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A87 B Buscopan is a branded preparation containing hyoscine butylbromide, an antimuscarinic agent that reduces gastrointestinal motility. Antimuscarinic agents are contraindicated in cases of angle-closure glaucoma as they may aggrevate the condition. Hyoscine butylbromide is a quaternary ammonium compound, unlike atropine, which is a tertiary ammonium compound. Quaternary ammonium compounds are less lipid-soluble and therefore tend to cause fewer central atropine-like side-effects, whereas peripheral side-effects are more common. A88 B Bactroban is the trade name for the topical preparation containing mupirocin. Bactroban is available as nasal ointment or skin ointment.

Mupirocin is very effective for treating skin infections caused by Gram-positive organisms but it is not active against Gram-negative microorganisms.

Mupirocin should not be used for longer than 10 days, to avoid development of resistance.

Aspirin may cause gastrointestinal bleeding through its cyclo-oxygenase-1 interference. The concomittant administration discount pharmacy phentermine purchase of warfarin and aspirin potentiates the risk of bleeding; moreover, internal haemorrhage is very dangerous.

A90 C Digital thermometers are safer to use in children than glass thermometers as there is no risk of the glass being broken. A91 A Elderly patients must be started on the lowest possible dose of diuretics as they tend to be more susceptible to their side-effects, such as postural hypotension.

A92-94 The use of topical antifungal agents (imidazole antifungals and terbinafine) is the first-line of treatment in athlete's foot. Patients should be advised to be persistent in treatment and that application of the product should be continued for about 10 days after all traces have disappeared.

Patient should be educated on non-pharmacotherapeutic measures and adjunctive therapy that contribute towards the management of the condition. The area should be washed regularly and dried thoroughly as fungal infection predominates in moist environments. The use of tolnaftate powder as a dusting powder for shoes and socks limits re-infection from contaminated footwear. A92 2 A93 1 A94 3 A95 E Diuretics such as bendroflumethiazide tend to cause gout, a condition characterised by a red, swollen great toe caused by the deposition of uric acid at the metatarsophalangeal joint. A96 D Gout is a common side-effect of diuretics such as bendroflumethiazide. A97 A Management of an acute attack of gout involves the use of high doses of nonsteroidal anti-inflammatory agents (NSAIDs). Colchicine is useful in patients with heart failure where the use of NSAIDs is contraindicated because of water retention. Allopurinol and other uricosuric agents are not indicated discount pharmacy phentermine purchase for acute attacks as they may aggravate the condition.

The use of an intra- articular corticosteroid injection in gout is unlicensed. A98 E Increasing fluid intake would help flush out urinary tract infections. A99 A Ciprofloxacin is a quinolone active against both Gram-positive and Gram- negative organisms. All quinolones must be used with caution in patients taking non-steroidal anti-inflammatory agents as the concurrent administration of the two agents may lead to convulsions. Common side-effects of quinolones include nausea, vomiting and dyspepsia.

A100 C Urinary tract infections are very commonly caused by Gram-negative bacteria such as Escherichia coli,the Proteus species and Pseudomonas species. Test 4 Questions Questions 1-5 Directions: Each of the questions or incomplete statements is followed by five suggested answers.

Q1 The Summaries of Product Characteristics (SPCs): A are issued by a medicines regulatory agency B have to be updated every year C are intended for patients' use D are the same for generic formulations as for the originator products E reflect information in the marketing authorisations of medici nal products changing an adult oral dosage form to a liquid formulation for administration to a paediatric patient use of a generic formulation instead of the originator product a request to the manufacturer for a specific amount of product for a one-time use the use of therapeutically equivalent licensed products the use of a product that is licensed with EMEA Q2 Unlicensed use of a medicine applies A B C D E Q3 Suspected adverse reactions: Aare reported by health professionals directly to the European medicines agency B may be reported only by pharmacists C to any therapeutic agent should be reported Dshould be immediately disseminated to the media to alert the public E should new phentermine buy cheap pharmacy phentermine usa discount pharmacy phentermine purchase be investigated by the regulatory body and, if necessary, the drug should be withdrawn prior to informing the marketing authorisation holder Q4 Methadone: A has a long duration of action B is only available for parenteral administration C is an opioid antagonist D is not addictive Edoes not present the risk of toxicity in non-opioid dependent adults Q5 The following statements are all applicable for a community phar macy EXCEPT: A premises are easily accessible to the public B walls, floors, ceilings and windows are kept clean in such manner that any surfaces present shall be impervious and may be easily wiped clean C the premises have a clear area set aside for the preparation and compounding of medicinal products and discount pharmacy phentermine purchase diagnostic testing Dall pharmaceutical and non-pharmaceutical waste and expired and deteriorated products are to be segregated from pharmacy stock E shop window is unobstructed when the pharmacy is closed to ensure that external appearance reflects the professional character of the pharmacy Questions 6-15 Directions: Each group of questions below consists of five lettered headings followed by a list of numbered questions.

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