T7 Flashcards
(28 cards)
Which one of the following medicines does NOT affect the monoamine oxidase enzyme family?
Clonidine
Linezolid
Moclobemide
Phenelzine
Selegiline
Clonidine is the only one that does NOT affect the monoamine oxidase enzyme family. Linezolid is a reversible, non-selective inhibitor of monoamine oxidase; however, at the doses used for antibacterial therapy, it does not exert an anti-depressive effect
A patient uses simvastatin 40 mg nocte and presents with a prescription for an antibiotic.
Which of the following antibiotics may precipitate rhabdomyolosis if given concomitantly with simvastatin?
Amoxicillin
Ciprofloxacin
Co-amoxiclav
Daptomycin
Doxycycline
Statins are predicted to increase the risk of rhab when given with daptomycin
Latin abbreviations are commonly seen on prescriptions in both hospital and community pharmacies.
A trainee pharmacist notices a prescription that has the abbreviation ‘p.c.’ written on it and asks what this means. What is the correct meaning of the Latin abbreviation p.c.?
After food
Before food
On an empty stomach
Take in the evening
With food
after food
A 21-year-old man comes to your pharmacy with a new prescription for himself. You look at the prescription and advise him to report immediately any sore throat, fever, infection, unexplained bleeding and bruising, purpura, mouth ulcers or rashes to his doctor.
Which of the following drugs is this counselling advice most suitable for?
Bezafibrate
Glucosamine
Loperamide
Penicillamine
Sumatriptan
Pencillamine has been associated with blood disorders. Therefore patients should be counselled to report these signs immediately
You are presented with a prescription form FP10PCD, written for a 12-year-old child for two items:
Rx
1. methylphenidate
10 mg tablets, 1 bd, mitte 60
2. paracetamol
250 mg/5 mL oral suspension, 10 mL qds mitte 200 mL
Which of the following statements is the most appropriate to indicate why the prescriber should be contacted?
The doctor should be contacted and asked to amend the quantity for methylphenidate to 56 tablets
The doctor should be contacted as the dose of paracetamol is too high for a 12 year old
The doctor should be contacted as the paracetamol should be prescribed on a different prescription
The doctor should be contacted as they should add the word ‘quantity’ instead of ‘mitte’ to methylphenidate
The doctor should be contacted as they should add the word ‘ten’ to the strength
The doctor should be contacted as the paracetamol should be prescribed on a different rx
Mrs Sloane, a 61-year-old woman, presents at your community pharmacy with a bright red left eye.
Which symptom cluster associated with this presentation do you feel most likely warrants referral to an optician?
Moderate pain with slight discharge and vision unaffected
Slight eye discomfort but no discharge with vision unaffected
Slight pain with little discharge and blurred vision due to tears
Slight pain with little discharge and vision unaffected
Slight pain with mucopurulent discharge and vision unaffected
Moderate pain with slight discharge and vision unaffected
According to BNF safety information, which of the following is NOT a recommendation to avoid dosing errors?
Methotrexate should be prescribed by brand
Only one strength of tablet should be prescribed
The dispensing label should clearly display the dose of methotrexate
The dispensing label should clearly display the frequency of administration
The patient should be warned to report a sore throat immediately
The correct answer was Methotrexate should be prescribed by brand
To avoid error with low-dose methotrexate, it is recommended that:
the patient is carefully advised of the dose and frequency and the reason for taking methotrexate and any other prescribed medicine (e.g. folic acid);
only one strength of methotrexate tablet (usually 2.5 mg) is prescribed and dispensed;
the prescription and the dispensing label clearly show the dose and frequency of methotrexate administration;
the patient is warned to report immediately the onset of any feature of blood disorders (e.g. sore throat, bruising, and mouth ulcers), liver toxicity (e.g. nausea, vomiting, abdominal discomfort, and dark urine), and respiratory effects (e.g. shortness of breath).
A 53-year-old woman comes into the hospital with a potassium level of 7 mmol/L (range 3.5-5.3) and is diagnosed with hyperkalaemia.
Which drug requires monitoring for hyperkalaemia?
Citalopram
Enoxaparin
Ferrous sulphate
Naproxen
Salbutamol
Enoxaparin can raise potassium levels due to it inhibiting aldosterone secretion. This is particularly in patients with diabetes mellitus, chronic renal failure, pre-existing metabolic acidosis, taking medicinal products known to increase potassium. Plasma potassium should be monitored regularly especially in patients at risk.
you are instructing a colleague into the different schedules of controlled drugs. 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 is split into two parts and contains substances such as benzodiazepines and anabolic steroids?
Schedule 1
Schedule 2
Schedule 3
Schedule 4
Schedule 5
4
You are working on a hospital ward and prior to discharge you are counselling a patient on their medication and its side effects.
Which of the following can cause a patients urine to turn red-orange?
Azithromycin
Ciclosporin
Mycophenolate
Rifampicin
Sodium valproate
Rifampicin
A 33-year-old patient comes into the pharmacy with a prescription for a skin complaint. He has erythema around his face in a ‘butterfly’ pattern, with no comedones present. He feels otherwise well and has no other symptoms.
Which of the following treatment options is the LEAST suitable for this skin condition?
Benzoyl peroxide
Brimonidine tartrate
Camouflaging make-up
Erythromycin
Oxytetracycline
Benzoyl peroxide is used to treat acne not rosacea
What age is hydrocortisone 1% (P) cream licensed from?
2 years
10 years
12 years
16 years
18 years
10
A 70-year-old male patient has severe heart failure due to left ventricular systolic dysfunction for which he has been prescribed a medicine. He was recently admitted into A & E for a systemic fungal infection and he was given amphotericin intravenously. He is currently exhibiting signs of nausea, visual disturbances and arrhythmia.
Which heart failure medication is most likely to be the cause of the symptoms this patient is experiencing?
Bisoprolol
Candesartan
Digoxin
Nebivolol
Valsartan
Digoxin has a narrow therapeutic window. Amphotericin is predicted to increase the risk of digoxin toxicity when given with digoxin. The signs of digoxin toxicity include: confusion, arrhythmias, nausea and visual disturbances. None of the remaining listed drugs interact with amphotericin
Mrs L brings her 6-year-old child into your pharmacy. The child has scabies. The mother would like to purchase a cream, which might stop the child from itching and causing a secondary infection.
Which of the following creams could you recommend for non-prescription supply?
Clotrimazole 1% cream
Cod liver oil and zinc oxide cream (Morhulin®)
Crotamiton cream 10% (Eurax®)
Hydrocortisone cream 1%
Titanium dioxide cream (Metanium®)
Crotamiton cream is recommended for treating scabies infection, other creams are not. Morhulin® and Metanium® are nappy rash creams and hydrocortisone being a steroid is not suitable for children in this setting. Neither is the antifungal agent clotrimazole.
A woman presents to your community pharmacy requesting a painkiller, because she just fell over outside and banged her head. There is no visible blood, and she says she feels otherwise fine. She mentions that she takes warfarin. Her last INR test, from a week ago, was 2.9.
What would you recommend to the patient?
Advise her to take paracetamol tablets
Advise her to take ibuprofen tablets
Advise her to use an ice pack
Advise her to see a doctor immediately
Advise her to see her GP in the morning
The correct answer was Advise her to see a doctor immediately
Patients on current anticoagulant therapy such as warfarin are at a higher risk of internal bleeding. They should be advised to seek immediate medical attention if they suffer a significant blow to the head.
A 15-year-old woman presents to you at a community pharmacy - she has a complaint of a thick white vaginal discharge.
What is the most appropriate course of action in this instance?
Carry out a consultation with the patient and ascertain a recent sexual history to rule out an STI
Inform the patient that they must go to a sexual health clinic as symptoms are indicative of an STI
Refer the woman to her GP
Sell the woman an OTC pessary to use for treatment of vaginal thrush
Sell the woman clotrimazole 1% cream to alleviate external symptoms of vaginal thrush
Refer as below 16
You are working on a hospital ward when you receive a query from a junior doctor. The junior doctor is seeking advice regarding the blood glucose levels of an adult diabetic patient. The patients blood glucose level is reading as 3.5 mmol/L.
What would the best advice to give the junior doctor regarding treatment for the patient?
Allow the patient bed rest as this blood glucose reading is not concerning
Inform the junior doctor that the patient will need fluid and recommend that they prescribe 1 litre of sodium chloride 0.9%
Inform the junior doctor that the patient will need 1 mg of glucagon STAT
Inform the junior doctor that the patient will require a 20% glucose IV infusion
Recommend that the ward nursing staff give the patient a glucogel STAT
The correct answer was Recommend that the ward nursing staff give the patient a glucogel STAT
Initially 10-20 grams of glucose is given by mouth for treatment of a mild hypo. This can be in the form of a glucogel.
A patient, who has a history of alcoholism, has been admitted into hospital after collapsing and complains of a bad headache. Upon screening the patients drug chart, you suspect a potential interaction.
Which of the following medications would you flag to the medical team as having a potential interaction that could have caused the collapse?
Amoxicillin 500 mg TDS
Metronidazole 400 mg TDS
Omeprazole 20 mg OD
Paracetamol 1 g QDS
Thiamine 100 mg OD
A disulfiram like reaction occurs when metronidazole is taken with alcohol
You are training a counter assistant to provide advice to patients.
Regarding head lice, which one of the following statements is true?
Everybody in the same household must be treated
Head lice are able to jump from head to head
Head lice can be detected using a fine tooth comb and a piece of white paper
Head lice infestation is caused by poor hygiene
Head lice only affects children aged 4-11 years
Head lice can be detected using a fine tooth comb and white piece of paper
A 37-year-old woman walks into your pharmacy and mentions that she has a ‘burning feeling’ behind the sternum and a ‘sour taste’ in her throat.
You suspect gastro-oesophageal reflux disease (GORD). Which one of the following risk factors is NOT a trigger factor for GORD?
Ibuprofen
Obesity
Smoking
Stress
Travelling abroad
The correct answer was Travelling abroad
Trigger factors for GORD include: drugs which cause lower oesophageal sphincter relaxation (e.g. calcium channel blockers), smoking, alcohol, obesity and stress.
Opiates are known drugs of abuse. You are running a training work shop to educate community pharmacists on the abuse potential of these drugs.
Which of the following is NOT a symptom of opioid toxicity?
Coma
Pinpoint pupils
Pupil dilation
Respiratory depression
Unconsciousness
Pupil dilation
You want to obtain guidance on prescribing restrictions for podiatrist IP. Which of the following is the most appropriate reference source to use to find this information?
BNF
British Pharmacopoeia
Martindale
MEP
Stockleys
Restrictions by prescriber types are legal requirements and can be found in the MEP
You are training a counter assistant on medicines that may cause a dry mouth.
Which ONE the following is most likely to cause dry mouth?
Ipratropium
Salbutamol
Salmeterol
Terbutaline
Theophylline
Ipratropium is an antimuscarinic drug and therefore can cause dry mouth
You are the on duty pharmacist in a community pharmacy. A 17-years-old woman presents in your pharmacy enquiring about a rash she has developed. You note from her patient medication record that you recently dispensed amoxicillin capsules for her. She tells you that this was for tonsillitis. Her patient medication record suggests she has received amoxicillin before but she states that she has never had a rash like this before now.
What is the most suitable course of action?
Refer the patient to her dentist
Refer the patient to her GP for further investigation and/or treatment
Refer the patient to her GP urgently
Sell the patient a throat lozenge
Send the patient to the Accident and Emergency department
The patient’s symptoms suggest she may have glandular fever and the GP should investigate this further. Patients with glandular fever may experience a rash when given amoxicillin.
