectile drusfucntion life style advice?

A

Regular exercise
Reduction in body mass
Smoking cessation
Reduced alcohol consumption

63
Q

Life style risk factors for erectile dysfunction?

A 
Sedentary lifestyle
Obesity
Smoking
Alcohol use
Cycling
64
Q

Dose of sildenafil?

A

50mg tabs taken with water approximately 1hr before sexual activity
Max is one 50mg/day
Taking it with food can delay effect

65
Q

Referral when selling sildenafil?

A

Coadminsiteration with riociguat, ritonavir, nitrates (nicorandil)
Pts with CV disorders like recent stroke, MI, unstable angina, severe cardiac failure
Mild to moderate hepatic impairment
Hypotebtion
Anatomican deformity in penis
Under 18
Severe renal failure

66
Q

Side effects of sildenafil?

A 
Headache
Flushing
Nasal congestion
Dizziness
Visual disturbances
Priapism (prolonged and sometimes painful erections lasting longer than 4hrs)
Severe skin recation
67
Q

What anti malaria are available as p Meds?

A

Maloff protect (Atovaquone 250mg with proguanil 100mg)

Avloclor (chloroquine 250mg)

Paludrine (proguanil 100mg)

Paludrine/avloclor antimalarial travel pack (proguanil 100mg/chloroquine 250mg)

68
Q

Maloff licensing age and duration?

A

Plus 18

For up to 12 months

69
Q

Dose of maloff?

A

1OD starting 1-2 days prior to entering and continued 7 days after trip

70
Q

Refer whne selling maloff?

A 
Diagnosed renal/hepatic impairment
Under 18s
Preg and bf
If needing treatment more than 12 eks
Pts who weight less than 40jg
71
Q

Missed dose advice on maloff?

A

Take as soon as remembered

Don’t take 2 doses at the same time

72
Q

Supply criteria for sumatriptan?

A

Migraine must be diagnosed by doctor or pharmacist
Established pattern of migraine (a history of 5 or more migraine attacks occurring over a period of at least one Yr)
Simple analgesics tried and ineffective

73
Q

Dose of sumatriptan ?

A

One 50mg should be taken as soon as possible after the migraine has started
A single dose should relieve symptoms after 30mins, if symptoms do not improve in this time no further doses should be taken for the same migraine attack
If there is a second migraine attack within 24hrs a second dose may be taken

74
Q

Referral when selling sumatriptan if pt is taking what drugs?

A 
Ergotamine
MAOIs
Other triptans
Tricyclic antidepressants
SSRIs /SNRIs
75
Q

Patient characteristics of refferal when selling sumatriptan?

A

Risk of CV risk
Under 18 or over 65
Pregnancy or Bf
Seizures

76
Q

Symptom history referral when selling sumatriptan?

A

Headaches lasting for over 24hrs
Symptoms have chnages
First migraine occurring after 50
Four or more attacks/month

77
Q

Contraindications in sumatriptan?

A

Hepatic impairment
Renal impairment
Cardiovascular disorders Inc hypertention

78
Q

Supply criteria for tamsulosin?

A

Male pts aged 45-75

Symptoms of BPH present for a minimum of 3 months

79
Q

Supply duration of tamsulosin?

A

A 2wk supply of tamsulosin initially
If there has been an improvement in urinary symptoms within the initial 2wks, a further supply of 4wks can be made
After 6wks, a further supply can be made only when the pt confirms with the doctor his diagnosis

80
Q

Dose of tamsulosin

A

400mcg to be taken after the same meal each day

81
Q

Counselling points when selling tamsulosin?

A

See Dr within 6wks of starting the treatment
Have a clinical review with the doctor every 12 months
Sit down if any dizzinrss
May affect driving

82
Q

Refer pts taking which drugs when selling tamsulosin?

A

Strong enzyme inhibitors like ketoconazole and eythromycin
Verapamil
Diclofenac
Warfarin

83
Q

When to stop treatment with pt taking tamsulosin?

A

If no improvements after 14 days

84
Q

What conditions need to be referred when selling tamsulosin?

A 
Cloudy urine and fever
Postural hypotention
Heart, kidney, liver disease
Uncontrolled diabetes
Blurred cloudy vision
85
Q

What’s OTC trsnexamic acid licensed for?

A

Reduction of heavy Menstural bleeding over several cycles in women aged 18 plus with regular 21-35 day cycle, with no more than 3 days individual variabilities in cycle duration

86
Q

Who to refer to a doctor when selling tranrxamic acid?

A

Under 18 and over 45
Pts who have been taking it for 3 Menstural cycle without a reduction jn bleeding
Bf
Obese or diabetic
PCOS
Pts taking tamoxifen or unopposed oestrogen

87
Q

What heavy Menstural cycle considered as

A

Loss of 60-80ml or morr and affects women’s physical, social and quality of life.
Iron deficiency anaemia = refer if this is the casr

88
Q

Signs of endometrial cancer?

A

Irregular bleeding
Abnormal bleeding
Bleeding between periods
Prolonged periods

89
Q

Sings and symptoms of cervical cancer?

A

Bleeding between periods
Pain during sex
Bleeding after sex
Bleeding after Menopause

90
Q

How does tranexamic acid work?

A

Antifibrinolytic which inhibits fibrinolysis which subsequently increases clot formation and reduce blood loss

91
Q

Dose of tranexamic acid?

A

Two 500mg TDS until symptoms are alleviated

Take once bleeding has started

92
Q

Max dose of tranexamic acid?

A

8 tabs a day (max 4g daily)

Use if bleeding is very heavy

93
Q

Tranexamic acid should not be taken for more than?

A

4 consecutive days

94
Q

Do not supply tranexamic acid if?

A 
Mild to moderate to severe renal imapirment
Active/previous thromboembolic disease
Haematuria
Irregular Menstural cycle
Pts taking warfarin, oral contraception
Pregnancy
History of convulsions
95
Q

Side effects that prompt pt to see gp when taking tranexamic acid?

A

Visual disturbances

Inori Pre Reg (22 decks)

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