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Flashcards in Test Revision Deck (70):
1

What are the two divisions of chronic pain?

Cancer pain
Non-cancer pain

2

Is paracetamol addictive?

No

3

Should you refer a patient with acid reflux with coffee grind vomit and lethargy?

Yes

4

When are H2 antagonists used?

When a prolonged effect is needed

5

Does paracetamol have antipyretic properties?

Yes

6

What is breakthrough pain?

The recurrence of pain in patients already receiving regular analgesia.

7

Is paracetamol associated with gastrointestinal issues?

No

8

Is paracetamol associated with constipation?

No

9

What is Panafen Plus used for?

Strong pain
Headache (migraine, tension)
Neuralgia
Dysmenorrhoea
Dental pain
Back pain
Arthritic pain
Muscular pain
Cold/flu symptoms
Fever

10

Are liquid antacids and alginates safe for use in pregnancy?

Yes

11

Is paracetamol generally safe for use with other medicines?

Yes

12

What is Aspalgin used for?

Pain relief

13

Should you refer a patient with crushing heart pain radiating down the left arm?

Yes

14

What drug classification(s) does Dimetapp Cough Cold/Flu Day Liquid Capsules come under?

Analgesic
Antipyretic
Nonopioid cough suppressant

15

Does paracetamol have anti-inflammatory properties?

Paracetamol is only weakly anti-inflammatory

16

Are antacids containing high quantities of sodium salts are the best option for heart burn in patients with renal failure and heart failure?

No

17

What is the recommended daily dose of ibuprofen?

A typical adult dose of ibuprofen is 200-400mg, every 6-8 hours (max 2400mg / 24h).
Children (> 3 months old) may use 5-10mg/kg, every 6-8 hours

18

What is breakthrough pain mostly associated with?

Chronic pain

19

Select the MOST appropriate statement regarding ibuprofen:
a. Ibuprofen is COX-2 selective NSAID. It therefore an effective anti-inflammatory and has minimal GI side effects.
b. Ibuprofen is safe to use in asthmatics if taken after food
c. Ibuprofen is contra-indicated in asthmatics unless they are using a ventolin inhaler regularly
d. A typical adult dose of ibuprofen for mild to moderate pain is 200-400mg, every 6-8 hours (max 2400mg / 24h). Children (> 3 months old) may use 5-10mg/kg, every 6-8 hours

d. A typical adult dose of ibuprofen for mild to moderate pain is 200-400mg, every 6-8 hours (max 2400mg / 24h). Children (> 3 months old) may use 5-10mg/kg, every 6-8 hours

20

What can be used to treat nociceptive pain?

Non-opioid or opioid analgesics.

21

What is Maxigesic used for?

Headache (migraine, tension) (temporary)
Toothache
Dental procedures
Backache
Sore throat
Arthritis
Tennis elbow
Cold/flu pain
Sinus pain
Period pain
Muscular pain
Rheumatism
Fever

22

Select the MOST appropriate statement regarding Aspirin:
a. Aspirin has two major indications, mild to moderate pain (max 4g daily in divided doses) and as anti-platelet therapy (75-150mg daily).
b. Aspirin is the treatment of choice for patients suffering from gout
c. Aspirin is used in children’s teething gels and is therefore safe to use in children <16 years old
d. Aspirin can safely be combined with ibuprofen and/or diclofenac for greater pain relief

a. Aspirin has two major indications, mild to moderate pain (max 4g daily in divided doses) and as anti-platelet therapy (75-150mg daily).

23

Which is more effective for acute muscle pain: topical ibuprofen or oral ibuprofen?

There is little difference in the effectiveness for acute muscle pain in practice.

24

Is chronic pain always associated with cancer?

No.

25

Does ventolin use in asthmatics reduce ibuprofen contraindications?

Not necessarily

26

Are magnesium salts associated with constipation or diarrhoea?

Diarrhoea

27

Select the LEAST appropriate answer from the following options regarding opioid medicines:
a. Opioids are agonists of endogenous opioid receptors, their pharmacology is complex as there are many receptor subtypes with different effects
b. Codeine is metabolised to morphine the body by CYP2D6, it is the morphine metabolite which provides the majority of its analgesic effect. CYP2D6 distribution varies widely from patient to patient, hence so does the effect of codeine
c. The therapeutic dose of codeine is claimed to be 30-60mg, despite this many over the counter combination products contain between 8 and 12mg of codeine only
d. Codeine is only available to purchase OTC in combination with other painkillers such as paracetamol and ibuprofen. This minimises the risk of opioid addiction and makes these medicines safe to use for all adult patients

d. Codeine is only available to purchase OTC in combination with other painkillers such as paracetamol and ibuprofen. This minimises the risk of opioid addiction and makes these medicines safe to use for all adult patients

28

Select the LEAST appropriate statement regarding paracetamol:
a. Paracetamol has analgesic and antipyretic properties, but is only weakly anti-inflammatory
b. Paracetamol can be used in children (> 1 month old), with a recommended dosage of 15g/kg every 4-6 hours. Max daily dose 90g/kg in divided doses.
c. Paracetamol is very safe at therapeutic dosages, however overdose (>10g/24h) is a major concern, particularly in the presence of alcohol
d. Paracetamol is present in many different over the counter remedies, hence care should be taken to check active ingredients of branded medicines

b. Paracetamol can be used in children (> 1 month old), with a recommended dosage of 15g/kg every 4-6 hours. Max daily dose 90g/kg in divided doses.

29

Can aspirin be combined with diclofenac?

No

30

Is ibuprofen safe for asthmatics if taken after food?

Not necessarily

31

What are adjuvant analgesics mostly used for?

The treatment of chronic and neuropathic pain

32

Does ibuprofen have Gastrointestinal side effects?

Yes.

33

Which of the following sporting injuries may be treated with simple first aid (RICER) without necessarily the immediate need referral for medical attention?
a. A soccer player who has been walking only with the aid crutches for 7 days with no improvement in their right knee injury
b. A netball player who fell on the court earlier today and has numbness in their left hand
c. A long distance runner who tripped on a pavement stone and ‘went over’ on their ankle 30 minutes ago. It is sore and swollen but they are able to weight bear and there is no obvious deformity
d. A hockey player who got hit in the head with a stick earlier today and now has vision problems and feels nauseous

c. A long distance runner who tripped on a pavement stone and ‘went over’ on their ankle 30 minutes ago. It is sore and swollen but they are able to weight bear and there is no obvious deformity

34

Should you refer a patient with acid reflux with difficulty/pain when swallowing ongoing for 3 weeks?

Yes

35

Are Black tarry stools associated with tiredness a common sign of haemorrhoids?

No.

36

When is paracetamol overdose of particular concern?

In the presence of alcohol.

37

What are the five types of laxatives?

Bulking agents
Stool softeners
Lubricants
Osmotic
Stimulants

38

An adult patient has cold and flu type symptoms and is complaining of aching muscles, headache, temperature and a bit of congestion (the pain is the worst symptom) for 3 days. They do not have any other medical conditions and are not taking any other medicines. Which of the following combinations COULD you safely recommend they use the maximum dose (i.e. the max dose of each medicine) of today?
a. Panadol® optizorb tablets, Advil® tablets, aspalgin® soluble tablets and Nurofen® back pain caplets
b. Advil® tablets, Dimetapp® cough, cold+flu, day+night liquid capsules and Panafen® plus caplets
c. Maxigesic® tablets, Aspalgin® soluble tablets, Advil® tablets and Panadeine® tablets
d. Nurofen® back pain tablets, Panadeine® caplets and Dimetapp® DM elixir cough and cold oral liquid

d. Nurofen® back pain tablets, Panadeine® caplets and Dimetapp® DM elixir cough and cold oral liquid

39

How do osmotic laxatives work?

Draw water into the bowel to maintain an iso-osmolar state

40

What is Panadol Optizorb used for?

Headache (tension, migraine)
Backache
Period pain
Toothache
Muscular ache
Arthritis
Osteoarthritis
Cold and Flu
Fever

41

Is paracetamol associated with drowsiness?

No

42

When are antacids used?

When an immediate effect is needed

43

What is the function of bulking agents?

They increase the stool volume to stimulate bowel motility.

44

Which of the following would you NOT generally recommend for an adult female patient who occasionally suffers from migraines?
a. 2-3 soluble paracetamol as soon as her typical ‘prodromal’ symptoms are recognised
b. Waiting until the headache phase before going to the pharmacy to buy some ibuprofen tablets
c. Soluble paracetamol and codeine tablets which she states she has taken on her previous 2 migraines (2 and 6 months ago respectively) with great success at managing the headache phase
d. Rest in a quiet darkened room, avoiding movement and activity

b. Waiting until the headache phase before going to the pharmacy to buy some ibuprofen tablets

45

What is the range of a paracetamol overdose?

Over 10 grams in 24 hours

46

What are Nurofen back pain caplets used for?

Temporary relief of pain and inflammation associated with back pain

47

What is a common way to reduce NSAID use?

Using fish oil and paracetamol

48

What is the mechanism of action for stimulant laxatives?

Stimulate gut movement
May also stimulate water secretion into bowel

49

Which statement BEST completes this sentence. The ideal analgesic:
a. Has a rapid onset of action, high degree of tolerability and works across a wide range of pain types
b. Is available only on prescription, hence a referral is needed.
c. Has only a short duration of action to minimise side effects
d. Must be renally cleared to protect the liver

a.
Has a rapid onset of action, high degree of tolerability and works across a wide range of pain types

50

What should over-the-counter recommendation of NSAIDs be for?

Acute relief only, with a maximum duration of a few days. If longer courses are required, then patients should see a GP

51

What is coffee grind vomit and lethargy a sign of?

Blood loss from peptic ulcers

52

Select the LEAST appropriate answer from the following options regarding the use of NSAIDs in practice:
a. NSAIDs should be taken with or after food to minimise the risk of GI bleeds and hospitalisation
b. Steps should be taken to minimise patient NSAID exposure, such as combination with paracetamol and regularly reviewing NSAID indication
c. OTC recommendation of NSAIDs should be for acute relief only, with a maximum duration of a few days. If longer courses are required then patients should be referred to their GP
d. NSAIDs should be recommend in sub-therapeutic dosages wherever possible as toxicity is dose dependent and needs to be minimised

d. NSAIDs should be recommend in sub-therapeutic dosages wherever possible as toxicity is dose dependent and needs to be minimised

53

Can aspirin be combined with ibuprofen?

No

54

What are Dimetapp Cough Cold/Flu Night time Liquid Capsules used for?

Headaches
Body aches
Pains
Sore throat
Dry irritating coughs Fever
Runny nose
Sneezing
Itchy
Watery eyes

55

Why must aspirin not be given to children under 16 years old?

It is associated with Reye's Syndrome

56

What drug classification(s) does Dimetapp Cough Cold/Flu Night Liquid Capsules come under?

Analgesic
Antipyretic
Nonopioid cough suppressant
Antihistamine

57

Should you refer a headache patient if they have experienced dramatic weight loss?

Yes

58

What would be the first thing you would try if antacids aren't working during pregnancy?

Ranitidine (after consulting with your doctor)

59

Are aluminium salts associated with constipation or diarrhoea?

Constipation

60

What is nociceptive pain?

Stimulation of nociceptors in skin and deep tissue

61

Is it appropriate to recommend sub-therapeutic doses of a medicine?

No.

62

Which of the following patients with headaches are you LEAST likely to be required to refer for medical assistance?
a. An adult patient with a recent dramatic loss in weight
b. A 60 year old patient experiencing their first suspected migraine
c. A baby that has been highly irritable and is now difficult to wake, with cold hands and feet, a rash and a dislike of bright lights
d. An adult women who has bilateral feeling of heaviness ‘like tight band’ around her head for 3 hours. No other symptoms or medical conditions although she has been under stress at work to complete a project deadline

d. An adult women who has bilateral feeling of heaviness ‘like tight band’ around her head for 3 hours. No other symptoms or medical conditions although she has been under stress at work to complete a project deadline

63

Why should NSAIDs be taken after food?

To minimise the risk of gastrointestinal bleeds and hospitalisation

64

What are Dimetapp Cough Cold/Flu Daytime Liquid Capsules used for?

Headaches
Body aches
Pains
Sore throat
Dry irritating coughs Fever

65

What is Advil used for?

Acute pain
Migraine (temporary)
Headache
Arthritis
Rheumatoid Arthritis
Tennis elbow
Period pain
Dental pain
Sore throat
Sinus pain
Cold and flu pain
Fever

66

Does prolonged use of proton pump inhibitors cause gastric ulcers?

No

67

What is a common sign of duodenal ulcers?

Gastrointestinal pain which is initially relieved by eating but then worsens hours later (often during sleeping) may be a sign of a duodenal ulcer. This requires a referral.

68

Do you necessarily need to refer a patient with blood in their faeces?

No.

69

Does paracetamol have analgesic properties?

Yes

70

Select the MOST appropriate statement from the following options regarding pain classification:
a. Acute pain is best managed with long term courses of analgesics to prevent the pain from recurring
b. Chronic pain is only associated with cancer and is best treated with OTC analgesics
c. Breakthrough pain is recurrence of pain in patients already receiving regular analgesia. This is mostly associated with chronic pain
d. Nociceptive pain is usually due to damaged nerve signal transmission and always requires complex treatment with anti-epileptic therapies

c. Breakthrough pain is recurrence of pain in patients already receiving regular analgesia. This is mostly associated with chronic pain