randoms

Question 1

What do w/w, w/v and v/v mean? (short definitions + examples)

Answer 1

w/w (weight/weight): mass of solute per mass of final product (e.g., 1% w/w = 1 g solute per 100 g total). Used for ointments/creams.

w/v (weight/volume): mass of solute per volume of solution (e.g., 1% w/v = 1 g per 100 mL). Used for aqueous solutions.

v/v (volume/volume): volume of liquid solute per volume of final product (e.g., 70% v/v ethanol = 70 mL ethanol per 100 mL product). Temperature affects v/v measurements.

Question 2

Name two laws governing the pharmacy profession in Botswana
Two primary laws/regulatory frameworks:

Answer 2

Medicines and Related Substances Act (MRSA), Cap. 63:04 (2013) and its Regulations (2019) — establishes classification, registration, BoMRA, and controls.

Drugs and Related Substances Act (older/historical controls) / subsidiary regulations — still referenced for schedules and controls (some provisions carried forward). Also the Botswana Health Professions Act and BoMRA guidance documents govern who may practise and the scope.

Question 3

Brief description of prescribing powers in Botswana

Answer 3

Registered medical practitioners and dentists may prescribe all medicines (including Schedule 1 & 2) in the exercise of their profession.

The Director/Authority may authorize limited prescription powers to other cadres (pharmacists, registered nurses, other health personnel) in suitable circumstances (protocols/authorisations).

Prescriptions must meet MRSA requirements (contents, validity periods, record keeping).

Question 4

Who is authorised to make the laws

Answer 4

Parliament enacts primary legislation (e.g., Medicines and Related Substances Act).

The Minister of Health may make subsidiary regulations under the Act;
the Authority (BoMRA) issues guidelines, schedules and enforcement instruments within the statutory framework. In practice:
Parliament → Act; Minister/Authority → Regulations and statutory instruments.

Question 5

When can a prescription be sent by email or facsimile?

Answer 5

MRSA Regulations permit a prescription to be made by telephone, email or facsimile in certain emergency dispensing circumstances — provided that a written (signed) prescription is supplied within 48 hours. The Regulations set quantity limits for emergency supplies and require that the written prescription be produced promptly.

Question 6

Supply of medicines should not exceed 5 days — name three exceptions where more may be supplied

Answer 6

Ointment/cream/aerosol for asthma that is made up in a container elsewhere — dispenser may supply the smallest pack available (may exceed 5 days).

Oral contraceptives: dispenser may supply a full cycle.

If the product package cannot be split practically, the whole package may be supplied

Question 7

Four clinical uses of diazepam
Examples of clinical uses:

Answer 7

Acute anxiety / severe agitation (short-term).

Acute muscle spasm / spasticity (adjunct therapy).

Status epilepticus / acute seizure control (IV/rectal diazepam as emergent benzodiazepine).

Alcohol withdrawal (to control tremor, agitation, prevent seizures) and pre-operative sedation.

Question 8

Name 4 tests used to check the quality of tablets.

Answer 8

Uniformity of weight – ensures correct amount of drug per tablet.

Hardness test – checks mechanical strength.

Friability test – measures tendency to crumble.

Disintegration test – checks how quickly tablet breaks down.

Question 9

Q: Main difference between QC and QA?

Answer 9

A: QC = Detects defects (after production) | QA = Prevents defects (throughout production).

Question 10

Q: What is Quality Control in pharmaceuticals?

Answer 10

A: Product-focused testing to detect defects in finished products (e.g., hardness, dissolution, assay).

Question 11

Q: In tableting, why are granules lubricated with powder? (Give 2 reasons)

Answer 11

Reduce friction between granules and die wall (prevent sticking).

Improve powder flow for consistent die filling.

Question 12

Q: What is Quality Assurance in pharmaceuticals?

Answer 12

A: Process-focused system to prevent defects by improving manufacturing processes (e.g., SOPs, validation, training).

Question 13

Q: Give examples of lubricants used in tableting.

Answer 13

A: Magnesium stearate, stearic acid, talc.

Question 14

After how long should you start ART if the person is on TB treatment with CD4 of 380?

Answer 14

For HIV/TB coinfection, ART initiation depends on CD4 count and TB treatment stage:

CD4 <50 cells/mm³ → Start ART within 2 weeks of starting TB treatment.

CD4 ≥50 cells/mm³ (like here, CD4 = 380) → Start ART within 8 weeks of starting TB treatment.

Exception: If the patient has TB meningitis, ART is delayed until at least 8 weeks (to reduce risk of IRIS).

Question 15

Side effects of the same regimen (TDF/3TC/EFV or AZT/3TC/NVP)

Answer 15

TDF: nephrotoxicity (renal impairment, Fanconi syndrome), reduced bone mineral density.

3TC/FTC: generally well tolerated, but can cause headache, nausea, fatigue, rare pancreatitis.

EFV: CNS side effects (insomnia, vivid dreams, dizziness, mood changes, psychosis in rare cases), rash, hepatotoxicity.

AZT (if used): anemia, neutropenia, GI upset, lipodystrophy.

NVP (if used): hepatotoxicity, severe rash (Stevens-Johnson Syndrome).

Question 16

5. Methyldopa in pregnancy:

Answer 16

acts as a centrally-acting alpha-2 adrenergic agonist, reducing sympathetic outflow and lowering blood pressure by inhibiting norepinephrine release.

✅ Adherence & follow-up is good.
👉 Add: “Common SE include drowsiness, depression, liver toxicity — so monitor LFTs.”

Question 17

Q: What anticoagulants are used to treat deep vein thrombosis (DVT)?

Answer 17

A: LMWH, UFH, warfarin, DOACs (apixaban, rivaroxaban, dabigatran)

Question 18

Q: What is one major administration advantage of enoxaparin over unfractionated heparin?

Answer 18

A: Subcutaneous injection with predictable dosing; no need for continuous IV infusion.

Question 19

Q: How does the pharmacokinetic profile of enoxaparin benefit patients?

Answer 19

A: Longer half-life allows for once or twice daily dosing, making it more convenient.

Question 20

Q: How does the risk of heparin-induced thrombocytopenia (HIT) compare?

Answer 20

A: Enoxaparin has a lower risk of HIT than UFH.

Question 21

Q: Which anticoagulants are used for atrial fibrillation (AF) to prevent stroke?

Answer 21

A: Warfarin, DOACs (apixaban, rivaroxaban, dabigatran, edoxaban)

Question 22

Q: Which anticoagulants are used for pulmonary embolism (PE)?

Answer 22

A: LMWH, UFH, warfarin, DOACs (initial: LMWH/UFH; long-term: warfarin or DOACs)

Question 23

Q: Which anticoagulant is typically used for left ventricular thrombus after MI?

Answer 23

A: Warfarin (usually 3–6 months, sometimes with antiplatelets)

Question 23

Q: Which anticoagulants are used in acute coronary syndromes (ACS)?

Answer 23

A: UFH, LMWH, sometimes bivalirudin (usually combined with antiplatelets)

Question 23

Q: How does monitoring differ between enoxaparin and UFH?

Answer 23

A: Enoxaparin usually does not require routine aPTT monitoring, while UFH requires frequent aPTT checks.

Question 23

Q: Which anticoagulants are used for post-surgical prophylaxis (e.g., hip/knee replacement)?

Answer 23

A: LMWH, UFH, DOACs in select cases

Question 24

Q: What is the risk of bleeding with enoxaparin compared to UFH?

Answer 24

A: Enoxaparin has a lower risk of major bleeding.

Question 25

Counselling tips for asthma inhaler

Answer 25

Demonstrate inhaler technique (shake, breathe out, inhale deeply with actuation, hold breath 10 sec, exhale slowly). Rinse mouth after corticosteroid inhalers (e.g., budesonide, fluticasone) → prevents oral thrush. Carry reliever (SABA e.g., salbutamol) at all times. Preventer (ICS) must be taken daily, even if no symptoms. Know the difference between reliever & preventer inhalers. Advise on spacer use (esp. for children/elderly). Monitor frequency of reliever use → if too frequent, asthma may be uncontrolled.

Question 26

Objectives of BNDP:

Answer 26

Ensure equitable access to essential medicines. Guarantee quality, safety, and efficacy. Promote rational prescribing and dispensing. Strengthen regulatory and distribution systems. Enhance information, training, and DIC support. Implement pharmacovigilance and post-marketing surveillance.