RPS reference guides Flashcards by Rosie Darby

Amorlofine can be sold OTC to patients over what age?

Over 18

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Treatment with amorofine OTC is limited to how many infected nails?

Max 2 infected nails at one time

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How should amorolfine nail lacquer be applied?

Filed down the affected areas thoroughly, the surface of the nail should be cleansed and degreased. Then apply the lacquer.

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How long should amorolfine be used for?

Treatment should be continued, without interruption until the nail is regenerated and the affected areas are finally cured. Generally 6 months for finger nails and 9-12 months for toe nails

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Can amorlofine be used in pegnancy?

No - refer if pregnant or breastfeeding

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Orlistat can be sold over the counterto what patients?

Adults age 18 and over who have a BMI >28

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Why must you refer patients with diabetes who wish to purchase orlistat?

Dose of diabetic medication may need adjusting as weight loss may be accompanies by improved metabolic control.

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Orlistat can be supplied to a patient taking:

a) levothyroxine
b) naproxen
c) lamotrigine
d) ramipril
e) amiodarone

B- naproxen

levothyroxine - may decrease absorption
lamotrigine- there is an increased risk of convulsions when orlistat is given with antiepileptics
amiodarone - dose may need to be adjusted
ramipril- should refer patients taking anti hypertensives as weight loss may be accompanied by an improvement in blood pressure

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How long orlistat be used OTC?

Treatment with orlistat should not exceed 6 months

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What is the OTC dose of orlistat?

60mg TDS with meals (note - if a meal is missed or contains no fat then a dose should be missed)

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Vitamin advice to a patient taking orlistat?

Treatment with orlistat may impair the absorption of fat soluble vitamins. Advise all users of orlistat to use a multivitamin supplement at bedtime

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Can you supply orlistat to a third party?

Yes - it is possible to make a supply to a patients representative provided that you are satisfied it is a genuine request.

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Under the PPP, prescriptions for isotretinoin are valid for how many days?

7 days

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The maximum quantity of isotretinoin that can be supplied under the PPP?

30 days supply

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What is the name of the mandatory CD requisition form?

FP10CDF

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What SIX details must be on a CD requisition form?

Signature of the recipient
Name of the recipient
Address of the recipient
Profession or occupation 
Total quantity of drug
Purpose of requisition

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Can a CD be supplied in an emergency to a doctor without a requisition?

Yes - In an emergency, a doctor, dentist or vet can be supplied with a sch 2 or 3 controlled drug on the undertaking that a requisition will be supplied within the next 24 hours. Failure to do so would be an offence on the part of the requesting practitioner

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How long must CD requisitions be retained for?

2 years

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Can both chloramphenicol eye drops and ointment be used at the same time?

Yes - when both are being used the drops should be used during the day and the ointment just once at night.

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How should chloramphenicol eye drops be stored

in the fridge

How should chloramphenicol ointment be stored?

Does not require refrigeration and should be stored <25’C

How long can chloramphenicol be given OTC?

5 days

Reasons to refer someone with experiencing eye problems

Photophobia, vision is affected, eye surgery within past 6 months, symptoms get worse despite using chloramphenicol treatments, pupils look unusual, eye looks cloudy, patient is a contact lens wearer.

Maximum recommended dose of viagra a day?

Max dose is one 50mg tablet a day. To be taken one hour before sexual activity.

Should sildenafil be taken with or without food?

Either but when taken with food the onset may be delayed compared to the fasted state.

Patients requesting sildenafil, may need to be referred if you believe sexual activity may be inadvisable. Such as?

Those with severe cardiovascular disorder, recent acute MI or stroke, unstable angina.

Side effects of sildenafil

Common - headache, flushing, dyspepsia, nasal congestion, dizziness, nauesa, blurred vision. Priapism - prolonged, painful erections lasting more than 4 hours. seek immediate medical assistance Sudden visual defects - seek immediate medical assistance

How many tablets of sildenafil can be sold OTC?

No limit - pharmacists should use their professional judgment on a case by case basis.

OTC age for tranexamic acid

18-45 years

After how many months of no reduction in bleeding while taking tranexamic acid should you refer a patient?

3 months

what is the dose of tranexamic acid OTC?

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. Can be increased to a max of eight tablets a day (4g) if needed)

Should tranexamic acid be taken before menstruation to reduce bleeding?

NO - use only once bleeding has started. It will not work properly if taken before menstruation has started.

How many days can tranexamic acid be taken for OTC?

Should not be taken for more than four consecutive days

What is sumatriptan indicated for?

acute relief of migraine with or without aura

What is the supply criteria for OTC sumatriptan - 3 points

1. Migraine must be diagnosed by a doctor or pharmacist 2. Established pattern of migraine (a history of five or more migraine attacks occuring over a period of at least one year) 3. Simple analgesics have been tried and ineffective

What is the dose of sumatriptan?

One 50mg tablet taken immediately. No further doses should be taken for the same migraine attack. If there is a second migraine attack within 24 hours a second dose may be taken.

Patients taking what medicines should be referred when requestion sumatriptan?

SSRIs, TCAs, MAOIs

Patients over what age, experiencing their first migraine should be referred?

Over 50

Patients with a PMH of what should not be given sumatriptan?

``` Seizures Myocardial infarction Cerebrovascular disease CoC use St johns wort ```

Tamulosin can be supplied to patients OTC within what age bracket?

45-75 years

How many weeks supply of tamulosin can be supplied initially?

2 weeks

Symptoms of BPH must be present for X months for tamulosin to be supplied OTC

3 months

After how many weeks of OTC tamulosin, should a patient see their doctor?

6 weeks

What drugs should not be taken with tamulosin OTC?

Verapamil, diclofenac, warfarin and strong CYP3A4 inhibitors

EllaOne can be given to patients over the age of what?

No age limit but patients under 13 are not deemed old enough to consent

Levonelle can be given to patients over what age?

16 years

Which EHC can be taken more than once in a cycle?

Levonelle

Which EHC would be best in a patient taking phenytoin?

Levonelle - patients taking enzyme inducing drugs within the last 4 weeks should be offered referral for a copper IUD however if this is not a suitable option the women should take double the usual dose. Ella one- does not recommend concomitant use