OTC Flashcards
(151 cards)
1
Q
What is dyspepsia?
A
Collection of symptoms including upper abdominal discomfort and pain, heartburn, acid reflux (with or without bloating), N&V.
2
Q
Red Flag symptoms of dyspepsia?
A
GI bleeding
dysphagia
unintentional weight loss
persistent vomiting
3
Q
How long does symptoms of a common cold last?
A
7-14 days
4
Q
What is the usual duration of acute otitis media?
A
4 days
5
Q
What is the usual duration of a cough/ bronchitis?
A
3 weeks
6
Q
What is the usual duration of acute sore throat/ pharyngitis/ tonsilitis?
A
1 week
7
Q
What is the usual duration of acute rhinosinusitis?
A
2 and a half weeks
8
Q
Frontal headache above or below the eyes may be associated with which respiratory tract infection?
A
Sinusitis
9
Q
Earache is associated with which respiratory tract infection especially in children?
A
colds
10
Q
When may acute sinusitis be more indicative of bacterial cause?
A
Fever
Symptoms lasting > 10 days
11
Q
What non pharmacological symptom advice can be given for sinusitis?
A
Steam inhalation
Nasal irrigation
12
Q
Which of the following has a more rapid onset?
-Flu
-Cold
A
Flu
13
Q
Dextromethorphan and pholcodeine are what type of medications?
A
anti-tussives
14
Q
Dextromethorphan is licensed in what age range?
A
> 12 years
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)
16
Q
Guaifenesin and ipepacuanha are usually contained in which type of cough medicines?
A
Chesty cough
(both are expectorants)
17
Q
Ephidrine, oxymetazoline, phenylephrine, pseudoephedrine and xylometazoline are all used for which OTC common ailment?
A
Nasal decongestants
18
Q
Guaifenesin and ipepacuanha are licensed OTC in what age group?
A
> 6 years
19
Q
Ephidrine, oxymetazoline, phenylephrine, pseudoephedrine and xylometazoline are licensed OTC in what age group?
A
> 6 years
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)
21
Q
Fluribiprofen lozenges are licensed in which age range?
A
> 12 years
22
Q
Benzydamine mouthwash is licensed in which age range?
A
> 12 years
23
Q
What treatment options are available for a sore throat OTC?
A
Analgesics
Benzydamine mouthwash/ spray
Antiseptic lozenges
Anaesthetic lozenges
24
Q
Which of the following is an older, sedating antihistamine?
-Loratidine
-Acrivastine
-Promethazine
-Cetirizine
-Fexofenadine
A
Promethazine
25
Which of the following antihistamines are not taken once daily?
-Cetirizine
-Fexofenadine
-Acrivastine
-Loratidine
Acrivastine
26
Which of the following antihistamines can be taken in children over the age of 2?
-Cetirizine
-Fexofenadine
-Acrivastine
-Loratidine
Loratidine
27
Which of the following antihistamines is licensed for children over the age of 6?
-Cetirizine
-Fexofenadine
-Acrivastine
-Loratidine
Cetirizine
28
Which TWO of the following antihistamines is licensed for children over the age of 12?
-Cetirizine
-Fexofenadine
-Acrivastine
-Loratidine
Fexofenadine & Acrivastone
29
Steroid nasal sprays are licensed OTC for what indication?
Hay fever
30
Beclometasone, budesonide, fluticasone and mometasone nasal sprays are licensed for which age range?
> 18 years
31
Sodium cromoglicate eye drops, nasal drops and nasal spray is licensed OTC for which indication?
Hay fever
32
How does thixotropic gel nasal spray work in hay fever?
Acts as a barrier
33
Mouth ulcers lasting longer than how many weeks needs referral?
3 weeks
34
Which of the following medications is least likely to cause mouth ulcers?
-ACE inhibitors
-sulfasalazine
-NSAIDs
-feverfew (herbal medication for migraines)
ACE inhibitors
35
Treatment options for mouth ulcers?
-Chlorhexidine gluconate mouthwash
-Hydrocortisone mucoadhesive buccal tablet (>12)
-Benzydamine mouthwash (>12) / spray
-Choline salicylate gel (>16)
-Lidocaine/ benzocaine
36
Antacids with a high sodium count should be avoided by which patient group?
Pregnant patients
37
How do alginates work to reduce symptoms of heartburn?
Form a raft that sits on the top of the stomach and prevents reflux
38
What can be used instead of sodium bicarbonate in patients needing low sodium forms of alginate?
Potassium bicarbonate
39
Which PPIs are licensed OTC?
Omeprazole 10mg
Esomeprazole 20mg
Pantoprazole 20mg
40
Sodium bicarbonate has what effect on lithium?
Increases lithium excretion
41
Aluminium salt based antacids are associated with which side effect?
Constipation
42
Magnesium salt based antacids are associated with which side effect?
Diarrhoea
43
The BNF advises taking a gap of how long between doses of antacids and other medications?
1 hour
44
Which antihistamines are licensed OTC for motion sickness?
Cinnarizine and promethazine teoclate
45
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
Promethazine
(Long duration of action, taken once daily, more suitable for long journeys)
(cinnarizine shorter duration of action, cetirizine not licensed OTC for motion)
46
What formulations are available OTC of hyoscine hydrobromide for motion sickness?
Tablets (lasts 1-3 hrs)
Patch (lasts up to 3 days)
47
Name bulk forming agents used for constipation?
Bran
Isphagula husk
Methylcellulose
48
Which group of laxatives are unsuitable for opioid induced constipation?
Bulk forming laxatives
49
Name osmotic laxative agents used for constipation?
Lactulose
Lactilol
Macrogol
Glycerine
50
Name stimulant laxative agents used for constipation?
Senna
Bisacodyl
51
What is the maximum duration that stimulant laxatives should be used for?
1 week
52
Name the stool softener agent used for constipation?
Docusate
53
Which group of laxatives should be avoided in children under 12 years?
Stimulant
54
What is the laxative group of choice for pregnant patients?
Bulk forming
55
Oral rehydration sachets should be used to combat dehydration in which OTC ailment?
Diarrhoea
56
What is the max amount of days treatment with loperamide?
2 days
57
Loperamide is licensed OTC for diarrhoea in which age range?
> 12 years
58
What is the dose of loperamide and maximum daily dose?
Two 2mg tablets straight away and then one tablet after every loose movement, max 16mg daily
59
OTC treatment options for IBS?
-Alverine citrate
-Mebevrine
-Peppermint oil
-Hyoscine
60
Mebeverine is licensed OTC for what age range?
> 18 years
61
Which of the following would not be an option for patients suffering eczema?
-Emollient
-Aqueous cream
-Emulsifying ointment
Aqueous creams
(contain sodium lauryl sulfate which has been shown to worsen eczema)
62
What strength of steroid is hydrocortisone cream?
Mild
63
What is OTC topical hydrocortisone licensed to treat?
-Irritant/ allergic dermatitis
-Insect bites
-Mild to moderate eczema
64
What areas of the body are contraindicated in treatment of topical hydrocortisone OTC?
Face (excluding ears) and anogenital areas
65
What age range is OTC topical hydrocortisone licensed in?
> 10 years
66
What is the maximum treatment duration that OTC topical hydrocortisone and clobetasone is licensed for?
1 week
67
Which TWO of the following could you not sell topical hydrocortisone to?
-eczema
-athletes foot
-acne
-allergic dermatitis
Athletes foot
(topical hydrocortisone is contraindicated in acne and infected skin i.e athletes foot, coldsores )
68
What strength of steroid is topical clobetasone?
Moderate
69
What are the licensed indications for OTC topical clobetasone?
Dermatitis and eczema
70
What age range is OTC topical hydrocortisone licensed in?
12 years and over
71
What is the first line OTC treatment option for acne?
Benzoyl peroxide
72
Which of the following keratolytics are offered as second line treatments for acne OTC?
-Salicylic acid
-Benzoyl peroxide
-Potassium hydroxyquinoline sulfate
Salicylic acid & potassium hydroxyquinoline sulfate
73
What POM medications can be prescribed for acne?
Tetracyclines
Retinoids
74
What is the major contraindication with retinoids?
Pregnancy - teratogenic
75
Why are steroids contraindicated in acne?
Potentiate the effects of androgenic hormones on the sebaceous glands and make the acne worse
76
How is tinea pedis more commonly known?
Athletes foot
77
What OTC treatment options are available for athletes foot?
- terbinafine
- miconazole, ketoconazole, clotrimazole
- tolnaftate
- undecylenates
78
Which of the following is for adults only?
- miconazole
- clotrimazole
- ketoconazole
ketonconazole
79
Which of the following terbinafine preparations is licensed in > 18 years as opposed to > 16?
-Cream
-Spray
-Solution
-Gel
Solution
80
Treatment with amorolfine nail lacquer is how long for fingernail vs a toenail?
Fingernail 6 month
Toenail 9-12 months
81
What OTC treatment options are available for cold sores?
Aciclovir cream
Penciclovir cream
82
Which of the following is licensed in children and adults?
penciclovir cream
aciclovir cream
Aciclovir cream
83
Which of the following is licensed in > 12 years?
penciclovir cream
aciclovir cream
Penciclovir cream
84
What is the dosage frequency and duration of aciclovir cream?
Four hourly during waking hours for 5 days
85
What is the dosage frequency and duration of penciclovir cream?
Two hourly during waking hours for 4 days
86
What is the first line treatment for scabies OTC?
Permethrin cream
87
When treating scabies, where should the cream be applied?
The entire body
88
What is the treatment regime for permethrin cream for scabies?
Two treatments are recommended, 7 days apart. Apply in the evening and leave overnight.
89
Who else should be treated when treating scabies?
Everyone in household, close contacts and sexual contacts
90
What OTC options are available for dandruff?
Ketoconazole 2% shampoo
91
What is the treatment frequency of ketoconazole shampoo for dandruff?
Twice weekly for 2-4 weeks, then once weekly/ fortnightly
92
What treatment options are available for psoriasis?
- Topical vitamin D preparations
- Coal tar preparations
- Dithranol (<1% for OTC)
93
When offering non-pharmacological advice for treatment of a sprain/ strain, what does PRICE stand for?
Protect
Raise
Ice
Compression
Elevation
94
In a supermarket, what is the maximum number of paracetamol tablets that can be sold?
32 (two boxes of 16 tablets)
95
In a pharmacy, what is the maximum number of paracetamol tablets that can be sold?
32 tablet pack size
96
In a supermarket, what is the maximum number of tablets and strength of ibuprofen that can be sold?
Pack sizes of 16 tablets
200mg
97
In a pharmacy, what is the maximum strength of ibuprofen that can be sold?
400mg
98
Ibuprofen tablets/ capsules is licensed in what age range?
>12 years
99
What OTC option of ibuprofen is available for children < 7 years?
Ibuprofen suspension 100mg in 5ml
100
What OTC option of ibuprofen is available for children > 7 years?
Ibuprofen suspension 200mg in 5ml
101
Which OTC medication should be avoided in a patient taking lithium?
NSAIDs
102
For GSL of aspirin, what is the maximum strength and pack size available to buy?
2 packs of 16 tablets, 300mg
103
When given to > 16 years, what can aspirin cause?
Reyes syndrome
104
What is the max. dose of aspirin OTC?
3.6g daily
105
What is the OTC licensing age for codeine and dihydrocodeine?
> 12 years
106
What is the maximum treatment duration of OTC codeine and dihydrocodeine? And what is the risk if this is surpassed?
Maximum 3 days treatment, risk of addiction over this period
107
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 patient experiencing a headache with a dull pain around the base of their head
108
What is the age range of OTC sumatriptan?
Between 18 and 65
109
What is the total maximum daily dose of sumatriptan OTC?
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
What OTC options are available for patients suffering n&v associated with migraines?
Prochlorperazine (buccal)
111
What OTC options are available to help with making the urine more alkaline in cystitis?
Potassium and sodium citrate
(if symptoms do not improve after 2 days - GP)
112
What type of urinary incontinence is associated with weakening of the sphincter and pelvic floor muscles leading to leakages when sneezing/ coughing/ laughing?
Stress incontinence
113
What type of urinary incontinence is associated with a sudden urgency to pass urine?
Urge incontinence
114
What is first line treatment option OTC for heavy painful periods?
NSAIDs (ibuprofen and naproxen)
115
Naproxen 250mg tablets can be sold to what age range for period pain?
15-50
116
What is the administration advice for naproxen 250mg for period OTC?
two tablets taken initially followed by one tablet every 6-8 hours
(maximum 750mg daily)
(maximum duration of 3 days)
117
What is the licensed OTC age range for tranexamic acid for heavy periods?
18-45
118
What is the usual dose of tranexamic acid for heavy periods?
1g (two 500mg tablets) TDS or QDS if especially heavy
119
What OTC option is available for vaginal atrophy in postmenopausal women?
Oestradiol 10mcg pessary
120
What is the dose of oestradiol vaginal pessaries in vaginal atrophy?
once daily for two weeks, then twice weekly
121
What OTC options are available for vaginal thrush?
Clotrimazole and oral fluconazole
122
What are the missed pill rules for desogestrel?
If < 12 hrs, take and continue as normal
If > 12 hrs, take pill but additional contraception for 7 days
123
How long after UPSI can levonorgestrel be given?
3 days
124
How long after UPSI can ulipristal acid be given?
5 days
125
Which types of laxatives should be avoided near term in pregnant women
stimulant
126
What type of laxatives are best for pregnant women?
Isphagula husk and lactulose
127
how can you manage a tension type headache?
simple analgesic
128
what is the licensed age range for diclofenac gel?
>14 years
129
how long after injury should NSAIDs be avoided?
48 hours
130
in what instances may you use a double dose of levenorgestrel?
overweight (>70kg) - unlicensed
given with an enzyme inducers - licensed
(unlicensed so would need a prescription)
131
after taking ella-one, how many days should you wait before restarting progesterone containing pill and what additional contraception may you need?
5 days, will need an additional barrier method for these 5 days and 2 additional days
132
can you use ella one more than once within a cycle?
yes
133
what are the fat soluble vitamins?
A,D,E,K
134
can you sell orlistat to people with diabetes?
no
135
what is the maximum daily dose of omeprazole OTC?
20mg
136
what treatments are recommended for colic?
none - lack of evidence
137
can NSAIDs be used in chicken pox?
no, risk of necrotising skin infection
138
what can you offer for chicken pox?
paracetamol, calamine and/or chlorphenamine
139
how often are oestrogen pessaries used?
every day for the first 2 weeks, then twice a week
140
how long should women under the age of 50 continue contraception after their last menstrual period?
2 years
141
how long should women over the age of 50 continue contraception after their last menstrua period?
1 year
142
CHM recommends that patients of what age range should be referred with symptoms of vaginal thrush?
<16
>60
143
what are the symptoms of vaginal thrush?
itchy and sore
creamy, thick, curdy discharge
dysuria (pain on urination)
dyspareunia (pain during sex)
144
what type of discharge is associated with BV?
white/ grey watery discharge with a fishy odour
145
what type of discharge is associated with gonorrhoea/ chlamydia?
yellow/ green discharge
146
women who experience more than how many attacks of thrush within the last 6 months should be referred?
> 2
147
what OTC options are available for thrush?
clotrimazole and fluconazole
148
which laxatives are preferred OTC in pregnancy?
lactulose and ispaghula husk
149
what is the OTC age restriction for sildenafil?
>18
150
what OTC drug is available for hair loss?
minoxidil
151
what POM is available for hair loss?
finasteride
