T10 Flashcards
A doctor contacts you in relation to analgesia and maximum dosing of analgesics that can be safely prescribed under their care. They wish to use an anti-inflammatory and would like to know the maximum daily dose.
What is the maximum TOTAL daily dose of immediate release ibuprofen for an adult?
1.2 grams
1.6 grams
1.8 grams
2.4 grams
2.8 grams
The max dose that can be prescribed as per BNF is 600mg QDS which is 2.4g a day
A mother brings her 3 year-old child to your pharmacy. They are suffering from the symptoms associated with otitis media, a common complaint in young children.
Which of the following symptom groups best describe the signs and symptoms of otitis media in this age group?
irritability and crying
Irritability and fever
Irritability and pain
Irritability, crying and pain
Irritability, crying, fever, pain and restlessness
The correct answer was Irritability, crying, fever, pain and restlessness
A mother requests a product over the counter for her 7-year-old son who is suffering from a cold.
She wants to purchase a nasal drop containing xylometazoline. What is the maximum length of time the child should use it for?
Two days
Three days
Five days
Seven days
A child this age must not use it
Xylometazoline nasal drops can be used in children between the ages of 6 and 12 but should not be used for more than 5 days in a 8 year old. Other xylometazoline products should not be used in patients under the age of 12
You are the regular pharmacist at a pharmacy. Mr WK who is a regular customer, comes into your pharmacy with his new born baby. He has brought in a prescription for senna tablets and lactulose solution for his wife who is at home resting. You ask him how his wife and he are managing with the new baby. He says that he is fine but his wife is still in a lot of pain and discomfort. She suffered with gestational diabetes so is still required to monitor her blood glucose levels. He wants you to recommend a really strong painkiller. He informs you that his wife is breast-feeding.
What would be the SAFEST analgesic to recommend for Mr WK’s wife?
Anadin® Extra
Co-codamol 8/500
Nurofen® plus
Panadol® original tablets
Paracetamol and ibuprofen together
Aspirin is not recommended due to the risk of Reye’s syndrome. Codeine should not be given to breastfeeding women because mother’s vary considerably in their capacity to metabolise codeine and there is a risk or morphine overdose in the infant. Ibuprofen should be used with caution in conjunction with other painkillers. Paracetamol is the simple analgesic of choice in breastfeeding women because the amount excreted in milk is too small to be harmfu
In your pharmacy there is a dispensing error leading to a patient safety incident.
What is the most appropriate technique to identify the cause of the dispensing error?
Clinical audit
Root cause analysis
SMART criteria
SWOT analysis
Systematic review
RCT
You are instructing a trainee pharmacist in the schedules contained in the Misuse of Drugs Regulations. The Misuse of Drugs Regulations 2001 (as amended) classify controlled drugs into 5 schedules according to the different levels of control attributed to each.
Which schedule includes temazepam?
Schedule 1
Schedule 2
Schedule 3
Schedule 4
Schedule 5
3
You are training your foundation trainee pharmacist on food interactions with warfarin.
Which of the following foods is most likely to contain a large amount of vitamin K?
Artichoke
Broccoli
Cauliflower
Green pepper
Peas
Certain foods such as liver, broccoli, brussels sprouts and green leafy vegetables contain large amounts of vitamin K.
A patient has been prescribed a cream to treat their condition. You need to counsel them that this cream may stain their clothing.
Which of the following creams/ointments could stain clothing?
Betamethasone valerate/clioquinol cream
Daktacort® ointment
Fucibet® cream
Locoid®ointment
Synalar® cream
Betamethasone valerate/clioquinol cream
You are training your trainee pharmacist on food interactions with warfarin.
Drinking which of the following is most likely to lead to a bleeding event in patients?
Apple juice
Cranberry juice
Grapefruit juice
Orange juice
Tomato juice
Cranberry juice can interact causing an increase in INR and potentially a bleeding event
You are the Responsible Pharmacist in a community pharmacy and you receive a written requisition for morphine tablets.
Which of the following is a legal requirement for this requisition?
Date of birth of recipient
Purpose of the requisition
Quantity of the drug in words and figures
Strength of the drug in words and figures
Your signature
The correct answer was Purpose of the requisition
The six legal requirements for a CD requisition include:
Recipients signature
Name of recipient
Address of recipient
Profession/occupation
Total quantity of drug
Purpose of requisition.
The doctor asks your advice on which adverse effects to monitor with vancomycin. Which one of the following is NOT an adverse effect of vancomycin?
High platelet count
Low neutrophil count
Nephrotoxicity
‘Red man’ syndrome
Tinnitus
High platelet count - it can cause thrombocytopenia which is a low platelet count
Mr J comes into your pharmacy to ask you about dermatophytic onychomycosis.
What part of the body does this condition affect?
Genitals
Nails
Oral cavity
Scalp
Soles of the feet
Nails
A 6-year-old child presents with the following signs and symptoms: vomiting, malaise and sudden stomach ache which comes and goes.
Which one of the following is the most likely cause of these effects?
Dyspepsia
Encephalitis
Food poisoning
Hypoxia
Migraine
The correct answer was Food poisoning
This patient is presenting with possible signs of food poisoning. Signs and symptoms include; poison in the stool, vomit and urine of the patient, as well as, malaise and repeated attacks of GI irritation.
A woman presents in your pharmacy asking for advice. She has been breastfeeding her child for 5 weeks. She is experiencing pain in both breasts which has recently started. Her baby has been unsettled during this time and also has bad nappy rash, along with white spots on it’s tongue.
Which of the following is the lady most likely experiencing?
Blocked ducts
Engorgment
Mastitis
Reduced milk supply
Thrush in the nipple/breast
The correct answer was Thrush in the nipple/breast
The symptoms described are those of thrush (candida) infection in the breast. Breastfed babies can also develop thrush in their mouths, a sign for which in some babies is nappy rash that won’t clear up.
You have a patient who has been prescribed naproxen.
Which one of the following medicines has an interaction with naproxen which is graded as severe?
Allopurinol
Amlodipine
Paracetamol
Ramipril
Warfarin
BNF grades warfarin as severe with naproxen and ramipril as amber which is less severe
Which ONE of the following anti-hypertensives is considered suitable in pregnancy?
Lacidipine
Losartan
Methyldopa
Moxonidine
Ramipril
Methyldopa is not known to be harmful during pregancy. Females who have been managed with methyldopa during pregnancy should discontinue treatment within 2 days of the birth and switch to an alternative antihypertensive.
You are asked for advice on bedwetting by a parent.
Which one of the following statements regarding the treatment of nocturnal enuresis in a 7-year-old is FALSE?
http://patient.info/doctor/nocturnal-enuresis-in-children
Avoid caffeine-based drinks before going to bed
Encourage the child to use the toilet to pass urine at regular intervals during the day and before sleep
Ensure the child eats a healthy diet
Reward the child for going to the toilet before bed
When the enuresis alarm goes off the child should go back to sleep if there is no urge to urinate
The correct answer was When the enuresis alarm goes off the child should go back to sleep if there is no urge to urinate
A doctor on a cardiology ward is seeking advice regarding a patient’s medication history. The doctor is wondering if any of the patient’s current medication may be contributing to the QT prolongation the patient is currently presenting with.
Which of the following medications may be the causative factor in the QT prolongation?
Bendroflumethiazide
Chlorphenamine
Ciprofloxacin
Paracetamol
Sodium Valproate
Quinolones including ciprofloxacin may prolong the QT interval
Mrs Jones presents to the pharmacy complaining of headaches. She tells you that the pain has been present for the last 24 hours and is at the front left of her head, and she has felt a little sick.
Based on this information what would be the most likely diagnosis?
Haematoma
Migraine
Sinusitis
Temporal arteritis
Tension-type headache
The correct answer was Migraine
Unilateral headache associated with sickness in women is highly suggestive of migraine. Haematoma can cause sickness but the duration of symptoms is too short for this to be considered. Other conditions listed do not have sickness as a symptom, although temporal arteritis can cause malaise.
Miss WQ is a regular patient of your pharmacy and comes to collect her weekly instalment of methadone. She returns, an hour later, asking for another to be dispensed as she dropped the bottle containing methadone. She shows you pieces of the broken bottle.
Which of the following is the most appropriate response?
Advise Miss WQ that she needs to obtain another prescription from her prescriber
Dispense next week’s methadone instalment and contact her prescriber to obtain a replacement prescription to cover the additional supply
Get more details about the area where she dropped it and send a member of staff to confirm her story and, if true, supply another bottle
Inform Miss WQ that you must contact the police and prescriber before dispensing any more methadone to her
Tell her there’s nothing you can do about it
The correct answer was Advise Miss WQ that she needs to obtain another prescription from her prescriber
Methadone is a schedule 2 Controlled Drug which is used to treat opioid misusers and can only be legally prescribed and dispensed against a valid instalment prescription. Pharmacists must be aware of the abuse potential of any Controlled Drug.
A 61-year-old man has been prescribed finasteride 5 mg tablets for the treatment of benign prostatic hyperplasia.
For which of the following adverse effects should you advise him to immediately stop his finasteride tablets and refer him back to the prescriber?
Depression
Erectile dysfunction
Low libido
Pruritis
Rash
The correct answer was Depression
MHRA/CHM (May 2017) advice regarding reports of depression and suicidal ideation is to stop finasteride immediately and inform a healthcare professional if patient develops depression.
Which of the following symptoms is most likely to be attributed to ferrous sulfate?
Black stools
Bruising that may be heavy
Dry mouth
Myositis
Weight gain
Black stools
You are discussing with a member of your team how the interaction of medicines may affect absorbtion.
Intestinal absorption of which ONE of the following drugs may be impaired when taken with magnesium trisilicate?
Amoxicillin
Cefalexin
Co-amoxiclav
Metronidazole
Tetracycline
Tetracycline - absorption of tetracycline from the GI tract may be impaired by the concomitant amdistation of di and trivalent cations such as iron, calcium, zinc, bismuth, magnesium and aluminium
You attend a CPD seminar on side-effects of mineralocorticoid and glucocorticoids.
Which one of the following effects is associated more with glucocorticoid use?
Calcium loss
Diabetes
Hypertension
Potassium loss
Water retention
Glucocorticoid side-effects include diabetes, osteoporosis and muscle wasting. The other listed side-effects are associated with mineralocorticoids.
