OTC & Self-Care Flashcards

A patient with type 2 diabetes requests an OTC decongestant for a blocked nose. What is the concern?

Answer: Pseudoephedrine and phenylephrine can raise blood glucose and blood pressure

Oral sympathomimetic decongestants (pseudoephedrine, phenylephrine) can raise blood glucose via glycogenolysis and raise blood pressure, making them unsuitable without medical advice in diabetics.

Which OTC product should be recommended for vaginal thrush?

Answer: Clotrimazole pessary and/or cream (Canesten Combi)

Clotrimazole 500 mg pessary and topical cream (Canesten Combi) is the standard OTC treatment for vaginal candidiasis. Oral fluconazole 150 mg is available as a Pharmacy medicine.

What is the WWHAM mnemonic used for in OTC consultations?

Answer: Who, What, How long, Action taken, Medication — a framework for OTC symptom consultation

WWHAM (Who is it for? What are the symptoms? How long? Action taken? Medicines already taken?) is a structured framework pharmacists use to triage OTC requests and assess appropriateness of self-care.

A 70-year-old patient requests a sleep aid OTC. Which is the most appropriate recommendation?

Answer: Sleep hygiene advice and referral if persistent; avoid sedating antihistamines in elderly

Sedating antihistamines (diphenhydramine, promethazine) are on the Beers Criteria as inappropriate for the elderly due to risks of falls, confusion, urinary retention, and next-day sedation. Sleep hygiene and GP referral are preferred.

A patient asks about using Gaviscon Advance for heartburn. What is its mechanism?

Answer: It forms a raft on top of stomach contents, reducing acid reflux into the oesophagus

Gaviscon Advance contains sodium alginate and potassium bicarbonate, forming a viscous gel raft on top of gastric contents, acting as a physical barrier against reflux into the oesophagus.

Which OTC analgesic is recommended for a patient with chronic renal impairment experiencing mild pain?

Answer: Paracetamol at lowest effective dose

Paracetamol is the safest OTC analgesic in renal impairment (used at lowest effective dose). NSAIDs reduce renal perfusion and worsen CKD. Codeine may accumulate with renally-cleared active metabolites.