PHAR110 Practice answers 2021

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PHAR110 Practice Exam answers Question 1 (23 marks) There are 10 schedules in the Poisons Standard, S1 to S10. a) Complete the following table by writing the schedule next to the corresponding signal heading, the first one has been completed as an example. (5 marks) Signal heading Schedule None because intentionally blank Schedule 1 Prescription Only Medicine S4 Dangerous Poison S7 Substances of such danger to health as to warrant prohibition of sale, supply and use. S10 Prohibited substance S9 Pharmacy Medicine S2 Poison S6 Prescription Animal Remedy S4 Controlled Drug S8 Pharmacist only medicine S3 Caution S5 b) In the Poisons Schedule thiourea is in Schedule 4 except in preparations containing 0.1 per cent or less of thiourea What is the % w/v of a saturated solution of thiourea? Explain why a saturated solution of thiourea in water (solubility 142 g/L) would or would not be considered an S4 poison? (3 marks) 142 g/L = 142 g/ 1000 mL = 14.2 g/ 100 mL 14.2% w/v Saturated solution would be an S4 poison. Because concentration > 0.1% Question 1(c) is located on the next page 2

PHAR110 Special, Trimester 3 2018 Hydrogen peroxide (excluding its salts and derivatives) is listed in 3 of the Poisons Standard schedules:  Schedule 10 in teeth whitening preparations containing more than 6 per cent of hydrogen peroxide except in preparations manufactured for, and supplied solely by, registered dental practitioners as part of their dental practice.  Schedule 6: except a) when included in Schedule 5; b) in hair dye preparations containing 6 per cent or less of hydrogen peroxide; or c) in other preparations containing 3 per cent or less of hydrogen peroxide.  Schedule 5 a) in hair dye preparations containing 12 per cent or less of hydrogen peroxide except in hair dyes containing 6 per cent or less of hydrogen peroxide; or b) in other preparations containing 6 per cent or less of hydrogen peroxide except in preparations containing 3 per cent or less of hydrogen peroxide. Ibuprofen as a single API is listed in 3 of the Poisons Standard schedules,  Schedule 4 except: a) when included in or expressly excluded from Schedule 2 or 3; or b) in preparations for dermal use.  Schedule 3 a) in divided preparations, each containing 400 mg or less of ibuprofen in a primary pack containing not more than 50 dosage units, when labelled: i) with a recommended daily dose of 1200 mg or less of ibuprofen; and ii) not for the treatment of children under 12 years of age; or b) in a modified release dosage form, each containing 600 mg of ibuprofen in a primary pack containing not more than 32 dosage units, when labelled: i) with a recommended daily dose of 1200 mg or less of ibuprofen; and ii) not for the treatment of children under 12 years of age; except when included in or expressly excluded from Schedule 2.  Schedule 2: in preparations for oral use when labelled with a recommended daily dose of 1200 mg or less of ibuprofen: a) in liquid preparations when sold in the manufacturer’s original pack containing 8 g or less of ibuprofen; or b) in divided preparations, each containing 200 mg or less of ibuprofen, in packs of not more than 100 dosage units except when: i) as the only therapeutically active constituent (other than phenylephrine or when combined with an effervescent agent); ii) packed in blister or strip packaging or in a container with a child-resistant closure; iii) in a primary pack containing not more than 25 dosage units; iv) compliant with the requirements of the Required Advisory Statements for Medicine Labels; v) not labelled for the treatment of children 6 years of age or less; and vi) not labelled for the treatment of children under 12 years of age when combined with phenylephrine. 3

PHAR110 Special, Trimester 3 2018 c) Use the information from the Poisons Schedule provided above to complete the following table. For each product indicate where in the pharmacy it could be stored (front of shop, professional services area, dispensary, safe or nowhere) and if it could be sold (freely, with a prescription or never). At room temperature ibuprofen is a solid and hydrogen peroxide is a liquid. (15 marks) Product Product Schedul e Place stored in pharmacy: front of shop, professional services area, in the dispensary, in the drug safe or nowhere Able to be sold: freely, with a prescription or never A 1 L bottle of 30% w/v aqueous solution of hydrogen peroxide. S6 front of shop freely Gold Cross hydrogen peroxide 6% w/v 100ml. S5 front of shop freely A hair dye containing 8% w/v of hydrogen peroxide chloride. NS front of shop freely Dental Teeth Whitening Kit with 16% Hydrogen Peroxide S10 nowhere never Gold Cross hydrogen peroxide 3% w/v 400ml NS front of shop freely Pack of 30 400mg ibuprofen tablets labelled with a recommended daily dose of 1200mg. S3 professional services area freely A 100g tube of 5%w/v ibuprofen gel. NS front of shop freely Pack of 20 200 mg ibuprofen liquid capsules labelled according to the requirements of the Poisons Schedule. NS front of shop freely Pack of 10 800mg/8mL ibuprofen injection S4 in the dispensary with a prescription Pack of 20 Childrens 2-7 years chewable tablets containing 100mg of ibuprofen S2 professional services area freely 4

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PHAR110 Special, Trimester 3 2018 Question 2 is located on the next page Question 2 (40 marks) Mrs Sweet has a lot of pain from throat cancer that is no longer responding to paracetamol or ibuprofen. Mr Sweet brings the following prescription into your pharmacy for dispensing. Dr John Smith Dr John Smith 69 Dark St 69 Dark St Armidale 2350 Armidale 2350 Dr telephone number 124568 124568 3456 78956 345 4 3456 78956 345 4 Mrs Jane Sweet Mrs Jane Sweet Patient’s address Script date X X Ordine strength of solution Ordine 5mg qqh 5 mg qqh 200 (two hundred) mL 200 (two hundred) mL Dr handwriting medication strength quantity and repeats Dr signature Ordine, is an oral solution of morphine hydrochloride (an S8 active pharmaceutical ingredient). a. Identify the features missing on the prescription above that may affect its legality and explain why each one is needed. (8 marks) 5

PHAR110 Special, Trimester 3 2018 Question 2(b) is located on the next page b. Ordine comes in 4 strengths 1 mg/mL (not on PBS), 2mg/mL, 5 mg/mL or 10 mg/mL. For each strength of Ordine calculate the dose volume Jane would require and the number of doses Jane would obtain from the prescribed quantity. (6 marks) 5mg dose 1mg/mL - 5mL dose – 200/5 = 40 doses 2mg/mL, - 2.5 mL dose – 200/2.5 = 80 doses 5 mg/mL - 1mL dose – 200/1 = 200 doses 10 mg/mL – 0.5 mL dose – 200/0.5 = 400 doses c. Which strength of Ordine would you recommend to Dr Smith and why? (3 marks) Any reasonable justification of choice that relates the choice to the patient 2mg/mL can be measured with measuring cup and spoon and would last over week. 5mg/mL 200 1 mL doses so last longer ok to measure with a syringe 10mg/mL too concentrated for 5 mg dose, hard to measure, might be useful because of small volume if trouble swallowing. taste Illogical reasoning 0 Question 2(d) is located on the next page 6

PHAR110 Special, Trimester 3 2018 d. Write a label for Jane’s medicine assuming the Dr Smith accepts your recommendation and Mr Sweet has agreed to a non-PBS dispensing of any strength. Ensure all the legally required information is included. The recommended Cautionary Advisory labels for morphine are: 1, A* (10 marks) Sedative warning label. Name of product, Directions or Patients name incorrect Name of product, Directions AND Patients name CORRECT Number of errors 9 8 7 6 5 4 3 2 1 0 Marks awarded 1 2 3 4 5 6 7 8 9 10 e. Write the following Latin abbreviations out in full for an adult patient (13 marks) i. i tab od ____ Swallow ONE (1) tablet once daily _______________________ ii. i inj sc 6/12 ____ Inject the contents of ONE (1) syringe subcutaneously every 6 months ____ iii. ii cap tds ac ___ Swallow TWO (2) capsules three times a day before food ______ iv. i inhal qid uf ___ Inhale ONE (1) dose four times a day until finished ____ v. v mL garg qqh prn Gargle FIVE (5) millilitres every four hours when required Question 3 is located on the next page 7 Ordine Oral solution (morphine hydrochloride) 2mg/mL Take TWO and a HALF (2.5) mL by measure every four hours. Mrs Jane Sweet Dr John Smith #1234543 Qty: 200mL Date of exam KEEP OUT OF REACH OF CHILDREN Name, address and phone number of pharmacy

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PHAR110 Special, Trimester 3 2018 Question 3 (15 marks) Reflection is an important part of professional practice. After your experiential visit you were asked to use the Gibbs model of reflection. Using paragraphs and sentences explain how using this model to reflect on experiences contributes to learning and can improve professional practice. Include the names of at least 3 of the model components in your answer. Marking rubric 0 marks 1-2 mark 3-4 marks 5-6 marks 7-8 marks 9-10 marks Jumbled response that does not relate to the topic Limited explanation with 1 component accurately included Explanation shows limited understanding of the role of reflection. At least 2 components included. Explanation show some understandin g of the role of reflection. At least 2 components included. Explanation show some understandin g of the role of reflection. At least 3 components included. Clear explanation that shows good understanding of the role of reflection and includes 3 components of the model. 0 marks 1 mark 2 marks 3 marks 4 marks 5 marks No sentence s used A few sentences. No paragraphs Dot points At least one paragraph and sentences More than one paragraph. English in the sentences can be followed Sentences flow well. Most content relates to the topic. Story flows well and has an introduction and a conclusion. All content relates to the topic. Question 4 is located on the next page 8

PHAR110 Special, Trimester 3 2018 Question 4 (26 marks) WHATSTOPGO and CARER are two commonly used acronyms for the supply of over the counter (OTC) medicines in Australia. a. Choose one of the acronyms and explain how it could be used to safely evaluate the supply of an OTC medicine in a community pharmacy. Include what each element of the acronym stands for in your answer. (10 marks) Answer should include the elements of Ask Assess Advise. Need to 1. establish who the patient is, 2. information about symptoms, 3. if anything has been tried for the symptoms and how effective it was, 4. information about other medications and conditions, 5. that appropriate advice be given to the patient about the medicine, a. how to take it, b. what to do if it doesn’t work. A good answer will include why each of these contributes to safety. No acronym words but answer covers issues 5 or 6 marks Question 4(b) is located on the next page 9 6 4

PHAR110 Special, Trimester 3 2018 b. Write FOUR (4) questions that you would ask a man that came into your community pharmacy and requested something to treat a cough. Relate the reason for each questions to the protocol you used to answer Part a) of this question. (8 marks) 1 mark / questions 1 mark for how each relates to the protocol Full marks need to establish who the patient is, ask about symptoms (severity and length), ask at least one safety question (other conditions/meds) Need at least 2 open questions. Question 4(c) is located on the next page 10

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PHAR110 Special, Trimester 3 2018 c. You recommend Advil Children’s Pain & Fever Relief (contains 100 mg of ibuprofen in 5 mL) to treat a fever. The suggested dosage is 5-10 mg/kg/dose; which may be repeated every 6-8 hrs (max 4 doses/24 hrs). Children 2-< 4 yrs (12-16 kg): 5 mL 4-< 7 yrs (16-22 kg): 7.5 mL 7-< 10 yrs (22-32 kg): 10 mL 10-12 yrs (32-41 kg): 15 mL. Show you full working out for the questions below. i. If the child is 11 years old how many doses would there be in a 250 mL bottle? (2 marks) Dose for 11 year old 15 mL 250/15 = 16.667 so 16 doses ii. Assuming the maximum dose was used, how many days would a 250 mL bottle last? (2 marks) 4 doses/24 hours 16/4 is 4 days iii. What is the percentage strength of ibuprofen in the product? (4 marks) 100 mg/5mL 0.1 g/5mL = 0.2 g/10mL 2 g/100mL so 2% w/v Question 5 is located on the next page 11

PHAR110 Special, Trimester 3 2018 Question 5 (10 marks) The four central objectives of the National Medicines Policy are: 1. timely access to the medicines that Australians need, at a cost individuals and the community can afford; 2. medicines meeting appropriate standards of quality, safety and efficacy; 3. quality use of medicines; and 4. maintaining a responsible and viable medicines industry. a. Explain some of the strategies that are used to facilitate meeting objective 1? (Note the PBS is one component, include in your answer what PBS stands for.) (6 marks) Wide distribution of community pharmacies provides timely access Cost is reduced through Subsidizing of medicines through the PBS (Pharmaceutical benefits scheme). The Australian government subsidizes some of the cost of medicines depending on ability to pay. Government contribution = community contribution so cost has to be worn by the community (Tax payers). Level of subsidy has to reflect this. All people share responsibility for not abusing the subsidy system so as not to put undue cost on the PBS Sharing between governments so not cost shifting. – PBS available through hospitals. Wholesaler contract provide for ready availability of medicines to pharmacies b. Discuss what is meant by quality use of medicines. (4 marks) When medicines are used: • judiciously - medicines, whether prescribed, recommended, and/or self-selected should be used only when appropriate, with non-medicinal alternatives considered as needed; • appropriately - choosing the most appropriate medicine, taking into account factors such as the clinical condition being treated, the potential risks and benefits of treatment, dosage, length of treatment, and cost; • safely - misuse, including overuse and underuse, should be minimised; and • efficaciously - the medicines must achieve the goals of therapy by delivering beneficial changes in actual health outcomes. Please remember - This examination paper MUST BE HANDED IN . Failure to do so will result in the cancellation of all marks for this examination. 12 3 2

PHAR110 Special, Trimester 3 2018 Writing your name and number on the front will help us confirm that your paper has been returned. 13

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PHAR110 Practice answers 2021

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