Coach

Question 1

mother comes into the pharmacy with her
10-year-old child who is suffering from an itchy, red rash on their arm. She
has tried
antihistamines and is now requesting to buy a steroid cream for the
rash.
What is the minimum age clobetasone 0.05%
cream can be sold OTC?
A. 10
B. 12
C. 6
D. 18
E. No age limit

Answer 1

12

Question 2

A 45-year-old female comes into the pharmacy asking for some advice. She explains she has been feeling unwell with a raised temperature
for the last few days. She now has a painful, blistering rash on one side of her torso. The patient takes no medication.
Which of the following is the most likely diagnosis?
A. Chicken pox
B. Meningitis
C. Shingles
D. Impetigo
E. Measles

Answer 2

Shingles

Question 3

A patient comes in with a prescription for Dermovate ointment. She has read online that steroids should not be used long term due to their
side effects. She would like to know more about topical corticosteroids.
Which of the following topical corticosteroids is classified as potent?
A. Clobetasol propionate 0.05% (Dermovate)
B. Mometasone furoate 0.1% (Elocon)
C. Clobetasone 0.05% (Eumovate)
D. Hydrocortisone 0.1% (Dioderm)
E. Betamethasone valerate 0.025% (Betnovate RD)

Answer 3

B

Question 4

A regular patient comes into the pharmacy asking to speak to the pharmacist. They explain that they are going for an operation next week
and have not been told whether he should stop any of his medications before his surgery.
Which medication does not need to be stopped before major surgery?
A. Lithium
B. Warfarin
C. Clopidogrel
D. Ramipril
E. Levothyroxine

Answer 4

✅ E. Levothyroxine
Can be continued before surgery.
It’s a maintenance hormone with a long half-life (~7 days), and sudden stopping could risk hypothyroidism, especially perioperatively.

Question 5

A 21-year-old patient comes in with a new prescription for an inhaler. She explains she has never used it before and would like some advice
on how to use this type of inhaler. The prescription states Fostair NEXThaler 100/6 (beclometasone/formoterol) – one puff twice daily.
What is the most appropriate advice for the patient on how to use her inhaler?
A. Slowly and forcefully
B. Slowly and deeply
C. Fast and shallow
D. Fast and deeply
E. Place a capsule in the base chamber of the inhaler

Answer 5

Fast + deeply

Question 6

A patient approaches you in your pharmacy and asks for some advice regarding a problem with their eye. Upon questioning, you find out
that they are suffering from nausea and vomiting as well as a cloudy eye. They notice your new display and express their joy that it looks
rainbow coloured. Your new display is white.
What is the most appropriate course of action?
A. Tell the patient the symptoms will resolve in a few days
B. Tell the patient to go A&E
C. Sell the patient chloramphenicol eye drops
D. Advise the patient to make a non-urgent GP appointment
E. Sell cyclizine over the counter for their nausea and vomiting

Answer 6

B
🧠 Here’s why:
The patient is showing red flag symptoms that suggest acute angle-closure glaucoma, a sight-threatening emergency.

⚠️ Key symptoms they describe:
Nausea and vomiting
Cloudy eye
Rainbow-coloured haloes around lights (seeing a white display as rainbow)
Often also associated with eye pain, redness, and blurred vision
🚨 Why it’s serious:
Acute angle-closure glaucoma causes a sudden increase in intraocular pressure, which can cause permanent vision loss within hours if not treated promptly.

Question 7

Mr A presents at your pharmacy with a prescription for colchicine 500microgram tablets for an acute episode of gout. From his PMR you
notice he has never had this medication before so you decide to counsel him on the medication.
What is the least appropriate advice to give Mr A?
A. Take one tablet 2-4 times a day until symptoms are relieved
B. Maximum 6mg per course
C. The course can be repeated after 2 days if symptoms occur again
D. Common side effects include nausea, vomiting and diarrhoea
E. Colchicine should be used in caution when given with simvastatin

Answer 7

The course can be repeated after 2 days if symptoms occur again

Question 8

A regular patient comes into the pharmacy asking to buy multivitamins. She explains to you that she has been feeling very fatigued recently
even though she is sleeping well and is not stressed. She also tells you she recently took some ibuprofen over the counter as she had back
and shoulder pain after a sporting injury.
You check the PMR and she is on the following medication:
Folic acid 5mg tablets – take one daily
Lansoprazole 30mg GR capsules – take one daily
Lithium 400mg tablets – take one twice daily
Olanzapine 10mg tablets – once daily
TheiCal D3 tablets – chew one daily
What is the most appropriate action to take?
A. Sell the multivitamins to the patient as requested
B. Advise the symptoms she is experiencing are self-limiting and will resolve by itself
C. Advise the patient to book an urgent appointment with the doctors as she will need her thyroid levels checked
D. Advise the patient to go A&E as she is showing signs of lithium toxicity
E. Recommend the patient use co-codamol instead of ibuprofen for any back pain she experiences

Answer 8

✅ C. Advise the patient to book an urgent appointment with the doctors as she will need her thyroid levels checked

🧠 Here’s why:
The patient is on lithium, which is known to interfere with thyroid function, potentially leading to hypothyroidism — a condition that can cause:

Fatigue (despite good sleep)
Weight gain
Cold intolerance
Depression or low mood
Dry skin, constipation, or hair thinning
She is describing fatigue without an obvious cause, which is a classic early symptom.

Question 9

A 49-year-old female comes into the pharmacy asking to buy clotrimazole 2% cream. She explains she has used it in the past years ago
when she had thrush. She explains that she has vulval itching and soreness when urinating. She mentions a thin greyish discharge that
sometimes has a strong fishy odour and would like to buy the cream to clear it up quickly.
What is the most appropriate diagnosis for this patient?
A. Bacterial Vaginosis
B. Chlamydia
C. Candidiasis
D. Trichomoniasis
E. Vaginitis

Answer 9

BV

Question 10

A 50-year-old man comes into the pharmacy asking for some advice. He tells you for the last few days he has had a strong urge to urinate
more frequently and there is a burning sensation when he urinates. He mentions this is the second time he has had these symptoms and
wonders if it is a side effect of a new medication he has started.
What medication has this patient recently started?
A. Metformin
B. Canagliflozin
C. Indapamide
D. Amitriptyline
E. Sertraline

Answer 10

B

Question 11

Miss A, a regular patient of yours comes into the pharmacy asking to speak to you. They tell you they have recently passed their driving test
and would like to know what the DVLA advice is for diabetic patients.
What is the least appropriate advice to give to Miss A?
A. All drivers treated with insulin should notify DVLA
B. Drivers must carry a glucose meter and test strips with them
C. Blood glucose should be checked no more than 4 hours before driving and at least every 4 hours while driving
D. Blood glucose levels should be above 5mmol/L before driving
E. You should not drive if your blood glucose level falls below 4mmol/L or there are signs of hypoglycaemia

Answer 11

C is incorrect:
“Blood glucose should be checked no more than 4 hours before driving and at least every 4 hours while driving”
🔻 What’s wrong?

This is too infrequent. DVLA guidance is:
Check blood glucose within 2 hours before driving
Then every 2 hours during long drives, not every 4 hours

Question 12

A 65-year-old has recently undergone hip replacement surgery. His wife comes into the pharmacy asking for some advice. She explains he
has been taking some painkillers since his surgery and since then he has been constipated. She asks whether lactulose will help her
husband go to the toilet.
What is the least appropriate laxative to suggest in opioid-induced constipation?
A. Lactulose
B. Methylcellulose
C. Senna
D. Docusate Sodium
E. Picosulfate

Answer 12

B

Question 13

A regular patient presents at the pharmacy with a prescription for alendronic acid 70mg tablets. You notice that it is her first time taking
this medication and would like to counsel her.
What would be the least appropriate advice to give the patient?
A. The dose should be taken weekly
B. The dose should be taken 30 minutes before any other medication
C. Swallow the tablet sitting or standing upright
D. Take the tablet with food to reduce side effects
E. Report any signs of thigh, hip or groin pain during treatment

Answer 13

D is incorrect - Food impairs absorption – alendronic acid must be taken on an empty stomach with plain water only, and the patient should remain upright for at least 30 minutes.

Question 14

Mrs CJ has recently been initiated on sulfasalazine for active rheumatoid arthritis. She comes into the pharmacy asking to speak to the
pharmacist as she is worried about the side effects she read online.
Which of the following does the patient need to report immediately if it occurs?
A. Bruising
B. Diarrhoea
C. Headache
D. Vomiting
E. Rash

Answer 14

bruising would be a sign of blood dyscariasa

Question 15

3-year-old child has been brought into A&E with a high temperature of 39°C and pale, mottled blotchy skin. You are the hospital
pharmacist working on Saturday and have been asked to recommend an antibiotic for a child with suspected meningitis. The child’s
medical records show she is allergic to cephalosporins.
What is the most appropriate antibiotic to recommend for this patient?
A. Benzylpenicillin IV
B. Chloramphenicol IV
C. Cefotaxime IV
D. Ampicillin IV
E. Gentamicin IV

Answer 15

Why Chloramphenicol IV?
Effective broad-spectrum coverage for meningitis pathogens
Good CNS penetration
Used as alternative in patients allergic to penicillins or cephalosporins
Safe to use in children, though monitored carefully due to potential for bone marrow suppression

Question 16

You are working in a community pharmacy and conducting an audit on non-steroidal anti-inflammatory drugs (NSAIDs) and the risk of
cardiovascular events.
Which non-steroidal anti-inflammatory drug has the highest risk of a cardiovascular event?
A. Diclofenac 150mg daily
B. Ibuprofen 1.2g daily
C. Naproxen 1g daily
D. Etorcoxib 90mg daily
E. Celecoxib 100mg daily

Answer 16

Diclofenac

Question 17

Miss F has been initiated on tuberculosis treatment. After one month of treatment, she complains of blurred vision. She asks you if it is a
side effect of one of her medications she is taking.
Which of the following medications has most likely caused the blurred vision?
A. Isoniazid
B. Pyrazinamide
C. Rifampicin
D. Pyridoxine
E. Ethambutol
The correct answer is:
Ethambutol

Answer 17

Ethambutol is well-known for causing optic neuritis as a potential side effect, which can lead to:

Blurred vision
Reduced visual acuity
Red-green colour blindness
Visual field defects
These effects are dose-dependent and can be reversible if detected early and the drug is stopped promptly.

Question 18

Miss R hands a prescription for a new medication, hydroxychloroquine, for rheumatoid arthritis. She tells you she has read online about the
drug and is unsure whether she wants to start this medication. You decide to counsel Miss R on her new medication.
What is the most appropriate advice to tell Miss R?
A. An eye test should be performed before starting treatment, then every 12 months
B. Thyroid function test should be carried out before starting treatment, after 3 months and then annually
C. Contraindicated in hepatic and renal impairment
D. Must monitor patient BMI annually to avoid overdosing
E. Hydroxychloroquine should be taken on an empty stomach

Answer 18

Hydroxychloroquine can cause retinopathy, which may lead to irreversible vision loss.
Baseline eye exam (including visual acuity and retinal screening) is recommended within 12 months of starting, ideally at baseline.
Annual eye tests are required after 5 years of use (or earlier in high-risk patients — such as those on higher doses, renal impairment, or elderly).

Question 19

You are working as the on-call pharmacist at a hospital. You receive a call from a doctor who would like some advice on what antibiotic to
prescribe for a patient who is 15 weeks pregnant with an upper respiratory tract infection. He informs you this patient is going on holiday
tomorrow for 4 weeks and has a penicillin allergy.
What is the most appropriate antibiotic to prescribe?
A. Amoxicillin
B. Clarithromycin
C. Doxycycline
D. Erythromycin
E. Ciprofloxacin

Answer 19

✅ D. Erythromycin

🧠 Here’s why:
This patient is:

15 weeks pregnant (2nd trimester),
Has a penicillin allergy, and
Has an upper respiratory tract infection (URTI).
✅ Erythromycin is:
Safe in pregnancy (classified as safe throughout all trimesters)
Macrolide antibiotic → suitable for penicillin-allergic patients
Effective against typical URTI pathogens

Question 20

Mrs P comes into the pharmacy asking to speak to the pharmacist in private. In the consultation room, she explains that since
she has started the metformin, she has been experiencing really bad side effects such as an upset tummy and diarrhoea.
What is the least appropriate action to take to give to the patient?
A. Recommend taking the metformin with food or just after a meal.
B. Recommend switching to a modified release formulation
C. Advise the patient to start taking one tablet three times a day and titrate down each week to one tablet once daily to reduce
side effects
D. Advise that gastro-intestinal side effects are very common when starting metformin
E. Refer the patient to her GP for an alternative if the side effects are affecting daily activities

Answer 20

C

Question 21

A regular patient comes into the pharmacy asking to buy cystitis relief sachets. After speaking to the patient, they mention they’ve been
going to the bathroom more often than usual and a burning sensation when passing urine. He also mentions he has seen some blood in
his urine yesterday.
You check the PMR and he is on the following medication:
Aspirin 75mg tablets – take one daily
Atorvastatin 20mg tablets – take one in the evening
Lansoprazole 15mg GR capsules – take one daily
Pioglitazone 15mg tablets – take once daily
Metformin 500mg tablets – take one three times a day with food
Ramipril 2.5mg capsules – take one daily
What is the most appropriate action to take?
A. Selling the cystitis relief sachets and advising patient to book an appointment with the GP if symptoms have not improved in two
days
B. Refer to the GP for antibiotics
C. Advise the patient on lifestyle advice such as avoiding caffeine and fizzy drinks
D. Advise the patient it is a serious side effect of one of their medications and needs to book an urgent GP appointment
E. Advise the patient his symptoms are due to an interaction between pioglitazone and aspirin

Answer 21

D

Question 22

Miss E, a pregnant lady comes into the pharmacy asking for some advice. She is currently in her last trimester and would like to buy a
soothing haemorrhoid cream over the counter. She explains that she is experiencing perianal itching and blood in her stools.
Which of the following is not a reason to refer patients?
A. Pregnancy and breastfeeding
B. Symptoms longer than 3 weeks
C. Unresponsive to 1 week of OTC treatment
D. Dark tarry stools
E. Bright red blood in stools

Answer 22

Bright red blood in stools

Question 23

A regular patient comes into the pharmacy asking for advice. She has been prescribed leflunomide for rheumatoid arthritis. Miss F explains
that her and her partner are planning on starting a family and is wondering if she can take this medication.
Which of the following statements is correct?
A. Leflunomide does not cause any teratogenicity and contraception is not needed
B. Effective contraception is essential during treatment and for 6 months after treatment has ended for both men and women
C. Effective contraception is essential during treatment and for 2 years after treatment has ended for women and men
D. Effective contraception is essential during treatment and for 2 years after treatment has ended for women and 3 months for men
E. Effective contraception is essential during treatment and for 3 months after treatment has ended for women and men

Answer 23

2 years for women and 3 months for men

Question 24

Mr G is being treated with gentamicin IV by a multiple daily dose regimen for a severe soft tissue infection. You receive a call from the on-
call doctor asking for some advice prior to Mr G’s next dose. The peak gentamicin concentration level is 8mg/ml with a trough
concentration of 5mg/ml.
Which of the following is the most appropriate advice to give?
A. Decrease the dose and decrease the dosage interval
B. Increase the dose and increase the dosage interval
C. Increase the dose and maintain the same dosage interval
D. Maintain the same dose and increase the dosage interval
E. Maintain the same dose and decrease the dosage interval

Answer 24

Maintain the same dose and increase the dosing interval

Question 25

A mother comes into the pharmacy with a prescription for her daughter. She has recently been diagnosed with asthma and has been prescribed a new spacer to be used with her blue and brown inhalers. Which of the following statements regarding spacers is false? A. Spacers should be cleaned once every 6 months B. Spacers should be cleaned using a detergent such as washing up liquid C. Spacers should be left to air-dry to reduce static D. Boiling water should not be used as it can cause damage E. You should replace your spacer at least every year especially if used daily

Answer 25

A is incorrect

Question 26

You are the on-call pharmacist working in a hospital pharmacy. You receive a call on the weekend from the palliative care doctor who would like to switch a patient from fentanyl 25microgram patches to the equivalent intravenous morphine dose. A.120mgB.90mgC.60mg D.30mgE.18mg

Answer 26

30mg

Question 27

A.120mgB.90mgC.60mg D.30mgE.18mgYou receive a call from one of your regular patients, Mr F aged 69. He has been feeling unwell with abdominal cramps over the last couple of days and asks if you have anything he can buy over the counter to help with sickness. Upon further questioning, he mentions his vomit yesterday resembled ‘ground coffee’.You check the PMR and he is on the following medication: Amlodipine 10mg tablets –take one dailyIndapamide 2.5mg tablets –take one daily Naproxen 500mg tablets –take one twice daily Omeprazole 20mg capsules –take one dailyBeclometasone 50mcg nasal spray –1-2 sprays in each nostrildaily Atorvastatin 20mg tablets –take one dailyWhich of the following drugs most likely have caused Mr F’s symptoms? A.Indapamide B.Naproxen C.Amlodipine D.Beclometasone E.Atorvastatin

Answer 27

Vomiting with a ‘ground coffee’ appearance → This is a classic description of upper gastrointestinal bleeding (UGIB), specifically coffee ground vomitus, which suggests partially digested blood due to gastric bleeding. 🔍 Medication review: Let’s look at the culprit drugs: Naproxen ✅ Non-Steroidal Anti-Inflammatory Drug (NSAID) ➤ Known to cause gastric irritation, ulcers, and GI bleeding — especially in elderly patients ➤ Most likely cause here, even though Mr. F is on omeprazole (a PPI), which offers some protection but not full prevention

Question 28

A patient comes into the pharmacy requesting to buy hydrocortisone 1% cream for a rash. Your dispenser asks for some advice as she is unsure whether she can sell hydrocortisone to this patient. Which of the following patients would you be able to sell hydrocortisone 1% cream over the counter? A. A 9-year-old boy with a rash on his hand B. A 28-year-old pregnant female with an insect bite on her leg C. A 40-year-old male with allergic dermatitis on her ears D. A 19-year-old with an eczema flare-up on his face E. A 35-year-old with infective eczema on her elbows

Answer 28

C

Question 29

A 55-year-old male patient comes into A&E as he has accidentally taken too many of his atenolol tablets by mistake. In A&E, tests were performed immediately after the patient was admitted which showed a peak serum concentration of 50mg/L. The half-life of atenolol = 12 hours How long will it take for the serum concentration of atenolol to reach 9.375mg/L if no further doses were given? A. 12 hours B. 24 hours C. 28 hours D. 30 hours E. 36 hours

Answer 29

30 HRS

Question 30

You are working in a community pharmacy when you receive a call from a regular patient. He asks if you could recommend a suitable painkiller over the counter as they have recently sprained their ankle in a football match over the weekend. The patient explains that his ankle is swollen and painful even after using ice. You check the PMR and he is on the following medication: Amlodipine 10mg tablets – take one daily Citalopram 20mg tablets – take one daily Fexofenadine 180mg tablets – take one daily Pregabalin 50mg capsules – take one three times a day Sodium valproate 300mg MR tablets – take one twice a day Ramipril 5mg capsules – take one daily What is the least appropriate choice of analgesic over the counter for this patient? A. Ibuprofen tablets B. Paracetamol tablets C. Co-codamol tablets D. Paracetamol & dihydrocodeine tablets E. Paracetamol & caffeine tablets

Answer 30

✅ A. Ibuprofen tablets 🧠 Why? This patient is on several medications that increase the risk of adverse effects if NSAIDs like ibuprofen are added: 🔍 Key interacting or high-risk meds on his PMR: Ramipril (ACE inhibitor) ➤ NSAIDs can reduce renal perfusion when combined with ACE inhibitors → risk of acute kidney injury (AKI). Amlodipine (CCB) + Ramipril ➤ Together, these manage blood pressure. NSAIDs can raise blood pressure and oppose antihypertensive effects. Citalopram (SSRI) ➤ Combined with NSAIDs, increases bleeding risk, especially GI bleeding. Sodium valproate ➤ Can affect platelet function. When combined with NSAIDs, bleeding risk increases further.

Question 31

A mother comes into the pharmacy with her 10-year-old daughter seeking advice from the pharmacist. You go into the consultation room where the mother explains she has recently noticed dry, itchy, flaky patches on her daughter’s skin around her neck and has now started behind her knees. She explains it can also look like a red rash with darker red spots. Which of the following is the most likely diagnosis? A. Atopic eczema B. Psoriasis C. Scabies D. Insect bites E. Seborrhoeic dermatitis

Answer 31

Atopic eczema

Question 32

A patient comes into the pharmacy to ask for a suitable mouthwash. He has noticed whilst brushing his teeth, that his gums are sore and often bleed. He thinks he could be brushing too hard as he has recently replaced his old toothbrush. You check the PMR and he is on the following medication: Aspirin 75mg dispersible tablets – take one daily Amlodipine 10mg tablets – take one daily Gabapentin 100mg tablets – take one three times a day Phenytoin 300mg tablets – take one twice daily Ramipril 2.5mg capsules – take one daily Simvastatin 20mg tablets – take one daily Which of the following is the most appropriate action to take? A. Give the patient oral hygiene advice such as using a soft bristle toothbrush B. Advise the patient that it will resolve by itself after a week C. Advise the patient to use a salt water rinse twice a day after brushing their teeth D. Sell the patient chlorhexidine 0.5% mouthwash to use E. Refer him to the doctor due to possible side effects of one of their medications

Answer 32

✅ E. Refer him to the doctor due to possible side effects of one of their medications 🧠 Why? The patient is experiencing: Sore, bleeding gums While brushing, which may seem mechanical, but... His medication history raises concern for a drug-induced cause, specifically: 🚩 Key medication to watch: Phenytoin Phenytoin is well-known for causing gingival hyperplasia (overgrowth of gum tissue), which can lead to: Swelling Tenderness Bleeding, especially during brushing This side effect is dose-related and more common with poor oral hygiene.

Question 33

A patient brings you a private prescription for gabapentin 100mg capsules. You are aware that private prescriptions for controlled drugs and prescriptions for non controlled drugs have different legal requirements. You check the legality of the prescription in the MEP before dispensing it. What prescription form must this medicine be on for it to be a legally valid private prescription? A. FP10SS B. FP10MDA C. FP10PCD D. FP10D E. A headed private prescription

Answer 33

C

Question 34

A mother comes into your pharmacy to buy Calpol for her 4-year-old son. She explains that her son has developed a fever this morning and would like to purchase paracetamol for him. He uses a salbutamol 100mcg inhaler - when required and has recently been prescribed a course of amoxicillin 250mg/5ml oral solution. What is the maximum amount of Calpol she can give him per dose? A. 60mg B. 120mg C. 180mg D. 240mg E. 360mg

Answer 34

240mg

Question 35

Ms A is planning to go abroad to a high risk malaria area and asks if there are any over the counter malaria protection to reduce the risk of malaria as a friend suggested she buy Maloff Protect (atovaquone and proguanil) from the pharmacy. You begin the consultation to see if she is eligible to buy it over the counter. Which one of the following would result in refusing the sale? A. Diagnosed with diabetes mellitus B. Weighing 60kg C. Aged 18 D. Travelling for 9 weeks E. History of depression

Answer 35

E

Question 36

Mr A had an appointment today with his doctor as he was experiencing pain in his stomach, vomiting and indigestion. The doctor has given him a prescription of 3 medications due to the diagnosis. Mr A is worried about taking three new medications as he is taking other regular medicines. He asks you to check if it will be okay taking these alongside his regular medicines. He is allergic to penicillin. You check the PMR and he is on the following medication: Gliclazide 80mg tablets - one to be taken daily Sitagliptin 100mg tablets - one to be taken daily Clopidogrel 75mg tablets - one to be taken in the morning Losartan 50mg tablets - one to be taken daily Clenil (beclometasone) 100microgram inhaler - use one puff twice a day Salbutamol 100microgram inhaler - use one or two puffs when required. Maximum four times a day Which of the following regimes is suitable for Mr A? A. Amoxicillin 1g BD, Omeprazole 20mg BD, Clarithromycin 500mg BD B. Clarithromycin 250mg BD, Lansoprazole 30mg BD, Metronidazole 400mg BD C. Pantoprazole 40mg BD, Amoxicillin 1g BD, Clarithromycin 500mg BD D. Omeprazole 20mg BD, Clarithromycin 250mg BD, Metronidazole 400mg BD E. Clarithromycin 250mg BD, Lansoprazole 15mg BD, Metronidazole 400mg TDS

Answer 36

B

Question 37

You receive a call from a doctor asking for some advice about a 19-year-old girl asking for emergency contraception. It has been 50 hours since unprotected intercourse. She takes carbamazepine 400mg tablets - twice a day for her epilepsy which has been well controlled for 3 years. What is the most appropriate advice to give? A. A copper IUD is first line and should be inserted immediately B. A double dose of levonorgestrel is recommended for her C. Barrier method should be used until next menstrual cycle D. If vomiting occurs within five hours of taking EHC, another tablet should be taken immediately E. Not suitable for lactose intolerant patients

Answer 37

A copper IUD is first line and should be inserted immediately

Question 38

A 56-year-old woman from an Afro-Caribbean origin has been diagnosed with hypertension recently after consecutive high blood pressure readings. The decision was made to start her on medication to lower his blood pressure. You check the PMR and he is on the following medication: Levothyroxine 50microgram tablets - once in the morning Gliclazide 40mg tablets - one tablet daily Sitagliptin 50mg tablets - one tablet daily What is the most appropriate medication? A. Ramipril B. Losartan C. Amlodipine D. Diltiazem E. Doxazosin

Answer 38

Losartan

Question 39

A patient has been initiated on vincristine in hospital after investigations and blood test results. He was on vincristine a few years ago and he is concerned due to the side effects he experienced last time. You discuss the side effects with him. What is the least likely side effect he will experience? A. Neurotoxicity B. Headache C. Bone marrow suppression D. Alopecia E. Increased appetite

Answer 39

E

Question 40

After some consideration about the side effects he agrees to start treatment with vincristine. The nurse on duty asks you how to administer the vincristine as the drug chart does not indicate how to give him his dose. What is the least appropriate advice to give to the nurse? A. Intramuscular B. Intravenous C. Intrathecal D. Subcutaneous E. Orally

Answer 40

Least appropriate would be intrathecal

Question 41

You have had a few consultations over the past week reviewing patients' bloods and U&Es at your GP practice. Quite a few patients mentioned they have turned vegan in the past 1-2 years. You take this opportunity to do a reflective record for the health needs of vegan patients and which supplements are required, if any. Which of the following vitamins is recommended for vegan patients to maintain a good nervous system? A. Vitamin A B. Vitamin B12 C. Vitamin C D. Vitamin D E. Vitamin E

Answer 41

B12

Question 42

A patient that takes warfarin has come into the GP practice today for his routine blood test. Soon after, he called the nurse as he had a minor nosebleed. He is otherwise fit and well, and says that he doesn't usually get nose bleeds. The doctor on duty has asked you for some advice regarding his warfarin after measuring his INR. His INR today is 7. Which of the following is the most appropriate? A. Stop warfarin sodium; give phytomenadione by slow intravenous injection; repeat dose of phytomenadione if INR still too high after 24 hours, restart warfarin when INR < 5 B. Stop warfarin sodium; give phytomenadione by mouth using the intravenous preparation orally; repeat dose of phytomenadione if INR still too high after 24 hours, restart warfarin when INR < 5 C. Stop warfarin; give phytomenadione by slow intravenous injection; restart warfarin when INR < 5 D. Withhold 1 or 2 doses of warfarin and reduce subsequent maintenance dose E. Unexpected bleeding at therapeutic levels, continue with regular dose

Answer 42

C

Question 43

A patient has been presenting with the following symptoms; stiff neck, blurry double vision, nausea and a severe headache. After investigation in hospital, the diagnosis has confirmed a subarachnoid haemorrhage. Which one of the following is the most appropriate first line management for this patient? A. Amlodipine B. Nimodipine C. Nifedipine D. Diltiazem E. Verapamil

Answer 43

✅ B. Nimodipine 🧠 Why Nimodipine? Subarachnoid haemorrhage (SAH) is a type of bleeding into the space surrounding the brain, and it's often due to a ruptured cerebral aneurysm. One of the most dangerous complications after SAH is cerebral vasospasm, which can lead to delayed cerebral ischemia (stroke-like symptoms). 🎯 Nimodipine: A calcium channel blocker (CCB) in the dihydropyridine class Highly selective for cerebral blood vessels Reduces the risk of vasospasm and ischemia following subarachnoid haemorrhage Typically given orally or via NG tube for 21 days after SAH

Question 44

You receive a private prescription for one of your regular patients’ dog. The prescription is for a POM-V veterinary medicine from your pharmacy. A record of supply must be made in the pharmacy. Your trainee pharmacist asks you about the details of holding records. How long does the pharmacy need to keep the record of supply? A. Not required as it will be in the private POM register B. 2 years C. 5 years D. 7 years E. 10 years

Answer 44

5 years

Question 45

Following on from question 61, you are aware that the legal requirements for veterinary prescriptions are different to human prescriptions including the labelling requirements. As you are checking the legal requirements, you notice your dispenser has dispensed the prescription as a private prescription rather than a private veterinary prescription. Which of the following is the least appropriate to be included on the label of a veterinary prescription under the cascade? A. Name and address of prescriber B. Name and address of pharmacy C. Name and address of owner D. Warning and withdrawal of the medication E. Keep out of reach and sight of children

Answer 45

E

Question 46

One of your regular patients has called asking if you have Viagra Connect® in stock to buy. You check your stock and you have plenty. He also asks you if his prescription is ready to collect so you check his PMR. He is on: Aspirin 75mg tablets - once a day Atorvastatin 20mg tablets - one at night, Bisoprolol 2.5mg tablets - one in the morning, Monomil XL (Isosorbide mononitrate M/R) 60mg tablets - once a day GTN spray - use under the tongue when required. Which of the following is the most appropriate action? A. Inform him he can collect his prescription and buy Viagra Connect® OTC B. Inform him he can collect his prescription but cannot buy Viagra Connect® from your pharmacy but to try the one down the road C. Inform him he can collect his prescription but you cannot sell Viagra Connect® and refer to GP if he needs it D. Inform him he should speak to his GP to change the medication he’s taking regularly so he can buy Viagra Connect® E. He can buy Viagra Connect® once, if he gets dizzy to report it to the doctor ASAP

Answer 46

C

Question 47

A patient has returned morphine sulphate 10mg XL tablets x 28 to your pharmacy as they have been increased to 60mg. Your counter assistant says she cannot return them as they are controlled drugs, over hearing this you politely interrupt and take the medication from the patient. You take this opportunity to remind all your pharmacy staff of the rules of accepting patient returns. What is the most appropriate action to follow with the patient's return made today? A. Denature the medication witnessed by staff and record in the controlled drugs returns register B. Dispose of the medication in the appropriate waste bin and record in the controlled drugs register C. Denature the medication witnessed by an authorised person and record in the controlled drugs register D. Dispose of the medication in the appropriate waste bin and record in the controlled drugs returns register E. Denature the medication witnessed by an authorised person and make a record in the controlled drugs returns register

Answer 47

A

Question 48

A 34-year-old patient has been referred to the neurology department because she has been getting seizures more often despite the medication that she is currently on. She has been taking lamotrigine 100mg tablets once daily and has been stable until recently. The neurologist wants to add sodium valproate to her treatment for the next 4 weeks. Which statement is the least appropriate? A. Pregnancy should be excluded before treatment initiation and highly effective contraception must be used during treatment B. Seek immediate medical attention if abdominal pain, anorexia, jaundice, oedema, drowsiness develop C. A common side effect is weight increased D. Plasma concentrations are a useful measure of efficacy, therefore routine monitoring is helpful E. Monitor liver function before and for the first 6 month

Answer 48

The least appropriate option would be that plasma conc are a useful measure of efficacy and therefore monitoring is helpful- this is not the case

Question 49

You are working in a community pharmacy and a patient has called you to let you know not to order their regular antidepressant as the specialist is switching his antidepressants and titrating the new medication. Which of the following is the least appropriate washout period when starting tranylcypromine? A. Stopping clomipramine for 3 weeks B. Stopping amitriptyline for 2 weeks C. Stopping sertraline for 7 days D. Stopping fluoxetine for 5 weeks E. Stopping imipramine for 2 weeks

Answer 49

Stop imipramine for 2 weeks is the least appropriate option

Question 50

A patient has been admitted to hospital and initiated on clozapine for schizophrenia after unsuccessful treatment from previous medications. The patient is anxious to start this new medication as she says she’s worried about the effects it can have on her body. You reassure her and explain that the clinicians will be monitoring her very frequently and inform her of the side effects that can occur. Which of the following is the least appropriate with clozapine therapy? A. Constipation needs medical attention immediately B. White blood cell monitoring weekly for 18 weeks, then fortnightly for up to one year, and then monthly C. Weight monitored at 3 months then annually D. Blood glucose should be measured at 4 –6 months and then annually E. Hypersalivation can be treated with hyoscine butylbromide

Answer 50

Hypersalivation treated with hyoscine butylbromide ❌ — This is NOT ideal. Hyoscine butylbromide (Buscopan) is an antimuscarinic that doesn't cross the blood–brain barrier well, so it doesn't effectively treat hypersalivation caused by clozapine (which is mostly centrally mediated). Plus, antimuscarinics can worsen constipation, which is already a big danger with clozapine

Question 51

You are the on call pharmacist and receive a call from a junior doctor working at the accident and emergency department. They have just seen a elderly patient who accidentally overdosed on one of his medications as he is very confused. You check the PMR and he is on the following medication: Apixaban 5mg tablets - one tablet twice a day Amlodipine 10mg tablets - one a day Fostair 100/6 microgram (beclometasone/formoterol) inhaler - one puff twice a day Simvastatin 20mg tablets - one at night. He recently had an infection and was prescribed amoxicillin 500mg capsules - three times a day which he confused with apixaban 5mg tablets. Which of the following will reverse the effects of apixaban? A. Andexanet alfa B. Idarucizumab C. Phytomenadione D. Digibind E. Flumazenil

Answer 51

Andexanet alfa

Question 52

An aggressive patient has come into the pharmacy after receiving the wrong medication. He received quinine sulphate 200mg instead of quetiapine 200mg. You apologise and rectify the mistake. After confirming the patient hasn’t taken any of the incorrect medication, you take this opportunity to inform your team. What is the best way to avoid this type of dispensing error? A. Dispense from the labels only B. The pharmacist should dispense and check C. Moving the medications away from each other on the shelf D. Write a note on their patient medication record to double check their prescription in the future E. To hire an accuracy checking technician

Answer 52

C

Question 53

The pre-registration pharmacist has just finished a consultation under your supervision for alprostadil. The patient feels very informed by your pre-registration pharmacist. On the way out the patient asks what to do if erection doesn’t go away. https://www.medicines.org.uk/emc/product/2917/smpc Using the SPC provided, what time would be classed as a medical emergency for prolonged erection? A. 30 minutes B. 60 minutes C. 120 minutes D. 240 minutes E. 360 minutes

Answer 53

240 mins

Question 54

A worried 18-year-old girl has asked if you can speak in the consultation room. She explained she had unprotected intercourse yesterday and forgot to take her microgynon contraception yesterday and is asking for the morning after pill. What is the most appropriate advice? A. To take levonelle or ellaOne B. Inform her she’s protected and to continue with normal pill taking from today C. To use the barrier method from now until her next period D. To take 2 pills today and resume normal pill taking from tomorrow E. Take this as a 7 day break since she’s missed 1 pill

Answer 54

d- Take 2 pills today and resume normal pill taking from tomorrow

Question 55

A 7-year-old child was diagnosed with type 1 diabetes 2 years ago. You check the PMR and he is on the following medication: Novorapid 100 unit/ml flex pen - as directed Lantus 100 unit/ml flex pen - as directed Freestyle libre sensor - as directed Glucogel 80% gel - when required He has had a blood test recently where his ferritin levels were very low and was prescribed iron supplements in the form of oral solution. His dad is concerned when he collects his prescription for this as his diabetic nurse said his diabetes was well controlled and asked if this preparation is sugar free. Which of the following is not sugar free? A. Hydrogenated glucose syrup B. Mannitol C. Maltitol D. Sorbitol E. Sucrose

Answer 55

Sucrose

Question 56

A palliative patient has been taking morphine 30mg MR tablets - twice a day, morphine 15mg MR tablets - twice a day and morphine 5 mg MR tablets - twice a day to control her pain. She recently gets breakthrough pain during the afternoon and requires pain relief for this throughout the day and has been prescribed morphine 10mg/5ml oral solution when required. Which of the following doses is most appropriate for the minimum amount of morphine 10mg/5ml solution for breakthrough pain? A. 2.5 mls B. 5 mls C. 7 mls D. 10 mls E. 17 mls

Answer 56

5ml

Question 57

You receive a prescription for a 9-year-old for methylphenidate 10mg tablets - once a day for ADHD from a specialist clinic. The mother has come into the pharmacy to collect the medication & remembers the specialist informing her that her child will have to undergo regular monitoring but doesn’t remember what specific monitoring will be required and asks you if you know. What is the least likely to be monitored during methylphenidate treatment? A. Blood pressure B. Agranulocytosis C. Height D. Weight E. Appetite

Answer 57

Agranulocytosis

Question 58

A 76 year old patient has Parkinson's disease and he has been feeling unusual lately. He explains has been feeling very nauseous recently. You ask him if anything has changed recently and he explains his Parkinson's medication dose was increased. You check the PMR and he is on the following medication: Rosuvastatin 20mg tablets - one tablet daily Amlodipine 10mg tablets - one tablet daily Co-beneldopa 12.5mg/50mg tablets - one to be taken four times a day Which of the following is the most appropriate for this patient? A. Prochlorperazine B. Pepto Bismol C. Metoclopramide D. Domperidone E. Haloperidol

Answer 58

Domperidone

Question 59

You are a practice based pharmacist and have a telephone appointment with a patient who was recently diagnosed with rheumatoid arthritis. She was prescribed methotrexate 15mg tablets once a week. A week later she had a consultation with the doctor about new symptoms she had been feeling and was prescribed medication. The GP received a call from the pharmacy requesting an alternative due to an interaction between the medications. Which of the following was least likely to cause an interaction? A. Amoxicillin B. Nitrofurantoin C. Trimethoprim D. Ciprofloxacin E. Sulfamethoxazole The correct answer is: Nitrofurantoin

Answer 59

Amoxicillin 🚨 Yes Can reduce renal excretion of methotrexate. Nitrofurantoin ✅ No significant interaction Safe to use; mainly concentrates in the bladder. Trimethoprim 🚨 Yes Very dangerous — additive antifolate effect → risk of severe bone marrow suppression. Ciprofloxacin 🚨 Yes Can reduce methotrexate clearance, increasing toxicity risk. Sulfamethoxazole (often combined with trimethoprim as co-trimoxazole) 🚨 Yes Same as trimethoprim — severe risk.

Question 60

A patient has been diagnosed with leukaemia and has been on treatment with cyclophosphamide. The patient develops dysuria and urinary urgency and after further monitoring, urethral toxicity is diagnosed. The consultant would like to treat this as soon as possible so the patient can carry on with leukaemia treatment. Which of the following is recommended for this patient's symptoms? A. Solifenacin B. Mesna C. Nitrofurantoin D. Trimethoprim E. Cystitis sachets

Answer 60

Cyclophosphamide (and ifosfamide) can cause a specific type of bladder toxicity called haemorrhagic cystitis. This happens because a toxic metabolite called acrolein irritates the bladder lining. Mesna (mercaptoethane sulfonate sodium) binds to acrolein and neutralises it, protecting the bladder

Question 61

While working in a community pharmacy you receive a phone call from a locum doctor at the local GP surgery. He would like advice regarding which drug he should prescribe for one of his patients that is having problems with his urinary frequency. The patient is not taking any other medication but does have gastrointestinal obstruction for which the doctor has referred him to the hospital. Which of the following drugs is the most appropriate to recommend? A. Oxybutynin B. Tolterodine C. Solifenacin D. Darifenacin E. Mirabegron

Answer 61

the patient has gastrointestinal (GI) obstruction. Antimuscarinics (like oxybutynin, tolterodine, solifenacin, darifenacin) are contraindicated in GI obstruction because they: Reduce gut motility, Can worsen the obstruction, and Increase risk of paralytic ileus. Mirabegron works differently — it’s a β3-adrenoceptor agonist. It relaxes the detrusor muscle in the bladder to improve storage without affecting gut motility. Safe to use in patients with GI obstruction.

Question 62

A mother had recently given birth to her daughter one month ago. She remembers her midwife asking her to book appointments for her daughter's first set of immunisations. She doesn’t remember when the midwife asked her to book the appointments. She is worried and asks you to check at what age her daughter needs her first set of immunisations. What is the most appropriate advice to give? A. 4 weeks, 8 weeks and 12 weeks B. 4 weeks, 8 weeks and 16 weeks C. 8 weeks, 12 week and 16 weeks D. 8 weeks, 16 weeks and 20 weeks E. 12 weeks, 16 weeks and 20 weeks

Answer 62

8 weeks, 12 weeks and 16 weeks

Question 63

You are working in a busy pharmacy and in the middle of a consultation a member of the public shouts for help outside your pharmacy. You immediately attend to them and find a middle aged man on the floor, unconscious and not breathing. What is the most appropriate action to take? A. Call the ambulance and wait for them to arrive to perform CPR B. Call the ambulance and administer adrenaline C. Call the ambulance and perform CPR D. Perform CPR and call ambulance if unresponsive E. Call the ambulance and administer buccal midazolam

Answer 63

Call the ambulance and perform CPR

Question 64

A 5-year-old boy presents in the pharmacy with widespread non-bullous impetigo. He has no known allergies. A.Amoxicillin B.Ciprofloxacin C.Doxycycline D.Erythromycin E.Flucloxacillin F.Nitrofurantoin G.Rifampicin H.Trimethoprim

Answer 64

Flucoxacillin

Question 65

A 30-year-old woman who is currently breastfeeding was diagnosed with mastitis. She is currently taking no medication and is allergic to penicillin. A. Amoxicillin B. Ciprofloxacin C. Doxycycline D. Erythromycin E. Flucloxacillin F. Nitrofurantoin G. Rifampicin H. Trimethoprim

Answer 65

Mastitis (especially in breastfeeding women) is most often caused by Staphylococcus aureus. First-line treatment is usually flucloxacillin — but she’s penicillin allergic, so that’s not suitable. The recommended alternative for penicillin-allergic breastfeeding women is erythromycin. Erythromycin is considered safe in breastfeeding and effective against Staph aureus.

Question 66

A 40-year-old lady suffering with an uncomplicated urinary tract infection. She is currently taking no medication and has no known drug allergies. Her eGFR is 41ml/min/1.73m A. Amoxicillin B. Ciprofloxacin C. Doxycycline D. Erythromycin E. Flucloxacillin F. Nitrofurantoin G. Rifampicin H. Trimethoprim

Answer 66

Trimethoprim - nitro cannot be used in under 45ml/min renal function

Question 67

A 23-year-old lady suffering from uncomplicated urinary tract infection. She is currently taking methotrexate weekly and has no known allergies. A. Amoxicillin B. Ciprofloxacin C. Doxycycline D. Erythromycin E. Flucloxacillin F. Nitrofurantoin G. Rifampicin H. Trimethoprim

Answer 67

Nitrofuratoin

Question 68

A 50-year-old patient who has recently started on tuberculosis treatment. She has noticed her urine has become a reddish colour. A. Amoxicillin B. Ciprofloxacin C. Doxycycline D. Erythromycin E. Flucloxacillin F. Nitrofurantoin G. Rifampicin H. Trimethoprim

Answer 68

Rifampicin

Question 69

This drug has a long half-life for about 50 days. A. Amiodarone B. Carbamazepine C. Digoxin D. Gentamicin E. Lithium F. Methotrexate G. Theophylline H. Warfarin

Answer 69

Amiodarone

Question 70

The therapeutic range of this drug is between 4-12 mg/l and should be measured after 1-2 weeks. A. Amiodarone B. Carbamazepine C. Digoxin D. Gentamicin E. Lithium F. Methotrexate G. Theophylline H. Warfarin

Answer 70

Carbamazepine

Question 71

Patients taking this medicine should protect their skin from sunlight during treatment and for several months after discontinuation. A. Amiodarone B. Carbamazepine C. Digoxin D. Gentamicin E. Lithium F. Methotrexate G. Theophylline H. Warfarin

Answer 71

Amiodarone

Question 72

Patients should be advised to avoid cranberry juice when taking this medicine. A. Amiodarone B. Carbamazepine C. Digoxin D. Gentamicin E. Lithium F. Methotrexate G. Theophylline H. Warfarin

Answer 72

Warfarin

Question 73

A. Amiodarone B. Carbamazepine C. Digoxin D. Gentamicin E. Lithium F. Methotrexate G. Theophylline H. Warfarin

Answer 73

Digoxin

Question 74

Dose adjustments are necessary if a patient starts or stops smoking during treatment of this drug. A. Amiodarone B. Carbamazepine C. Digoxin D. Gentamicin E. Lithium F. Methotrexate G. Theophylline H. Warfarin

Answer 74

Theophylline

Question 75

Mrs B has just turned 70 and has been recommended by his GP to have this vaccination for the first time. A. HPV B. Influenza C. Pneumococcal vaccine D. Meningitis ACWY E. Meningitis B F. Rotavirus G. Shingles H. Whooping cough

Answer 75

Shingles

Question 76

Girls and boys aged between 12 to 13 are offered the first dose in school, the second dose is offered 6 to 24 months after. A. HPV B. Influenza C. Pneumococcal vaccine D. Meningitis ACWY E. Meningitis B F. Rotavirus G. Shingles H. Whooping cough

Answer 76

HPV

Question 77

Miss AP is currently pregnant; she has been advised by her midwife she is eligible to have this vaccination from 16 weeks onwards. A. HPV B. Influenza C. Pneumococcal vaccine D. Meningitis ACWY E. Meningitis B F. Rotavirus G. Shingles H. Whooping cough

Answer 77

Whooping cough

Question 78

This vaccination is given before starting college and university to protect against serious infections. A. HPV B. Influenza C. Pneumococcal vaccine D. Meningitis ACWY E. Meningitis B F. Rotavirus G. Shingles H. Whooping cough

Answer 78

Meningitis ACWY

Question 79

A patient who has been taking lithium for nearly 3 years. Recently he has developed swollen legs and has been prescribed furosemide to be taken in the morning. A. Hyponatraemia B. Hypernatraemia C. Hypokalaemia D. Hyperkalaemia E. Hypomagnesaemia F. Hypermagnesaemia G. Hypercalcaemia H. Hyperuricaemia

Answer 79

Hypokalaemia

Question 80

A patient with diagnosed heart failure who has been taking ramipril and spironolactone. A. Hyponatraemia B. Hypernatraemia C. Hypokalaemia D. Hyperkalaemia E. Hypomagnesaemia F. Hypermagnesaemia G. Hypercalcaemia H. Hyperuricaemia

Answer 80

Hyperkalemia

Question 81

A patient who has been taking fluoxetine now feels it isn't working as well as it had previously. Their specialist would like to switch treatment and the patient is now being titrated to sertraline. A. Hyponatraemia B. Hypernatraemia C. Hypokalaemia D. Hyperkalaemia E. Hypomagnesaemia F. Hypermagnesaemia G. Hypercalcaemia H. Hyperuricaemia

Answer 81

Hyponatraemia

Question 82

A patient initiated on filgrastim as a part of their chemotherapy treatment. A. Hyponatraemia B. Hypernatraemia C. Hypokalaemia D. Hyperkalaemia E. Hypomagnesaemia F. Hypermagnesaemia G. Hypercalcaemia H. Hyperuricaemia

Answer 82

Hyperuricaemia

Question 83

A patient has been over using his blue inhaler for months and has been having palpitations recently. A. Hyponatraemia B. Hypernatraemia C. Hypokalaemia D. Hyperkalaemia E. Hypomagnesaemia F. Hypermagnesaemia G. Hypercalcaemia H. Hyperuricaemia

Answer 83

Hypokalaemia

Question 84

A patient who has been on lansoprazole 30mg capsules, one to be taken twice a day for three years now. A. Hyponatraemia B. Hypernatraemia C. Hypokalaemia D. Hyperkalaemia E. Hypomagnesaemia F. Hypermagnesaemia G. Hypercalcaemia H. Hyperuricaemia

Answer 84

Hypomagnesaemia

Question 85

A patient has recently developed a patch of red, inflamed, painful skin which has become blistered. He had an appointment with his doctor who has prescribed flucloxacillin QDS for 7 days. A. Take 30 - 60 minutes before food B. Take with or just after food, or a meal C. Do not take indigestion remedies 2 hours before or after you take this medicine D. Take this medicine when your stomach is empty. This means an hour before food or 2 hours after food E. Warning: Do not stop taking this medicine unless your doctor tells you to stop F. Warning: This medicine may make you sleepy. If this happens, do not drive or use tools or machines. Do not drink alcohol G. Warning: Read the additional information given with this medicine H. Protect your skin from sunlight—even on a bright but cloudy day. Do not use sunbeds

Answer 85

Take the medicine when your stomach is empty. This means a hour before food or two hours after food

Question 86

Mrs DG 78-year-old was admitted to hospital due to shortness of breath and dizziness. She has been diagnosed with atrial fibrillation and has been initiated on digoxin. A. Take 30 - 60 minutes before food B. Take with or just after food, or a meal C. Do not take indigestion remedies 2 hours before or after you take this medicine D. Take this medicine when your stomach is empty. This means an hour before food or 2 hours after food E. Warning: Do not stop taking this medicine unless your doctor tells you to stop F. Warning: This medicine may make you sleepy. If this happens, do not drive or use tools or machines. Do not drink alcohol G. Warning: Read the additional information given with this medicine H. Protect your skin from sunlight—even on a bright but cloudy day. Do not use sunbed

Answer 86

Do not stop taking this medicine unless your doctor tells you to stop

Question 87

Mrs DG has a review and now has been switched medications for atrial fibrillation. She has now been asked to stop her digoxin and take a new medication with the dose as 200mg three times a day for 1 week then 200mg twice a day for 1 week, then to continue on 200g once a day. A. Take 30 - 60 minutes before food B. Take with or just after food, or a meal C. Do not take indigestion remedies 2 hours before or after you take this medicine D. Take this medicine when your stomach is empty. This means an hour before food or 2 hours after food E. Warning: Do not stop taking this medicine unless your doctor tells you to stop F. Warning: This medicine may make you sleepy. If this happens, do not drive or use tools or machines. Do not drink alcohol G. Warning: Read the additional information given with this medicine H. Protect your skin from sunlight—even on a bright but cloudy day. Do not use sunbeds

Answer 87

Protect your skin from sunlight - even on a bright but cloudy day. Do not use sunbeds

Question 88

A patient has been taking this medication for one year for the prophylaxis of migraines. She has now developed flank pain and has renal stone formation. A. Carbamazepine B. Sodium valproate C. Phenytoin D. Topiramate E. Levetiracetam F. Lamotrigine G. Midazolam H. Gabapentin

Answer 88

Topiramate

Question 89

A 6-year-old has been prescribed a controlled drug to take when required for status epilepticus. It has been recommended by the specialist to carry this with her at all times. A. Carbamazepine B. Sodium valproate C. Phenytoin D. Topiramate E. Levetiracetam F. Lamotrigine G. Midazolam H. Gabapentin

Answer 89

Midazolam

Question 90

Before prescribing this medication for generalised tonic clonic seizures to a patient with Thai origin, the consultant would like to test for HLA-B*1502 allele. The patient is also warned about some side effects that can occur such as headache, ataxia, drowsiness and blurring of vision. A. Carbamazepine B. Sodium valproate C. Phenytoin D. Topiramate E. Levetiracetam F. Lamotrigine G. Midazolam H. Gabapentin

Answer 90

Carbamazepine

Question 91

A patient has been prescribed this medication under specialist supervision. They are advised that they must take the same brand of this medication and if symptoms of nystagmus, diplopia, slurred speech, ataxia or confusion occur, to report it straight away. A. Carbamazepine B. Sodium valproate C. Phenytoin D. Topiramate E. Levetiracetam F. Lamotrigine G. Midazolam H. Gabapentin

Answer 91

Phenytoin

Question 92

A 32-year-old female has been newly diagnosed with generalised tonic-clonic seizures. She has been prescribed first-line treatment for this by a specialist. They also inform the patient they should take effective contraception and inform their consultant if planning to become pregnant. A. Carbamazepine B. Sodium valproate C. Phenytoin D. Topiramate E. Levetiracetam F. Lamotrigine G. Midazolam H. Gabapentin

Answer 92

SV