T6 Flashcards
(27 cards)
A female patient is usually prescribed theophylline 175 mg once every 12 hours for her asthma. Lately, this has been insufficient to control her symptoms.
Which one of the following products that this patient is buying could be causing a reduction in her theophylline plasma concentration?
Diclofenac gel
Naproxen
Paracetamol
Pepto-bismol
St John’s Wort
St john wort is an enzyme inducer which increases theophylline metabolism and subsequently reduces plasma concentration of theophylline
A female patient has AIDS. She has been diagnosed with mild pneumocystis pneumonia. She is unable to tolerate trimethoprim.
Which single medication is the most likely treatment option for her pneumonia?
Atovaquone Co-trimoxazole Hydrocortisone Pentamidine isetionate Prednisolone
Atorvaquone is licensed for the treeatment of mild to moderate pneumocystitis infection in patients who cannot tolerate co-trimoxazole. All the other options are suitable for severe pneumocystitis infection
You are giving a training session on the effects of alcohol consumption with various drugs.
Regarding the concomitant use of alcohol with the following drugs which one is LEAST likely to be correct?
Alcohol plus diazepam decreases a person’s motor skills
Alcohol plus glipizide increases the risk of hyperglycaemia
Alcohol plus isoniazid increases the risk of isoniazid-related liver disease
Alcohol plus phenytoin increases phenytoin metabolism
Alcohol plus promethazine increases the risk of sedation
The antidiabetic effect of sulphonulureas is enhanced by alcohol leading to the risk of hypoglycaemia
You are treating a patient who has just been diagnosed with high blood pressure.
Which ONE of the following antihypertensive drugs would be the first choice for a newly diagnosed 60 year old male Caucasian patient with no other comorbidities?
Bisoprolol 2.5 mg tablets
Captopril 25 mg tablets
Felodipine M/R 5 mg tablets
Indapamide 2.5 mg tablets
Losartan 25 mg tablets
Step 1 hypertension therapy in patients over 55 years old is calcium channel blocker, felodipine is the only calcium channel blocker listed in the options above.
Ms G is a 78-year-old female who is a regular customer at your pharmacy. She has recently been initiated on Flupentixol.
Which of the following risks are NOT associated with the use of anti-psychotics in elderly patients?
Hyperprolactinaemia
Hyperthermia Hypoglycaemia Postural hypotension Stroke
Hyperglycaemia and sometimes diabetes is a risk of all antipsychotics
You are explaining to the team in your pharmacy your requirement to maintain patient confidentiality.
Which one of the following sources of information is NOT confidential?
Coded audit material concerning individual patients and side effects to drugs
Electronic data concerning patients
Hard copy data with patient identifiers on it
Patient’s address information
The fact a patient’s husband has died, something they have told you in the pharmacy
Coded audit material concerning individual patients and side effects to drugs
Mrs WB is a 77-year-old woman, who is admitted to hospital for the treatment of hallucinations. Her past medical history is multiple sclerosis. Her doctor decides to prescribe haloperidol.
The next day the ward pharmacist carries out a medicines reconciliation with Mrs WB. Which ONE of the following medicines could be contributing to the reason for Mrs WB’s admission to hospital?
Baclofen 10 mg TDS started 3 weeks ago
Bendroflumethiazide 2.5 mg OM started 20 years ago
Dantrolene 100 mg four times daily started three months ago
Metformin 500 mg TDS started 5 years ago
Paracetamol 1 g QDS started 5 years ago
Baclofen can cause hallucinations
You a conducting an evidence-based review of a patient’s medicines. Evidence-based practice promotes better clinical outcomes for patients. To ensure that medicines and practice are evidence-based, a process of reviewing and appraising the literature is needed.
Which of the following types of literature would be deemed to provide ‘the best available evidence’?
Case-control studies Cohort studies Expert opinion Randomised controlled trials Systematic reviews
Systematic reviews take into account all literature created and therefore provide the best evidence in research
A 24-year-old girl comes into your pharmacy and asks for advice regarding itchy, red, dry skin around her ring finger. She recently started wearing a ring on that finger. There is no broken skin or signs of infection and on further enquiry she tells you that she also suffers from hay fever.
What is the likely cause of this patient’s concerns?
Contact dermatitis
Eczema
Insect bite
Psoriasis
Scabies
Contact dermatitis caused by an allergy to the metal in her ring
You are trying to prevent prescribing errors in your pharmacy.
Which of the following is NOT a recommended check point for avoiding prescribing errors?
Right dose Right medicine Right patient Right quantity Right route
Right quantity
You have a patient who has just been prescribed Ciprofloxacin. Quinolones may induce convulsions in patients that have not previously experienced them.
Taking which medicine concomitantly with quinolones could also induce convulsions?
Co-codamol Codeine Ibuprofen Paracetamol Tramadol
Ibuprofen and NSAIDS
A parenteral drug misuser is seen in the clinic.
Which vaccine is indicated for this patient?
BCG vaccine Hepatitis A vaccine Human papilloma virus vaccine Intradermal seasonal influenza vaccine Poliomyelitis vaccine for oral use
Hep A
You are working at a pharmacy in England. You will need to follow the Drug Tariff in England and Wales rules to follow when dispensing.
Which of the following statements is correct for English prescriptions?
The drug tariff is available here: https://www.nhsbsa.nhs.uk/pharmacies-gp-practices-and-appliance-contractors/drug-tariff
All appliances attract a single fee regardless of the number of actual items
Any appliance can be prescribed by a dentist on a FP10D form
Any appliance can be prescribed by community nurses on a FP10 form
Any appliance may be supplied against a FP10 providing an invoice accompanies the prescription when submitted for pricing
Appliances in section IX A/B/C of the Drug Tariff are the only ones that can be supplied against a FP10 form
The correct answer was Appliances in section IX A/B/C of the Drug Tariff are the only ones that can be supplied against a FP10 form
A patient has been newly started on a number of medicines for a cardiovascular condition.
Which agent is most likely to cause headaches in this patient?
Bisoprolol Diltiazem Isosorbide mononitrate Ramipril Spironolactone
The patient is newly started on the medicines and isosorbide mononitrate is known to have the potential to cause headaches, particularly on initiation. In this situation, although other medicines may cause a headache, this would be the most likely cause and this should be excluded before looking at other causes for the headaches.
A patient presents in your community pharmacy stating that they think they are suffering from a side effect of amlodipine which they started take for the first time last week.
What is a common side effect of amlodipine?
Cold extremities Dry mouth Oedema Rash Tremor
Oedema
Mr G is a 45-year-old mechanic who has angina. His GP contacts you to discuss the options of beta-blockers to prescribe to Mr G. He is looking for a once daily dosing regimen.
Which of the following beta-blockers is LESS suitable for a once daily regimen?
Atenolol Bisoprolol fumarate Celiprolol hydrochloride Nadolol Propanolol
The correct answer was Propanolol
Some beta blockers, such as atenolol, bisoprolol fumarate, celiprolol hydrochloride, and nadolol, have an intrinsically longer duration of action and need to be given only once daily.
You are instructing a Foundation Trainee on the effective use of reference sources.
Select from the following reference sources which ONE is most likely to contain a detailed analysis of the outcomes of giving medicines together.
British National Formulary
British Pharmacopoeia
Drug Tariff
Martindale
Stockley’s Drug Interactions
Stockleys
You are providing training on antisecretory and mucosal protection drugs.
Which of the following antisecretory and mucosal protectant drugs inhibits the metabolism of warfarin?
Cimetidine
Lansoprazole
Misoprostol
Ranitidine Tripotassium dicitratobismuthate
Cimetidine increases the anticoagulant effect of warfarin.
A 47-year-old man comes into your pharmacy. He has been suffering from a headache since this morning. He describes it as feeling like there is a tight band around his head. He says that the head ache is about a 5 out of 10 (0 = not painful at all; 10 = extremely painful), is not aggravated by his daily activities and is not accompanied by nausea.
Which one of the following is he most likely to be suffering from?
Chronic daily headache Cluster headache Migraine Referred jaw pain Tension headache
Tension
You are providing training on interactions between medicines.
Which of the following drug combinations is known to introduce a risk of rhabdomyolysis?
Beclomethasone with salbutamol
Digoxin with amiodarone
Fluvastatin with bezafibrate
Ibuprofen with paracetamol
Phenytoin with sodium valproate
Fluvastatin with bezafibrate
You are the pharmacist on duty in a busy community pharmacy. You are screening the prescriptions and notice that one of them has an incorrect dosage written on it.
Which one of the following is most likely the error?
Aspirin 75 mg once a day
Azithromycin 500 mg once daily
Chloroquine 310 mg once daily
Metronidazole 200 mg three times a day
Risedronate sodium 5 mg once daily
Chloroquine 310mg once daily is incorrect it is given weekly
You are providing training on side effects of medicines.
Which of the following can be a side-effect of ciclosporin?
The SmPC is available here: http://www.medicines.org.uk/emc/medicine/1307
Hypocalcaemia
Hypokalaemia
Hypomagnesaemia
Hyponatraemia
Hypophosphataemia
Ciclosporin enhances the clearnace of magnesium. Can lead to smptomatic hypomagneasemia, especially in the peri-transplant period.
Your dispenser is measuring out the daily methadone liquid prescriptions. As she returns the bottle to the cupboard she drops it and it smashes on the floor.
What is the most appropriate way to clear up the spillage?
Clear up with tissue and denature Clear up with tissue and store in a bag in the CD cupboard Clear up with tissue and throw in the bin Mop up the floor and pour waste water down the drain Mop up the floor and pour waste water into denaturing kit
The correct answer was Clear up with tissue and store in a bag in the CD cupboard
Destruction of stock of a CD should be witnessed by an authorised person. This includes spillages. Therefore, the spillage should be cleaned up and kept in the CD cupboard until destruction can be witnessed.
A patient presents to the community pharmacy asking for advice and treatment for a condition. The patient complains of a tingling and burning sensation on the lips.
Which of the following would be appropriate to sell OTC for this patient?
Aciclovir 5% cream Aciclovir 200 mg tablets Aqueous cream Chlorphenamine tablets Hydrocortisone 1% cream
Aciclovir 5% cream
