PHARMACY 301 THE UNIVERSITY OF AUCKLAND SECOND SEMESTER, 2006 Campus: Medical and Health Sciences PHARMACY Pharmacy Practice 3 (Time Allowed: TWO hours) NOTE: This exam is in four parts - Section A, Section B, Section C and Section D. Each section carries the same proportion of marks, Itis recommended that you spend no more than 30 minutes on each section Answer each section in a separate answer booklet. In all questions you are to assume the role of a practising pharmacist. Section A (25 marks) Short answer questions. Answer TWO questions from this section. Section B (25 marks) Short answer questions. Answer TWO questions from this section, Section (25 marks) ‘Long answer question. Answer ONE question from this section. Section (25 marks) Long answer question. Answer ONE question from this section, CONTINUEDPHARMACY 301 SECTION A (25 marks) Answer any TWO (2) of the following three questions. Answer questions in this section in a separate answer booklet It is recommended that you do not spend more than 30 minutes on this section. 1. Outline ALL the steps that you would take when you were dispensing, checking and ‘handing out a prescription containing three prescription items - flucloxacillin 250mg capsules, hydrocortisone 1% cream and Lipex® 20mg to an adult patient. Start from when the patient hands in the prescription and end with the patient leaving the pharmacy with the medicines. Assume all medicines are in stock. List the steps in the order that you would do them. [12.5 marks] You are managing a busy dispensary and you have hired a new inter. Review the label and prescription on Appendix 1 and check these for errors. List any errors that you see and briefly discuss how you would address these with the intern. Assume that the patient is an adult and that the medicine is fully funded. [12.5 marks] 3. A patient with asthma has been prescribed a budesonide turbuhaler and salbutamol inhaler. You have dispensed these items for him before. He has used three salbutamol inhalers during the last month and he is waking to use his salbutamol inhaler at night. Outline the main points that you would discuss with this patient and why you think these points are important. Which step of the six steps of asthma treatment does his therapy represent? [12.5 marks] CONTINUEDPHARMACY 301 SECTION B (25 marks) Answer any TWO (2) of the following four questions. Answer questions in this section in a separate answer booklet It is recommended that you do not spend more than 30 minutes on this section. 4, What is the Pharmacy Self Care Programme, what are the goals of the programme and ‘what benefits does it claim to provide? Give one example of how the Self Care scheme can be used to benefit patients. [12.5 marks] 5. a) List the main types of products / medicines that are available from a community pharmacy ‘over-the-counter’ for customers with constipation. Outline when each type of product is most appropriate, how they should be used and any adverse effects or contra-indications associated with them. [8 marks] b) Recommend a produet for 2 woman who is six months pregnant and has constipation. Explain the reason for your choice. [4.5 marks] 6. A.25 year old woman comes into your pharmacy complaining of “a headache” and asks you for some Paramax®. She has never used it before saying “a friend recommended it for headaches.” What issues are associated with this request? What questions would you ask her in order to make a diagnosis of her headache and why would you ask these questions? Discuss situations when you would refer. [12.5 marks] 7. What are ‘Standard Operating Procedures’ (S.O.Ps) and what is their purpose? Outline, in 2 logical order, the elements you would expect to see on a S.O.P for the sale of Pharmacy Medicines for pharmacy assistants to use. What are the main things that you would need to talk to pharmacy assistants about when you show them the S.0.P? [12.5 marks] CONTINUEDPHARMACY 301 SECTION C (25 marks) Answer any ONE (1) of the following two questions. Answer questions in this section in a separate answer booklet. It is recommended that you do not spend more than 30 minutes on this sectien 8, What is meant by the term critical appraisal? - In your answer: a) Describe how this relates to evidence based medicine in the context of ‘over-the- counter’ (OTC) prescribing in pharmacy. ) Discuss the things that you would evaluste when you are critically appraising a study and why these are important, c) Briefly outline how you would take an evidence based approach to the following request from a patient. ‘One of your regular patients brings you a study which showed a benefit for an OTC product claiming to prevent urinary tract infections and asks you whether you think it is a ‘good product. [25 marks} 9. Recently one of the regular current affairs TV shows did an exposé on pharmacies and described them as ‘retail outlets selling remedies of questionable quality.’ Discuss yout response to this statement, What recommendations would you make to help pharmacists present a more professional image? [25 marks] CONTINUEDPHARMACY 301 SECTION D (25 marks) Answer any ONE (1) of the following two questions. ‘Answer questions in this section in a separate answer booklet. It is recommended that you do not spend more than 30 minutes on this section. 10, You are a pharmacy manager and one of your regular patients is on a number of medicines. She has angina, osteoarthritis, Type II diabetes and asthma. She is overweight and takes FIVE oral medicines and TWO inhalers for her conditions. Tn your answer; a) Discuss some of the issues faced by patients with multiple chronic medical conditions. Discuss BOTH medication related and lifestyle issues. >) From your knowledge of these conditions provide specific examples of issues that are more likely to affect this particular patient. ©) What could you recommend as a pharmacist to help improve quality of life for this patient? [25 marks] 1. You manage a community pharmacy and you decide to focus on helping your patients to quit smoking during the month of Jamuary just after New Year. In your answer a) Briefly outline the issues for health professionals trying to help people quit smoking. b) Describe the tools or techniques available to assist health professionals as well as the products available to assist patients. ©) Discuss how you would make people aware of this service. 4) Describe any issues which might need to be addressed in order to provide a ‘quality service”. (25 marks] CONTINUEDPHARMACY 301 APPENDIX 1 Preseription for QUESTION 2 Cree st Py nt yO eet eric ister bre Mist Mb Dr (tee oe) Fe Fuleeeanl ano oa Siaewaae sackived 1 im pare R, Locoid ointment 0.1% . Sig Ap ba 3) LUCOID TIPOGREAM 11% Mitte 100g APELY lg. pe TICE say Mr Chris Farina $800 200.0 268906 Dew wae Da 2? Sept tos Peer helene Wally Were Dips. hada yen en