OTC

Question 1

Sport/Soft tissue injury referral (RED FLAGS)

Answer 1

1. acute with immediate swelling and severe pain
2. children under 12 and elderly
3. decreased range of motion in all directions
4. excessive range of movement in any joints
5. Unbale to bear any weight on foot/ankle/leg
6. suspected fracture
7. treatment failure

Question 2

Threadworm treatment

Answer 2

Also known as pinworms or enterobius infections
Treat all member of the family
NOT LICENSED UNDER 2 YRS OLD + PREGNANCY
Wash and scrub hands frequently
Do not scrash
Give mebendazole (P) MAX 100MG as a single dose. Repeat dose 2 weeks after.

Question 3

Cradle Cap treatment for infants

Answer 3

1. Daily use of baby shampoo and gentle brushing
2. apply olive oil to cap overnight and baby shampoo next morning
3. consider if treatment fails:
   - Clotrimazole 1% 2-3 times daily 4 weeks
   - Miconazole 2% BD for 4 weeks

Question 4

Nasal congestion treatment

Answer 4

Under 6’s: Give saline drops
Over 6’s:
- Xylometazoline hydrochloride nasal drop/spray: 6-17 yrs old. MHRA: MAXIMUM 5 DAY treatment
- Pseudoephedrine tabs: 6-17 yrs old. MHRA: not under 6’s. max 720mg pseudoephedrine salt can be sold at once OTC and not with ephedrine.
- Ephedrine nasal drops: 12-17 yrs old. max 180mg of ephedrine salt can be sold at one time OTC and not with pseudoephedrine.

Question 5

Trichomoniasis vaginosis S+S

Answer 5

50% asymptomatic
profuse, frothy, greenish-yellowish coloured, malodor discharge with valvular itching
Disshuria, urgency and vaginal spotting also symptoms
refer GP - need metronidazole 400mg TDS 4-5 days.

Question 6

Pseudoephedrine interactions

Answer 6

Linezolid - increases risk of high BP
Moclobemide/ Ozanimod/ rasagiline/ safinamide/ Selegiline - increases hypertensive crisis risk
Phenelzine - increases risk of hypertensive crisis. avoid for 14 days after discontinuation of MAOI

Question 7

sildenafil and similar C/I

Answer 7

within 3 mths of stroke/TIA/MI infraction
Systolic BP under 90 mmHg
recent unstable angina
sickle cell anaemia
degenerative retinal disorder and optic neuropathy

Question 8

constipation medicines that are used in palliative care

Answer 8

co-danthramer

co-danthrusate

Question 9

Hydrocortisone OTC

Answer 9

10 YEARS AND OVER
also HC45
X Pregnant women
X face, anogenital area, broken or infected skin, cold sores, acne, athlete’s foot
For allergic contact dermatitis, irritant dermatitis, insect bite reaction, mild to moderate eczema
Apply 1-2 OD MAX 7 days
usually hydrocortisone 1%

Question 10

Canesten HC OTC

Answer 10

Hydrocortisone with clotrimazole
able to sell 15g tube
for athletes foot, fungal infections of skin folds
10 YEARS OLD AND OVER

Question 11

Daktacort OTC

Answer 11

Hydrocortisone and miconazole
able to sell 15 g tube
for athletes foot and candida intertrigo
10 YEARS OLD AND OVER

Question 12

Eumovate OTC

Answer 12

Clobetasone butyrate 0.05%
for short term control of eczema and dermatitis
maximum 15g sold
X seborrhoeic dermatitis 
12 YEARS OLD AND OVER

Question 13

Headlice

Answer 13

Only treat mb where lie lice is seen 
1. dimethicone 4% - Hedrin lotion ONLY
OK in pregnancy and breastfeeding 
OK child older than 6 months 
OK in asthma
retreat after 7 days

Question 14

classification obesity

Answer 14

healthy BMI - 18.5 to 24.9
overweight - 25 to 29.9
obesity 1 - 30 to 34.9 
obesity 2 - 35 to 39.9
obesity 3 - 40+

Question 15

BMI calculation

Answer 15

BMI = weight in kg /(height in m)2