Qu's Flashcards
Mrs H has been diagnosed with coeliac disease and has just started a gluten free diet. She comes into your pjharmacy for some dietary advice. Which food should Mrs H avoid? Rice Ready made gravy Pure oat Corn flour Nuts
Ready made gravy, tends to have wheat flour as a thickener
Which would not form counselling for recently diagnosed coeliac disease patient?
You could self medicate with OTC vitamins and minerals
Your risk of osteoporosis is increased
Autoimmune condition where small intestines is inflamed causing malabsorption of nutrients
High fibre diet is recommended
Best effective treatment is a strict life long gluten diet
It is not recommended to self medicate with OTC vits and minerals, a discussion with healthcare team should be made to find the best supplementation formula for you.
Which drugs are not used in chronic bowel disorders? Sulfalasazine Golimumab Methotrexate Olsalazide Orlistat
Orlistat, its a lipid binder used in weight loss
Which is a complication of Crohns? Infertility Myocardial infaction HT Hyperlipidemia Delayed puberty in children
Delayed puberty
Which is not used as monotherapy in Crohns? Sulfalasazine Infliximab Methylprednisolone Methotrexate Prednisolone
Methotrexate
Which is CI in acute UC due to risk of toxic megacolon? Loperamide Macrogol Sodium bicarbonate Mesalazine Mebevarine
Loperamide
Which is not a SE of mesalazine? Vomitting fever Haemolytic anaemia Constipation Neutropenia
Constipation
Which is not true about peppermint oil in IBS?
Can irritate the mouth and oesophagus hence shouldnt be chewed
Can cause bradycardiac effects
Taken 30-60 mins before food
Max dose is 2xQDS for up to 3 months
Can cause nausea and vomitting as SE
D, TDS not QDS
Which is false about laxatives in constipation?
Adequate fluid is advised with ispaghula husks to avoid intestinal obstruction
Methylcellulose believed to act as a stimulant laxative and faecal softener
Lactulose works by increasing the amount of water in the large bowel
Bulk formers increase faecal mass stimulating peristalsis
Lactulose can be used in 1 month old babies
Methylcellulose is a bulk former not stimulant or faecal softener
Which laxatives to be avoided in opioid induced constipation? Lactulose Ispaghula husk Macrogol Magnesium HCL Arachis Oil
Ispaghula Husks- bulk formers
What is licensed for symptomatic control of food allergy? Ceproheptadine HCL Clemastine Chlorphenamine Acrivastine
Chlorphenamine
Which antimuscarinics are used for GI smooth muscle spasm? (More than one answer) Ammonium compounds Atropine Dicycloverine Propantheline bromide
All, tertiary amines such as those listed above used for GI SM spasm
Food allergy is associated with which symptoms? Anaphylaxis GI reactions Cutaneous reactions Respiratory reactions
All
Which can be used as an adjunct to dietary avoidance in patients with food allergies? Hyoscine butylbromide Mebeverine HCL Sodium chromglomicate Dicycloverine HCL
Sodium chromglomicate
The MHRA advised hyopscine butylbromide should be avoided in which patients? Renal disease Paralytic ileus Pregnant Cardiac disease
Cardiac disease
Cholestasis typically presents with... fatigue Pale stools Jaundice dark urine All the above
All
Can rifampicin, sertraline and naltrexone be used to treat cholestatis pruritis?
Yes
Mebeverine MR caps are licensed from what age?
18+ yrs
Mr J comes in to complain of a burning sensation in his chest that gets worst at night. He is 33yrs old and has had this for 5 days. He is a heavy smoker and BMI 25, what do you recommend? Gaviscon Esomeprazole Lactculose Loperamide Ranitidine
Gaviscon
Mr J has previously been taking gaviscon, it has calmed down the burning sensation but still feels worst after food. What do you do?
Sell another bottle
Sell esomeprazole and instruct to try it for a week
Sell another bottle and rennie
Sell him pepto-bismal
Sell esompeprazole, if this doesnt improve after a week instruct to go GP
What BMI is classed as obese?
30kg/m2
What is the medical treatment for obesity?
If weight management programme hasnt helped, use Orlistat
how does orlistat work and how is it taken?
Lipase inhibitor, works by reducisng the absorption of dietary fat. taken TDS before during or after a meal
Which centrally acting apetite suppressant can be used to control appetite?
None, Sertogenic drugs such as rimonabant and dexenfenfluramine are no longer used for obesity due to safety concerns
Which vitamin does orlistat impair the absorption of?
Fat soluble vitamins (A,D,K,E)
Why is long term topical steroids not recommended in piles?
if used longer than 7 days can increase risk of perianal skin thinning and ulceration
Which treatment is most appropriate for piles in pregnancy? Ispaghula husk Anusol HC Scheriproct lactulose Ibuprofen
Ispaghula husks- Bulk formers as they are not absorbed, Topical preparations are not licensed in pregnancy
MRS J has completed h pylori eradication treatment but has come to the pharmacy with a rash, it has become worst since she went to the beach and she also experiences wrist pain, which of the following medication is most likely to be causing the presenting symptoms? Lansoprazole Metronidazole Tripotassium Amoxicillin Clarithromycin
Lansoprazole- very low risk of subacute cutaneous lupus erythemateous
