silver Flashcards by Simon Evans

The MHRA issued an alert, after an EU-wide review concluded that on rare occasions, the use of drug X can lead to calciphylaxis—patients are advised to consult their doctor if they develop a painful skin rash. If calciphylaxis is diagnosed, then appropriate treatment should be started, and consideration should be given to stopping treatment with drug X. Which of the following options is most likely drug X?
Warfarin
Digoxin
Rivaroxaban
Vancomycin
Liothyronine

Calciphylaxis (also called calcific uremic arteriolopathy) is a rare but serious condition characterized by vascular calcification and skin necrosis, most commonly seen in patients with end-stage renal disease. However, it has also been reported in patients taking warfarin, which inhibits the activation of vitamin K-dependent proteins, including matrix Gla protein—a key inhibitor of vascular calcification

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In England, all of the following drugs can be supplied in instalments on an FP10MD form except:
Suboxone
Buprenorphine
Diazepam
Morphine
Codeine

Codiene

In England, an FP10MDA form (blue prescription) allows instalment dispensing of certain Schedule 2 and 3 Controlled Drugs, mainly for opioid dependence treatment.

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Oral retinoids (including acitretin, alitretinoin and isotretinoin) are used for severe skin conditions. They are described in their Summary of Product Characteristics (SPCs) as ‘a powerful human teratogen inducing a high frequency of severe and life-threatening birth defects’ and therefore contraindicated in pregnant women and women of childbearing potential unless all of the conditions of the PPP are met. Under the PPP, prescriptions are valid only for ________ and ideally should be dispensed on the date the prescription is written
5 days
7 days
14 days
28 days
6 months

7 days

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Oral retinoids (including acitretin, alitretinoin and isotretinoin) are used for severe skin conditions. They are described in their Summary of Product Characteristics (SPCs) as ‘a powerful human teratogen inducing a high frequency of severe and life-threatening birth defects’ and therefore contraindicated in pregnant women and women of childbearing potential unless all of the conditions of the PPP are met. The quantity supplied can only be for a maximum of _________ supply. A quantity for more than this can only be dispensed if the patient is confirmed by the prescriber as not being under the PPP.
7 days
14 days
28 days
30 days
56 days

30 days

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All macrolides are associated with QT interval prolongation. However, the MHRA has issued an alert for ________ in particular as there is an increased risk of cardiotoxicity
Clarithromycin
Azithromycin
Erythromycin
Roxithromycin
Vancomycin

Erythromycin

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n the event of renal impairment, the dose of Erythromycin should not exceed ____ in adults.
1g
1.5g
2g
2.5g
3g

1.5g

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Sell Mrs Payne Ibuprofen 400mg tablets; to be taken up to 4 four times a day as necessary.
Sell Mrs Payne Ibuprofen 200mg tablets; to be taken up to 4 four times a day as necessary
Sell Mrs Payne Paracetamol 500mg tablets; 2 tablets to be taken up to 4 four times a day as necessary
Sell Mrs Payne Paracetamol 500mg tablets; 2 tablets to be taken up to 2 four times a day as necessary
Refer Mrs Payne to the GP

Refer

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Mrs Lek Payne’s leg is red, swollen and painful, the skin is warm and tender to the touch. What is the most likely diagnosis?
Possible folliculitis infection
Possible impetigo infection
Possible cellulitis infection
Possible shingles infection
Possible erysipelas infection

Cellulitis

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After visiting the GP, Mrs Payne was confirmed to have cellulitis; most likely caused by the scratch as a result of the fall. She was prescribed 500mg Erythromycin to be taken 4 times a day for 5-7 days (and then a review). Which of Mrs Payne’s regular medicines would be a cause for concern due to a potential interaction with Erythromycin?
Ramipril
Amlodipine
Lansoprazole
Simvastatin
Naproxen

Erythromycin is a strong inhibitor of CYP3A4, the enzyme responsible for metabolizing Simvastatin. This interaction can increase Simvastatin levels, leading to a higher risk of myopathy and rhabdomyolysis (muscle breakdown that can cause kidney damage).

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Lower urinary tract infection (UTI) is an infection of the bladder (also known as cystitis) usually caused by bacteria from the gastrointestinal tract. Which of the following is not a risk factor for complicated UTI’s?
Pregnancy
Urinary catheterisation
Co-morbidities such as immunosuppression
Structural abnormalities
Smoking

Smoking

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Which of the following options correctly identifies the antidote for opioid toxicity?
Naloxone
Suboxone
Naltrexone
Cortexone
Copaxone

Naloxone

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Lower urinary tract infection (UTI) is an infection of the bladder (also known as cystitis) usually caused by bacteria from the gastrointestinal tract. Lower urinary tract infections are most commonly caused by which of the following organisms?
Staphylococcus
Micrococcus
Escherichia coli
Pesudomonas maltophilia
Clostridium kluyveri

E.Coli

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What should be done in the event of concomitant treatment of Digoxin and Amiodarone?
The dose of Amiodarone should be halved
The dose of Digoxin should be halved
The dose of Digoxin should be reduced by 20-33%
The dose of Amiodarone should be reduced by 20-33%
No change needs to be made

dose should be halved

Amiodarone inhibits P-glycoprotein, which is responsible for Digoxin elimination.
This reduces Digoxin clearance, leading to increased serum Digoxin levels.
Digoxin has a narrow therapeutic index, meaning small increases in concentration can lead to toxicity (nausea, bradycardia, visual disturbances).

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Which of the following options correctly identifies the reversal agent for Dabigatran?
Abciximab
Adalimumab
Idaricuzumab
Bezlotoxumab
Basiliximab

Dabigatran is a direct thrombin (Factor IIa) inhibitor, used as an anticoagulant.
In cases of life-threatening bleeding or urgent surgery, Idarucizumab (Praxbind) is used as a specific reversal agent for Dabigatran.
It is a monoclonal antibody fragment that binds to Dabigatran with high affinity, neutralizing its anticoagulant effects within minutes.

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Which of the following options correctly identifies the reversal agent for Heparin?
Penicillamine
Protamine
Paragrad
Percocet
Protonic

Protamine sulfate is a positively charged molecule that binds to the negatively charged Heparin, forming a stable complex and neutralizing its anticoagulant effect.

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Mrs Wheek Neez (54) popped into the pharmacy today for some advice. She tells you she has been experiencing some ear pain and noticed some discharge too this morning. PMR: Simvastatin 20mg daily, Lisinopril 20mg daily, Alendronic acid 70mg once weekly, Bisoprolol 10mg daily, Paracetamol 500mg QDS PRN. How do you proceed?
Sell Mrs Neez Ibuprofen 200mg tablets; to be taken up to 4 four times a day as necessary.
Sell Mrs Neez Paracetamol 500mg tablets; 2 tablets to be taken up to 4 four times a day as necessary.
Sell Mrs Neez Olive oil ear drops
Sell Mrs Neez Otomize ear spray
Refer Mrs Neez to the GP

Refer

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Glycopeptide antibiotics are a class of drugs of microbial origin that are composed of glycosylated cyclic or polycyclic nonribosomal peptides. Which of the following is an example of a glycopeptide antibiotic?
Azithromycin
Doxycycline
Gentamicin
Teicoplanin
Amoxicillin

Teicoplanin

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Alpha-glucosidase inhibitors work by delaying the digestion and absorption of starch & sucrose by inhibiting alpha glucosidase enzymes and thus lower blood glucose levels. Which of the following drugs is an example of an alpha-glucosidase inhibitor?
Glimepiride
Repaglinide
Metformin
Pioglitazone
Acarbose

Acarbose

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Class X of anti-diabetic drugs work by blocking the re-absorption of glucose in the kidneys and promoting the excretion of excess glucose in the urine; due to this common side effects of this drug class include genital infections, polyuria and thirst. Of the following options which is most likely to be class X?
SGLT2 inhibitors
Meglitinides
Incretin mimetics
DPP4 inhibitors
Biguanides

SGLT2

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Mrs Tipe Tew (52) has been commenced on a new anti-diabetic medication. She informs you that her friend told her that this particular diabetes medicine often causes people to gain substantial weight and she was quite worried about this. You provide Mrs Tew with reassurance that this medicine will not cause weight gain as a side effect. Which of the following anti-diabetic drugs was Mrs Tew most likely prescribed?
Gliclazide
Nateglinide
Linagliptin
Glimepiride
Repaglinide

Linagliptin is a DPP-4 inhibitor used to manage type 2 diabetes.
One of the key benefits of DPP-4 inhibitors (like Linagliptin) is that they are weight-neutral, meaning they do not typically cause weight gain or weight loss.

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Which of the following class of drugs or drug should be used with caution in people of black African or Caribbean origin, or with primary aldosteronism — as these groups of people respond less well?
Beta blockers
Spironolactone
ACE inhibitors
Calcium channel blockers
Tramadol

ACE

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Which of the following drugs/drug classes is not known to induce acute kidney injury?
Ibuprofen
Alendronic acid
Gentamicin
Quinapril
Furosemide

Alendronic acid

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The MHRA advises patients and carers to seek medical attention if changes in speech or behaviour occur following administration of which of the following drugs?
Montelukast
Levothyroxine
Gentamicin
Tramadol
Amlodipine

Montelukast is a leukotriene receptor antagonist commonly used to manage asthma and allergic rhinitis.
The MHRA has issued a warning about neuropsychiatric side effects associated with Montelukast, which may include changes in speech, behavior, and other neuropsychiatric symptoms (e.g., aggression, agitation, depression, suicidal thoughts).

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Ms Dee Joxin (82) was recently admitted to the hospital after taking too many digoxin tablets due to a mechanical error with her dossete box and it dispensing too many tablets. Which of the following symptoms would Ms Joxin most likely have not experienced?
Nausea
Yellow/green visual disturbances
Confusion
Loss of appetite
Speech disturbances e.g., stutter

Speech disturbances (e.g., stutter) are not typically associated with digoxin toxicity. While neurological symptoms can occur, they are more likely to manifest as confusion, disorientation, or even arrhythmias (e.g., bradycardia, ventricular arrhythmias) rather than speech problems.

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Carbimazole is associated with an increased risk of congenital malformations when used during pregnancy, especially in the first trimester and at high doses (daily dose of ______ or more). 1mg 2mg 5mg 10mg 15mg

15mg

Women of childbearing potential should use effective contraception during treatment with all of the following drugs except? Isotretinoin Carbimazole Sodium valproate Metformin Lithium

Metformin

Because of the possibility of phototoxic reactions, patients are advised to shield the skin from light during treatment with drug X and for several months after due its very long half-life. Which of the following options is most likely to be drug X? Lithium Phenytoin Theophylline Amiodarone Warfarin

Amiodarone is an antiarrhythmic drug used for treating certain types of arrhythmias, particularly atrial fibrillation. One of its side effects includes phototoxic reactions (i.e., skin sensitivity to light), which can cause a rash or severe sunburn even with limited exposure to sunlight. Amiodarone has a very long half-life (up to several weeks), meaning it remains in the body for an extended period and patients may need to shield their skin from light for several months after stopping treatment to avoid phototoxic reactions.

The Pregnancy Prevention Programme (PPP) protects females of childbearing potential who are using drug class X, by minimising the risk of becoming pregnant. Drug class X are associated with a high risk of causing severe birth defects and miscarriage. Which of the following options correctly identifies drug class X? ACE inhibitor ARB’s Oral retinoids DPP4 inhibitors Biguanides

Oral Retinoids

A chest X-ray is required before treatment with drug X. Which of the following options correctly identifies drug X? Digoxin Lithium Phenytoin Phenytoin Amiodarone

Amiodarone is an antiarrhythmic drug that requires a chest X-ray before starting treatment, mainly due to the risk of pulmonary toxicity.

Theophylline is a bronchodilator. In addition, it affects the function of a number of cells involved in the inflammatory processes associated with asthma and chronic obstructive airways disease. Theophylline is most likely to cause which of the following electrolyte disturbances? Hyperkalemia Hypokalemia Hypernatremia Hyponatremia Hypocalcemia

Theophylline can cause hypokalemia (low potassium levels in the blood) as one of its side effects. The mechanism behind this involves theophylline's effect on the kidneys, where it can increase renal excretion of potassium. Additionally, theophylline can have a stimulant effect on the sympathetic nervous system, which can contribute to increased potassium loss through the kidneys

With regards to Theophylline therapy and patients with heart failure which of the following statements is correct? The plasma-theophylline concentration is increased in heart failure therefore an increased dose adjustment is needed The plasma-theophylline concentration is decreased in heart failure therefore an increased dose adjustment is needed The plasma-theophylline concentration is increased in heart failure therefore a decreased dose adjustment is needed The plasma-theophylline concentration is decreased in heart failure therefore a decreased dose adjustment is needed All of the statements are incorrect

The plasma-theophylline concentration is increased in heart failure therefore a decreased dose adjustment is needed

Which of the following is the correct antidote for benzodiazepine poisoning/toxicity? Protamine Flumazenil Dicobalt Penicillamine Naloxone

Flumazenil

With regards to Theophylline therapy and patients who smoke or consume alcohol which of the following statements is correct? The plasma-theophylline concentration is decreased in smokers, and by alcohol consumption therefore an increased dose adjustment is needed The plasma-theophylline concentration is increased in smokers, and by alcohol consumption therefore an increased dose adjustment is needed The plasma-theophylline concentration is decreased in smokers, and by alcohol consumption therefore a decreased dose adjustment is needed The plasma-theophylline concentration is increased in smokers, and by alcohol consumption therefore a decreased dose adjustment is needed All of the statements are incorrect

The plasma-theophylline concentration is decreased in smokers, and by alcohol consumption therefore an increased dose adjustment is needed

Pre-treatment screening for the HLA-B*1502 allele needs to be done in patients of Han Chinese or Thai origin for which of the following drugs? Lithium Carbamazepine Theophylline Ciclosporin Sodium valproate

Carmazepine

Patients of Han Chinese or Thai origin who are taking Carbamazepine and have the HLA-B*1502 allele are at an increased of? Stevens-Johnson syndrome Red man syndrome Erythema multiforme Grey man syndrome Mycoplasma pneumonia

SJS

Which of the following options, correctly identifies the class of the anti-diabetic drug Repaglinide? Incretin mimetics DPP4 inhibitors Sulfonylureas Meglitinides Biguanides

Repaglinide belongs to the class Meglitinides. It works by stimulating the pancreas to release more insulin, helping to control blood sugar levels.

Which of the following antibiotics is an example of a glycopeptide? Temocillin Amoxicillin Clarithromycin Teicoplanin Gentamicin

Teicoplanin

Which of the following is an example of an anti-diabetic drug from the Sulfonylurea class? Gliclazide Metformin Nateglinide Acarbose Liraglutide

Glicazide

Which of the following is an example of an echinocandin? Fluconazole Amphotericin B Colistin Caspofungin Clotrimazole

Caspofungin

Which of the following is an example of an anti-diabetic drug from the incretin mimetic class? Liraglutide Acarbose Pioglitazole Sitagliptin Metformin

Liraglutide

Which of the following is an example of a rapid acting insulin? Humulin M3 Lantus Levemir Humulin I Fiasp

Fiasp

Which of the following drugs is most likely to cause an orange-red urine discolouration? Doxorubicin Rifampicin Amoxicillin Traimterene Senna

Rifampcin

Hydrocortisone 1% cream should not be sold to anyone under the age of ___ without medical advice. 18 years 12 years 10 years 8 years 6 years

10 years

Loperamide 2mg capsules can be sold OTC for the symptomatic treatment of acute diarrhoea, in adults and children aged ___ . 18 years and over 12 years and over 10 years and over 8 years and over 6 years and over

12 years and over

What is the active ingredient inside Derbac M liquid? Malathion Permethrin Dimeticone Simeticone Clotrimazole

Malathion

Which of the following penicillins can NOT be taken orally? Benzylpenicillin Pivmecillinam Ampicillin Flucloxacillin Phenoxymethylpenicillin

Benzyl

Of the following options, which drug is an example of an antibiotic from the tetracycline drug class? Clindamycin Ceftriaxone Chloramphenicol Levofloxacin Eravacycline

Eravacycline

Which of the following options is NOT a risk factor for contracting scabies? Sharing clothes Sharing towels Poor housing Being elderly or a child Poor hygiene

Being elderly or a child

Which of the following adverse effects are ACE inhibitors most likely to cause? Gingival hyperplasia Hypernatremia Alopecia Bradycardia Hepatitis

Alopecia??

Which of the following is an example of an anti-diabetic drug from the DPP4 inhibitor drug class? Liraglutide Acarbose Pioglitazone Sitagliptin Metformin

Sitagliptin

Which of the following options, correctly identifies the class of the anti-diabetic drug Pioglitazone? Biguanide Thiazolidinediones Incretin mimetics DPP4 inhibitors Sulphonylureas

Pioglitazone belongs to the class Thiazolidinediones. It works by improving insulin sensitivity in muscle and adipose tissue, helping to lower blood sugar levels.

Which of the following can be used to treat a C. difficile infection? Amoxicillin Temocillin Fidaxomicin Gentamicin Clindamycin

Fidaxomicin is an antibiotic specifically used to treat C. difficile infections, as it is effective against the bacteria and has a lower risk of recurrence compared to other antibiotics.

Which of the following is an example of a narrow spectrum antibiotic? Fusidic acid Doxycycline Amoxicillin Meropenem Ertapenem

Fusidic acid

Which of the following is an example of an aminoglycoside? Vancomycin Streptomycin Clarithromycin Azithromycin Linezolid

Streptomycin

You are the pharmacist working in a new branch. When you notice that one of the pharmacy students has incorrectly stored a controlled drug on the shelves instead of the locker in safe custody. You educate the student on safe custody requirements and then move the drug into the safe. Which of the following controlled drugs needs to be kept in a safe custody? Temazepam Gabapentin Pregabalin Phenobarbital Midazolam buccal

Temazepam is a Class C controlled drug under the Misuse of Drugs Regulations 2001, which requires it to be stored in a secure, locked area (safe custody).

Of the following options, which healthcare professional can NOT prescribe any schedule 2 to 5 controlled drugs? Pharmacist independent prescriber Veterinary surgeon Physiotherapist independent prescriber Nurse/midwife independent prescriber Optometrist independent prescriber

Optometrist IP

For which of the following controlled drugs is a drug entry into the register not necessary? Zomorph 60mg Concerta XL 36mg Oramorph 10mg/5ml Diamorphine hydrochloride 5 mg Matrifen 75 micrograms/hour Transdermal patch

Oramorph

Private prescriptions for a POM must be retained for ______ from the date of the sale or supply or for repeatable prescriptions from the date of the last sale or supply. 2 years 3 years 5 years 7 years Record keeping is not a requirement

2 years

One of your regular customers, a 32-year-old female comes into the pharmacy with an FP10MDA prescription for three times weekly pick-up of unsupervised methadone. She asks you how long the prescription is valid for as she is struggling to make the appointments with her prescriber as she has started a new job recently. FP10MDA forms are limited to a maximum period of treatment of how many days? 7 days 14 days 28 days 30 days 56 days

FP10MDA prescriptions for supervised or unsupervised methadone are limited to a maximum period of 14 days. This is to ensure regular monitoring and to prevent misuse or diversion of the medication.

You are a day 1 pharmacist working your first shift when you receive a prescription for Temazepam 10mg tablets into the pharmacy and notice that the quantity is missing in both words and figures. How do you proceed? Return the prescription to the prescriber as it is not clinically complete Return the prescription to the prescriber as it is not legally complete Check the patient’s PMR to see what quantity they had been prescribed in the past and then endorse the prescription and write in the missing quantity Ask a member of the pharmacy team to see if they are familiar with this patient and the quantity of tablets they usually receive Contact the prescriber for clarification on the quantity then add in the quantity and endorse with PC (prescriber contacted)

Return to prescriber as not legally complete

What is the maximum length of treatment that can be supplied in the event of an emergency for Phenobarbital 30mg tablets? 30 days 28 days 14 days 7 days 5 days

5 days

Prescriptions and repeatable prescriptions issued by an approved health professional in an approved country (EEA/Switzerland) are legally recognised in the UK. Which of the following options correctly identifies an additional legal requirement of EEA prescriptions? Direct contact details of the prescriber including email address and telephone or fax number Prescription must be in English Prescription must not be older than 28 days Medicine must not be of one that is commonly misused Quantity prescribed must not be large or excessive for the condition being treated

Direct contact details of the prescriber including email address and telephone or fax number

With regards to the sale and supply of GSL medicines which of the following statements is correct? Within a pharmacy, GSL medicines can only be sold when a pharmacist has assumed the role of responsible pharmacist; however, the pharmacist may be physically absent for a limited period of time while remaining responsible, thus permitting sales of general sale medicines during this absence GSL medicines can be sold and supplied if the pharmacist has not assumed the role of responsible pharmacist as these medicines are available for self-selection to the public in stores other than pharmacies GSL medicines can only be sold when a pharmacist has assumed the role of responsible pharmacist; if the pharmacist is going to be physically absent for any given period of time, they can no longer remain responsible, and sales of GSL medicines must be halted Both A and B are correct All of the statements are incorrect

Within a pharmacy, GSL medicines can only be sold when a pharmacist has assumed the role of responsible pharmacist; however, the pharmacist may be physically absent for a limited period of time while remaining responsible, thus permitting sales of general sale medicines during this absence

With regards to the sale and supply of Ephedrine and Pseudoephedrine which of the following statements is correct? It is unlawful to supply a product or combination of products that contain more than 180mg of pseudoephedrine and 720mg of ephedrine at any one time, without a prescription It is unlawful to sell or supply any pseudoephedrine product at the same time as an ephedrine product without a prescription It is unlawful to supply a product or combination of products that contain more than 120mg of pseudoephedrine or 780mg of ephedrine at any one time, without a prescription It is permissible to sell or supply any pseudoephedrine product at the same time as an ephedrine product as long as the quantity of these products does not exceed the legal requirements (720mg of pseudoephedrine or 180mg of ephedrine) None of the statements are correct

It is unlawful to sell or supply any pseudoephedrine product at the same time as an ephedrine product without a prescription

The pharmacy record is an important legal document. It shows who the responsible pharmacist is at any given date and at any time. The pharmacy owner or superintendent pharmacist must keep the pharmacy record for a period of how many years? 1 year 2 years 3 years 5 years 7 years

5 years

Legislation allows the responsible pharmacist to be absent for up to a maximum period of _____ during the pharmacy’s business hours between midnight and midnight 1 hours 2 hours 3 hours 4 hours 6 hours

2 hours

Which of the following activity cannot take place in a pharmacy without a responsible pharmacist being in charge of the pharmacy? (Provided that support staff undertaking the activities are appropriately trained) Ordering stock from pharmaceutical wholesalers Accessing the PMR Receiving of prescription directly from EPS systems Processing of prescription forms that have been dispensed Sale/supply of P medicines

Sale/Supply of P meds

Mr Ova Dozin (52) was recently rushed into hospital after mistakenly taking his wife’s Methotrexate tablets instead of his iron supplements in a chaotic morning. Which of the following drug would most likely have been administered to Mr Dozin upon admission? Desferrioxamine Folinic acid Flumazenil Naltrexone Idaricuzumab

The correct drug that would most likely have been administered to Mr. Ova Dozin is Folinic acid. Methotrexate is an antimetabolite that can cause toxicity, and folinic acid (also known as leucovorin) is used as an antidote to reverse the toxic effects of methotrexate, especially if administered in overdose. Folinic acid helps to rescue normal cells from the effects of methotrexate and reduce the risk of severe toxicity

Record associated with supplies of veterinary medicines must be retained for a minimum of _______ following the date of supply and can be copies of documents or entries in private prescription register (POM register) 1 years 2 years 3 years 5 years 7 years

5 years

With regards to differences between veterinary and human controlled drug prescriptions which of the following statements is false? Standardised forms are required for both human and veterinary private prescriptions for Schedule 2 and 3 CDs For all CDs, it is considered good practice for only 28 days’ worth of treatment to be prescribed on veterinary prescriptions unless in situations of long-term ongoing medication (e.g., when treating epilepsy in dogs) For human prescriptions the maximum quantity of Schedule 2, 3 or 4 CDs should not exceed 30 days Veterinary prescriptions for Schedule 2 and 3 CDs must include the Royal College of Veterinary Surgeons (RCVS) registration number of the prescriber. Human private prescriptions for Schedule 2 and 3 CDs must include a prescriber identification number

Standardised forms are required for both human and veterinary private prescriptions for Schedule 2 and 3 CDs

The following characteristic is descriptive of which of the following veterinary prescription category? “Prescription-only medicines that can only be prescribed by a veterinary surgeon and supplied by a veterinary surgeon or a pharmacist with a written prescription” POM-V POM-VPS NFA-VPS AVM-GSL SAEs

POM-V

Mrs Hed Dake (42) one of your regular customers pops into the pharmacy to collect her mother’s medication. She tells you that she’s been experiencing a migraine and would also like to purchase medication for it. After some further questioning and ascertaining they are no red flags present, you recommend Sumatriptan. Which of the following options correctly identifies the counselling points for administration? Two 50mg tablets; should be taken as soon as possible after the migraine has started One 50mg tablet; should be taken as soon as possible after the migraine has started. If no improvement is seen in 30 minutes, a second dose may be taken One 50mg tablet; should be taken as soon as possible after the migraine has started Two 50mg tablets; should be taken as soon as possible after the migraine has started. If there is a second migraine attack within 24 hours a second dose may be taken One 50mg tablet; should be taken as soon as possible after the migraine has started. If there is a second migraine attack within 12 hours a second dose may be taken

One 50mg tablet; should be taken as soon as possible after the migraine has started

Mrs Hart Atek (57) had recently been experiencing chest pain and discomfort, following which, she was diagnosed with stable angina. Which of the following drug classes would be used as 1st line therapy for the symptomatic relief of stable angina as per NICE guideline? ACEi or ARB Beta blocker or ACEi Beta blocker or ARB Calcium channel blocker or ACEi Calcium channel blocker or beta blocker

CCB OR BB

Mrs Patel, a 37-year-old patient, visits her GP and is diagnosed with acute otitis media. She has a penicillin allergy and develops a rash when she takes penicillin, she is 25 weeks pregnant. What is the most appropriate treatment for her acute otitis media? Amoxicillin Co-amoxiclav Clarithromycin Erythromycin Vancomycin

First-line for acute otitis media is amoxicillin, but Mrs. Patel has a penicillin allergy, so this is not an option. Macrolides (erythromycin or clarithromycin) are used in penicillin-allergic patients, but in pregnancy, erythromycin is preferred because it has more established safety data.

Mr Ivory has been prescribed doxycycline for the treatment of cellulitis. Which of the following is not a side effect of doxycycline? Photosensitivity reaction Nausea Increased appetite Benign intracranial hypertension Oral disorders

Increased Appetite

Mr Manchester brings in a dental prescription to your community pharmacy. Which of the following medications can not be prescribed by a dental practitioner on a FP10D prescription? Aciclovir cream Amoxicillin capsules Cefalexin tablets Temazepam tablets Vancomycin capsules

Vancomycin

Mr Allen, a 25-year-old patient, presents at the accident and emergency department with a dog bite. He is assessed and the decision has been made by the medical team to prescribe him antibiotics, he has no medication allergies. Which of the following would be the first-line treatment for a dog bite? Amoxicillin Co-amoxiclav Clarithromycin Erythromycin Doxycycline

Dog bites can introduce polymicrobial infections, including Pasteurella species, Staphylococcus, Streptococcus, and anaerobes. Co-amoxiclav (amoxicillin + clavulanic acid) is first-line because: It covers Pasteurella multocida, a common bacteria in dog bites. It also covers anaerobes (e.g., Fusobacterium, Bacteroides), which are often present in bite wounds. The clavulanic acid component helps overcome beta-lactamase-producing bacteria.

Mrs London brings in a prescription for methadone hydrochloride. In the 2001 regulations, drugs are divided into five schedules. Which schedule does methadone belong to? Schedule 1 Schedule 2 Schedule 3 Schedule 4 Schedule 5

Mrs Williams is diagnosed with type 1 diabetes mellitus and commenced on insulin. She is counselled on the side effects of insulin, which of the following is not a side effect of insulin? Oedema Lipodystrophy Hypoglycaemia Skin reactions Weight loss

Insulin does not cause weight loss; in fact, it is associated with weight gain due to its anabolic effects.

Mr Smith has been prescribed long-term steroids. Which of the following is not a side effect of corticosteroid use? Diabetes mellitus Osteoporosis Weight gain Addison's disease Muscle wastage

Addison’s disease (primary adrenal insufficiency) is not a side effect of corticosteroid use. Instead, long-term steroid use can cause secondary adrenal insufficiency due to suppression of the hypothalamic-pituitary-adrenal (HPA) axis, but this is not the same as Addison’s disease.

A 56-year-old patient, Andrew Smith, presents to the cardiorespiratory ward with chest pain that occurs on exertion. He is diagnosed with stable angina, which of the following would be the most suitable treatment option to prevent further episodes of chest pain? Clopidogrel Apixaban Ranolazine Bisoprolol Glyceryl trinitrate

For stable angina, the first-line treatment to prevent further episodes of chest pain is a beta-blocker (e.g., bisoprolol) or a calcium channel blocker (e.g., amlodipine). Why Bisoprolol? Reduces myocardial oxygen demand by lowering heart rate and contractility. Improves exercise tolerance and prevents angina attacks

A 47-year-old patient, Mark Wright, is admitted into hospital following a paracetamol overdose. Mr Wright presents with severe nausea and vomiting. What is the most appropriate treatment for paracetamol overdose? Activated charcoal Procyclidine hydrochloride Acetylcysteine Naloxone hydrochloride Methylthioninium chloride

Acetylcysteine

Mr Andews, a 67-year-old patient is admitted for the acute admissions ward due to a fall, the medical team believe it was due to one of his newly started medications. Which of the following medications is likely to have caused his fall? Adcal D3 Canagliflozin Bisoprolol Metformin Prednisolone

Bisoprolol ?

Mrs Washingston, a 74-year old patient, calls your community pharmacy. She has noticed that she is extremely shaky and sweaty since starting a new medication. Which of her medication is likely to be responsible for her symptoms? Metformin Glibenclamide Bendroflumethiazide Losartan Adcal D3

Glibenclamide is a sulfonylurea, a class of diabetes medication that stimulates insulin release, which can cause hypoglycaemia. Common symptoms of hypoglycaemia include: Shakiness Sweating Palpitations Dizziness Confusion or irritability

Mr Adams walks into your pharmacy and complains his new inhaler has led to him experiencing soreness in his mouth and he has noticed white patches on his tongue. Which of the following inhalers is likely to be responsible for his symptoms? Fostair ® Ventolin Evohaler ® Serevent Evohaler ® Spiriva ® Atrovent ®

Fostair

A patient brings in a prescription for Temazepam 10mg tablets. How long is the prescription valid for from the date stated on the prescription? 14 days 28 days 30 days 6 months 12 months

28 days

Mrs Joshua has been started on digoxin for the maintenance of atrial fibrillation. Which of the following is not a side effect of digoxin? Vision disorders Arrhythmias Diarrhoea Increased appetite Skin reactions

Increased Appetite

Mrs Doris brings in a prescription for pethidine hydrochloride. In the 2001 regulations, drugs are divided into five schedules. Which schedule does pethidine belong to? Schedule 1 Schedule 2 Schedule 3 Schedule 4 Schedule 5

Mr Patel has been started on a new medication for type 2 diabetes mellitus that mainly exerts its effect by decreasing gluconeogenesis and by increasing peripheral utilisation of glucose. Which of the following medications is likely to have been prescribed? Acarbose Metformin Gliclazide Glibenclamide Canagliflozin

Metformin

A patient brings in a prescription for Zopiclone 7.5mg tablets. How long is the prescription valid for from the date stated on the prescription? 14 days 28 days 30 days 6 months 12 months

28 days

Mrs Smith has been started on a new medication that has to be prescribed by brand. Which of the following medications should preferably be prescribed by brand? Metformin MR Gliclazide Nifedipine MR Ramipiril Losartan

Nifedipine MR

Mrs Hand attends a Medicines Use Review (MUR) in your community pharmacy. She has noticed that her blood glucose is higher since starting a new medication. Which of her medication is likely to be responsible for her hyperglycaemia? Metformin Gliclazide Bendroflumethiazide Losartan Adcal D3

Bendroflumethiazide is a thiazide diuretic, which can cause increased blood glucose levels by: Reducing insulin sensitivity Impairing glucose tolerance Causing electrolyte imbalances (e.g., hypokalaemia), which may worsen insulin resistance

Mr Andrews has been started on a new antifungal medication in hospital. The doctor initially prescribed a test dose for Mr Andews due to the risk of anaphylaxis. Which of the following antifungals was likely prescribed for Mr Andrews? Voriconazole Isavuconazole Clotrimazole Amphotericin B Caspofungin

Amphotericin B is a potent antifungal commonly used for serious fungal infections, but it has a known risk of anaphylaxis and infusion-related reactions, which is why doctors typically start with a test dose to monitor for adverse reactions

Mr Smith, a 57-year-old patient, has been admitted with a diabetic foot infection. The decision has been made to prescribe an antibiotic for the treatment of a diabetic foot infection caused by vancomycin resistant enterococci (VRE). Which of the following antibiotics is likely to be a suitable treatment option? Teicoplanin Pivmecillinam Flucloxacillin Linezolid Metronidazole

Linezolid is an oxazolidinone antibiotic that is effective against VRE, including both vancomycin-resistant Enterococcus faecium and Enterococcus faecalis. It works by inhibiting bacterial protein synthesis. VRE infections are resistant to vancomycin, so linezolid is often used as an alternative for treating these infections.

Mrs Alison, a 37-year old patient, brings in a prescription for Azithromycin. She has never taken this medication before and has an allergy to penicillin. Which of the following conditions is Azithromycin licensed to treat? Infective endocarditis Otitis media Sepsis Hosptial acquired pneumonia Animal bite

Otitis media

Mr Andews is commenced on a new medication for type 2 diabetes mellitus. Since starting the medication he has severe persistent abdominal pain and is urgently admitted to the acute admissions ward, after investigation it is concluded the symptoms are due to the new medication. Which medication is he likely to have been prescribed? Metformin Acarbose Sitagliptin Canagliflozin Gliclazide

Sitagliptin is a DPP-4 inhibitor used in type 2 diabetes to increase insulin secretion in response to meals. It has been associated with rare cases of pancreatitis, which can present as severe abdominal pain.

Mr Smith, a 33-year-old patient, is diagnosed with mild cellulitis. Mr Smith has a penicillin allergy and develops a rash when he takes penicillin. Which of the following antibiotics would be the most suitable option for Mr Smith? Teicoplanin Flucloxacillin Doxycycline Vancomycin Metronidazole

Doxy

Mr Allan, a 47-year-old patient, has been diagnosed with a severe diabetic foot infection caused by Pseudomonas aeruginosa. Which of the following antibiotics does not demonstrate activity against Pseudomonas aeruginosa? Ciprofloxacin Gentamicin Ceftazidime Cefuroxime Meropenem

Cefuroxime is a second-generation cephalosporin and has limited or no activity against Pseudomonas aeruginosa, which is a gram-negative bacterium known for its resistance to many antibiotics.

Miss Washington, a 25-year-old patient, comes into your community pharmacy with a prescription for 7 temazepam tablets for insomnia. How long is the prescription valid for from the date stated on the prescription? 14 days 28 days 30 days 6 months 12 months

28 days

Mr Ruiz, a 53-year-old patient, walks into your community pharmacy with a prescription for a new medication for type 2 diabetes mellitus. He was advised that he may experience gastrointestinal disturbances during the first few weeks on the medication, however, these are usually transient and should resolve. Which medication is Mr Ruiz most likely to have been prescribed? Sitagliptin Canagliflozin Gliclazide Metformin Glibenclamide

Metformin

Mr Andrews, a 57-year-old patient, is admitted to the acute admissions ward and diagnosed with adrenal crisis. Mr Andrews requires a short-acting glucocorticoid. Which of the following is an example of a short-acting glucocorticoid? Prednisolone Deflazacort Dexamethasone Hydrocortisone Betamethasone

Hydrocortisone is a short-acting glucocorticoid that is commonly used in the treatment of adrenal crisis. It has a relatively short half-life compared to other glucocorticoids and is often used in emergency settings for patients with adrenal insufficiency.

Mr Benson, a 67-year-old patient, is admitted to the geriatric ward due to fall. The medical team have deduced that it is likely due to one of his medications. Which of the following medications is likely to be responsible for his fall? Metformin Adcal D3 Finasteride Sitagliptin Zopiclone

Zopiclone

Mr Rahman is diagnosed with a staphylococcal diabetic foot infection with osteomyelitis. The decision has been made to prescribe him a lincosamide antibiotic. Which of the following is a lincosamide antibiotic? Linezolid Dalbavancin Daptomycin Clindamycin Azithromycin

Clindamycin

Mr Andrews has been diagnosed with type 1 diabetes mellitus and commenced on a basal-bolus insulin regimen. Which of the following insulins is an example of a bolus insulin? Tresiba® Humulin I® Humulin M3® Fiasp® Lantus®

Fiasp

Adam Smith is 15 years old and has been prescribed aspirin. The consultant explained to him that aspirin is normally not recommended for patients his age, however, due to his condition it can be used. Which condition was Adam Smith likely diagnosed with? Hashimotos disease Kawasaki disease Disseminated intravascular coagulation Graves' disease Unstable angina

Kawasaki

Mr Smith has been diagnosed with infective endocarditis. The consultant would like to prescribe a glycopeptide for his treatment. Which of the following antibiotics is an example of a glycopeptide? Fidaxomicin Azithromycin Gentamicin Teicoplanin Streptomycin

Teicoplanin

Miss Alison has been prescribed an antibiotic, the nurse administered the antibiotic too quickly and they have noticed erythema on her face, neck and upper torso. Which of the following antibiotics is likely to be responsible for her reaction? Clarithromycin Clindamycin Vancomycin Gentamicin Amoxicillin

The reaction described, with erythema on the face, neck, and upper torso, is characteristic of red man syndrome. Vancomycin is known to cause red man syndrome if infused too quickly. This reaction is not an allergic reaction, but rather a histamine release due to rapid infusion, causing flushing and erythema

Mr Smith, a 55-year-old patient, is diagnosed with atrial fibrillation and commenced on a new medication. He is advised by the medical team that the medication may remain in his body for several weeks or even months after the medication has been stopped. Which of the following medications is he likely to have been prescribed? Bisoprolol Digoxin Amiodarone Aspirin Propranolol

Amiodarone is an antiarrhythmic medication used to treat conditions like atrial fibrillation. It is known for its long half-life, meaning it can remain in the body for weeks or even months after discontinuation. This is due to its lipophilic nature and slow tissue accumulation, which allows it to stay in the body for an extended period.

Mr Harrison is diagnosed with pituitary diabetes insipidus and the plan has been made to commence treatment. Which of the following medications is a suitable treatment for pituitary diabetes insipidus? Triamcinolone Metformin Desmopressin Sodium zirconium cyclosilicate Dexamethasone

Desmopressin

Mr Hameed is diagnosed with hyperthyroidism and is commenced on a new medication. Since starting the new medication he has noticed he is experiencing a sore throat and has mouth ulcers. Which medication has he likely been prescribed? Propylthiouracil Levothyroxine Liothyronine Carbimazole Naloxone

Carbimazole

Mrs Berry, a 47-year-old patient, walks into your community pharmacy. She has noticed, since starting a new medication, her urine is a red-brownish colour and is quite concerned. Which of her following medication is likely to be causing this side effect? Ramipril Atorvastatin Senna Nefopam Caspofungin

Senna is a laxative commonly used to treat constipation. It contains compounds called anthraquinones, which can cause reddish-brown urine due to the excretion of these pigments. This is a harmless side effect and is not indicative of any underlying health issue.