POM to P Flashcards
1
Q
Amorolfine 5% nail lacquer is used in treatment of what?
A
Fungal nail infection
2
Q
What are the symptoms of onychomycosis?
A
Brittle/ broken parts of nail
Changes to nail
Debris accumulating under nail
Thickening of nail
Turning yellow/ white at tip
3
Q
How many infected nails is amorolfine 5% nail lacquer licensed to treat?
A
Maximum two infected nails
4
Q
What age range is amorolfine 5% nail lacquer licensed to treat?
A
> 18 years
5
Q
Is amorolfine 5% nail lacquer licensed in pregnancy and breastfeeding?
A
No
6
Q
Which of the following wouldn’t be an underlying cause of nail infection?
Peripheral circulatory disease
Diabetes
Heart Failure
Immunosupression
A
Heart Failure
7
Q
Which of the following wouldn’t require a referral instead of treatment with amorolfine 5% nail lacquer?
Pregnant woman
17 Year Old
Patient with broken/ brittle nails
Patient with 4 infected nails
Patient with diabetes
A
Patient with broken/ brittle nails
(symptom of fungal nail infection)
8
Q
Which of the following medications mechanism of action is through inhibiting sterol biosynthesis?
Chloramphenicol
Desogestrel
Amorolfine
A
Amorolfine
(inhibits sterol biosynthesis, disrupting fungal cell membrane and leading to cell death)
9
Q
Which of the following wouldn’t be an underlying cause of nail infection?
Peripheral circulatory disease
Diabetes
Heart Failure
Immunosuppression
A
Heart Failure
10
Q
Mechanism of action of chloramphenicol?
A
Binds to bacterial ribosomes and inhibits bacterial protein synthesis
11
Q
Chloramphenicol is licensed for which indication as a P medicine?
A
Acute bacterial conjunctivitis
12
Q
Symptoms of bacterial conjunctivitis?
A
Yellow purulent discharge
Eyes stuck together in the morning
Swelling of eyelid
Irritated, itchy, red or watery eyes
Burning or gritty sensation
13
Q
What age range is chloramphenicol licensed in as a P medicine?
A
2 years and over
14
Q
What are the red flags for bacterial conjuncitivitis?
A
Cloudy eye
Unusual looking pupil
Contact lenses in contact with water
Affected vision
Photophobia
Painful eye movement
Eye/ head injury
15
Q
Which of the following would you be able to sell chloramphenicol to?
-Pregnant woman
-30 year old man who wears contact lenses
-4 year old child
-Breastfeeding woman
A
4 year old child
16
Q
What is the dose for chloramphenicol drops?
A
1 drop every 2 hrs, for 48 hours,
then
1 drop every 4 hours
5 days treatment
(Only waking hours)
17
Q
What is the dose for chloramphenicol ointment?
A
Alone: 3-4 times daily
In combination with drops: At night
5 days treatment
18
Q
What two brands of desogestrel are available as P medicines?
A
Hana & Lovima
19
Q
What type of hormonal pill is desogestrel?
A
Progesterone only pill
20
Q
MoA of desogestrel?
A
Inhibits ovulation, thinning the lining of the uterus preventing implantation and increasing thickness of cervical muscle preventing sperm reaching egg
21
Q
Which brand of desogestrel is licensed for use in adolescents and adults?
A
Lovima
22
Q
Which brand of desogestrel is licensed for use in adults only?
A
Hana
23
Q
Which of the following is not a contra-indication for desogestrel?
-Blood clot
-IBS
-Hx of liver disease
-Pregnant
-Unknown vaginal bleeding
-Breast cancer
A
IBS
24
Q
What is the dose of desogestrel?
A
1 tablet daily without a break
same time each day
25
How to counsel patient when starting new desogestrel?
Take on day 1 of period
If starting on days 2-5 of period, barrier protection will be required for 7 days
26
A patient has taken levonorgestrel (EHC) and wants to begin taking desogestrel, how do you manage this?
Start straight away, barrier protection will be needed for 7 days
27
A patient has taken ulipristal (EHC) and wants to begin taking desogestrel, how do you manage this?
Wait 5 days and then start, barrier protection required for 7 days
28
A patient taking desogestrel has missed a dose, it has been <12 hours, what advice would you give?
Take as soon as they remember and carry on
29
A patient taking desogestrel has missed a dose, it has been >12 hours, what advice would you give?
Take as soon as they remember and carry on, barrier protection will be required for 7 days
30
What two products and strengths are available OTC as EHC?
Ulipristal acetate 30mg
Levonorgestrel 1500mcg
31
Which method of EHC is licensed for use if last unprotected sex was <120 hrs (5 days)?
Ulipristal acetate
32
Which is the most effective form of emergency contraception?
Copper coil
33
What age range is levonorgestrel licensed for EHC?
>16 years
34
How long after unprotected sex could you supply levenorgestrel?
Up to 72 hours
35
Ulipristal can not be taken if patient has taken CYP3A4 inducer or herbal medicine within the last how many weeks?
Ulipristal is not recommended for patients who have taken CYP3A4 enzyme inducing medicines or herbal products within the last 4 weeks.
36
Levonorgestrel has been shown to be less effective in which group of women?
Women weighing over 70kg
37
If patients have taken a CYP3A4 inducer or herbal medicine within the last 4 weeks, what dose should be given of levonorgestrel as EHC?
Two tablets of 1500mcg
38
If vomiting occurs within how many hours after taking EHC should the dose be taken again?
3 hours
39
Which of the following medicines could you safely give alongside levonorgestrel or ulipristal?
-carbamazepine
-phenytoin
-St Johns Wort
-lithium
-rifampicin
Lithium
(All others are CYP3A4 inducers)
40
Is ulipristal acid use safe in breastfeeding?
After using ulipristal breast feeding is not recommended for a week because it is present in breast milk
41
How long after taking ulipristal can progesterone pill be restarted?
The efficacy of ulipristal as an emergency contraceptive can also be reduced by a progestogen, progestogen-containing drugs should not be restarted for 5 days afterwards
42
What medication is within Clarinaze allergy control 0.05% nasal spray?
Mometasone 0.05%
43
Clarinaze nasal spray is licensed for what inidcation?
Seasonal hay fever AND perennial allergic rhinitis
44
What age group is clarinaze nasal spray licensed in OTC?
>18 years
45
What is the usual dose of clarinaze nasal spray?
2 sprays into each nostril OD until symptoms controlled, then 1 spray into each nostril OD
46
How many days of treatment with clarinaze nasal spray should you refer?
14 days
47
Clarinaze nasal spray is licensed OTC for how many months treatment?
3 months
48
Lidocaine containing products for teething are restricted to what pack size?
10 grams
49
What is the strength of Orlistat available OTC?
60mg
50
Orlistat is licensed for what age group OTC?
>18 years
51
OTC orlistat is licensed for who?
Adults with BMI > 28
52
Which of the following patients could you safely supply orlistat?
-Patient taking anti-epileptic
-Patient with obesity
-Patient with diabetes
-Patient taking amiodarone
-Patient with hypercholestereamia
Patient with obesity
(orlistat increases risk of convulsions when given with anti-epileptics)
(diabetes and cholesterol medication may need altered with weight loss)
53
What is the recommended daily dose of orlistat?
TDS
Immediately before, during, or up to one hour after
54
Treatment with orlistat should not exceed how many months?
6 months
55
What is the maximum daily dose of orlistat?
180mg
56
If a meal is missed whilst taking orlistat, how should you alter the dosing?
That dose of orlistat should be omitted
57
Can orlistat be supplied to pregnant and breastfeeding women?
No
58
Concurrent treatment with which of the following would not be a concern when supplying orlistat?
-Ciclosporin
-Levothyroxine
-Digoxin
-Warfarin
Digoxin
59
Which PPI's are available OTC?
Omeprazole 10mg
Pantoprazole 20mg
60
What is the MoA of a PPI?
Inhibit gastric acid secretion in the stomach by the 'proton pump'
61
What is the OTC dose of omeprazole?
Two (10mg) tablets OD
Before meal
62
What is the OTC dose of pantoprazole
One (20mg) tablet OD
Before mean
63
What is the licensed indication for OTC PPI?
Acid reflux
64
What age range is omeprazole and pantoprazole licensed for?
>18 years
65
How long after treatment with omeprazole/ pantoprazole OTC should a referral be made if no improvement in symptoms?
2 weeks
66
What is the MHRA alert for PPI's?
risk of subacute cutaneous lupus erythematosus
(watch for signs of skin lesions in sun exposed areas of skin and athralgia)
67
PPIs can mask the symptoms of gastric cancer. What age group should you particularly look out for? and what symptoms?
>55 years
-unexplained dyspesia non respondent to treatment
-bleeding
-dysphagia
68
Pantoprazole/ omeprazole will have full effect after how many days?
3-4
69
What immediate relief product can be given to reduce heartburn symptoms?
Antacid or antacid/alginate combination
70
What lifestyle advice could you give to improve symptoms of heartburn/ reflux?
-weight reduction
-smaller meals
-propping up head in bed
-stop smoking
-avoid spicy foods
-avoid alcohol
71
Maloff protect 250/100mg contains which products?
atovaquone with proguanil hydrochloride
72
What are the four anti-malarial products available OTC in UK? and what medicines do they contain?
-Maloff Protect (atovaquone and proguanil hydrochloride)
-Avloclor (chloroquine)
-Paludrine (proguanil hydrochloride)
-Paludrine/ Avloclor Anti-Malarial Travel Pack (proguanil hydrochloride and chloroquine)
73
Which of the following OTC anti-malarials is least likely to be innefective due to resistance?
-Maloff Protect (atovaquone and proguanil hydrochloride)
-Avloclor (chloroquine)
-Paludrine (proguanil hydrochloride)
-Paludrine/ Avloclor Anti-Malarial Travel Pack (proguanil hydrochloride and chloroquine)
Maloff Protect
74
Name three POM anti-malarials?
Atovaquone with proguanil (Malarone or generic)
Doxycycline
Mefloquine (Lariam)
75
What is the licensed indication for Maloff Protect?
Prophylaxis of P.falciparum malaria in adults over 18 years for up to 12 weeks
76
Dose of Maloff Protect?
one tablet daily
77
How long before travel should you commence Maloff Protect and how long after travel should it be continued?
1-2 days prior and until 7 days after
78
Which of the following is cautioned in Maloff Protect?
-Tuberculosis
-Diabetes
-Depression
-Seizures
79
What advice should be given to patients who are pregnant and wanting to travel to areas with malaria?
Pregnant women have an increased risk of developing severe malaria and higher risk of fatality
80
What weight range is Maloff Protect licensed for?
>40kg
81
What advice should be given to a patient that vomits after taking Maloff Protect?
If the vomiting is within one hour after taking the dose, another should be taken
82
What does the ABCD approach stand for in malaria prevention?
Awareness
Bite protection
Chemoprophylaxis
Diagnosing early
83
Products containing what are first line for insect repellent?
50% DEET
84
What are the symptoms of malaria?
Fever
Sweats & Chills
Headaches
Vomiting
Muscle Pains
Diarrhoea
Fatigue
85
What type of drug is sumatriptan?
5-HT1- receptor agonist
86
What strength tablet of sumatriptan is available OTC?
50mg
87
Which of the following patients would be inappropriate to supply sumatriptan to?
-Patient who has tried regular paracetamol already
-Patient who is 16
-Patient who is experiencing their first migraine
Patient who is experiencing their first migraine
88
A single dose of sumatriptan should relieve migraine symptoms after how long?
30 mins
(if symptoms do not improve, no further doses should be taken for the same attack)
89
Which of the following drugs do not interact with sumatriptan?
-Sertraline
-Phenelzine
-Tramadol
-Ramipril
-Trazodone
Ramipril
(All others increase risk of serotonin syndrome)
90
What age range is sumatriptan licensed for?
18-65 years
91
Which of the following patients could you supply sumatriptan to OTC?
-patient with a headache lasting 36 hours
-patient with 3 attacks in the last month
-patient with diabetes, high cholesterol and hypertension
-patient with hx of seizures
patient with 3 attacks in the last month
(4 or more attacks per month requires referral)
92
What indication is OTC tranexamic acid licensed for?
Reduction of heavy menstrual bleeding in women aged 18 years and over
93
What age range is tranexamic acid licensed in?
18-45 years
94
What is the MoA of tranexamic acid?
An antifibrinolytic which inhibits fibrinolysis, increases clot formation and reduces blood loss
95
What is the dose of tranexamic acid?
Two 500mg tablets TDS when bleeding starts until symptoms alleviated
96
How many consecutive days can tranexamic acid be taken?
No more than 4 consecutive days
97
What is the maximum daily dose of tranexamic acid?
If menstrual bleeding is very heavy, the dose may be increased to eight tablets (4g) daily
98
Which of the following would not be a contraindication to supplying tranexamic acid?
-irregular periods
-patient taking warfarin
-renal impairment
-diabetes
-pregnancy
Diabetes
99
What medication is within viagra?
sildenafil
100
What strength of sildenafil is available OTC?
50mg
101
What is the licensed indication for sildenafil OTC?
Erectile dysfunction
102
What age range is sildenafil licensed in OTC?
>18 years
103
What class of drug is sildenafil?
Phosphodiesterase type 5 inhibitor
104
What lifestyle factors can affect erectile dysfunction?
Sedentary lifestyle
Obesity
Smoking
Alcohol use
Cycling
105
What diseases can affect erectile dysfunction?
Hypertension
Diabetes mellitus
Hypercholesterolemia
Cardiovascular disease
106
What psychological disorders can affect erectile dysfunction?
Anxiety
Depression
107
What medications may contribute to erectile dysfunction?
Anti-hypertensives
Anti-depressants
Anti-psychotics
Hormones and hormone-modifying drugs
Diuretics
Fibrates
Histamine (H2) - antagonists
108
How long before sex should viagra be taken?
1 hour before
109
What is priaprism?
Prolonged and sometimes painful erections lasting longer than 4 hours. Patient should seek immediate medical assistance. If not treated immediately, penile tissue damage and permanent loss of potency could result.
110
Which of the following patients could you safely supply Viagra?
-17 year old with symptoms of ED
-21 year old man who takes poppers at the weekends
-68 year old man who had an MI 9 months ago
68 year old man who had an MI 9 months ago
(MI within the past 6 months)
111
A patient has recently taken sildenafil. Which of the following side effects would you be most concerned about?
-Flushing
-Priapism
-Dizziness
-Nausea
Priapism
112
What medicine is in the brand Gina?
Estradiol
113
What is estradiol?
Oestrogen
114
What is Gina licensed for?
Post-menopausal vaginal atrophy due to low oestrogen
115
What are the symptoms of vaginal atrophy?
Dryness
Soreness
Itching
Burning
Irritation
Painful sexual intercourse
116
How long does estradiol take to have a full effect?
8-12 weeks
117
Which patient could you supply Gina to OTC?
-51 year old patient who had a period 3 months ago
-49 year old patient who hasn't had a period in 4 years
-55 year old patient who hasn't had a period in 2 years
55 year old patient who hasn't had a period in 2 years
(can only be used in postmenopausal women aged > 50 years, who haven’t had a period for at least one year)
118
What is the initiation and maintenance doses of Gina?
Initiation - Insert ONE (10 microgram) tablet intravaginally daily for two weeks. Can be started on any day
Maintenance - Insert ONE (10 microgram) tablet intravaginally twice a week.
