PEBC MCQ study guide: Minor Ailments Prescribing & OTC Dermatology

Providing Care – Clinical Care

Pharmacist-prescribable minor ailments and common OTC/dermatologic recommendations.

Common Minor Ailments (Expanded Pharmacist Scope)

Most Canadian provinces now authorize pharmacists to assess and prescribe for a defined list of minor ailments — the exam expects familiarity with typical red-flag criteria that trigger referral rather than pharmacist management, more than exhaustive provincial scope lists (which vary by province).

Uncomplicated UTI: pharmacist-manageable in a non-pregnant woman with classic symptoms and no red flags (fever, flank pain, recurrent/complicated history) — red flags mean physician referral for pyelonephritis work-up.

Cold sores (herpes labialis): topical or oral antivirals (valacyclovir) started at first prodromal symptom (tingling) are most effective — treatment started after lesions are fully formed has much less benefit.

Allergic conjunctivitis: OTC antihistamine/mast-cell-stabilizer combination eye drops (ketotifen) are effective first-line; red flags for referral include pain (vs. itch), photophobia, vision change, or unilateral presentation (suggests something other than allergy).

Acne: topical benzoyl peroxide and/or topical retinoids are first-line for mild acne; topical/oral antibiotics are added for inflammatory acne (always paired with benzoyl peroxide to reduce resistance development — antibiotic monotherapy is discouraged); isotretinoin (severe/scarring/refractory acne) requires specialist-level monitoring including mandatory pregnancy prevention program given severe teratogenicity.

Tinea infections: topical antifungals (clotrimazole, terbinafine) for localized skin involvement; oral therapy is reserved for nail (onychomycosis) or scalp (tinea capitis) involvement, or extensive/refractory skin disease, since topical agents don't penetrate nail/hair adequately.

OTC Counseling Red Flags (General Pattern)

A recurring exam pattern across minor ailments: symptoms lasting beyond an expected self-limited course (e.g., cough >3 weeks, diarrhea >48–72 hours in an adult), symptoms in a vulnerable population (infant, pregnant patient, immunocompromised, elderly with comorbidities), "worst-ever" or sudden-severe presentation, or any systemic/red-flag symptom (fever, blood, significant pain, vision change) should prompt referral rather than continued self-treatment/pharmacist-level management.

High-yield points

• Cold sores: antivirals work best started at the prodrome (tingling) — much less effective once lesions are established.
• Acne: never use topical/oral antibiotic monotherapy — always pair with benzoyl peroxide to limit resistance.
• Isotretinoin requires a mandatory pregnancy prevention program given severe teratogenicity.
• Oral antifungals are reserved for nail/scalp involvement — topical agents don't penetrate nail or hair.
• General red-flag pattern: symptoms beyond expected duration, vulnerable population, sudden-severe onset, or systemic signs → refer, don't self-treat.

Guideline references

• Provincial Minor Ailments Prescribing Frameworks (varies by province)
• Canadian Pharmacists Association — Compendium of Therapeutics for Minor Ailments

Related topics

• Cardiovascular Disorders
• Endocrine & Metabolic Disorders
• Infectious Diseases & Antimicrobial Therapy
• Central Nervous System & Psychiatric Disorders
• Respiratory Disorders
• Gastrointestinal & Hepatic Disorders
• Rheumatology, Pain Management & Palliative Care
• Renal & Genitourinary Disorders

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