Pharmaceutical Technician Principles of Hospital and Community Pharmacy Practice Examination Notes

THE UNITED REPUBLIC OF TANZANIA

MINISTRY OF HEALTH

PHARMACY COUNCIL

PHARMACEUTICAL TECHNICIAN

PRINCIPLES OF HOSPITAL AND COMMUNITY PHARMACY PRACTICE

PROFESSIONAL EXAMINATION
13TH FEBRUARY, 2024

EXAMINATION CENTER-

INSTRUCTIONS:

  • (a) This paper consists of three Section A, B, and C
  • (b) Write your Examination number on each page of answer sheet used
  • (c) Time allocated for this paper is 3 hours only
  • (d) Answer all questions in section A and B
  • (e) Answer ONLY two questions in Section C
  • (f) All unauthorized materials including electronic devices are not allowed during the examination.

SECTION A: MULTIPLE CHOICE QUESTIONS (10 MARKS)

  • This section consists of TEN questions; Answer ALL questions. Circle the letter of the correct answer.

  1. Ledger is one of the important inventory tools in the management of medicine and medical supplies in the store. One of the key information to be filled when updating the stores ledger after receiving a consignment includes:

    • A. Quantity issued
    • B. Address of supplier
    • C. Quantity received
    • D. Adjustments

  2. Which of the following are topical antibiotic preparations used to treat skin bacterial infections?

    • A. Silver sulfadiazine, mupirocin, and fusidic acid.
    • B. Mupirocin, miconazole, and fusidic acid.
    • C. Silver sulfadiazine, miconazole, and fusidic acid.
    • D. Silver sulfadiazine, fusidic acid, and clotrimazole.

  3. A medication order reads, "Ciprofloxacin tablets PO b.d X 7 days". What essential information is missing from this order?

    • A. Route
    • B. Drug interactions
    • C. Timing
    • D. Dose

  4. It is the task of the pharmaceutical personnel in the hospital pharmacy store to make sure that medicines are properly arranged in order to:

    • A. Prevent stock out
    • B. Prevent piling up of stock
    • C. Prevent expiry
    • D. Prevent sunlight

  5. What is the benefit of stock reconciliation for health commodities in health facilities?

    • A. Reduction of medication errors
    • B. Reduction of inventory pilferage
    • C. Reduction of preventable adverse effects
    • D. Assessment of patient adherence to therapy

  6. A pharmaceutical technician is giving a presentation on medication adherence to a group of clients. Which of the following would be the most appropriate indicator of the effectiveness of the presentation?

    • A. Increase in fill quantity for each prescription refill
    • B. Reduced number of recurred cases
    • C. Reduced number of prescriptions filled per month
    • D. Reduced number of prescription refill dates per month

  7. One of your regular customers comes to the pharmacy to ask for some antihistamines. Which of the following are the main side effects of antihistamines?

    • A. Dry mouth and Blurred vision
    • B. Blurred vision and taste disturbance
    • C. Taste disturbances and dry mouth
    • D. Burning sensation and taste disturbance

  8. How can we minimize adverse drug reactions in clinical settings?

    • A. Avoid all appropriate use of drugs in the context of patient's clinical condition.
    • B. Rule out possibility of drug interactions when only one drug is prescribed
    • C. Use appropriate dose, route, and frequency of drug administration based on patient's specific variables.
    • D. Adopt correct drug administration technique (e.g. intravenous injection of vancomycin must be fast).

  9. Ascariasis management in pregnancy includes the following medication:

    • A. Albendazole
    • B. Mebendazole
    • C. Thiabendazole
    • D. Carbimazole

  10. Which of the following medicines would NOT require a prescription?

    • A. Metronidazole tablets
    • B. Amoxycillin capsules
    • C. Insulin injection
    • D. Clotrimazole cream

SECTION B: SHORT ANSWER QUESTIONS (50 MARKS)

  • Answer ALL questions from this section.
  • Write your answers in the space provided under each question.
  1. Why is it important to use a dispensing register when dispensing medicines in a pharmacy? (Outline four reasons). (8 Marks)
  2. A patient comes to the pharmacy asking for help on how to use her metered dose inhaler (MDI) for acute asthma. Describe to this patient the steps involved in using the device. (06 Marks).
  3. Mwaisa, an 11-year-old boy, presents to a dermatology clinic with superficial fungal infection (dermatophytosis) on the shoulders and arms. Clinical presentation shows enlarging raised annular lesions (with a central area of clearing with fine scales) and hair loss in areas of infection.
    • (a) As pharmaceutical personnel, state three (3) treatment alternatives on proper pharmacological management of the patient as per Standard Treatment Guidelines. (6 Marks)
    • (b) If the body is extensively infected, which medication would be proposed as per Standard Treatment Guidelines? (02 Marks)
  4. A patient from the internal medicine clinic presents a prescription with two medicines (Rabeprazole 20mg b.d for 1/12 and an Antacid suspension).
    • (a) Briefly explain the benefit of each medicine to the patient (4 Marks)
    • (b) Briefly explain the rationale of including both Aluminium hydroxide and Magnesium hydroxide in the antacid preparation. (2 Marks)
    • (c) If the patient was confirmed H. Pylori positive, mention the group of medicine missing in the prescription above? (2 Marks)
  5. A patient visits the community pharmacy that you are working at complaining of painful nodules under her armpit. She says that it started as firm, tender, red nodules and has now become painful and fluctuant (movable and compressible).
    • (a) What do you suspect regarding this patient? (3 Marks)
    • (b) What treatment approaches would be employed to the patient? (4 Marks)
  6. As a pharmaceutical technician on duty in the dispensing unit at Nyarugusu Health Centre, you have received a prescription to dispense medication. You realize that two drugs the customer is taking may interact. What would you do? State three (03) possible ways. (6 Marks)
  7. (a) What lifestyle advice will you recommend to a recently diagnosed patient who is diabetic comorbid with hypertension? (List four advices) (4 Marks)
    • (b) As pharmaceutical personnel, what are the specific antidotes you will recommend for the following overdose scenarios?
    • i. Magnesium injection overdose (1 Mark)
    • ii. Morphine overdose characterized by life-threatening respiratory depression (1 Mark)
    • iii. Isoniazid overdose/toxicity (1 Mark)

SECTION C: LONG ANSWER QUESTIONS (40 MARKS)

  • This section consists of THREE questions. Answer ONLY two (2) questions from this section.

  1. You have been appointed as pharmacy stores in charge at Mikumi District Hospital, a Government-owned hospital with registration number 00500, in Morogoro Region. One of the tasks is to oversee and handle all operations in the pharmacy store including updating of the Stores Ledger for each health commodity used in the Facility. A physical count was done on 31 October, 2023 with the following observations:

    • Item Description: Diclofenac 75mg Inj.
    • Unit of Measure: Vial
    • Balance in Store: 150

    After conducting the physical inventory, the ledger was updated and other transactions continued up to January 2024 as shown below:

    • On 3 November 2023, 10 boxes were received from MSD with Invoice number 01140. However, during receipt verification, it was identified that 80 vials were broken and thus returned to supplier for refill.
    • On 15 November 2023, 300 vials were issued to the dispensing section with issue voucher number 0140. On the same date, 150 vials were issued to the Dental clinic with issue voucher number 0117 and 50 vials to the Surgical Ward with issue voucher number 0123.
    • On 21 November 2023, four (4) boxes were issued to Mlimba HC with Issuer Voucher No. 0010.
    • Physical inventory was conducted on 30th November 2023 and found that 45 vials had been broken.
    • On 2nd December 2023, one (1) box was borrowed from Ifakara Health Centre (a nearby health facility) and came with issue voucher number 00190.

    Update the ledger by filling all required transactions as provided above.
    (Note: The stores ledger was opened on 10th January 2020 (given number 1B). All transactions are done in dispensing units.)

  1. A 29-year-old female and her 2-year-old child (weighing 14kg) presented to the emergency department, the mother complaining of headache, joint pains, malaise, and vomiting while the child had impaired consciousness with episodes of convulsions, vomiting everything and jaundiced. Investigations showed the mother was diagnosed with uncomplicated malaria while the child was diagnosed with severe malaria. As pharmaceutical personnel you are required to advise on proper management for the two patients. What will be the pharmacological treatment of malaria for the two cases? (10 Marks)

  2. Mr. Kiki came to the emergency department with his 10-year-old child presenting with a 24-hour history of vomiting and diarrhea. The child was prescribed with five sachets of Oral Rehydration Salts (ORS) and Zinc sulfate tablets 20mg od for 1/52.

    • (i) What instructions will be provided to Mr. Kiki on the reconstitutions and use of ORS? (4 Marks)

    • (ii) What is the rationale of including zinc sulfate in this therapy? (3 Marks)

    • (iii) Elaborate to Mr. Kiki on the alternative way to prepare ORS at home provided that the ready-made ORS was out of stock in the pharmacy. (3 Marks)

    • (a) Improper prescription of drugs is a common cause of morbidity in elders. Common-sense rules for prescribing do not apply only to the elderly, but are especially important in this vulnerable group. As pharmaceutical personnel, briefly state five (5) precautions you should take/advice on drug use in elderly to avoid minimizing the problem? (10 Marks)

    • (b) A customer asks about an over-the-counter medication which you have never heard of before. How would you handle this situation? (5 Marks)

    • (c) A 28-year-old male customer came to the pharmacy with a bottle of prescription medication that is partially used and says it doesn't work. In five (5) points, briefly explain how you would address the issue.