GPhC OTC & Self-Care 4 — Questions and Answers
Question 1: A customer requests treatment for cold sores on their lip. Which OTC product is most effective?
- Aciclovir 5% cream (Zovirax) applied at first sign of tingling (Correct answer)
- Chloramphenicol ointment
- Hydrocortisone cream
- Antiseptic lip balm
Correct answer: Aciclovir 5% cream (Zovirax) applied at first sign of tingling
Aciclovir 5% cream is the antiviral OTC treatment for herpes labialis (cold sores). It must be applied at the earliest prodromal sign (tingling) for maximum effect, before vesicle formation.
Question 2: A mother asks if her 2-year-old can take OTC cough medicine. What is the correct advice?
- OTC cough and cold medicines are not recommended for children under 6 years (Correct answer)
- Pholcodine linctus is appropriate
- Codeine linctus can be used
- Adult dose divided by 4 is safe
Correct answer: OTC cough and cold medicines are not recommended for children under 6 years
MHRA guidance states that over-the-counter cough and cold medicines should not be used in children under 6 years. Most are ineffective and may cause harm. Supportive care is recommended.
Question 3: Which OTC product is used for the treatment of scabies?
- Permethrin 5% cream (Correct answer)
- Hydrocortisone 1% cream
- Clotrimazole cream
- Fusidic acid cream
Correct answer: Permethrin 5% cream
Permethrin 5% cream (Lyclear Cream) is first-line OTC treatment for scabies. The whole body (excluding face) must be treated and all household contacts treated simultaneously.
Question 4: A patient taking SSRIs asks about taking St John's Wort for additional mood support. What is the critical interaction?
- Serotonin syndrome risk — both increase serotonin, a potentially life-threatening combination (Correct answer)
- No interaction with modern SSRIs
- St John's Wort reduces SSRI absorption only
- Beneficial combination that can replace one SSRI
Correct answer: Serotonin syndrome risk — both increase serotonin, a potentially life-threatening combination
St John's Wort has serotonergic activity. Combined with an SSRI, it can precipitate serotonin syndrome (hyperthermia, clonus, agitation, tachycardia), which can be life-threatening.
Question 5: What is the OTC age restriction for selling aspirin in the UK?
- Not recommended under 16 years due to Reye's syndrome risk (Correct answer)
- Not recommended under 6 years
- No age restriction applies
- Not recommended under 12 years only
Correct answer: Not recommended under 16 years due to Reye's syndrome risk
Aspirin is contraindicated in children under 16 years (under 18 in some guidelines) due to the risk of Reye's syndrome — a rare but potentially fatal condition causing liver and brain damage.
Question 6: A customer is buying paracetamol and codeine OTC (co-codamol 8/500). What advice must be given?
- Not to be taken for more than 3 days without medical advice; risk of codeine dependence and constipation (Correct answer)
- Can be taken indefinitely as it is OTC
- Take double dose for severe pain
- Safe to take with other paracetamol-containing products
Correct answer: Not to be taken for more than 3 days without medical advice; risk of codeine dependence and constipation
OTC co-codamol should not be used for more than 3 days without medical review due to codeine dependence risk and constipation. Patients must also be warned against combining with other paracetamol products.
GPhC OTC & Self-Care 4
A customer requests treatment for cold sores on their lip.
Which OTC product is most effective?