A female patient, aged 57 years old, is currently prescribed paracetamol 500mg tablets

and tramadol 50mg capsules. Her GP starts her on a new medication. Which of the following

drugs would you be most concerned about, if taken concurrently with her current

medication?

A 29-year-old female patient has schizophrenia. The patient smokes around 20 cigarettes

and drinks two litres of cider (5% ABV) each day. She has previously been prescribed

quetiapine and haloperidol, but both have failed in getting her symptoms under control. The

specialist would like to start prescribing clozapine. Which of the following is the most

appropriate advice to give to this patient concerning her new prescription?

Ulipristal (ellaOne) is licensed to be sold for unprotected sexual intercourse in which of the

following age ranges?

A 62-year-old male patient is diagnosed with early stage Parkinson’s disease after being

seen by a specialist for symptoms of tremor and rigidity that were significantly impacting his

quality of life. He takes no regular medication and has no known drug allergies. Which of the

following is the most appropriate treatment to initiate for this patient?

You are a practice pharmacist undertaking a structured medication review. You speak to a

56-year-old patient who tells you she has put on a lot of weight in the past six months. She

explains she does not feel like she can control her appetite and tends to binge eat, especially

at night. Which of the following medications prescribed to the patient may be contributing to

this behaviour?

An 85-year-old care home patient has been admitted to hospital with

increasing confusion and dizziness following a fall. The patient has

advanced dementia and had become increasingly agitated in the

care home so the GP decided to prescribe a medication to manage

this agitation. Which medication is most likely to be associated with

the patient’s fall?

You receive a prescription for a female patient, aged 34 years old,

with pyelonephritis. The prescription is for ciprofloxacin 500mg

tablets, ONE to be taken TWICE a day for 7 days. Which of the

following medications, that the patient is usually prescribed, would

you be most concerned about if taken concurrently with

ciprofloxacin?

A 32-year-old male with type 1 diabetes has presented to your

pharmacy asking for advice relating to his diabetes. He is currently

being treated for a chest infection and understands he needs to enforce temporary changes to his diabetes management. Which of

the following would be inappropriate to recommend?

A patient has newly been prescribed domperidone for nausea and

vomiting. You decide to contact the prescriber over concerns

surrounding the prescribing of domperidone alongside which of his

regular medications?

The Medicines and Healthcare products Regulatory Agency (MHRA)

asks for which one of the following to be reported via the yellow card

scheme?

Following a medication review, you have noted that your patient has not been offered Vitamin D

supplementation. You request for a vitamin D level to be taken.

Select the drug the patient is most likely to be taking.

What counselling would be most appropriate to provide to this patient

about their new prescription for lansoprazole?

A 59-year-old patient presents at A&E with shortness of breath. The

consultant diagnoses him as having a DVT and decides to start

rivaroxaban. Which of the following is the most suitable dose for this

indication?

You are reviewing the prescribing of anti-epileptic medications as part

of an audit. You are assessing the prescribing habits of these

medications in women of child-bearing potential. Which of the

following anti-epileptic medications would be most appropriate to

prescribe in women of child-bearing potential?

You receive a prescription for a female patient, aged 34 years old,

with pyelonephritis. The prescription is for ciprofloxacin 500mg

tablets, ONE to be taken TWICE a day for 7 days. Which of the

following medications, that the patient is usually prescribed, would

you be most concerned about if taken concurrently with

ciprofloxacin?

Mrs L has been initiated on sodium valproate to take in addition to lamotrigine for the

management of epilepsy. Whilst collecting the prescription, Mrs L enquires about suitable dietary

supplements to boost her nutritional intake as she is hoping to start a family in the near future.

Mrs L has no known allergies and does not take any other medication.

Which of the following would be the most appropriate course of action?

You are the GP practice pharmacist, and you are conducting a review with 53-year-old Mrs. Z

who is taking Co-careldopa 25/100mg, one tablet three times daily. She explains to you that she

has been feeling nauseous recently and would like a treatment for it.

Which of the following antiemetics would you recommend to Mrs Z’s doctor to prescribe?

Your GP practice is conducting a meeting to review the prescribing of antiepileptic

medication to help consider if any cost-reducing measures can be introduced to improve the

efficiency of the care being provided.

One proposal that was suggested is that all antiepileptic medication are prescribed as generic

products as this would reduce prescribing costs and improve accessibility of medication from the

pharmacy.

Which of the following medications must be prescribed by brand-name?

A 46-year-old woman presents at the pharmacy on a Sunday afternoon whilst you are working as a locum. She explains that she has epilepsy and has run out of her phenobarbital tablets.

With her consent, you access her Summary Care Record (electronic health record) and confirm

that this medication is on her repeat.

Which of the following options is the most appropriate next action to take?

Mr Y is a 65-year-old patient with epilepsy who has come in today for a medication review. He

tells you he is having unpleasant side effects with his generic lamotrigine tablets and would like

to try the branded version which he used to take. You are aware that antiepileptic drugs have

been divided into three risk-categories to help decide whether a change is possible or if a

specific product must be maintained.

Which of the following responses would be most appropriate for you to give Mr Y?

Which chronic adverse effect is particularly associated with Carbamazepine due to its effect on

ADH secretion, leading to electrolyte imbalance?

A 75-year-old patient has started on Sertraline 50mg daily. Which of the following parameters should the pharmacist advise the prescriber to monitor closely in the first few weeks, especially given the patient's age?

A patient is taking Phenelzine (a non-selective Monoamine Oxidase Inhibitor, MAOI) for depression. They start taking an over-the-counter cold remedy containing Pseudoephedrine. Which serious adverse event is the patient at highest risk of experiencing?

Which of the following is a key characteristic triad associated with Serotonin Syndrome?

Which class of antidepressant carries the highest risk of cardiotoxicity in overdose and requires caution in patients with pre-existing cardiac disease, necessitating an ECG before initiation in some cases?

A patient with significant anxiety symptoms and pre-existing hypertension requires an antidepressant. Which agent should generally be avoided or used with caution due to the risk of dose-related blood pressure increase?

A patient with major depressive disorder also suffers from chronic neuropathic pain. Which antidepressant would be the most appropriate first-line choice, as it is licensed for both conditions?

Which specific non-motor symptom of Parkinson's disease is often managed using Rotigotine patch due to its continuous, non-pulsatile dopaminergic stimulation, which can help regulate circadian rhythms?

A 25-year-old female patient, taking Carbamazepine for focal seizures, is also using a combined hormonal contraceptive pill. Which counselling point must the pharmacist give regarding this combination?