GPhC OTC & Self-Care 2 — Questions and Answers
Question 1: A patient asks for Chloramphenicol eye drops OTC. When should they be referred to a GP?
- If symptoms do not improve within 2 days or if vision is affected (Correct answer)
- Only if both eyes are affected
- Never — chloramphenicol eye drops are always safe OTC
- Only if the patient is over 60
Correct answer: If symptoms do not improve within 2 days or if vision is affected
OTC chloramphenicol is for bacterial conjunctivitis. Failure to improve within 2 days, pain, visual disturbance, photophobia, or contact lens wear requires GP referral for further assessment.
Question 2: Which OTC antihistamine is least sedating and therefore preferred for daytime use?
- Loratadine or cetirizine (second-generation antihistamines) (Correct answer)
- Chlorphenamine (Piriton)
- Promethazine
- Diphenhydramine
Correct answer: Loratadine or cetirizine (second-generation antihistamines)
Second-generation antihistamines (loratadine, cetirizine, fexofenadine) have poor CNS penetration and minimal sedating effects, making them suitable for daytime use without impairment.
Question 3: A customer requests omeprazole OTC for heartburn. For how long is it recommended before GP review?
- Up to 4 weeks; refer if no improvement or symptoms persist beyond 4 weeks (Correct answer)
- Indefinitely without GP review
- Only for 2 days
- It should never be used OTC
Correct answer: Up to 4 weeks; refer if no improvement or symptoms persist beyond 4 weeks
OTC omeprazole (Nexium Control, Pyrocalm) is licensed for up to 4 weeks for adults with symptomatic gastro-oesophageal reflux. Persistent or worsening symptoms beyond 4 weeks require GP review.
Question 4: Which OTC product is appropriate for the treatment of athlete's foot (tinea pedis)?
- Clotrimazole cream (Canesten) (Correct answer)
- Hydrocortisone 1% cream
- Chloramphenicol ointment
- Fusidic acid cream
Correct answer: Clotrimazole cream (Canesten)
Clotrimazole is a topical imidazole antifungal effective against dermatophytes causing athlete's foot. Hydrocortisone is inappropriate (immunosuppressant, worsens fungal infection).
Question 5: What is the recommended maximum OTC dose of ibuprofen per day for an adult?
- 1200 mg per day (400 mg three times daily) (Correct answer)
- 3200 mg per day
- 600 mg per day
- 800 mg three times daily
Correct answer: 1200 mg per day (400 mg three times daily)
The OTC maximum for ibuprofen is 1200 mg/day (400 mg three times daily). Prescription doses can go up to 3200 mg/day under medical supervision. OTC use is intended for short-term mild-to-moderate pain.
Question 6: A customer requests treatment for oral thrush. Which OTC product is first-line?
- Miconazole oral gel (Daktarin) or nystatin suspension (Correct answer)
- Chlorhexidine mouthwash
- Amoxicillin
- Hydrocortisone pellets
Correct answer: Miconazole oral gel (Daktarin) or nystatin suspension
Miconazole oral gel (Daktarin 2%) is the first-line OTC antifungal for oral thrush (candidiasis). Nystatin suspension is also used but is prescription-only in some formulations.
GPhC OTC & Self-Care 2
A patient asks for Chloramphenicol eye drops OTC.
When should they be referred to a GP?