Community Pharmacy and Health Education: counselling and referral
What community pharmacy and health education tests
This domain tests patient counselling, OTC selection, prescription screening, referral, health promotion and practical communication in Nepali community settings. Questions often present a patient or caregiver asking for advice and expect a safe, guideline-based response.
Core rules
- Counsel on dose, frequency, duration, route, timing, storage, missed doses and expected effects; use plain language and teach-back.
- Prescription-only medicines require a valid prescription; antibiotics are not to be sold for self-limiting viral illness.
- Red flags require referral: high fever, bloody diarrhoea, dehydration, chest pain, severe headache, breathing difficulty, pregnancy complications and signs of severe infection.
- WHO low-osmolarity ORS is reconstituted in 1 litre of clean water; do not use juice or soft drinks. Discard after 24 hours.
- Health education should be specific and culturally appropriate: tobacco cessation, family planning, immunisation, hand hygiene and prevention of diarrhoeal disease.
Worked example
A mother asks for an antibiotic for her child's watery diarrhoea. The pharmacy assistant should not dispense one routinely. Most acute watery diarrhoea is viral or self-limiting; antibiotics are indicated only for specific cases such as cholera or dysentery with red flags. The correct advice is ORS and zinc where indicated by national guidance, continued feeding, and immediate referral if the child is lethargic, unable to drink, has sunken eyes, or blood in stool.
Traps
Giving adult doses to children; recommending ORS made with too little water; selling antibiotics for viral illness; and failing to refer dehydration or other red flags.