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Pharmacy > POM to P > Flashcards

POM to P Flashcards

1
Q

Amorolfine 5% nail lacquer is used in treatment of what?

A

Fungal nail infection

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2
Q

What are the symptoms of onychomycosis?

A

Brittle/ broken parts of nail
Changes to nail
Debris accumulating under nail
Thickening of nail
Turning yellow/ white at tip

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3
Q

How many infected nails is amorolfine 5% nail lacquer licensed to treat?

A

Maximum two infected nails

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4
Q

What age range is amorolfine 5% nail lacquer licensed to treat?

A

> 18 years

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5
Q

Is amorolfine 5% nail lacquer licensed in pregnancy and breastfeeding?

A

No

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6
Q

Which of the following wouldn’t be an underlying cause of nail infection?
Peripheral circulatory disease
Diabetes
Heart Failure
Immunosupression

A

Heart Failure

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7
Q

Which of the following wouldn’t require a referral instead of treatment with amorolfine 5% nail lacquer?
Pregnant woman
17 Year Old
Patient with broken/ brittle nails
Patient with 4 infected nails
Patient with diabetes

A

Patient with broken/ brittle nails

(symptom of fungal nail infection)

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8
Q

Which of the following medications mechanism of action is through inhibiting sterol biosynthesis?
Chloramphenicol
Desogestrel
Amorolfine

A

Amorolfine

(inhibits sterol biosynthesis, disrupting fungal cell membrane and leading to cell death)

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9
Q

Which of the following wouldn’t be an underlying cause of nail infection?
Peripheral circulatory disease
Diabetes
Heart Failure
Immunosuppression

A

Heart Failure

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10
Q

Mechanism of action of chloramphenicol?

A

Binds to bacterial ribosomes and inhibits bacterial protein synthesis

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11
Q

Chloramphenicol is licensed for which indication as a P medicine?

A

Acute bacterial conjunctivitis

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12
Q

Symptoms of bacterial conjunctivitis?

A

Yellow purulent discharge
Eyes stuck together in the morning
Swelling of eyelid
Irritated, itchy, red or watery eyes
Burning or gritty sensation

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13
Q

What age range is chloramphenicol licensed in as a P medicine?

A

2 years and over

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14
Q

What are the red flags for bacterial conjuncitivitis?

A

Cloudy eye
Unusual looking pupil
Contact lenses in contact with water
Affected vision
Photophobia
Painful eye movement
Eye/ head injury

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15
Q

Which of the following would you be able to sell chloramphenicol to?
-Pregnant woman
-30 year old man who wears contact lenses
-4 year old child
-Breastfeeding woman

A

4 year old child

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16
Q

What is the dose for chloramphenicol drops?

A

1 drop every 2 hrs, for 48 hours,
then
1 drop every 4 hours
5 days treatment
(Only waking hours)

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17
Q

What is the dose for chloramphenicol ointment?

A

Alone: 3-4 times daily
In combination with drops: At night
5 days treatment

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18
Q

What two brands of desogestrel are available as P medicines?

A

Hana & Lovima

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19
Q

What type of hormonal pill is desogestrel?

A

Progesterone only pill

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20
Q

MoA of desogestrel?

A

Inhibits ovulation, thinning the lining of the uterus preventing implantation and increasing thickness of cervical muscle preventing sperm reaching egg

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21
Q

Which brand of desogestrel is licensed for use in adolescents and adults?

A

Lovima

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22
Q

Which brand of desogestrel is licensed for use in adults only?

A

Hana

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23
Q

Which of the following is not a contra-indication for desogestrel?
-Blood clot
-IBS
-Hx of liver disease
-Pregnant
-Unknown vaginal bleeding
-Breast cancer

A

IBS

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24
Q

What is the dose of desogestrel?

A

1 tablet daily without a break
same time each day

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25
Q

How to counsel patient when starting new desogestrel?

A

Take on day 1 of period
If starting on days 2-5 of period, barrier protection will be required for 7 days

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26
Q

A patient has taken levonorgestrel (EHC) and wants to begin taking desogestrel, how do you manage this?

A

Start straight away, barrier protection will be needed for 7 days

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27
Q

A patient has taken ulipristal (EHC) and wants to begin taking desogestrel, how do you manage this?

A

Wait 5 days and then start, barrier protection required for 7 days

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28
Q

A patient taking desogestrel has missed a dose, it has been <12 hours, what advice would you give?

A

Take as soon as they remember and carry on

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29
Q

A patient taking desogestrel has missed a dose, it has been >12 hours, what advice would you give?

A

Take as soon as they remember and carry on, barrier protection will be required for 7 days

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30
Q

What two products and strengths are available OTC as EHC?

A

Ulipristal acetate 30mg
Levonorgestrel 1500mcg

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31
Q

Which method of EHC is licensed for use if last unprotected sex was <120 hrs (5 days)?

A

Ulipristal acetate

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32
Q

Which is the most effective form of emergency contraception?

A

Copper coil

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33
Q

What age range is levonorgestrel licensed for EHC?

A

> 16 years

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34
Q

How long after unprotected sex could you supply levenorgestrel?

A

Up to 72 hours

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35
Q

Ulipristal can not be taken if patient has taken CYP3A4 inducer or herbal medicine within the last how many weeks?

A

Ulipristal is not recommended for patients who have taken CYP3A4 enzyme inducing medicines or herbal products within the last 4 weeks.

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36
Q

Levonorgestrel has been shown to be less effective in which group of women?

A

Women weighing over 70kg

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37
Q

If patients have taken a CYP3A4 inducer or herbal medicine within the last 4 weeks, what dose should be given of levonorgestrel as EHC?

A

Two tablets of 1500mcg

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38
Q

If vomiting occurs within how many hours after taking EHC should the dose be taken again?

A

3 hours

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39
Q

Which of the following medicines could you safely give alongside levonorgestrel or ulipristal?
-carbamazepine
-phenytoin
-St Johns Wort
-lithium
-rifampicin

A

Lithium

(All others are CYP3A4 inducers)

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40
Q

Is ulipristal acid use safe in breastfeeding?

A

After using ulipristal breast feeding is not recommended for a week because it is present in breast milk

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41
Q

How long after taking ulipristal can progesterone pill be restarted?

A

The efficacy of ulipristal as an emergency contraceptive can also be reduced by a progestogen, progestogen-containing drugs should not be restarted for 5 days afterwards

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42
Q

What medication is within Clarinaze allergy control 0.05% nasal spray?

A

Mometasone 0.05%

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43
Q

Clarinaze nasal spray is licensed for what inidcation?

A

Seasonal hay fever AND perennial allergic rhinitis

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44
Q

What age group is clarinaze nasal spray licensed in OTC?

A

> 18 years

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45
Q

What is the usual dose of clarinaze nasal spray?

A

2 sprays into each nostril OD until symptoms controlled, then 1 spray into each nostril OD

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46
Q

How many days of treatment with clarinaze nasal spray should you refer?

A

14 days

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47
Q

Clarinaze nasal spray is licensed OTC for how many months treatment?

A

3 months

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48
Q

Lidocaine containing products for teething are restricted to what pack size?

49
Q

What is the strength of Orlistat available OTC?

50
Q

Orlistat is licensed for what age group OTC?

A

> 18 years

51
Q

OTC orlistat is licensed for who?

A

Adults with BMI > 28

52
Q

Which of the following patients could you safely supply orlistat?
-Patient taking anti-epileptic
-Patient with obesity
-Patient with diabetes
-Patient taking amiodarone
-Patient with hypercholestereamia

A

Patient with obesity

(orlistat increases risk of convulsions when given with anti-epileptics)
(diabetes and cholesterol medication may need altered with weight loss)

53
Q

What is the recommended daily dose of orlistat?

A

TDS
Immediately before, during, or up to one hour after

54
Q

Treatment with orlistat should not exceed how many months?

55
Q

What is the maximum daily dose of orlistat?

56
Q

If a meal is missed whilst taking orlistat, how should you alter the dosing?

A

That dose of orlistat should be omitted

57
Q

Can orlistat be supplied to pregnant and breastfeeding women?

58
Q

Concurrent treatment with which of the following would not be a concern when supplying orlistat?
-Ciclosporin
-Levothyroxine
-Digoxin
-Warfarin

59
Q

Which PPI’s are available OTC?

A

Omeprazole 10mg
Pantoprazole 20mg

60
Q

What is the MoA of a PPI?

A

Inhibit gastric acid secretion in the stomach by the ‘proton pump’

61
Q

What is the OTC dose of omeprazole?

A

Two (10mg) tablets OD
Before meal

62
Q

What is the OTC dose of pantoprazole

A

One (20mg) tablet OD
Before mean

63
Q

What is the licensed indication for OTC PPI?

A

Acid reflux

64
Q

What age range is omeprazole and pantoprazole licensed for?

A

> 18 years

65
Q

How long after treatment with omeprazole/ pantoprazole OTC should a referral be made if no improvement in symptoms?

66
Q

What is the MHRA alert for PPI’s?

A

risk of subacute cutaneous lupus erythematosus

(watch for signs of skin lesions in sun exposed areas of skin and athralgia)

67
Q

PPIs can mask the symptoms of gastric cancer. What age group should you particularly look out for? and what symptoms?

A

> 55 years
-unexplained dyspesia non respondent to treatment
-bleeding
-dysphagia

68
Q

Pantoprazole/ omeprazole will have full effect after how many days?

69
Q

What immediate relief product can be given to reduce heartburn symptoms?

A

Antacid or antacid/alginate combination

70
Q

What lifestyle advice could you give to improve symptoms of heartburn/ reflux?

A

-weight reduction
-smaller meals
-propping up head in bed
-stop smoking
-avoid spicy foods
-avoid alcohol

71
Q

Maloff protect 250/100mg contains which products?

A

atovaquone with proguanil hydrochloride

72
Q

What are the four anti-malarial products available OTC in UK? and what medicines do they contain?

A

-Maloff Protect (atovaquone and proguanil hydrochloride)
-Avloclor (chloroquine)
-Paludrine (proguanil hydrochloride)
-Paludrine/ Avloclor Anti-Malarial Travel Pack (proguanil hydrochloride and chloroquine)

73
Q

Which of the following OTC anti-malarials is least likely to be innefective due to resistance?
-Maloff Protect (atovaquone and proguanil hydrochloride)
-Avloclor (chloroquine)
-Paludrine (proguanil hydrochloride)
-Paludrine/ Avloclor Anti-Malarial Travel Pack (proguanil hydrochloride and chloroquine)

A

Maloff Protect

74
Q

Name three POM anti-malarials?

A

Atovaquone with proguanil (Malarone or generic)
Doxycycline
Mefloquine (Lariam)

75
Q

What is the licensed indication for Maloff Protect?

A

Prophylaxis of P.falciparum malaria in adults over 18 years for up to 12 weeks

76
Q

Dose of Maloff Protect?

A

one tablet daily

77
Q

How long before travel should you commence Maloff Protect and how long after travel should it be continued?

A

1-2 days prior and until 7 days after

78
Q

Which of the following is cautioned in Maloff Protect?

A

-Tuberculosis
-Diabetes
-Depression
-Seizures

79
Q

What advice should be given to patients who are pregnant and wanting to travel to areas with malaria?

A

Pregnant women have an increased risk of developing severe malaria and higher risk of fatality

80
Q

What weight range is Maloff Protect licensed for?

81
Q

What advice should be given to a patient that vomits after taking Maloff Protect?

A

If the vomiting is within one hour after taking the dose, another should be taken

82
Q

What does the ABCD approach stand for in malaria prevention?

A

Awareness
Bite protection
Chemoprophylaxis
Diagnosing early

83
Q

Products containing what are first line for insect repellent?

84
Q

What are the symptoms of malaria?

A

Fever
Sweats & Chills
Headaches
Vomiting
Muscle Pains
Diarrhoea
Fatigue

85
Q

What type of drug is sumatriptan?

A

5-HT1- receptor agonist

86
Q

What strength tablet of sumatriptan is available OTC?

87
Q

Which of the following patients would be inappropriate to supply sumatriptan to?
-Patient who has tried regular paracetamol already
-Patient who is 16
-Patient who is experiencing their first migraine

A

Patient who is experiencing their first migraine

88
Q

A single dose of sumatriptan should relieve migraine symptoms after how long?

A

30 mins

(if symptoms do not improve, no further doses should be taken for the same attack)

89
Q

Which of the following drugs do not interact with sumatriptan?
-Sertraline
-Phenelzine
-Tramadol
-Ramipril
-Trazodone

A

Ramipril

(All others increase risk of serotonin syndrome)

90
Q

What age range is sumatriptan licensed for?

A

18-65 years

91
Q

Which of the following patients could you supply sumatriptan to OTC?
-patient with a headache lasting 36 hours
-patient with 3 attacks in the last month
-patient with diabetes, high cholesterol and hypertension
-patient with hx of seizures

A

patient with 3 attacks in the last month

(4 or more attacks per month requires referral)

92
Q

What indication is OTC tranexamic acid licensed for?

A

Reduction of heavy menstrual bleeding in women aged 18 years and over

93
Q

What age range is tranexamic acid licensed in?

A

18-45 years

94
Q

What is the MoA of tranexamic acid?

A

An antifibrinolytic which inhibits fibrinolysis, increases clot formation and reduces blood loss

95
Q

What is the dose of tranexamic acid?

A

Two 500mg tablets TDS when bleeding starts until symptoms alleviated

96
Q

How many consecutive days can tranexamic acid be taken?

A

No more than 4 consecutive days

97
Q

What is the maximum daily dose of tranexamic acid?

A

If menstrual bleeding is very heavy, the dose may be increased to eight tablets (4g) daily

98
Q

Which of the following would not be a contraindication to supplying tranexamic acid?
-irregular periods
-patient taking warfarin
-renal impairment
-diabetes
-pregnancy

99
Q

What medication is within viagra?

A

sildenafil

100
Q

What strength of sildenafil is available OTC?

101
Q

What is the licensed indication for sildenafil OTC?

A

Erectile dysfunction

102
Q

What age range is sildenafil licensed in OTC?

A

> 18 years

103
Q

What class of drug is sildenafil?

A

Phosphodiesterase type 5 inhibitor

104
Q

What lifestyle factors can affect erectile dysfunction?

A

Sedentary lifestyle
Obesity
Smoking
Alcohol use
Cycling

105
Q

What diseases can affect erectile dysfunction?

A

Hypertension
Diabetes mellitus
Hypercholesterolemia
Cardiovascular disease

106
Q

What psychological disorders can affect erectile dysfunction?

A

Anxiety
Depression

107
Q

What medications may contribute to erectile dysfunction?

A

Anti-hypertensives
Anti-depressants
Anti-psychotics
Hormones and hormone-modifying drugs
Diuretics
Fibrates
Histamine (H2) - antagonists

108
Q

How long before sex should viagra be taken?

A

1 hour before

109
Q

What is priaprism?

A

Prolonged and sometimes painful erections lasting longer than 4 hours. Patient should seek immediate medical assistance. If not treated immediately, penile tissue damage and permanent loss of potency could result.

110
Q

Which of the following patients could you safely supply Viagra?
-17 year old with symptoms of ED
-21 year old man who takes poppers at the weekends
-68 year old man who had an MI 9 months ago

A

68 year old man who had an MI 9 months ago

(MI within the past 6 months)

111
Q

A patient has recently taken sildenafil. Which of the following side effects would you be most concerned about?
-Flushing
-Priapism
-Dizziness
-Nausea

112
Q

What medicine is in the brand Gina?

113
Q

What is estradiol?

114
Q

What is Gina licensed for?

A

Post-menopausal vaginal atrophy due to low oestrogen

115
Q

What are the symptoms of vaginal atrophy?

A

Dryness
Soreness
Itching
Burning
Irritation
Painful sexual intercourse

116
Q

How long does estradiol take to have a full effect?

A

8-12 weeks

117
Q

Which patient could you supply Gina to OTC?
-51 year old patient who had a period 3 months ago
-49 year old patient who hasn’t had a period in 4 years
-55 year old patient who hasn’t had a period in 2 years

A

55 year old patient who hasn’t had a period in 2 years

(can only be used in postmenopausal women aged > 50 years, who haven’t had a period for at least one year)

118
Q

What is the initiation and maintenance doses of Gina?

A

Initiation - Insert ONE (10 microgram) tablet intravaginally daily for two weeks. Can be started on any day
Maintenance - Insert ONE (10 microgram) tablet intravaginally twice a week.

Pharmacy (20 decks)

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