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On 1st April 2019, pregabalin was classified as a controlled drug. This reclassification presented a number of different challenges for prescribers and patients. a) Explain how the reclassification affected patients using the NHS Repeat Dispensing Scheme and suggest a solution. (2 marks)   b) Explain how the change in classification affected prescribers who prescribe the drug privately. (1 mark)   A 38-year-old epileptic patient who takes carbamazepine and pregabalin for epilepsy.  She has been taking both medicines for a number of years and is stable on them, her last seizure being four years ago.  The GP practice where she is registered issues her with a 56-day supply of each medicine on a prescription. c) How will the change in classification of pregabalin practically affect the patient?  (2 marks)

A 23-year-old woman is admitted to hospital with abdominal cramps, epigastric pain, perfuse diarrhoea, fever, tiredness and weight loss. She is newly diagnosed with Crohn’s Disease. PMH Nil of note Medication History Paracetamol 1g QDS PRN (OTC) Ibuprofen 400mg TDS PRN (OTC) Allergies NKDA Social History Occupation: IT Technician in a busy secondary school Smoking History: 7 cigarettes per day Diet: varies depending on work and how much money she has. Doesn’t like cooking so often gets takeaways or ready meals. Drinking: 18 units per week (mainly at weekends) Weight: 66kg   a) What are the possible triggers of this patient’s symptoms?   (3 marks)   Test Results Haemoglobin 9.0                         (11.5 – 16.5g/dL) Red cell count 3.4                         (4.0 – 5.8×1012/L) Packed cell volume 0.31                        (0.37 – 0.47%) Mean cell volume 72                          (76 – 100fL)   b) What do the blood results show and how should they be managed? (2 marks)                

What is A [a]  Name a hormone secreted from this gland [b] What is the function of the hormone [c]

 Which of the following medicines does NOT have to be kept in safe custody?

On the LEFT side:  Name the first digestive organ shown (it is cut and deflected) [a] Name the next digestive organ [b] Name the last DIGESTIVE system organ on the left [c] What digestive system organ has endocrine functions as well [d]

The [1] is also known as the birth canal The [2] produce the eggs and the hormones The [3] is a pear-shaped organ that is the home to a developing fetus The [4] is a small, sensitive protrusion that is comparable to the penis

A 76-year-old woman presents to her GP with low mood, lack of interest in daily activities and insomnia following the loss of her husband.  She is diagnosed with mild depression.  The GP decides to prescribe a tricyclic antidepressant, dosulepin 75mg ON.   Past Medical History Hypertension NSTEMI (2011) Hypercholestrolemia Medication History Aspirin 75mg OD Atorvastatin 80mg OD Ramipril 5mg OD Bisoprolol 2.5mg OD GTN Spray 400microg PRN NKDA Discuss the appropriateness of the GPs choice of first line agent for the patient with reference to NICE guidelines.  (5 marks)                                                                                 

Mr 35-year-old man has arrived on holiday in Kent from his home in Glasgow. When he arrived, he realised that he had forgotten to bring his salbutamol inhaler with him and has come to the pharmacy to ask if he can buy one to last him while he is away from home.   Which of the following is a legal requirement for the pharmacist when deciding whether to make an emergency supply for the patient?

Mrs B is currently 28 weeks pregnant with her second child. She has been diagnosed today with gestational diabetes.   a)  What are the potential risk factors for developing gestational diabetes? (2 marks)   The consultant provides lifestyle advice and monitors the patient over the following weeks. However, 8 weeks later there is no improvement in glycaemic control.   b) What pharmacological options are available for the management of Mrs B’s gestational diabetes? (3 marks)

Name this gland shown [a] Is this an old or young cat [b] How do you know [c] (for Adrien… what I mean by “how do you know” is how do you know that this is an old or young cat? What did you base your answer on… that is what I mean)