OTC

Question 1

Paediatric doses for Paracetamol

Answer 1

• Child 1–2 months
  30–60 mg every 8 hours as required, maximum daily dose to be given in divided doses; maximum 60 mg/kg per day.
• Child 3–5 months
  60 mg, every 4–6 hours; maximum 4 doses per day.
• Child 6–23 months
  120 mg, every 4–6 hours; maximum 4 doses per day.
• Child 2–3 years
  180 mg, every 4–6 hours; maximum 4 doses per day.
• Child 4–5 years
  240 mg, every 4–6 hours; maximum 4 doses per day.
• Child 6–7 years
  240–250 mg, every 4–6 hours; maximum 4 doses per day.
• Child 8–9 years
  360–375 mg, every 4–6 hours; maximum 4 doses per day.
• Child 10–11 years
  480–500 mg, every 4–6 hours; maximum 4 doses per day.
• Child 12–15 years
  480–750 mg, every 4–6 hours; maximum 4 doses per day.
• Child 16–17 years
  0.5–1 g, every 4–6 hours; maximum 4 doses per day.

Question 2

Paediatric doses for Ibuprofen

Answer 2

• Child 1–2 months
  5 mg/kg 3–4 times a day.
• Child 3–11 months
  50 mg 3 times a day
• Child 1–3 years
  100 mg 3 times a day
• Child 4–6 years
  150 mg 3 times a day
• Child 7–9 years
  200 mg 3 times a day
• Child 10–11 years
  300 mg 3 times a day
• Child 12–17 years
  Initially 300–400 mg 3–4 times a day; maintenance 200–400 mg 3 times a day, increased if necessary up to 600 mg 4 times a day.

Question 3

Codeine
1. Age limit
2. Contraindications
3. Max duration OTC

Answer 3

1. Age limit:
   12 years
2. Contraindications
   Afro-carribean (ultra-rapid metabolisers)
   Children < 18 who have had their tonsils removed
3. Max duration OTC
   3 days

Question 4

Laxatives- what are the different types and how long do they take to work?

Answer 4

1. Bulk- forming (e.g., Fybogel)
   2-3 days
2. Osmotic (e.g., Laxido and Lactulose)
   2-3 days
3. Stimulant (e.g., Senna and Bisacodyl)
   6-12 hours
4. Softeners (e.g., Docusate)
   Enema: 5-20 minutes

Question 5

Loperamide- age limit

Answer 5

• Over 12 years OTC
• Over 4 years with prescription

Question 6

Legal restrictions of Pseudoephedrine sales

Answer 6

1. Cannot sell a product or combination of products that contain more than:
   720mg of Pseudoephedrine
   180mg of Ephedrine
2. Cannot sell any pseudoephedrine product at the same time as a ephedrine product

Question 7

CD Classifications

Answer 7

• Schedule 1:
  No therapeutic use
• Schedule 2:
  Opiates (diamorphine, morphine, methadone, oxycodone)
  Phenobarbital and Ketamine
• Schedule 3:
  Buprenorphine, Tramadol, Midazloam, Gabapentin, Pregabalin
• Schedule 4:
  Benzos
• Schedule 5:
  Oramorph, codeine

Question 8

Contraindications for combined hormonal contraception?

Answer 8

• > 50 years (or >35 years and a smoker)
• Uncontrolled hypertension
• Migraine with aura

Question 9

A patient has D&V- when is it considered a missed pill?

Question 10

Adrenaline doses

Answer 10

• 6 months - 5 years: 150mcg
• 6 years - 11 years: 300mcg
• 12 years+: 500mcg

Question 11

Vitamins:
1) Which one should be avoided in pregnancy?
2) Which ones are fat-soluble?
3) Which ones are water-soluble?
4) What are the different subclasses of Vitamin B?

Answer 11

1. Vitamin A
2. Vitamins: A, D, E and K
3. Vitamins B and C
4. B1- Thiamine (Wernickes)
   B2- Riboflavin
   B6- Pyridoxine (Isonizaid-induced peripheral neuropathy)
   B12- Hydroxocobalamin (Megablastic anaemia)

Question 12

What drugs are enzyme inducers?

Answer 12

• Sodium Valproate
• Isonizaid
• Cimetidine
• Ketoconazole
• Fluconazole
• Alcohol (acute)
• Chloramphenicol
• Eryth/ Clarithromycin
• Sulfonamides (Trimethroprim)
• Ciprofloxacin
• Omeprazole
• Metronidazole
• Grapefruit
• Amiodarone
• Verapamil
• Itroconazole
• Diltiazem

Question 13

What drugs are enzyme inducers?

Answer 13

• St. Johns Wart
• Carbamazipene
• Rifampicin
• Alcohol (chronic)
• Phenytoin
• Griseofulvin
• Phenobarbital
• Sulphonylureas

Question 14

What drugs are enzyme substrates?

Answer 14

• Warfarin
• Corticosteroids
• Oral contraceptives
• Aminophylline/ Theophylline
• Statins
• Tricyclic antidepressants