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Patient Counselling & Drug Interactions Flashcards

5 cards from real PSI practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 5 Patient Counselling & Drug Interactions flashcards as text

  1. Which patient group should always be asked about allergies before dispensing amoxicillin?

    Answer: All patients — particularly those with known penicillin or cephalosporin allergy

    Penicillin allergy affects 8–10% of patients; ~1% cross-react with cephalosporins. Asking about penicillin, amoxicillin and related antibiotic allergy before dispensing is mandatory to prevent potentially fatal anaphylaxis.

  2. Which drug interaction causes 'serotonin syndrome' when tramadol is co-prescribed with an SSRI?

    Answer: Additive serotonergic effect — tramadol inhibits serotonin reuptake in addition to opioid activity

    Tramadol is both a mu-opioid agonist and a serotonin/noradrenaline reuptake inhibitor. Combined with SSRIs, the serotonergic burden increases risk of serotonin syndrome (hyperthermia, clonus, agitation, autonomic instability).

  3. A patient on carbamazepine is prescribed the oral contraceptive pill. The pharmacist should advise:

    Answer: Carbamazepine induces CYP3A4 reducing OCP efficacy — additional contraception or higher-dose OCP/alternative is needed

    Carbamazepine is a potent CYP3A4 inducer, increasing metabolism of oestrogen and progestogen in the OCP. Plasma levels fall significantly, reducing contraceptive efficacy. A non-hormonal or IUD method is recommended.

  4. Which approach best supports medication adherence in an elderly patient with multiple daily medicines?

    Answer: Simplify regimen, use once-daily formulations where possible, provide clear labelled blister packs, and arrange regular medicine reviews

    Regimen simplification, modified-release formulations, compliance aids, and regular review all improve adherence in older patients. Complexity is the biggest adherence barrier — reducing the number of daily doses helps significantly.

  5. A patient taking spironolactone asks to buy a potassium supplement. The pharmacist should advise:

    Answer: Avoid routine potassium supplementation — spironolactone already raises potassium, and additional potassium risks hyperkalaemia

    Spironolactone is a potassium-sparing diuretic — it retains potassium. Additional supplementation risks serious hyperkalaemia (cardiac arrhythmia, cardiac arrest). The combination is contraindicated unless medically directed.