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Flashcards in Miscellaneous Deck (154)
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1

A patient presents at the pharmacy complaining of mild diarrhoea, elevated temperature and some other flu-like symptoms. On further questioning they tell you that they returned from Bolivia three months ago. What do you do/ what product do you recommend for this patient?

Refer to GP ASAP, don't recommend a product.

Bolivia is in South America and this area has Malaria. Patient could be displaying Malaria symptoms- refer in case.

2

What are the target levels of gentamicin in treating endocarditis?

Post-dose one hour PEAK serum concentration: 3-5 mg/L

Pre-dose TROUGH serum concentration: less than 1mg/L

3

A patient presents a prescription for Clobazam tablets, with no extra endorsements. What is the issue?

Clobazam is an SLS item. This means it can be prescribed for certain conditions only as listed in the drug tariff *it can only be prescribed for epilepsy*.
You should ask the patient what the indication is and return the prescription to the prescriber for endorsement of SLS if it is for epilepsy.

4

Which epilepsy drugs should prescribers ensure the same brand is maintained?

Phenytoin
Carbamazepine
Phenobarbital
Primidone
(all the P's!)

5

What is Atropine used as a reversal agent for?

Overdose of beta blockers!

6

What should be recommended for strained muscles?

RICE- Rest, Ice, Compression, Elevation
Ibuprofen good as its anti-inflammatory
Remember must be over 16 years old to buy ibuprofen, nurofen, paracetamol etc

7

A patient comes in to your pharmacy requesting an emergency supply as he is on holiday, he is on Zopiclone, simvastatin and Tramadol. What do you do?

I can give him a max 5 day supply of his Zopiclone as this is a Schedule 4 (Part I) CD.
I can give him max 30 days supply of his Simvastatin as this is a POM.
Tramadol is a schedule 3 CD therefore cannot be given as an emergency supply, only CD that can in Phenobarbital for epilepsy.

8

What age does one have to be to buy Curanail?

18 years and over

9

What is the active ingredient in Curanail 5% nail lacquer?

amorolfine

10

When should people requesting Curanail 5% nail lacquer be referred?

Should only be sold OTC for treatment of MILD cases of fungal nail infection
For treatment of 2 NAILS MAX- any more and refer!
Patients with underlying conditions, which predispose for fungal nail infection (impaired circulation, diabetes mellitus, immunosuppression)

11

A patient on warfarin presents with an INR of 5.0, their usual range is 2.0- 3.0. They have recently started taking St Johns Wort for a mild depressive episode. What is going on here?

St Johns Wort is a CYP450 enzyme INHIBITOR.
Warfarin is metabolised by CYP450.
Metabolism is decreased, warfarin levels rise, thins blood even more and INR increased.

12

What parkinsons drug is known to cause a sudden onsets of drowsiness, so people should be careful driving?

Pramiprexole

13

What vitamin should pregnant women avoid?

Vitamin A
Do not eat liver or liver products, such as pâté, because these are very high in vitamin A.

14

Pregnant women should take Folic acid and Vitamin D supplements. When? Dose?

Folic acid 400mcg for first trimester (12 weeks)
Vitamin D 10mcg- whole of pregnancy and breastfeeding.

15

In an anaphylactic reaction, how would you expect the pulse to be?

Weak!
also may lose conciousness, confusion, dizziness

16

When is "prescribed for an animal under my care" needed on Vet prescriptions?

For CD's!!
Prescribed under the veterinary cascade is needed for all other prescriptions

17

Is the strength of medication needed when entering in the POM book?

Only when MORE than one strength is available. Think in exam- is this the only strength

18

Use By date vs Expiry date?

Use by= end of previous month
Expiry= end of current month

19

A patient has an INR of 8.5 but is not experiencing any bleeding. What should be done?

Hospital admission needed: stop warfarin and give phytomenidione 5mg daily.

20

What drugs need to be handled with care?

Finasteride
Methotrexate
Vinocristeine injection

21

What is first line for preventing post-menopausal osteoporosis?

Bisphosphonates- alendronic acid, risedronate
Bisphosphonates are used for both preventing and treating post menopausal osteoporosis.

Other options (2nd line):
HRT
Calcitriol

22

Which NSAID has the most favourable thrombotic safety profile?

Naproxen

23

What is strontium?

Bone formation stimulant
Used in osteoporosis
Contra-indicated: Current/ previous VTE
Temporary/ prolonged immobilisation
Uncontrolled HTN

24

What vaccination produces small fluid-filled spots at the injection site?

BCG

25

What can phenytoin cause you to become deficient in?

Folate

26

Which antidepressant is recommended first line in children?

Fluoxetine

27

What antibiotics are used to treat C. diff?

Metronidazole or Vancomycin
Usually prescribe a 10-14 day course of these

28

What is tonsillitis most commonly caused by?

Mostly Viral e.g. adenovirus, rhinovirus
Also by Streptocococcus bacteria

29

Non-blanching rash = ?

Meningitis
refer to hospital ASAP
Means it does not disappear with a glass

30

Tacrolimus, an immunosuppressant, has been prescribed with fluconazole. What do you need to do?

Interaction!
Tacrolimus is metabolised by CYP450
Fluconazole is an enzyme inhibitor
Therefore need to reduce the dose of tacrolimus, increased levels could lead to nephrotoxicity- monitor renal function