Symptoms in the Pharmacy : A Guide to the Management of Common Illnesses

Fully updated to reflect NHS moves to encourage greater self-care and more use of over-the-counter remedies Informed by the experiences and expertise of seasoned pharmacists and GPs, this reference guide provides pharmacists working in the community with the treatment information they need when they need it. Each chapter incorporates a decision-making framework which distills the information necessary for treatment along with suggestions on “when to refer” set off in summary boxes. Elucidating case studies are provided throughout, in which pharmacists and doctors describe, in their own words, listening to and treating patients suffering with a range of common problems, from migraine to eczema to IBS. The indispensable guide to assessing and managing common symptoms seen in the pharmacy Includes information about medicines recently reclassified for OTC supply such as those for malaria prophylaxis and erectile dysfunction Now includes more highlights of “Red Flag” signs and symptoms Covers respiratory, gastrointestinal, skin, ear and eye, cardiovascular, and pain conditions Offers specific recommendations for women’s, men’s and children’s health problems Provides decision making support for cases involving ethical dilemmas Features a visual display of relevant treatment guidelines Emphasizes the evidence base for OTC medicines With expert coverage of most common ailments which will be encountered by pharmacists on a daily basis, Symptoms in the Pharmacy, 8th Edition is a professional resource you’ll want to keep close at hand for frequent consultation. Symptoms in the Pharmacy......Page 2 Contents......Page 6 Preface......Page 8 Introduction: How to Use This Book......Page 10 How to make a consultation more successful from the patients perspective: tips from lay people......Page 11 Responding to a request for a named product......Page 12 Information gathering......Page 13 Treatment......Page 15 Developing your consultation skills......Page 17 Structuring the consultation......Page 18 Decision making: risk assessment......Page 21 Accidents and injuries......Page 22 Privacy in the pharmacy......Page 23 Working in partnership with family doctors and nurse colleagues in primary care......Page 24 About the Companion Website......Page 26 What you need to know......Page 28 Duration......Page 29 Symptoms......Page 30 When to refer......Page 33 Management......Page 34 Decongestants......Page 35 Antihistamines (see also Allergic rhinitis (hay fever): Management, later in this chapter)......Page 37 Zinc......Page 38 Practical points......Page 39 Antivirals and seasonal flu......Page 41 Antibiotics......Page 42 Case 1......Page 43 Case 2......Page 44 Age......Page 45 Nature of cough......Page 46 Previous history......Page 48 Present medication......Page 49 Treatment timescale......Page 50 Cough suppressants......Page 51 Expectorants......Page 52 Cough remedies: Other constituents......Page 53 Practical points......Page 54 Case 1......Page 55 Sore throat......Page 56 Severity......Page 57 Present medication......Page 58 Appearance of throat......Page 59 When to refer......Page 60 Oral analgesics......Page 61 Practical points......Page 62 Case 1......Page 63 Case 3......Page 64 What you need to know......Page 65 Duration......Page 66 Previous history......Page 67 Medication......Page 68 Management......Page 69 Antihistamines......Page 70 Steroid nasal sprays......Page 71 Further advice......Page 72 Case 2......Page 73 Respiratory causes......Page 74 Respiratory causes......Page 75 Wheezing......Page 76 COPD......Page 77 Haemoptysis......Page 78 What you need to know......Page 80 Nature of the ulcers......Page 81 Previous history......Page 82 Medication......Page 83 Chlorhexidine gluconate mouthwash......Page 84 Local anaesthetics (e.g. lidocaine [lignocaine] and benzocaine)......Page 85 Case 2......Page 86 What you need to know......Page 87 Symptoms/associated factors......Page 88 Management......Page 90 H2 antagonists (ranitidine)......Page 91 Practical points......Page 92 Patient perspectives......Page 93 Case 1......Page 94 Case 2......Page 95 What you need to know......Page 96 Duration/previous history......Page 97 Details of pain/associated symptoms......Page 98 Smoking habit......Page 99 Medication......Page 100 Antacids......Page 101 Case 1......Page 103 Case 2......Page 104 Nausea and vomiting......Page 105 Age......Page 106 Alcohol intake......Page 107 Motion sickness and its prevention......Page 108 Mode of travel/length of journey......Page 109 Anticholinergic agents......Page 110 What you need to know......Page 112 Associated symptoms......Page 113 Diet......Page 114 Medication......Page 115 Bulking agents (e.g. bran, ispaghula husk, methylcellulose and sterculia)......Page 116 Constipation in children......Page 117 Laxative overuse......Page 118 Case 1......Page 119 Case 2......Page 120 Case 3......Page 121 What you need to know......Page 122 Symptoms......Page 123 Causes of diarrhoea......Page 124 Medication......Page 127 Treatment timescale......Page 128 Oral rehydration therapy......Page 129 Other therapies......Page 130 Practical points......Page 131 Case 2......Page 132 Case 3......Page 133 Case 4......Page 134 What you need to know......Page 135 Symptoms......Page 136 Medication......Page 137 Antispasmodics......Page 138 Bulking agents......Page 139 Practical points......Page 140 Case 1......Page 141 Case 2......Page 142 Haemorrhoids......Page 143 Symptoms......Page 144 Medication......Page 146 Skin protectors......Page 147 Shark liver oil/live yeast......Page 148 Practical points......Page 149 Case 2......Page 150 Case 3......Page 151 What you need to know......Page 154 Age/distribution......Page 155 Occupation/contact......Page 156 Medication......Page 157 Management......Page 158 Advice......Page 159 Antipruritics......Page 160 Patient perspectives......Page 161 Case 2......Page 162 Case 3......Page 163 Case 4......Page 164 What you need to know......Page 165 Severity......Page 166 Affected areas......Page 167 Medication......Page 168 Benzoyl peroxide......Page 169 Antiseptic agents......Page 170 Practical points......Page 171 What you need to know......Page 173 Appearance......Page 174 Medication......Page 175 Management......Page 176 Practical points......Page 178 Ringworm (tinea)......Page 179 Fungal nail infections (onychomycosis)......Page 180 Intertrigo (candidal skin crease infections)......Page 182 Case 1......Page 183 Case 2......Page 184 Age......Page 185 Previous history......Page 186 Aciclovir and penciclovir......Page 187 Practical points......Page 188 Warts and verrucae......Page 189 Appearance......Page 190 Medication......Page 192 Salicylic acid......Page 193 Practical points......Page 194 Age......Page 197 History......Page 198 Permethrin......Page 199 Practical points......Page 200 What you need to know......Page 201 Location......Page 202 Previous history......Page 203 Ketoconazole......Page 204 Practical points......Page 205 What you need to know......Page 206 Psychological factors......Page 207 Medication......Page 208 Topical treatments......Page 209 When to refer......Page 210 Second-line treatment......Page 212 What you need to know......Page 214 Nature and site of pain......Page 215 Associated symptoms......Page 216 International Headache Societys diagnostic pointers formigraine......Page 217 Medication......Page 220 Treatment timescale......Page 221 Ibuprofen......Page 222 Aspirin......Page 224 Caffeine......Page 225 Sumatriptan......Page 226 Patient perspectives......Page 228 Case 1......Page 229 Case 2......Page 230 Case 4......Page 231 What you need to know......Page 232 Symptoms and history......Page 233 Medication......Page 237 Counterirritants and rubefacients......Page 238 Topical anti-inflammatory agents......Page 240 Practical points......Page 241 How should I manage a sprain or strain in primary care?......Page 242 Case 1......Page 243 Case 3......Page 244 What you need to know......Page 246 Symptoms......Page 247 Previous history......Page 249 When to refer......Page 250 Potassium and sodium citrate......Page 251 Practical points......Page 252 Case 2......Page 253 Case 3......Page 254 What you need to know......Page 255 Timing and nature of pains......Page 256 Other symptoms......Page 257 NSAIDs (ibuprofen and naproxen) (see also Chapter 4 Painful Conditions: Headache: Management)......Page 258 Paracetamol......Page 259 Practical points......Page 260 Case 1......Page 261 Premenstrual syndrome......Page 262 Management......Page 263 Menorrhagia......Page 264 Menstrual cycle......Page 265 Tranexamic acid......Page 266 Vaginal thrush......Page 267 Age......Page 268 Symptoms......Page 269 Previous history......Page 270 Medication......Page 271 Management......Page 272 Practical points......Page 273 Case 1......Page 274 Case 2......Page 275 What you need to know......Page 276 Other medicines being taken......Page 277 Ulipristal......Page 278 Levonorgestrel......Page 279 Practical points......Page 280 Case 1......Page 281 Case 2......Page 282 Case 3......Page 283 Constipation (see Chapter 2 Gastrointestinal Tract Problems: Constipation)......Page 284 Headache......Page 285 Skin irritation and stretch marks......Page 286 Lower urinary tract symptoms......Page 288 Duration......Page 289 Management......Page 290 Tamsulosin......Page 291 Lifestyle advice......Page 292 What you need to know......Page 293 Sildenafil citrate......Page 294 When to refer......Page 295 Hair loss......Page 296 History and duration of hair loss......Page 297 When to refer......Page 298 Minoxidil......Page 299 What you should know......Page 302 Conjunctivitis......Page 303 Other conditions with similar symptoms......Page 304 Painful eye conditions......Page 306 What you should know......Page 308 Management......Page 309 Recommended treatments for dry eye syndrome......Page 310 Case 1......Page 311 Case 2......Page 312 What you need to know......Page 313 Recommendations for use of ear drops to soften earwax......Page 314 Otitis externa......Page 315 Self-care advice......Page 316 Otitis media......Page 317 Case 1......Page 318 Note......Page 319 Common childhood rashes......Page 320 Measles......Page 321 Rubella (German measles)......Page 323 Meningitis......Page 324 Fever......Page 325 What you need to know......Page 326 Management......Page 327 Teething......Page 329 What you need to know......Page 330 Previous history......Page 331 When to refer......Page 332 Emollient preparations......Page 333 Case 1......Page 334 Case 2......Page 335 What you need to know......Page 336 Signs of infection......Page 337 Physical insecticides......Page 339 Chemical insecticides......Page 340 Complementary therapies......Page 341 Threadworm (pinworm)......Page 342 Signs of infection......Page 343 Medication......Page 344 Non-drug measures......Page 345 Hygiene advice......Page 346 Age......Page 347 Medication......Page 348 Antifungal agents......Page 349 Case 1......Page 350 Case 2......Page 351 What you need to know......Page 354 Symptoms......Page 355 Contributory factors......Page 356 When to refer......Page 357 Benzodiazepines......Page 358 Complementary therapies......Page 359 Practical points......Page 361 Case 1......Page 362 Case 2......Page 363 Case 3......Page 364 What is cardiovascular disease?......Page 366 Screening and risk factors......Page 367 Age and gender......Page 368 Waist circumference/body mass index......Page 369 Alcohol intake......Page 370 Diabetes......Page 371 Medication......Page 372 Smoking cessation and nicotine replacement therapy......Page 373 Nicotine replacement therapy: formulation options......Page 374 Licenced indications for OTC nicotine replacement therapy......Page 375 Advice on physical activity......Page 376 Weight management......Page 377 OTC orlistat......Page 378 Medication......Page 379 Contraindications......Page 380 Aspirin 75mg......Page 381 Case 1......Page 382 Case 2......Page 383 What you need to know......Page 386 Immune system......Page 387 Medication......Page 388 Management......Page 389 Avoiding mosquito bites......Page 390 Practical points......Page 392 Cruises......Page 393 Useful information sources......Page 394 Gut......Page 396 Others......Page 397 Appendix B: Resource and Reference Grid......Page 398 Index......Page 414 EULA......Page 0 Intro -- Symptoms in the Pharmacy -- Contents -- Preface -- Introduction: How to Use This Book -- Working in partnership with patients -- How to make a consultation more successful from the patients perspective: tips from lay people -- Responding to a request for a named product -- A suggested sequence in response to a request for a named product -- Responding to a request for help with symptoms -- Information gathering -- Decision making -- Treatment -- Developing your consultation skills -- Structuring the consultation -- Decision making: risk assessment -- Accidents and injuries -- Privacy in the pharmacy -- Patient group directions and symptoms in the pharmacy -- Working in partnership with family doctors and nurse colleagues in primary care -- About the Companion Website -- 1 Respiratory Problems -- Colds and flu -- What you need to know -- Significance of questions and answers -- Age -- Duration -- Symptoms -- Previous history -- Present medication -- When to refer -- Colds and flu: Hygiene advice -- Treatment timescale -- Management -- Decongestants -- Antihistamines (see also Allergic rhinitis (hay fever): Management, later in this chapter) -- Zinc -- Echinacea -- Vitamin C -- Cough remedies -- Analgesics -- Products for sore throats -- Practical points -- Flu pandemic -- Antivirals and seasonal flu -- Surgical face masks -- Antibiotics -- Colds and flu in practice -- Case 1 -- Case 2 -- Cough -- What you need to know -- Significance of questions and answers -- Age -- Duration -- Nature of cough -- Associated symptoms -- Previous history -- Smoking habit -- Present medication -- When to refer -- Treatment timescale -- Management -- Cough suppressants -- Expectorants -- Cough remedies: Other constituents -- Practical points -- Coughs in practice -- Case 1 -- Case 2 -- Sore throat -- What you need to know "Informed by the experiences and expertise of seasoned pharmacists and GPs, this reference guide provides pharmacists working in the community with the treatment information they need when they need it. Each chapter incorporates a decision-making framework which distills the information necessary for treatment along with suggestions on "when to refer" set off in summary boxes. Throughout elucidating case studies are provided in which pharmacists and doctors describe, in their own words, listening to and treating patients suffering with a range of common problems, from migraine to eczema to IBS. The indispensable guide to assessing and managing common symptoms seen in the pharmacy Includes information about medicines recently reclassified for OTC supply such as those for malaria prophylaxis and psoriasis Now includes more highlights of "Red Flag" signs and symptoms Covers respiratory, gastrointestinal, skin, ear and eye, cardiovascular, and pain conditions Offers specific recommendations for women's, men's and children's health problems Provides decision making support for cases involving ethical dilemmas Features a visual display of guidelines Emphasizes the evidence base for OTC medicines With expert coverage of most common ailments which will be encountered by pharmacists on a daily basis, Symptoms in the Pharmacy, 8th Edition is a professional resource you'll want to keep close at hand for frequent consultation"--Provided by publisher