POM to P Switches Flashcards
How long can Ella One be taken after UPSI?
120 hours
If a patient takes Ella One and is on a POP, how long should they wait before they can restart it?
5 days
In which 2 conditions is Ella One not recommended?
- Severe hepatic impairment
2. Severe asthma that requires treatment with oral steroids
Patients who have taken which medicines within the last 4 weeks are not recommended to take Ella One?
CYP3A6 inducers or herbal medicines within the last 4 weeks
Is Ella One recommended in breast feeding?
No
Which EHC can be taken more than once during the menstrual cycle?
Levonelle
How long can Levonelle be taken after UPSI?
72 hours
What is first line EHC if a patient has taken CYP3A6 inducers or herbal medicines within the last 4 weeks?
Copper IUD
What is second line EHC if a patient has taken CYP3A6 inducers or herbal medicines within the last 4 weeks?
2 tablets of Levonelle
What should a patient do regarding their normal contraception following Levonelle EHC?
Take it as normal
Who is Levonelle less effective in?
Women weighing over 70kg or with a BMI >26
What can a woman weighing over 70kg or with a BMI >26 take as EHC?
2 Levonelle tablets
What must a woman who has taken EHC do if they vomit within 3 hours?
Go back to the pharmacy for another dose
At which point during the menstrual cycle must EHC be taken?
At any time
At what age OTC Levonelle licensed?
Over 16
At what age is EllaOne Licensed?
No limit
If a patient you suspect to be pregnant requests EHC, what must you do?
Refer
Can EHC be supplied to a representative?
Yes but you must speak to the patient on the phone
Can EHC be supplied in advance?
No
If a patient at which age requests EHC, safeguarding should be considered
Younger than 13, cannot legally consent
At what dose is orlistat available OTC?
60mg capsules
Orlistat can be supplied to patients at which age?
> 18
Orlistat can be supplied to patients at which BMI?
> 28
If a patient requests orlistat and is on which medicines, do you refer? (6)
- Antihypertensives / Cholesterol
- Amiodarone
- Ciclosporin
- Warfarin and anticoagulants
- Levothyroxine
- Antiepileptics
Patients requesting orlistat with which other comorbidities should be referred?
- Diabetes
- Hypertension
- Chronic malabsorption
- Cholestasis
- Pregnant or breastfeeding
How long should treatment with OTC orlistat not exceed?
6 months
What may orlistat impair the absorption of?
Fat-soluble vitamins
What is tranexamic acid licensed for OTC?
Heavy bleeding during periods
After how long should patients notice a difference after taking orlistat?
12 weeks
After how long on OTC tranexamic acid with no difference should patients be referred?
3 cycles
Which patients requesting tranexamic acid should be referred? (6)
- History of convulsions
- Taking oestrogen/tamoxifen
- Taking warfarin or other anticoagulants
- Breastfeeding
- Taking oral hormonal contraception
- Irregular periods
When should tranexamic acid be taken?
Only once the heavy bleeding has started
What is the dose of tranexamic acid?
500mg TDS
What is the dose of orlistat?
60mg TDS
How long can treatment with tranexamic acid be per cycle?
4 days
At what age are OTC PPIs licensed?
Over 18
After how long should you refer patients on OTC PPIs?
2 weeks
What can PPIs mask the symptoms of?
Gastric cancer
In which patients should you think about referring if they are asking for OTC PPIs due to the risk of gastric cancer?
Over 55
How long do PPIs take to work?
3-4 days
What lifestyle advice can you give to people experiencing dyspepsia? (5)
- Weight loss
- Smaller meals
- 3-4 hours between meals
- Propping up the head of the bed
- Avoiding things that trigger their GI irritation
At what age can tamsulosin be supplied OTC for BPH?
45-75
How long should the patient have been experiencing symptoms of BPH before you can supply OTC tamsulosin?
3 months
What are the symptoms of BPH? (5)
- Incomplete bladder emptying
- Nocturises
- Difficulty urinating
- Straining
- Weak flow
What is the initial supply you can make of tamsulosin?
2 weeks
After making the initial 2 week supply of tamsulosin and the patient has an improvement, how many more weeks can you supply?
Further 4 more weeks
After 6 weeks of OTC Tamsulosin, what must the patient do?
Have a review with their doctor so they can confirm that it is alright for the patient to keep having the treatment
When should tamsulosin be taken?
1 cap at the same time, after the same meal each day
How often should a patient being treated with OTC tamsulosin have a review with their doctor?
every 12 months
What are the side effects of tamsulosin?
- Dizziness
- Weakness
- Drowsiness
At what age can you supply sumatriptan OTC?
18-65
Can OTC sumatriptan be supplied without previous diagnosis?
No, must be diagnosed to have migraines by pharmacist or doctor
If the patient has not tried any other treatment for their migraines, can sumatriptan be supplied?
No, simple analgesia has to have been proven ineffective
What is the dose of sumatriptan?
1 tablet on onset per attack, no further tablets for the same attack
After a patient takes their does of sumatriptan, how soon after can they feel an effect?
30 minutes
What are the referral criteria for sumatriptan? (4)
- First migraine in over 50
- Headache >24 hours
- Sensitivity to sulfonamides
- Taking COC and they have gotten worse