GPhC OTC & Self-Care

Question 1

A mother asks for something to treat her 4-year-old child's fever. Which product is most appropriate?

Accepted Answer

Paracetamol suspension (120 mg/5 mL) or ibuprofen suspension

Answer

Paracetamol (120 mg/5 mL) and ibuprofen suspensions are appropriate for children aged ≥3 months. Aspirin is contraindicated under 16 (Reye's syndrome risk). Adult formulations are inappropriate doses.

Question 2

A customer asks about using ibuprofen for their cold symptoms. Which patient should NOT receive ibuprofen without medical advice?

Accepted Answer

A patient with a history of peptic ulcer disease

Answer

NSAIDs like ibuprofen are contraindicated or cautioned in patients with peptic ulcer disease due to risk of GI bleeding and mucosal damage through prostaglandin inhibition.

Question 3

What is the recommended first-line OTC treatment for head lice in the UK?

Accepted Answer

Dimeticone (Hedrin) — physical insecticide coating

Answer

NICE and PHE recommend dimeticone (e.g., Hedrin) as first-line for head lice. It physically coats and suffocates lice, avoiding insecticide resistance issues. Wet combing is an alternative if no products preferred.

Question 4

A customer requests emergency hormonal contraception. They had unprotected sex 60 hours ago. Which product is appropriate?

Accepted Answer

EllaOne (ulipristal acetate 30 mg) — effective up to 120 hours

Answer

Levonelle is licensed up to 72 hours, but is less effective after 72 hours. EllaOne (ulipristal) is licensed and effective up to 120 hours post-intercourse, making it the appropriate choice at 60 hours.

Question 5

A patient taking ibuprofen OTC also takes warfarin. What advice should the pharmacist give?

Accepted Answer

Avoid ibuprofen — recommend paracetamol instead; ibuprofen increases bleeding risk

Answer

NSAIDs including ibuprofen displace warfarin from protein binding and inhibit platelet function, significantly increasing bleeding risk. Paracetamol is the safer OTC analgesic choice for anticoagulated patients.

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GPhC OTC & Self-Care