T2 Flashcards
A patient presents in your pharmacy and asks you for advice.
When he was cleaning his teeth this morning, he noticed bleeding from his gums. He is taking no medicines and is otherwise healthy. What is the best course of action?
Advise the patient to stop brushing his teeth for 48 hours
Recommend the patient brush his teeth four times daily
Recommend the patient floss between his teeth
Tell the patient he needs to see a dentist urgently
Tell the patient he needs to see his GP
Flossing between the teeth can clean the area and help with bleeding gums
A 37-year-old woman has started a new medication which has been causing her nightmares and is disturbing her sleep. Her GP contacts you to discuss an alternative beta-blocker.
Which of the following beta-blockers is LESS likely to cause nightmares?
Labetolol
Nadolol
Oxprenolol
Propranolol
Timolol
The correct answer was Nadolol
She is less likely to experience nightmares with water soluble beta blockers as they are less likely to enter the brain, and may therefore cause less sleep disturbance and nightmares
Which of the following prescribers CANNOT request an emergency supply of a prescription-only medicine?
Community nurse prescriber
Dentist
Supplementary nurse prescriber
Swiss doctor
Vet
Vet
Who must have signed this order for it to be legally valid?
Chair of governors
Deputy head
Principal
Pupil’s parent
School nurse
Must be signed by principal or head teacher
In order to collect a prescription for someone else from a pharmacy, how old should the patient who is collecting it be?
10 years
12 years
16 years
18 years
There is no legal restriction, the pharmacist should exercise their professional judgement
No legal restriction - use professional judgement
You are teaching a trainee about medical terminology.
Which of the following terms describes ‘asbestos-like’ scales on the scalp?
Pityriasis alba
Pityriasis amiantacea
Pityriasis rosea
Pityriasis versicolor
Psoriasis
Pityriasis amiantacea describes ‘asbestos-like’ scales on the scalp.
You are running a workshop helping to educate pharmacy staff on the safe handling of medicines. You receive a question from an audience member regarding drugs which require caution in handling.
Which of the following drugs would you be able to use as an example of a drug which requires ‘caution in handling’?
Chloroquine
Famciclovir
Mebendazole
Pyrimethamine
Valganciclovir
Valganciclovir is a potential teratogen and carcinogen and caution is advised when handling the powder, reconstituted solution or broken tablets; if these come into contact with skin or mucosa, wash off immediately with water; avoid inhalation of powder.
A 22-year-old female who regularly comes to your pharmacy to collect her prescription for fluoxetine. Today she presents you her prescription with a new additional drug, phenelzine.
Which one of the following is the best course of action to take?
Dispense both medications and advise her to avoid eating foods rich in tyramine
Dispense both medications and advise her to take both of them on an empty stomach
Dispense both medications and advise her to take phenelzine after food
Dispense both medications and advise her to take them at least 4 hours apart
Do not dispense her medication and contact her prescriber to advise them of the serious adverse effects associated with this combination of drugs.
The combination of these two drugs may result in central serotonin syndrome which is characterised by changes in mental status, agitation, tachycardia and death - do not dispense together
A 55-year-old female patient has recently been suffering from acute migraine attacks which have not responded to paracetamol. She has a history of ischaemic heart disease.
Which of the following medications is the most suitable to treat her migraine?
Almotriptan
Aspirin and metoclopramide
Naratriptan
Rizatriptan
Sumatriptan
Aspirin and metoclopramide could be used to relieve the symptoms of a migraine: pain and vomiting, respectively. Serotonin 5HT1 agonists (i.e. the ‘triptans’) are contraindicated in patients with ischaemic heart disease.
ou have a patient with diabetes. Some medicines may affect blood glucose levels.
Which one of the following medicines can increase blood glucose levels in a person with diabetes?
Diclofenac
Folic Acid
Methotrexate
Paracetamol
Prednisolone
Red
Which of the following NSAIDs has a maximum daily dose of 600 mg?
Dexketoprofen
Etodolac
Etoricoxib
Felbinac
Ibuprofen
Etodolac
A patient presents you with a dental prescription for metronidazole and wants to discuss the medication with you. He informs you it is the weekend and he wanted to have a few alcoholic drinks.
What is the reason that alcohol must be avoided when this patient is taking his course of metronidazole?
Alcohol reduces the efficacy of metronidazole
Alcohol renders the use of metronidazole ineffective
Alcohol should be avoided when taking any course of antibiotics
Metronidazole produces a disulfiram like reaction with alcohol
Metronidazole toxicity can occur with alcohol
Disulfiram like reaction
You receive a prescription for haloperidol 500 mcg tablets for one of your patients. Your PMR system flags that haloperidol is contraindicated for this patient.
Which one of the following medical conditions would mean that haloperidol is contraindicated for this patient?
Depression
Diabetes
Parkinson’s disease
Schizophrenia
Tuberculosis
Parkinsons may be precipitated by haloperidol
A patient comes in to your pharmacy wishing to buy some Ibuprofen. Ibuprofen is a commonly used NSAID medication to help relieve pain and inflammation, which can be bought GSL.
What is the maximum TOTAL daily dose of Ibuprofen in an adult when used as a GSL product?
1.2 g
1.6 g
2 g
2.2 g
2.4 g
Adults can take 200 mg-400 mg every FOUR hours if required, however, they must not exceed 1.2 g in 24 hours when taking over-the-counter. The BNF doses are much higher as they are usually prescription only and patient should be under the care of a physician.
Which of the following controlled drugs can be classified as a Schedule 4 Part II drug?
Diamorphine
Diazepam
Clenbuterol
LSD
Zopiclone
Clenbuterol
Fluconazole capsules are available to buy over the counter to help treat a certain self-limiting condition.
Which of the following would oral fluconazole be used for as an over-the-counter medication?
Aspergillosis
Onychomycosis
Tinea corporis
Tinea pedis
Vaginal candidiasis
Fluconazole may sold over the counter for the treatment of previously diagnosed vaginal thrush or vaginal candidiasis.
You are dispensing a prescription which includes morphine. Morphine is a Schedule 2 controlled drug and is subject to strict regulations, including making records in the controlled drug register.
Which of the following is NOT true regarding entries in the controlled drug register?
A separate register is used for each class of drugs
Entries must be in chronological order
Entries must be made on day of the transaction or within the following five days
The register must not be kept for any other purpose
The register must not be removed from the premises at any time during use
When making an entry into the controlled drugs register the entry must be made on the day of transaction or the FOLLOWING DAY, no later
A patient with bipolar disorder, treated with lithium, requires analgesia.
Which is the LEAST appropriate analgesic for this patient?
Codeine
Ibuprofen
Morphine
Paracetamol
Tramadol
A serious interaction between lithium and NSAIDs can occur leading to reduced excretion of lithium and subsequent toxicity. CNS side effects of opioid analgesics are not desired but the risk of toxicity is lower. The pharmacokinetic interaction is more important than the pharmacodynamic interactions.
Miss S comes in to your pharmacy. She has bacterial conjunctivitis and is looking for something to help her treat it. Chloramphenicol is an antibiotic which can be bought over the counter to treat acute bacterial conjunctivitis.
What is the maximum pack size of chloramphenicol 0.5% eye drops which can be sold over the counter?
3 mL
5 mL
7 mL
10 mL
20 mL
10ml
One of your patients has been prescribed Yasmin as an oral contraceptive. Oral contraception is a very commonly used reversible method of contraception, Many women rely on the pill to help prevent unwanted pregnancy and Yasmin is one of the commonly prescribed pills in the UK.
Which of the following is UNTRUE regarding Yasmin?
It can cause vaginal discharge
It contains drospirenone 3 mg
It contains ethinylestradiol 30 mcg
It is a monophasic 28-day preparation
It may cause sexual dysfunction
Yasmin is a monophonic 21 day prep not 28
Rheumatoid arthritis presents with a myriad of symptoms, of which a very common presentation is pain and inflammation. You are treating a patient who is experiencing these symptoms.
Which of the following is licensed for pain and inflammation in rheumatoid arthritis?
Domperidone
Esketamine
Febuxostat
Nabumetone
Naloxone
The only medication on this list licensed for pain and inflammation in rheumatoid arthritis is nabumetone.
You are creating an antimicrobial prescribing policy for your trust.
Which one of the following statements best describes the role of linezolid in the treatment of infections caused by methicillin-resistant Staphylococcus aureus (MRSA)?
The BNF monograph is available here: https://bnf.nice.org.uk/drugs/linezolid/.
It does NOT have a role in the treatment of infections caused by MRSA
It is first line choice for all infections caused by MRSA
It is not active against Gram-negative organisms
It may be used for bronchiectasis caused by MRSA
It must be given with another antibacterial where infection involves Gram positive bacteria
The correct answer was It is not active against Gram-negative organisms
Linezolid, an oxazolidinone antibacterial, is active against Gram-positive bacteria including meticillin-resistant Staphylococcus aureus (MRSA), and glycopeptide-resistant enterococci. Resistance to linezolid can develop with prolonged treatment or if the dose is less than that recommended. Linezolid is not active against common Gram-negative organisms; it must be given in combination with other antibacterials for mixed infections that also involve Gram-negative organisms
You are updating your pharmacy SOPs with regards to the management and dispensing of pregabalin.
Which of the following is NOT a requirement for pregabalin?
Dose on prescription
Drug formulation on prescription
Drug strength on prescription
Safe custody
Total quantity in words and figures on prescription
no safe custody
A 21-year-old man who weighs 55 kg, is admitted to hospital seriously ill with diabetic ketoacidosis. He is diagnosed with type 1 diabetes. The doctor decides that the patient will be prescribed a ‘basal bolus regimen’.
The BNF treatment summary is available here: https://bnf.nice.org.uk/treatment-summaries/type-1-diabetes/
What is the most appropriate regimen for this patient?
Humalog (insulin lispro) three times daily plus Novorapid (insulin aspart) once daily Actrapid (insulin soluble) three times daily plus Novomix 30 (insulin aspart) once daily Novorapid (insulin aspart) three times daily plus Lantus (insulin glargine) once daily Humalog Mix25 (insulin lispro) twice daily Novorapid (insulin aspart) three times daily plus Actrapid (insulin soluble) once daily
Novorapid (insulin aspart) ads and Lantus (insulin glargine) once daily
