OTC

Question 1

Paracetamol dose for 3-5 months

Answer 1

60mg upto QDS

Question 2

Paracetamol dose for 6-23 months

Answer 2

120mg upto QDS

Question 3

Paracetamol dose for 2-3 years

Answer 3

180mg upto QDS

Question 4

Paracetamol dose for 4-5 years

Answer 4

240mg upto QDS

Question 5

Paracetamol dose for 6-7 years

Answer 5

250mg upto QDS

Question 6

Paracetamol dose for 8-9 years

Answer 6

375mg upto QDS

Question 7

Paracetamol dose for 10-11 years

Answer 7

500mg upto QDS

Question 8

Paracetamol dose for 12-15 years

Answer 8

750mg upto QDS

Question 9

Paracetamol dose for 16-17 years

Answer 9

1g upto QDS

Question 10

Which vaccines require babies to have prophylactic paracetamol?

Answer 10

Meningitis B

Question 11

How to give paracetamol following the MenB vaccine?

Answer 11

60mg (2.5ml of 120mg/5ml) ASAP after vaccine.
60mg 4-6h later.
60mg another 4-6h later.

Question 12

1st line ingredient OTC for chesty cough

Answer 12

Guaiphenesin (expectorant to break up mucus)

Question 13

OTC products containing Guaiphenesin

2

Answer 13

• Benylin chesty coughs
• Robitussin chesty cough

Question 14

1st line OTC ingredient for dry cough

Answer 14

Dextromethorphan (suppressant/antitussive)

Question 15

OTC products containing Dextromethorphan

3

Answer 15

• Covonia Bronchial Balsam
• VapoSyrup for dry coughs
• Meltys dry coughs plus pseudoephidrine

Question 16

2nd line OTC ingredient for dry cough

Answer 16

Pholcodine

Question 17

OTC products containing pholcodine for cough

2

Answer 17

• Pholcodine BP
• Pavacol-D

Question 18

OTC cough medicines for babies <3 months.

3

Answer 18

• Baby meltus cough linctus
• CalCough tickly
• Lemsip Cough Dry

Question 19

OTC cough meds for children >3 months

2

Answer 19

• Benylin Children’s tickly coughs
• Tixylix Baby syrup

Question 20

OTC cough products for children >1 year

3

Answer 20

• Beecham’s Veno Honey and Lemon
• Benylin Tickly Coughs (non-drowsy)
• Care Glycerin Lemon & Honey with glucose

Question 21

Which OTC cough and cold products are contraindicated in children of a certain age?

Answer 21

Under 6s should not be sold “cough and cold” medicines containing:
* Antihistamines e.g., diphendramine, chlorphenamine
* Antitussives e.g., dextromethorphan, pholcodine
* Expectorants e.g., guaifenesin
* Decongestants e.g., pseudoephedrine, phenylephrine, ephedrine

Question 22

Chesty cough referral points

Answer 22

• Chest pain
• > 3 weeks
• Pain on insipiration
• Persistant nocturnal couhg in child
• Wheeze or SOB

Question 23

Antitussive/suppressant OTC product refusal points

Answer 23

• Asthmatic
• COPD
• Pregnancy
• Hepatic/renal impairment
• <6

Question 24

Symptoms of sinusitis or nasal/sinus congestion

Answer 24

• Rhinorrhoea (runny nose)
• Blocked nose
• Headache
• Pain under eyes and in jaw

Question 25

OTC treatment of nasal/sinus congestion

Answer 25

* Lifestyle: steam inhalation - head over bowl of steaming water BD (cover with towel). * Oral: Pseudoephedrine (+ ibuprofen or paracetamol if paindul) * Topical: oxymetazoline, xylometazoline

Question 26

OTC pseudoephedrine products

Answer 26

Sudafed Sudafed syrup <6 years

Question 27

OTC topical decongestants

Answer 27

* Sinex (oxymetazoline) >6y * Otrivine (xylometazoline) >12 * Otrivine child (xylometazoline) >2

Question 28

Decongestants MOA

Answer 28

Sympathomimetics which activate alpha-adrenoceptors in the nasal mucosa leading to vasoconstriction and reduced swelling -> reduced nasal congestion.

Question 29

Pseudoephedrine contraindications OTC

Answer 29

* Risk of hypertensive crisis when given within 2 weeks of isocarboxazid, moclobemide, phenelzine, tranylcypromine, TCAs, and MAOIs. * Hypertension * Hyperthyroidism * Pregnancy

Question 30

OTC products for painful sinusitis

Answer 30

* Sinutab (>6) - paracetamol + pseudoephedrine * Nurofen cold and flu (>12) - ibuprofen + pseudoephedrine

Question 31

OTC treatment of sinus congestion in babies

Answer 31

1. Normal saline drops (no age limit) 2. Menthol (e.g., Karvol, Olvas) >3 months (risk of apnoea <3 months)

Question 32

OTC sore throat treatment

Answer 32

* Generally: Benzocaine (Merocaine, Dequacaine) * Pregnancy: Benzydamine (Difflam spray)

Question 33

Sore throat referral points

Answer 33

## Footnote Pharmacy first vs GP

Question 34

Hayfever OTC treatment

Answer 34

* General symptoms: loratidine (>2) * Nasal symptoms: beclometasone or fluticasone nasal spray (>18) * Occular symptoms: Sodium cromoglycate eye drops

Question 35

OTC antihistamine refusal points

Answer 35

* Glaucoma * Prostate hypertrophy * Liver impairment * <2

Question 36

OTC steroid nasal spray refusal points

Answer 36

* <18 * Glaucoma

Question 37

Hayfever/rhinitis counselling points

Answer 37

* Stay indoors and close windows if pollen count high. * Avoid grassy areas * Shower and wash hair after being outdoors. * Nasal sprays take upto 3 weeks to start working optimally so perservere and use continuously.