RPS mistakes 2025 Flashcards
(27 cards)
If a patient has mouth ulcers whilst on nicorandil, what is the best course of action?
Refer to GP
Need to stop treatment but does not need to be referred to emergency services
What is the typical recommended dosage for loperamide
2mg initially, followed by 1mg after each loose stool - maximum of 6 tablets (OTC)
What is the least appropriate treatment option for a type 2 diabetic with heart failure.
Pioglitazone, can exacerbate HF by causing fluid retention
What dietary change can reduce the efficacy of levodopa?
High protein diet
High protein competes with levodopa for absorption = reducing efficacy
Which beta-blockers are licensed for treatment of heart failure
BISOPROLOL
CARVEDILOL
NEBIVOLOL
What is the most appropriate antiplatelet regime to initiate after a suspected ischaemic stroke?
Aspirin 300mg once a day for 14 days then Clopidogrel 75mg once a day long term thereafter
Tamoxifen facts
Increases risk of endometrial cancer
Paroxetine can reduce the effectiveness of tamoxifen
Tamoxifen flushing is not affected by the time taken
Tamoxifen should be taken daily to reduce the risk of the breast cancer returning
A 64-year-old man attends his routine warfarin clinic appointment. His international normalised ratio (INR) is unexpectedly outside of the normal range. There have been no changes to his diet and lifestyle; adherence has not changed. He was recently initiated on a course of antibiotics.
Which of the following effect is most likely to occur in relation to antibiotics and warfarin?
A- Clarithromycin decreases the anticoagulant effect of warfarin
B- Doxycycline decreases the anticoagulant effect of warfarin
C- Erythromycin decreases the anticoagulant effect of warfarin
D- Metronidazole increases the anticoagulant effect of warfarin
E- Rifampicin increases the anticoagulant effect of warfarin
D- Metronidazole increases the anticoagulant effect of warfarin
What are the details needed in the POM register
- Date the POM was supplied
- Name, quantity and, where it is not apparent, formulation and strength of the POM supplied
- Name and address, trade, business or profession of the person to whom the medicine was supplied
- Purpose for which it was sold or supplied.
Can dihydrocodeine be used in BF?
Yes
Short term with caution
30mg TDS
How long is a prescription for oral isotretinoin valid for
7 days
What can ciclosporin oral solution be mixed
Apple juice, orange juice or soft drinks
What are the legalities around puberty blockers via private prescription
Puberty blockers via private prescriptions are banned for under 18s
How does lidocaine plasters work
Lidocaine from the plaster is absorbed slowly through the skin and enters the blood stream = metabolised by the liver
The plaster should be applied for 12 hours per day and you should remove it before going to BED
A patient who is unknown to you visits the community pharmacy late one Saturday evening. They are away for the weekend and have left their medication at home. They ask if you could give them some dexamethasone 0.1% w/v eye drops which has previously been prescribed by an optometrist prescriber.
What would be the most appropriate response in this situation?
A- Refer the patient to the emergency department
B- Supply a maximum of 5 days of medication and ask their prescriber to provide a prescription within 72 hours
C- Supply a maximum of 5 days of medication and make a register entry in the POM register
D- Supply the smallest pack of medication available and ask their prescriber to provide a prescription within 72 hours
E- Supply the smallest pack of medication available and make a register entry in the POM register
E- Supply the smallest pack of medication available and make a register entry in the POM register
There is an immediate need for the POM, Optometrist prescriber is unlikely to be available
How should GTN spray be used
Spray directly under the tongue and close mouth immediately after use
When would the copper coil not be first line EHC?
When there is unexplained vaginal bleeding
What is the most likely interaction between cimetidine and metformin?
Cimetidine is predicted to increase the exposure to metformin
Increased plasma conc = risk of lactic acidosis
It would not cause hypoglycaemia
What would a prescription of metronidazole 2g orally as a single dose be for
Bacterial Vaginosis
What is G6PD deficiency linked to
Genetic disorder of G6PD enzyme that supports the function of red blood cells
Individuals with this deficiency are susceptible to haemolytic anaemia when they take certain drugs - Nitrofurantoin being one of them
A 63-year-old woman is diagnosed with vitamin D deficiency and prescribed ergocalciferol 1.25mg (50,000IU) capsules. She takes regular medication to manage atrial fibrillation, epilepsy, hypertension, and hypercholesteremia. She also takes Senna 7.5mg tablets for occasional constipation.
Which of the following medicines is most likely to cause a severe interaction with ergocalciferol?
A- Bendroflumethiazide
B-Digoxin
C-Phenytoin
D-Senna
E-Simvastatin
B- Digoxin
Excessive dosing of Vit D can induce hypercalcemia = impact digoxin levels
A mother brings her 4-year-old daughter to the community pharmacy who has chronic otitis externa. Her mother explains that she believes her daughter has a mild fungal infection around the ear. She has no otorrhoea and no temperature spikes. Her mother explains that her daughter is incredibly sensitive to steroid creams, so would not want to try any steroid-containing preparations.
Which of the following would be the most appropriate first-line suggestion?
A- Acetic acid spray 2%
B- Clioquinol and flumetasone pivalate drops
C- Clotrimazole 1% solution
D- Refer the child to A&E
E- Refer the child to the GP
C- Clotrimazole 1% solution
Most appropriate first line choice for mild-moderate, UNCOMPLICATED fungal infection for chronic otitis media
An 85-year-old man is receiving palliative care for lung cancer and has been prescribed morphine 200mg capsule twice a day to relieve pain. He has had trouble eating and drinking and is slightly dehydrated.
Which one of the following medicines may predispose to faecal impaction in this patient?
A- Aluminium hydroxide
B- Co-danthramer
C- Diclofenac
D- Ispaghula husk
E- Magnesium hydroxide
D- Ispaghula husk
Bulk forming laxatives can cause obstruction and increase the risk of faecal impaction in opioid-induced constipation
Especially if fluid intake is inadequate
What is first line for a severe deep seated bone infection
Flucloxacillin at a high dose
