A4750C Good Dispensing Practice Graded Assignment Questions 2026, Singapore

A4750C Graded Assignment Questions

Question 1

Mr Tan was given the following follow-up prescription shown in Figure 1 for his heart failure. His medication history is shown in Table 1. He has normal kidney functions and doesn’t have other medical conditions. He would like to collect all for 1 month. The dispensing label and medications packed in the Ziploc bag are shown in Table 2. He is very familiar with his medications and has not experienced any side effects. (20 marks)

Table 1: Medication History

• Lisinopril 15mg OM
• Furosemide 20 mg OM PRN
• Potassium chloride SR  600mg OM PRN
• Bisoprolol 5 mg OM
• Spironolactone 25mg OM

Table 2: The dispensing labels and medications packed in the Ziploc bag for dispensing

Question 2

Refer to the following prescription shown in Figure 2 and answer the questions below. (9marks)

Question 3

Read the following clinical scenarios and the student’s recommendation, then answer the questions. (11marks)

3a. Mr Lim is a 58-year-old male who woke up at 3 am with sudden severe pain, redness, and swelling in his right big toe, with a pain score of 9/10. He was diagnosed with his first episode of acute gout this morning. He has no known drug allergies and is not on any current medications. A pharmacy student recommends tramadol 50 mg every 6 hours PRN, stating that it is a strong analgesic that will provide fast relief for his acute gout flare.

3b. Mr Hassan is a 60-year-old male diagnosed with an acute gout flare in his right ankle. He has a documented hypersensitivity to Ponstan^TM and is not on any current medications.

A pharmacy technician student used an AI chatbot to help answer a clinical question. The student entered the following prompt: ‘My patient has acute gout. He is 60 years old with no other medical conditions. What should I recommend for the flare?’

The AI responded: ‘For an acute gout flare in a 60-year-old with no other medical conditions, the first-line treatment is an NSAID such as naproxen 550 mg twice daily or indomethacin 50 mg three times daily, taken with food. This should be continued until the flare resolves, usually 5–7 days.‘

3c. It is 9 pm. Mdm Salmah, a 38-year-old patient with asthma, calls the pharmacy helpline and speaks to a pharmacy technician. She reports that her breathing has been getting worse throughout the day. She has taken 12 puffs of her Symbicort 160/4.5 Turbuhaler today — 2 puffs in the morning as prescribed, and 10 additional puffs as reliever doses throughout the day due to persistent breathlessness. She is still experiencing chest tightness and is unsure whether she can take more puffs. She had consulted an AI chatbot earlier and shows the technician the following response:

‘Symbicort can be used as both a preventer and a reliever (SMART therapy). The maximum daily dose is 12 puffs. Since you have already reached 12 puffs and are still symptomatic, you should wait and monitor your symptoms. If you do not feel better by tomorrow morning, see your doctor.’

3d. Mr Rajesh is a 55-year-old patient who comes to collect his repeat prescription for rosuvastatin 10 mg once daily at night. He is also on metformin 1 g twice daily and has no known drug allergies. While waiting, he mentions that his friend was recently advised by a pharmacist to avoid grapefruit juice due to his cholesterol medication (simvastatin). Mr Rajesh asks: ‘My friend cannot take grapefruit juice with his cholesterol tablet. I also take a cholesterol tablet — does that mean I cannot take grapefruit juice too?’

The pharmacy technician responds: ‘Yes, all cholesterol tablets have the same interaction with grapefruit juice. Since your friend cannot take it, you should also avoid grapefruit juice to be safe.’