S10

Question 1

You regularly dispense mycophenolate for this patient. What would be appropriate counselling for the patient? Each option may be used once, more than once or not at all.
He calls the pharmacy to state he is stopping his mycophenolate mofetil treatment to try for a baby. He would like to know how long he needs to continue to use contraception for.
1 week
4 weeks
30 days
6 weeks
2 months
90 days
26 weeks
One year

Answer 1

90 As a precautionary measure for male patients, it is now recommended that either the patient or their female partner use reliable contraception during treatment with mycophenolate medicines and for at least 90 days after stopping

Question 2

She calls the pharmacy to state she is stopping her mycophenolate mofetil treatment to try for a baby. She would like to know how long she needs to continue to use contraception for.
1 week
4 weeks
30 days
6 weeks
2 months
90 days
26 weeks
One year

Answer 2

Female patients of childbearing potential receiving mycophenolate should always use contraception and for up to 6 weeks after stopping treatment.

Question 3

A 22-year-old woman who has consumed 8 g of paracetamol over 24 hours.
Acetylcysteine
Aspirin
Digoxin-specific antibody
European viper snake venom antiserum
Flumazenil
Methaemoglobinaemia
Naloxone hydrochloride
Protamine sulfate

Answer 3

Acetylcysteine

Question 4

A 64-year-old man is prescribed alprazolam 500 mcg three times daily. He has consumed 5 mg today.
Acetylcysteine
Aspirin
Digoxin-specific antibody
European viper snake venom antiserum
Flumazenil
Methaemoglobinaemia
Naloxone hydrochloride
Protamine sulfate

Answer 4

Flumazenil

Question 5

A 37-year-old man has taken an overdose of his morphine tablets.
Acetylcysteine
Aspirin
Digoxin-specific antibody
European viper snake venom antiserum
Flumazenil
Methaemoglobinaemia
Naloxone hydrochloride
Protamine sulfate

Answer 5

Naloxone

Question 6

A 40-year old woman has accidentally given herself double her dose of Clexane® (enoxaparin hydrochloride) injection. She does not have any other medical conditions and has no known allergies.
Acetylcysteine
Aspirin
Digoxin-specific antibody
European viper snake venom antiserum
Flumazenil
Methaemoglobinaemia
Naloxone hydrochloride
Protamine sulfate

Answer 6

Protamine sulfate

Question 7

For each of the following patients, select the most relevant safety concern associated with the patient’s medication. Each option may be used once, more than once or not at all.
A 43-year-old woman is on the following medication:

metformin 500 mg twice daily
aspirin 75 mg daily
amlodipine 10 mg daily
clopidogrel 75 mg daily

She has been newly prescribed pioglitazone 15 mg once daily.
Atypical femoral fractures
Benign idiopathic osteonecrosis
Fatal diabetic ketoacidosis
Increased incidence of heart failure
Risk of severe harm and death
Subacute cutaneous lupus erythematosus
Suicidal ideation
Uterine perforation

Answer 7

Increased risk of heart failure linked with pioglitazone

Question 8

For each of the following patients, select the most relevant safety concern associated with the patient’s medication. Each option may be used once, more than once or not at all.
A 64-year-old woman prescribed empagliflozin 10 mg once daily.
Atypical femoral fractures
Benign idiopathic osteonecrosis
Fatal diabetic ketoacidosis
Increased incidence of heart failure
Risk of severe harm and death
Subacute cutaneous lupus erythematosus
Suicidal ideation
Uterine perforation

Answer 8

MHRA has issued a safety alert for increased risk of diabetic ketoacidosiss linked with empaglifozin

Question 9

This drug may be prescribed as a monotherapy for the prophylaxis of gout.
Allopurinol
Azathioprine
Azithromycin
Cholestyramine
Clindamycin
Co-beneldopa
Colchicine
Ethosuximide

Answer 9

Allopurinol

Question 10

This drug is commonly used in the treatment of seizure-related medical conditions.
Allopurinol
Azathioprine
Azithromycin
Cholestyramine
Clindamycin
Co-beneldopa
Colchicine
Ethosuximide

Answer 10

Ethosuximide is indicated in the treatment of absence seizures, atypical seizures, atypical absence seizures (adjunct) and myoclonic seizures

Question 11

Routine monitoring of full blood cell count must be carried out during treatment with this medication.
Allopurinol
Azathioprine
Azithromycin
Cholestyramine
Clindamycin
Co-beneldopa
Colchicine
Ethosuximide

Answer 11

Azathioprine - FBC must be carried out during treatment with this medication. Weekly for the first 4 weeks of treatment and at least every 3 months thereafter

Question 12

This drug may be used in the treatment of cellulitis. It can be administered orally or intravenously for this condition.
Allopurinol
Azathioprine
Azithromycin
Cholestyramine
Clindamycin
Co-beneldopa
Colchicine
Ethosuximide

Answer 12

Clindamycin is indicated in soft tissue infections such as cellulitis . It may be administered orally or via IV routes

Question 13

Indications for this drug include parkinsonism and tremors related to Parkinson’s disease.
Allopurinol
Azathioprine
Azithromycin
Cholestyramine
Clindamycin
Co-beneldopa
Colchicine
Ethosuximide

Answer 13

Co-benedopa

Question 14

This medication must be used with caution in patients who have a sensitivity to sulfonamides.
Aspirin 75 mg tablets
Clotrimazole 1% cream

Codeine 5mg/5 mL linctus

Guaifenesin 100 mg/5 mL & Levomenthol 1.1 mg/5 mL oral solution

Loratidine 10 mg tablets

Paracetamol 500 mg tablets

Sumatriptan succinate 50 mg tablets

Xylometazoline 0.1% nasal spray

Answer 14

Sumatriptan should be used with caution in patients with sensitivity to sulfonamides.

Question 15

A patient walks into the pharmacy in which you work. They wish to discuss symptoms with the pharmacist. Upon consulting with the patient it is apparent the patient has red, scaly and cracked feet. The patient asks if you can recommend some treatment to help resolve the symptoms.
Aspirin 75 mg tablets
Clotrimazole 1% cream

Codeine 5 mg/5 mL linctus

Guaifenesin 100 mg/5 mL & Levomenthol 1.1 mg/5 mL oral solution

Loratidine 10 mg tablets

Paracetamol 500 mg tablets

Sumatriptan succinate 50 mg tablets

Xylometazoline 0.1% nasal spray

Answer 15

These symptoms suggest that the patient has athlete’s foot (tinea pedis). Clotrimazole cream can be sold OTC for this indication.

Question 16

This medication is most often prescribed by a doctor. If you are to sell this medication OTC to a patient, the indication must be confirmed first and the indication previously diagnosed by a qualified doctor.
Aspirin 75 mg tablets
Clotrimazole 1% cream

Codeine 5 mg/5 mL linctus

Guaifenesin 100 mg/5 mL & Levomenthol 1.1 mg/5 mL oral solution

Loratidine 10 mg tablets

Paracetamol 500 mg tablets

Sumatriptan succinate 50 mg tablets

Xylometazoline 0.1% nasal spray

Answer 16

Sumatriptan

Question 17

This medication is a sympathomimetic which if used for more than seven days can cause rhinitis medicamentosa.
Aspirin 75 mg tablets
Clotrimazole 1% cream

Codeine 5 mg/5 mL linctus

Guaifenesin 100 mg/5 mL & Levomenthol 1.1 mg/5 mL oral solution

Loratidine 10 mg tablets

Paracetamol 500 mg tablets

Sumatriptan succinate 50 mg tablets

Xylometazoline 0.1% nasal spray

Answer 17

xylometazoline

Question 18

A patient presents to you complaining of an array of symptoms including achy joints and describes flu like symptoms and pyrexia. What would you recommend the patient takes to help alleviate the symptoms?
Aspirin 75 mg tablets
Clotrimazole 1% cream

Codeine 5 mg/5 mL linctus

Guaifenesin 100 mg/5 mL & Levomenthol 1.1 mg/5 mL oral solution

Loratidine 10 mg tablets

Paracetamol 500 mg tablets

Sumatriptan succinate 50 mg tablets

Xylometazoline 0.1% nasal spray

Answer 18

Paracetamol

Question 19

Adult patients who weigh less than 50 kg should use this drug with caution or adjust the dose as they may be at increased risk of toxicity.
Aspirin 75 mg tablets
Clotrimazole 1% cream

Codeine 5 mg/5 mL linctus

Guaifenesin 100 mg/5 mL & Levomenthol 1.1 mg/5 mL oral solution

Loratidine 10 mg tablets

Paracetamol 500 mg tablets

Sumatriptan succinate 50 mg tablets

Xylometazoline 0.1% nasal spray

Answer 19

Paracetamol

Question 20

You are working on a cardiology ward as the ward based pharmacist and you receive a phone call from a junior doctor on the ward. The doctor is concerned that the patient is suffering with a subcutaneous haematoma and queries which drug may be the causative factor.
Benzydamine hydrochloride
Dalteparin
Duloxetine
Isosorbide mononitrate
Isotretinoin
Pizotifen
Timolol 0.25% eye drops
Xylometazoline hydrochloride 0.1%

Answer 20

Dalteparin is known to cause injection site reactions including subcutaenous haematomas.

Question 21

You are on a respiratory ward and, upon counselling a patient who has asthma, he informs you that his breathing has become slightly more laboured since being initiated on a new medication whilst an inpatient. Which is the most likely cause of the breathing difficulty?
Benzydamine hydrochloride
Dalteparin
Duloxetine
Isosorbide mononitrate
Isotretinoin
Pizotifen
Timolol 0.25% eye drops
Xylometazoline hydrochloride 0.1%

Answer 21

Timolol is a beta-blocker. Beta-blockers are often contraindicated for use in asthmatics as they may worsen symptoms

Question 22

Each supply of this medication to women of childbearing age should be limited to 30 days only.

Benzydamine hydrochloride
Dalteparin
Duloxetine
Isosorbide mononitrate
Isotretinoin
Pizotifen
Timolol 0.25% eye drops
Xylometazoline hydrochloride 0.1%

Answer 22

Isotretonoin is subject to many safety and legal precautions, one of which is the supply that is allowed must not exceed 30 days

Question 23

A urologist calls the medicines formulary team to discuss stress urinary incontinence and treatment options available in the hospital in which you work. The urologist is unhappy with the current treatment outcomes and wants to prescribe this drug for a patient suffering with stress urinary incontinence.
Benzydamine hydrochloride
Dalteparin
Duloxetine
Isosorbide mononitrate
Isotretinoin
Pizotifen
Timolol 0.25% eye drops
Xylometazoline hydrochloride 0.1%

Answer 23

Duloxetine is indicated for stress urinary incontinecne

Question 24

A dentist wants to prescribe a medication for a patient suffering with painful inflammatory conditions of the oro-pharynx and asks can you advise accordingly.
Benzydamine hydrochloride
Dalteparin
Duloxetine
Isosorbide mononitrate
Isotretinoin
Pizotifen
Timolol 0.25% eye drops
Xylometazoline hydrochloride 0.1%

Answer 24

Benzydamine hydrochloride is commonly used in painful conditions affecting the oro-pharnyx and is normally administered as a mouthwash or localised spray

Question 25

The patient should provide a negative pregnancy test each month. If at any time during therapy the patient falls pregnant they must inform a clinician immediately. Benzydamine hydrochloride Dalteparin Duloxetine Isosorbide mononitrate Isotretinoin Pizotifen Timolol 0.25% eye drops Xylometazoline hydrochloride 0.1%

Answer 25

isotretinoin

Question 26

Certain medications are restricted with regards to amounts that can be prescribed at any one time. Repeat prescriptions of this medication are not allowed and should not be authorised. Benzydamine hydrochloride Dalteparin Duloxetine Isosorbide mononitrate Isotretinoin Pizotifen Timolol 0.25% eye drops Xylometazoline hydrochloride 0.1%

Answer 26

Isotretonoin is subject to many safety precautions, one of which is that the medication is NOT allowed to be dispensed on a repeat prescription.

Question 27

An elderly patient is admitted to the ward with recurrent falls and reports episodes of light headedness prior to falling. The consultant asks which of his medications could be the most likely to be contributing to this. The patient has a history of angina. Benzydamine hydrochloride Dalteparin Duloxetine Isosorbide mononitrate Isotretinoin Pizotifen Timolol 0.25% eye drops Xylometazoline hydrochloride 0.1%

Answer 27

Isosorbide mononitrate Isosorbide mononitrate exerts its mechanism of action by dilating blood vessels to reduce pressure build up. As a result this may cause episodes of dizziness and light headedness which can result in falls.

Question 28

A patient walks into the community pharmacy you are working in with a complaint of dry skin and in particular dry chapped lips. They want to know if any of the medications they are regularly taking could be contributing to or causing this. Benzydamine hydrochloride Dalteparin Duloxetine Isosorbide mononitrate Isotretinoin Pizotifen Timolol 0.25% eye drops Xylometazoline hydrochloride 0.1%

Answer 28

Isotretinoin Isotretonoin commonly causes skin thinning, drying of the skin and chapped skin. As such patients should be adequately counselled on how to manage these side effects and how to take precautions in the sun as this medication also leaves their skin more susceptible to the harmful UV sun ray

Question 29

This medication is routinely prescribed to help prevent the formation of thrombus. Benzydamine hydrochloride Dalteparin Duloxetine Isosorbide mononitrate Isotretinoin Pizotifen Timolol 0.25% eye drops Xylometazoline hydrochloride 0.1%

Answer 29

Dalteparin Dalteparin is commonly used as a prophylactic treatment to prevent thrombus formation in patients who are sedentary such as post-operative patients.