Practical Skills Assessment (PSA) PDF

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Sample steps of Counselling a patient about a drug...

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PHARMACY PRACTICE - 2020/21 PSA COUNSELING EXAM YEAR1.

OPTREX INFECTED EYE DROPS CHLORAMPHENICOL 0.5% EYE DROPS 1) Hello. Good afternoon, sir. My name is Stephenie and I am a student pharmacist. 2) I believe you are here to collect your child’s medication that has been prescribed for his minor eye infection so may I please confirm his name and his address? 3) Right! The purpose of this consultation is to explain and counsel you on how your child is going to use the medication, how it works, some common side effects that might occur and check back for your understanding and ask any questions about them. Is that okay with you? 4) The name of the medication that has been prescribed is Optrex Infected Eye drops (Chloramphenicol 0.5%w/v). 5) This medication contains an antibiotic called chloramphenicol which is commonly used to treat eye bacterial infections called acute bacterial conjunctivitis that affect the front surfaces of the eye. 6) It works by stopping bacterial growth by binding to the bacterial ribosome and protein synthesis.

7) Is your child allergic to any medicines or non-medicines? 8) Apply 1 drop to the left eye every 2 hours for the first 2 days while you are wake. After the first 2 days, then apply 1 drop every 4 hours for 2 days. 9) The course of treatment is 5 days. Keep using these eye drops for 5 days. Do not use Optrex Infected Eye Drops for more than 5 days without consulting your doctor. Discard any remaining eye drops after the 5 day course of treatment.

10)Before use, wash and dry your hands clean and be sure that the seal is not broken, if it is broken, do not use it, return to the pharmacy for assistance. 11) But if not broken, remove the cap from the bottle and Tilt your child’s head back while seated or lying down on his back. Avoid touching the eye with the tip of the bottle. If your child wears soft contact lenses, they should be removed before using the eye drops and wait at least 24 hours before reinserting.

12) Gently pull the lower eyelid downwards and look up to the ceiling. Hold the bottle upside down above the eye and gently squeeze the bottle to release a drop between the lower eyelid and the eye. Take care that the tip of the bottle does not touch his eye, the skin around his eye or your fingers. 13) Close his eyes for a moment of 1 min. Do this procedure during waking hours. 14) Replace and tighten the cap immediately after use. Wipe any excess liquid from the eyes with a clean tissue and wash your hands thereafter. 15) But please remember while applying this eye drop, make sure your child doesn’t breathe on or touch the dropper nozzle or touch his eyes or eyelids with the dropper nozzle and make sure the eye drop is not shared with anyone else. 16) If your child's left eye does not improve within 2 days, please consult your doctor. If it does get worse, seek medical advice immediately. Please do not stop using this medication until his doctor asks you to do so. 17) If you give your child more drops than you should, immediately wash his eyes with plenty of water and speak to his doctor or pharmacist for assistance. Overdose of eye drops cause eye irritation, pain, swelling, tears in the eye. 18) If you forget to use the drops on your child and have only missed a dose for a long time before the next dose is due, put in the missed dose of drops straight away but If you missed the dose some time ago and it is nearly time for your next dose, just put in the next dose of drops at the right time. Never double up on a dose to make up for the one you have missed.

19) Some common side effects; itchiness of the eye, rashes and fever. If these effects get worse, please come back to the pharmacy with your son or immediately consult your doctor.

20) Keep this medication out of sight and reach of your child or children. Store at 2°C to 8°C. Do not use after the ‘use by’ date shown on the bottle. Discard any unused product within 28 days of opening by bringing it back to the pharmacy. Do not dispose through wastewater or household waste.

21) Could I please ask you to repeat back to me what I have said to you? 22) Here is the Patient Information Leaflet (PIL) where you can refer back for further information. 23) Do you have any questions?

Questions; 1. The medication contains 10ml of the drops. The drops contain 0.5% w/v chloramphenicol, which is equivalent to 5mg of chloramphenicol per millilitre. They also contain purified water, boric acid, borax and phenylmercuric nitrate. 2. Manufactured in Nottingham, United Kingdom 3. Talk to your doctor or pharmacist before using this medicine, If your child wears soft contact lenses, they should be removed before using the eye drops and wait at least 24 hours before reinserting. 4. Discard any unused product within 28 days of opening by bringing it back to the pharmacy. Do not dispose through wastewater or household waste.

METFORMIN 500 mg TABLETS 1. Hello. Good afternoon, sir. My name is Stephenie and I am a student pharmacist. 2. Are you picking this up for yourself? So may I please confirm your name and your address? 3. Right! The purpose of this consultation is to explain and counsel you on how to use the medication, how it works, some common side effects that might occur and check back for your understanding and ask any questions about them. Is that okay with you? 4. The name of the medication that has been prescribed is Metformin 500mg tablets 5. This medication is used to treat Type 2 Diabetes which is having a high level of glucose in your blood and Metformin helps to lower your blood glucose to as normal a level as possible. Basically, It works by decreasing blood glucose levels and increasing insulin sensitivity. 6. Are you allergic to any medicines or non-medicines? 7. Take ONE tablet once a day for 7 days with breakfast, then increase to ONE tablet twice a day for 7 days with breakfast and dinner. Thereafter, increase to ONE tablet three times a day with breakfast, lunch and dinner. Do not crush or chew the tablets. Swallow each tablet with a glass of water. 8. Metformin Tablets on its own do not cause hypoglycemia (a blood glucose level which is too low). This means that it will not affect your ability to drive or use machines. However, take special care if you take Metformin Tablets together with other medicines to treat diabetes that can cause hypoglycaemia (such as sulphonylureas, insulin, meglitinides). Symptoms of hypoglycaemia include weakness, dizziness, increased sweating, fast heart beat, vision disorders or difficulty in concentration. Do not drive or use machines if you start to feel these symptoms. 9. Some common side effects are; loss of appetite, diarrhoea or feeling sick. These side effects most often happen at the beginning of the treatment with Metformin Tablets. If symptoms continue, stop taking metformin and talk to your doctor.

10. Avoid excessive alcohol intake while taking Metformin Tablets since this may increase the risk of lactic acidosis. 11. During pregnancy, you need insulin to treat your diabetes. If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine. This medicine is not recommended if you are breast-feeding or if you are planning to breast-feed your baby.

12. Always take this medicine exactly as your doctor has told you. Check with your doctor or pharmacist if you are not sure. Metformin Tablets cannot replace the benefits of a healthy lifestyle. Continue to follow any advice about diet that your doctor has given you and get some regular exercise 13. If you have taken more Metformin Tablets that you should have, you may experience lactic acidosis. Some symptoms of lactic acidosis are vomiting, bellyache (abdominal pain) with severe tiredness, and reduced body temperature or heart beat. If you experience some of these symptoms, you should seek immediate medical attention, as lactic acidosis may lead to coma. Stop taking Metformin Tablets immediately and contact a doctor or the nearest hospital straight away. 14. If you forget to take Metformin Tablets, do not take a double dose to make up for a forgotten dose. Take the next dose at the usual time. 15. Keep this medicine out of the sight and reach of children. This medicinal product does not require any special storage conditions. Do not use this medicine after the expiry date which is stated on the label and carton after 'EXP'. Do not throw away any medicines via wastewater or household waste but return it to the pharmacy. 16. Could I please ask you to repeat back to me what I have said to you? 17. Here is the PIL where you can refer back for further information. 18. Do you have any questions?

Questions;

1. Metformin 500 mg film-coated Tablets are White, round, biconvex film coated tablet, plain on one side and debossed with ‘E7’ on other side with approximate 12 mm in diameter 2. Manufactured in Middlesex, United Kingdom.

3. Avoid excessive alcohol intake while taking Metformin Tablets since this may increase the risk of lactic acidosis. 5. During pregnancy, you need insulin to treat your diabetes. If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine. This medicine is not recommended if you are breast-feeding or if you are planning to breast-feed your baby.

VENTOLIN EVOHALER 1. Hello. Good afternoon, sir. My name is Stephenie and I am the student pharmacist. 2. I believe you are here to collect your medication so may I please confirm your name and your address? 3. Right! The purpose of this consultation is to explain and counsel you on how to use the medication, how it works, some common side effects that might occur and check back for your understanding and ask any questions about them. Is that okay with you? 4. The name of the medication that has been prescribed is 200 dose Ventolin (Salbutamol sulfate) 100microgram/dose Evohaler 5. Ventolin Evohaler contains a medicine called salbutamol which used to treat breathing problems in people with asthma symptoms and similar conditions. It works by relieving asthma symptoms by relaxing the smooth muscle in the airways which allows air to flow in and out of the lungs more easily and therefore it is easier to breath.

6. Are you allergic to any medicines or non-medicines? 7. Inhale ONE or TWO puffs four times a day. 8. Before first use, do a test puff. Remove the mouthpiece cover by gently squeezing the sides with your thumb and forefinger and pull apart. To make sure it works, shake it well while pointing the mouthpiece away from you, press the canister to release two puffs into the air. If you have not used the inhaler for 5 days or more, shake it well and release two puffs of medicine into the air. 9. Before using the inhaler, Remove the mouth cap and check that nothing is inside the inhaler mouthpiece. Shake the inhaler 4 or 5 times. Sit or stand straight and slightly your tilt chin up as it helps the medicines reach the lungs. Breathe out gently and slowly from the inhaler until your lungs feel empty and feel ready to breathe in. Hold the inhaler upright with your thumb on the base, below the mouthpiece. 10. Place the mouthpiece on your lips and make a tight seal around it. Breathe in slowly and steadily, and at the same time, press the canister on the inhaler down and continue to breathe in slowly until your lungs feel full. Remove the inhaler from your mouth with your lips closed and hold your breath and hold your breath for up to 10 seconds and gently breathe out away from the inhaler. Wait for 30 seconds and then shake the inhaler again to repeat for the second puff. This usually acts within 5 minutes as it has a fast onset of action. 11. After use, always replace the cap straight away to keep out dust. Replace the cap by firmly pushing and clicking into position. Rinse your mouth with water and spit it out or brush your teeth after use to reduce the chance of side effects. 12. You can take Ventolin Evohaler at any time of day, with or without food. 13. Some common side effects; Headache, feeling shaky or mouth irritation. These effects usually wear off in a few hours. If your breathing or wheezing gets worse straight after taking this medicine, stop using it immediately, and tell your doctor as soon as possible. 14. If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor, nurse or pharmacist for advice before taking this medicine. 15. Ventolin is not likely to affect you being able to drive or use any tools or machines.

16. If you think this medicine is not working well enough for you, talk to your doctor as soon as possible. Your chest problem may be getting worse and you may need a different medicine. Do not take extra doses of Ventolin Evohaler unless your doctor tells you to do so. 17. If you take more than you should, talk to a doctor as soon as possible. If you forget a dose, take it as soon as you remember it. However, if it is time for the next dose, skip the missed dose. Do not take a double dose to make up for a forgotten dose. 18. Do not stop taking Ventolin Evohaler without talking to your doctor. If you have any further questions on the use of this medicine, ask your doctor, nurse or pharmacist. 19. Keep this medicine out of the sight and reach of children. Store below 30°C. Protect from frost and direct sunlight. If the inhaler gets very cold, take the metal canister out of the plastic case and warm it in your hands for a few minutes before use. Never use anything else to warm it up. 20. To stop your inhaler from blocking, it is important to clean it at least once a week. To clean your inhaler: Remove the metal canister from the plastic casing of the inhaler and remove the mouthpiece cover. Rinse the plastic casing thoroughly under warm running water. Dry the plastic casing thoroughly inside and out. • Replace the metal canister into the plastic casing and put on a mouthpiece cover. Do not put the metal canister in water. 21. The metal canister is pressurised. Do not puncture, break or burn it even when apparently empty. • Do not use this medicine after the expiry date, which is stated on the label and carton after ‘EXP’. The expiry date refers to the last day of that month. 22. Could I please ask you to repeat back to me what I have said to you? 23. Here is the PIL where you can refer back for further information. 24. Do you have any questions?

Questions;

1. Ventolin Evohaler comprises an aluminium alloy sealed with a metering valve, actuator and dust cap. Each canister contains 200 doses of 100 micrograms of salbutamol (as salbutamol sulfate) 2. Manufactured in Spain and France 3. Does Ventolin contain CFC? No 4. If you think this medicine is not working well enough for you, talk to your doctor as soon as possible. Your chest problem may be getting worse and you may need a different medicine. Do not take extra doses of Ventolin Evohaler unless your doctor tells you to do so....