Patient Counselling & Drug Interactions Flashcards
6 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 6 Patient Counselling & Drug Interactions flashcards as text
Which counselling point is essential for a patient starting bisphosphonate therapy for osteoporosis?
Answer: Take on an empty stomach with a full glass of water, remain upright for 30 minutes, and take calcium/vitamin D at a different time
Bisphosphonates are poorly absorbed and inactivated by food/calcium/dairy. They must be taken on an empty stomach, with plain water only, with 30 minutes upright to prevent oesophageal damage.
A patient taking atorvastatin is started on clarithromycin for a chest infection. The pharmacist should:
Answer: Recommend temporarily stopping atorvastatin during the course — clarithromycin strongly inhibits CYP3A4, raising statin levels and myopathy risk
Clarithromycin is a potent CYP3A4 inhibitor. Combined with atorvastatin (CYP3A4 substrate), plasma statin levels increase substantially, increasing risk of myopathy and rhabdomyolysis. Temporary statin suspension is safest.
Which important counselling point applies to all patients using topical corticosteroids long-term on the face?
Answer: Avoid prolonged use — risk of skin atrophy, telangiectasia, perioral dermatitis and steroid-induced rosacea
Facial skin is thin and absorbs corticosteroids more readily. Prolonged use causes skin thinning (atrophy), visible blood vessels (telangiectasia), and steroid rosacea/perioral dermatitis — all difficult to reverse.
A patient on digoxin for heart failure reports nausea, yellow-green visual disturbances and palpitations. The pharmacist should:
Answer: Suspect digoxin toxicity — advise urgent GP/A&E attendance and not to take another dose
Yellow/green visual disturbances (xanthopsia), nausea and palpitations are classic signs of digoxin toxicity. This requires urgent plasma level measurement and cardiac monitoring — potentially life-threatening arrhythmias can follow.
Which statement is correct regarding generic medicines vs branded medicines when counselling a patient?
Answer: Generic medicines contain the same active ingredient, dose and are bioequivalent — they are equally safe and effective
Generic medicines must demonstrate bioequivalence (within 80–125% of brand AUC/Cmax) before regulatory approval. They contain the same active ingredient and are equally safe and effective.
Which interaction is the basis for advising patients not to take tetracycline within 2 hours of taking a calcium supplement?
Answer: Calcium chelates tetracycline in the GI tract, forming insoluble complexes that reduce tetracycline absorption by 80%
Divalent cations (Ca2+, Mg2+, Fe2+, Al3+) form stable, insoluble chelates with tetracycline molecules in the GI tract, preventing absorption. A 2-hour separation (before) or 4-hour separation (after) is required.