OTC Flashcards

1
Q

What is dyspepsia?

A

Collection of symptoms including upper abdominal discomfort and pain, heartburn, acid reflux (with or without bloating), N&V.

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2
Q

Red Flag symptoms of dyspepsia?

A

GI bleeding
dysphagia
unintentional weight loss
persistent vomiting

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3
Q

How long does symptoms of a common cold last?

A

7-14 days

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4
Q

What is the usual duration of acute otitis media?

A

4 days

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5
Q

What is the usual duration of a cough/ bronchitis?

A

3 weeks

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6
Q

What is the usual duration of acute sore throat/ pharyngitis/ tonsilitis?

A

1 week

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7
Q

What is the usual duration of acute rhinosinusitis?

A

2 and a half weeks

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8
Q

Frontal headache above or below the eyes may be associated with which respiratory tract infection?

A

Sinusitis

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9
Q

Earache is associated with which respiratory tract infection especially in children?

A

colds

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10
Q

When may acute sinusitis be more indicative of bacterial cause?

A

Fever
Symptoms lasting > 10 days

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11
Q

What non pharmacological symptom advice can be given for sinusitis?

A

Steam inhalation
Nasal irrigation

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12
Q

Which of the following has a more rapid onset?
-Flu
-Cold

A

Flu

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13
Q

Dextromethorphan and pholcodeine are what type of medications?

A

anti-tussives

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14
Q

Dextromethorphan is licensed in what age range?

A

> 12 years

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15
Q

Which of the following wouldn’t you expect to see in a dry cough medicine?
-Guaifenesin
-Dextromethorphan
-Glycerol
-Pholcodeine

A

Guaifenesin

(used for chesty coughs)

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16
Q

Guaifenesin and ipepacuanha are usually contained in which type of cough medicines?

A

Chesty cough

(both are expectorants)

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17
Q

Ephidrine, oxymetazoline, phenylephrine, pseudoephedrine and xylometazoline are all used for which OTC common ailment?

A

Nasal decongestants

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18
Q

Guaifenesin and ipepacuanha are licensed OTC in what age group?

A

> 6 years

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19
Q

Ephidrine, oxymetazoline, phenylephrine, pseudoephedrine and xylometazoline are licensed OTC in what age group?

A

> 6 years

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20
Q

Decongestants have a severe interaction with which of the following medications, including after taking 2 weeks after this medication?
-SSRIs
-MAOIs
-ACE inhibitor

A

MAOIs

(induce hypertensive crisis)

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21
Q

Fluribiprofen lozenges are licensed in which age range?

A

> 12 years

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22
Q

Benzydamine mouthwash is licensed in which age range?

A

> 12 years

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23
Q

What treatment options are available for a sore throat OTC?

A

Analgesics
Benzydamine mouthwash/ spray
Antiseptic lozenges
Anaesthetic lozenges

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24
Q

Which of the following is an older, sedating antihistamine?
-Loratidine
-Acrivastine
-Promethazine
-Cetirizine
-Fexofenadine

A

Promethazine

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25
Q

Which of the following antihistamines are not taken once daily?
-Cetirizine
-Fexofenadine
-Acrivastine
-Loratidine

A

Acrivastine

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26
Q

Which of the following antihistamines can be taken in children over the age of 2?
-Cetirizine
-Fexofenadine
-Acrivastine
-Loratidine

A

Loratidine

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27
Q

Which of the following antihistamines is licensed for children over the age of 6?
-Cetirizine
-Fexofenadine
-Acrivastine
-Loratidine

A

Cetirizine

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28
Q

Which TWO of the following antihistamines is licensed for children over the age of 12?
-Cetirizine
-Fexofenadine
-Acrivastine
-Loratidine

A

Fexofenadine & Acrivastone

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29
Q

Steroid nasal sprays are licensed OTC for what indication?

A

Hay fever

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30
Q

Beclometasone, budesonide, fluticasone and mometasone nasal sprays are licensed for which age range?

A

> 18 years

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31
Q

Sodium cromoglicate eye drops, nasal drops and nasal spray is licensed OTC for which indication?

A

Hay fever

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32
Q

How does thixotropic gel nasal spray work in hay fever?

A

Acts as a barrier

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33
Q

Mouth ulcers lasting longer than how many weeks needs referral?

A

3 weeks

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34
Q

Which of the following medications is least likely to cause mouth ulcers?
-ACE inhibitors
-sulfasalazine
-NSAIDs
-feverfew (herbal medication for migraines)

A

ACE inhibitors

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35
Q

Treatment options for mouth ulcers?

A

-Chlorhexidine gluconate mouthwash
-Hydrocortisone mucoadhesive buccal tablet (>12)
-Benzydamine mouthwash (>12) / spray
-Choline salicylate gel (>16)
-Lidocaine/ benzocaine

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36
Q

Antacids with a high sodium count should be avoided by which patient group?

A

Pregnant patients

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37
Q

How do alginates work to reduce symptoms of heartburn?

A

Form a raft that sits on the top of the stomach and prevents reflux

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38
Q

What can be used instead of sodium bicarbonate in patients needing low sodium forms of alginate?

A

Potassium bicarbonate

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39
Q

Which PPIs are licensed OTC?

A

Omeprazole 10mg
Esomeprazole 20mg
Pantoprazole 20mg

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40
Q

Sodium bicarbonate has what effect on lithium?

A

Increases lithium excretion

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41
Q

Aluminium salt based antacids are associated with which side effect?

A

Constipation

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42
Q

Magnesium salt based antacids are associated with which side effect?

A

Diarrhoea

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43
Q

The BNF advises taking a gap of how long between doses of antacids and other medications?

A

1 hour

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44
Q

Which antihistamines are licensed OTC for motion sickness?

A

Cinnarizine and promethazine teoclate

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45
Q

Which of the following medications would the most appropriate option to sell OTC to a patient who get motion sickness and will be travelling by car for 14 hours?
-Cinnarizine
-Cetirizine
-Promethazine

A

Promethazine

(Long duration of action, taken once daily, more suitable for long journeys)

(cinnarizine shorter duration of action, cetirizine not licensed OTC for motion)

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46
Q

What formulations are available OTC of hyoscine hydrobromide for motion sickness?

A

Tablets (lasts 1-3 hrs)
Patch (lasts up to 3 days)

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47
Q

Name bulk forming agents used for constipation?

A

Bran
Isphagula husk
Methylcellulose

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48
Q

Which group of laxatives are unsuitable for opioid induced constipation?

A

Bulk forming laxatives

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49
Q

Name osmotic laxative agents used for constipation?

A

Lactulose
Lactilol
Macrogol
Glycerine

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50
Q

Name stimulant laxative agents used for constipation?

A

Senna
Bisacodyl

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51
Q

What is the maximum duration that stimulant laxatives should be used for?

A

1 week

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52
Q

Name the stool softener agent used for constipation?

A

Docusate

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53
Q

Which group of laxatives should be avoided in children under 12 years?

A

Stimulant

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54
Q

What is the laxative group of choice for pregnant patients?

A

Bulk forming

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55
Q

Oral rehydration sachets should be used to combat dehydration in which OTC ailment?

A

Diarrhoea

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56
Q

What is the max amount of days treatment with loperamide?

A

2 days

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57
Q

Loperamide is licensed OTC for diarrhoea in which age range?

A

> 12 years

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58
Q

What is the dose of loperamide and maximum daily dose?

A

Two 2mg tablets straight away and then one tablet after every loose movement, max 16mg daily

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59
Q

OTC treatment options for IBS?

A

-Alverine citrate
-Mebevrine
-Peppermint oil
-Hyoscine

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60
Q

Mebeverine is licensed OTC for what age range?

A

> 18 years

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61
Q

Which of the following would not be an option for patients suffering eczema?
-Emollient
-Aqueous cream
-Emulsifying ointment

A

Aqueous creams

(contain sodium lauryl sulfate which has been shown to worsen eczema)

62
Q

What strength of steroid is hydrocortisone cream?

A

Mild

63
Q

What is OTC topical hydrocortisone licensed to treat?

A

-Irritant/ allergic dermatitis
-Insect bites
-Mild to moderate eczema

64
Q

What areas of the body are contraindicated in treatment of topical hydrocortisone OTC?

A

Face (excluding ears) and anogenital areas

65
Q

What age range is OTC topical hydrocortisone licensed in?

A

> 10 years

66
Q

What is the maximum treatment duration that OTC topical hydrocortisone and clobetasone is licensed for?

A

1 week

67
Q

Which TWO of the following could you not sell topical hydrocortisone to?
-eczema
-athletes foot
-acne
-allergic dermatitis

A

Athletes foot

(topical hydrocortisone is contraindicated in acne and infected skin i.e athletes foot, coldsores )

68
Q

What strength of steroid is topical clobetasone?

A

Moderate

69
Q

What are the licensed indications for OTC topical clobetasone?

A

Dermatitis and eczema

70
Q

What age range is OTC topical hydrocortisone licensed in?

A

12 years and over

71
Q

What is the first line OTC treatment option for acne?

A

Benzoyl peroxide

72
Q

Which of the following keratolytics are offered as second line treatments for acne OTC?
-Salicylic acid
-Benzoyl peroxide
-Potassium hydroxyquinoline sulfate

A

Salicylic acid & potassium hydroxyquinoline sulfate

73
Q

What POM medications can be prescribed for acne?

A

Tetracyclines
Retinoids

74
Q

What is the major contraindication with retinoids?

A

Pregnancy - teratogenic

75
Q

Why are steroids contraindicated in acne?

A

Potentiate the effects of androgenic hormones on the sebaceous glands and make the acne worse

76
Q

How is tinea pedis more commonly known?

A

Athletes foot

77
Q

What OTC treatment options are available for athletes foot?

A
  • terbinafine
  • miconazole, ketoconazole, clotrimazole
  • tolnaftate
  • undecylenates
78
Q

Which of the following is for adults only?
- miconazole
- clotrimazole
- ketoconazole

A

ketonconazole

79
Q

Which of the following terbinafine preparations is licensed in > 18 years as opposed to > 16?
-Cream
-Spray
-Solution
-Gel

A

Solution

80
Q

Treatment with amorolfine nail lacquer is how long for fingernail vs a toenail?

A

Fingernail 6 month
Toenail 9-12 months

81
Q

What OTC treatment options are available for cold sores?

A

Aciclovir cream
Penciclovir cream

82
Q

Which of the following is licensed in children and adults?
penciclovir cream
aciclovir cream

A

Aciclovir cream

83
Q

Which of the following is licensed in > 12 years?
penciclovir cream
aciclovir cream

A

Penciclovir cream

84
Q

What is the dosage frequency and duration of aciclovir cream?

A

Four hourly during waking hours for 5 days

85
Q

What is the dosage frequency and duration of penciclovir cream?

A

Two hourly during waking hours for 4 days

86
Q

What is the first line treatment for scabies OTC?

A

Permethrin cream

87
Q

When treating scabies, where should the cream be applied?

A

The entire body

88
Q

What is the treatment regime for permethrin cream for scabies?

A

Two treatments are recommended, 7 days apart. Apply in the evening and leave overnight.

89
Q

Who else should be treated when treating scabies?

A

Everyone in household, close contacts and sexual contacts

90
Q

What OTC options are available for dandruff?

A

Ketoconazole 2% shampoo

91
Q

What is the treatment frequency of ketoconazole shampoo for dandruff?

A

Twice weekly for 2-4 weeks, then once weekly/ fortnightly

92
Q

What treatment options are available for psoriasis?

A
  • Topical vitamin D preparations
  • Coal tar preparations
  • Dithranol (<1% for OTC)
93
Q

When offering non-pharmacological advice for treatment of a sprain/ strain, what does PRICE stand for?

A

Protect
Raise
Ice
Compression
Elevation

94
Q

In a supermarket, what is the maximum number of paracetamol tablets that can be sold?

A

32 (two boxes of 16 tablets)

95
Q

In a pharmacy, what is the maximum number of paracetamol tablets that can be sold?

A

32 tablet pack size

96
Q

In a supermarket, what is the maximum number of tablets and strength of ibuprofen that can be sold?

A

Pack sizes of 16 tablets
200mg

97
Q

In a pharmacy, what is the maximum strength of ibuprofen that can be sold?

A

400mg

98
Q

Ibuprofen tablets/ capsules is licensed in what age range?

A

> 12 years

99
Q

What OTC option of ibuprofen is available for children < 7 years?

A

Ibuprofen suspension 100mg in 5ml

100
Q

What OTC option of ibuprofen is available for children > 7 years?

A

Ibuprofen suspension 200mg in 5ml

101
Q

Which OTC medication should be avoided in a patient taking lithium?

A

NSAIDs

102
Q

For GSL of aspirin, what is the maximum strength and pack size available to buy?

A

2 packs of 16 tablets, 300mg

103
Q

When given to > 16 years, what can aspirin cause?

A

Reyes syndrome

104
Q

What is the max. dose of aspirin OTC?

A

3.6g daily

105
Q

What is the OTC licensing age for codeine and dihydrocodeine?

A

> 12 years

106
Q

What is the maximum treatment duration of OTC codeine and dihydrocodeine? And what is the risk if this is surpassed?

A

Maximum 3 days treatment, risk of addiction over this period

107
Q

Which of the following would not require referral?
- A 55 year old suffering from their first migraine
- A patient suffering a headache who had a fall the day before
- A patient experiencing a headache with a dull pain around the base of their head
- A patient with a headache in the morning that eases off throughout the day

A

A patient experiencing a headache with a dull pain around the base of their head

108
Q

What is the age range of OTC sumatriptan?

A

Between 18 and 65

109
Q

What is the total maximum daily dose of sumatriptan OTC?

A

100mg (two 50mg tablets at least 2 hours apart if headache reappears)

Second dose should not be given if no improvement with first dose

110
Q

What OTC options are available for patients suffering n&v associated with migraines?

A

Prochlorperazine (buccal)

111
Q

What OTC options are available to help with making the urine more alkaline in cystitis?

A

Potassium and sodium citrate

(if symptoms do not improve after 2 days - GP)

112
Q

What type of urinary incontinence is associated with weakening of the sphincter and pelvic floor muscles leading to leakages when sneezing/ coughing/ laughing?

A

Stress incontinence

113
Q

What type of urinary incontinence is associated with a sudden urgency to pass urine?

A

Urge incontinence

114
Q

What is first line treatment option OTC for heavy painful periods?

A

NSAIDs (ibuprofen and naproxen)

115
Q

Naproxen 250mg tablets can be sold to what age range for period pain?

A

15-50

116
Q

What is the administration advice for naproxen 250mg for period OTC?

A

two tablets taken initially followed by one tablet every 6-8 hours

(maximum 750mg daily)
(maximum duration of 3 days)

117
Q

What is the licensed OTC age range for tranexamic acid for heavy periods?

A

18-45

118
Q

What is the usual dose of tranexamic acid for heavy periods?

A

1g (two 500mg tablets) TDS or QDS if especially heavy

119
Q

What OTC option is available for vaginal atrophy in postmenopausal women?

A

Oestradiol 10mcg pessary

120
Q

What is the dose of oestradiol vaginal pessaries in vaginal atrophy?

A

once daily for two weeks, then twice weekly

121
Q

What OTC options are available for vaginal thrush?

A

Clotrimazole and oral fluconazole

122
Q

What are the missed pill rules for desogestrel?

A

If < 12 hrs, take and continue as normal
If > 12 hrs, take pill but additional contraception for 7 days

123
Q

How long after UPSI can levonorgestrel be given?

A

3 days

124
Q

How long after UPSI can ulipristal acid be given?

A

5 days

125
Q

Which types of laxatives should be avoided near term in pregnant women

A

stimulant

126
Q

What type of laxatives are best for pregnant women?

A

Isphagula husk and lactulose

127
Q

how can you manage a tension type headache?

A

simple analgesic

128
Q

what is the licensed age range for diclofenac gel?

A

> 14 years

129
Q

how long after injury should NSAIDs be avoided?

A

48 hours

130
Q

in what instances may you use a double dose of levenorgestrel?

A

overweight (>70kg) - unlicensed
given with an enzyme inducers - licensed

(unlicensed so would need a prescription)

131
Q

after taking ella-one, how many days should you wait before restarting progesterone containing pill and what additional contraception may you need?

A

5 days, will need an additional barrier method for these 5 days and 2 additional days

132
Q

can you use ella one more than once within a cycle?

A

yes

133
Q

what are the fat soluble vitamins?

A

A,D,E,K

134
Q

can you sell orlistat to people with diabetes?

A

no

135
Q

what is the maximum daily dose of omeprazole OTC?

A

20mg

136
Q

what treatments are recommended for colic?

A

none - lack of evidence

137
Q

can NSAIDs be used in chicken pox?

A

no, risk of necrotising skin infection

138
Q

what can you offer for chicken pox?

A

paracetamol, calamine and/or chlorphenamine

139
Q

how often are oestrogen pessaries used?

A

every day for the first 2 weeks, then twice a week

140
Q

how long should women under the age of 50 continue contraception after their last menstrual period?

A

2 years

141
Q

how long should women over the age of 50 continue contraception after their last menstrua period?

A

1 year

142
Q

CHM recommends that patients of what age range should be referred with symptoms of vaginal thrush?

A

<16
>60

143
Q

what are the symptoms of vaginal thrush?

A

itchy and sore
creamy, thick, curdy discharge
dysuria (pain on urination)
dyspareunia (pain during sex)

144
Q

what type of discharge is associated with BV?

A

white/ grey watery discharge with a fishy odour

145
Q

what type of discharge is associated with gonorrhoea/ chlamydia?

A

yellow/ green discharge

146
Q

women who experience more than how many attacks of thrush within the last 6 months should be referred?

A

> 2

147
Q

what OTC options are available for thrush?

A

clotrimazole and fluconazole

148
Q

which laxatives are preferred OTC in pregnancy?

A

lactulose and ispaghula husk

149
Q

what is the OTC age restriction for sildenafil?

A

> 18

150
Q

what OTC drug is available for hair loss?

A

minoxidil

151
Q

what POM is available for hair loss?

A

finasteride