PSI Dispensing Practice 4 — Questions and Answers
Question 1: When dispensing eye drops, which key counselling point is most commonly omitted?
- Nasolacrimal occlusion (pressing inner corner of eye for 1 minute) to reduce systemic absorption (Correct answer)
- Instil 2 drops per dose
- Store in the fridge
- Shake before use
Correct answer: Nasolacrimal occlusion (pressing inner corner of eye for 1 minute) to reduce systemic absorption
Nasolacrimal occlusion reduces drainage of eye drops into the nasolacrimal duct, preventing systemic absorption via nasal mucosa. This is especially important for beta-blocker or anti-glaucoma eye drops.
Question 2: For patients on multiple medicines, a Medicines Use Review (MUR) aims to:
- Identify adherence issues, side effects and interactions to optimise therapy (Correct answer)
- Generate additional prescriptions
- Replace the prescriber consultation
- Only check expiry dates
Correct answer: Identify adherence issues, side effects and interactions to optimise therapy
MURs are structured, pharmacist-led consultations for patients on multiple long-term medicines, identifying problems with understanding, adherence, side effects and interactions to improve outcomes.
Question 3: Medicines reconciliation at hospital discharge involves:
- Comparing the patient's pre-admission medicines with discharge medicines to identify unintended discrepancies (Correct answer)
- Only supplying 28-day TTOs
- Having the patient bring in their medicines
- Checking allergies only
Correct answer: Comparing the patient's pre-admission medicines with discharge medicines to identify unintended discrepancies
Medicines reconciliation compares the complete pre-admission medication list with newly prescribed medicines at each care transition, identifying omissions, duplications and changes requiring communication.
Question 4: A Monitored Dosage System (MDS) such as a Dosette box is most appropriate for:
- Patients with poor adherence or cognitive impairment taking multiple medicines (Correct answer)
- All patients as standard
- Patients who only take one medicine
- Children under 5 years
Correct answer: Patients with poor adherence or cognitive impairment taking multiple medicines
MDS organises medicines by time of day and day of week. They are indicated for patients struggling with complex regimens due to cognitive impairment, polypharmacy or disability.
Question 5: Which term describes the practice of using a medicine outside its licensed indication?
- Off-label prescribing (Correct answer)
- Generic substitution
- Unlicensed prescribing
- Therapeutic interchange
Correct answer: Off-label prescribing
Off-label use means prescribing a licensed medicine outside its approved indication, patient group, dose or route. It is legal but requires additional clinical justification and patient counselling.
Question 6: Which question is most useful when assessing if a patient has understood their new antibiotic prescription?
- 'Can you tell me in your own words how you'll take this antibiotic and what to watch for?' (Correct answer)
- 'Did you read the patient information leaflet?'
- 'Do you have any allergies?'
- 'Have you taken antibiotics before?'
Correct answer: 'Can you tell me in your own words how you'll take this antibiotic and what to watch for?'
The 'teach-back' method — asking the patient to explain in their own words — is the most effective way to confirm comprehension, identifying gaps before the patient leaves the pharmacy.
PSI Dispensing Practice 4
When dispensing eye drops, which key counselling point is most commonly omitted?