PHARMACYKNOWLEDGE.CO.UK - FREE RPSGB and GPhC UK Pre Reg Past exam paper questions, answers AND revision guide

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We are now working hard to update the site. We are slowly uploading more past exam questions with extended answers. Good luck to all the new pre-reg students.

 

 

OTC
Pharmacy preregistration guide
Thrush/Vaginal Candidiasis

This is another very common problem you will find in the pharmacy, and has appeared in past papers of the pre-registration RPSGB exam various times. Understanding the legal restrictions on the sale of OTC medicines (clotrimazole and fluconazole), and knowledge on when to refer is important. Remember when there is a legal restriction on the sale of an OTC medication this is a sign to refer i.e Clotrimazole is only licensed in the UK for OTC (over the counter) sale for over 16 years old, if the patient is 15 years old then you need to refer to a medical practitioner. Just because it is unlicensed for sale OTC, doesn't mean its unlicensed for a prescriber to prescribe.

Usual symptoms of thrush
itching, soreness, vaginal discharge (odourless), trauma to vagina area (after a recent infection or sexual intercourse)

Thrush symptoms
When to refer:
Age: Under 16 and over 60's
       This is because under 16 are less likely to have thrush and presence of thrush/vaginal candidiasis symptoms may actually be due to something else. Over 60's are particularly susceptible to serious infections and are therefore required to visit the doctor if symptoms occur.
Unusual symptoms: Foul smelling discharge, pain, diarrhoea, fever, other signs of systemic infection,
       These symptoms usually indicate a bacterial infection which has developed after the thrush infection. Remember thrush is due to a fungal infection.

This to look out for:
Fluconazole: may interact with other medication, fluconazole is an enzyme inhibitor (see out section on enzyme inhibitors in the clinical section)

 

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