GPhC Clinical Therapeutics & BNF Guidelines 2

Question 1

Which inhaler technique error is most common with a pressurised metered-dose inhaler (pMDI)?

Accepted Answer

Inhaling too fast

Answer

Inhaling too fast is the most common critical error with pMDIs. The aerosol requires a slow, steady inhalation to ensure deep lung deposition.

Question 2

According to BNF, which medication should be avoided in patients with eGFR <30 mL/min/1.73m²?

Accepted Answer

Metformin

Answer

Metformin is contraindicated when eGFR <30 due to the risk of lactic acidosis from drug accumulation in renal impairment.

Question 3

What is the recommended duration of dual antiplatelet therapy after a drug-eluting coronary stent?

Accepted Answer

12 months

Answer

NICE and cardiology guidelines recommend 12 months of dual antiplatelet therapy (aspirin + P2Y12 inhibitor) following drug-eluting stent insertion to prevent stent thrombosis.

Question 4

Which opioid analgesic has the highest oral bioavailability?

Accepted Answer

Methadone

Answer

Methadone has oral bioavailability of approximately 80–95%, significantly higher than morphine (~35%), making it effective orally. It also has a long half-life.

Question 5

A patient with atrial fibrillation and a CHA₂DS₂-VASc score of 2 (male) should receive:

Accepted Answer

Anticoagulation with apixaban or warfarin

Answer

NICE recommends anticoagulation for males with CHA₂DS₂-VASc ≥2. A score of 2 warrants anticoagulation with a DOAC (e.g., apixaban) or warfarin.

GPhC Registration Practice Test

GPhC Registration Practice Test

GPhC Clinical Therapeutics & BNF Guidelines 2