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Community pharmacies are often the first source for information and advice when health problems arise. Increasingly patients are being referred to pharmacists by other health care professionals through Pharmacy First and similar schemes. This book presents a decision-making framework along with ‘red flags’, ‘when to refer’ and evidence-based treatment recommendations. A unique feature is that case studies appear throughout, in which pharmacists, doctors, nurses, and patients describe assessment and treatment of a wide range of common problems. Highlights of this substantially updated tenth edition are: The addition of seven major sections covering the initial Pharmacy First scheme in England: acute otitis media (AOM); impetigo; infected insect bites; shingles; acute sinusitis; sore throat; and uncomplicated urinary tract infection in women.A changed book title to reflect the increasing remit of community pharmacy in disease prevention, with extended content on topics such as blood pressure measurement and shingles vaccination.‘The consultation’ expanded in a new chapter, including decisions about supplying antibiotics with a suggested framework to reflect antimicrobial stewardship.Pharmacy continuation of contraceptive pills and the Pharmacy Contraception service.Revisited and updated information on COVID-19 and long COVID in the light of the transition of COVID-19 to an endemic state.Practicing and Foundation trainee pharmacists, as well as undergraduate pharmacy students and many other healthcare professionals, will find Symptoms in the Pharmacy: A Guide to the Management of Common Illnesses and Disease Prevention invaluable.
Alison Blenkinsopp, OBE, BPharm, FFRPS, PhD, Educational Consultant and Professor of the Practice of Pharmacy, UK. Martin Duerden, BMedSci, MB BS, DRCOG, DipTher, DPH, FRCGP, is a recently Retired General Practitioner and NHS Medical Director. John Blenkinsopp, MB ChB, BPharm, MRPharmS, trained both as a Pharmacist and a Doctor and is Chief Medical Officer for Avipero Ltd., UK.
Preface ixIntroduction and How to Use This Book xiAbout the Companion Website xxvChapter 1 The Consultation 1Requests for treatment 1Developing consultation skills 7Decision making and risk assessment 15Record keeping and communication 16Antimicrobial stewardship and consultation skills 18Chapter 2 Respiratory Problems 29Coughs and colds 29Cough 45Sore throat – pharmacy first 58Acute sinusitis – pharmacy first 73Allergic rhinitis (hay fever) 82Respiratory symptoms for direct referral 91Chapter 3 COVID- 19 and Long COVID 97Covid- 19 97Long COVID 104Chapter 4 Gastrointestinal Tract Problems 113Mouth ulcers 113Heartburn 121Indigestion 132Nausea and vomiting 141Motion sickness and its prevention 143Constipation 146Diarrhoea 160Irritable bowel syndrome 173Haemorrhoids 184Chapter 5 Skin Conditions 197Eczema/dermatitis 197Acne 210Common fungal infections 217Cold sores 229Excessive sweating – hyperhydrosis 233Sunburn 235Warts and verrucae 238Infected insect bites – pharmacy first 245Scabies 252Dandruff 255Psoriasis 259Chapter 6 Painful Conditions 267Musculoskeletal problems 267Headache 290Shingles – pharmacy first 308Post- herpetic neuralgia 315Herpes zoster vaccines 315Toothache 317Chapter 7 Women’s Health 323Uncomplicated urinary tract infection – pharmacy first 323Urinary incontinence 334Dysmenorrhoea 343Premenstrual syndrome 350Menorrhagia 352Menopause 355Vaginal thrush 366Pharmacy contraception service 375Desogestrel (DSG) OTC 381Emergency hormonal contraception 388Common symptoms in pregnancy 396Chapter 8 Men’s Health 403Lower urinary tract symptoms 403Erectile dysfunction 408Hair loss 413Chapter 9 Older People, Frailty and Falls Prevention 419Frailty 420Preventing falls 420Contents viiChapter 10 Eye and Ear Problems 427Working in partnership with optometrists 427Eye problems: the red eye 428Eye problems: the dry eye 436Common ear problems 443Chapter 11 Childhood Conditions 451Common childhood rashes and infections 451Acute otitis media – pharmacy first 464Impetigo – pharmacy first 477Infantile colic 481Teething 484Nappy rash (napkin dermatitis) 484Head lice 490Threadworm (pinworm) 496Oral thrush (oral candidiasis) 501Chapter 12 Insomnia and Mental Wellbeing 511Insomnia 511Mental wellbeing 519Suicidal thoughts and suicide prevention 523Chapter 13 Prevention of Heart Disease 531What is cardiovascular disease? 532What is cardiovascular disease risk? 533Community pharmacy blood pressure check service 540Smoking cessation and nicotine replacement therapy 543Physical activity, diet and weight 547Chapter 14 Malaria Prevention 559Significance of questions and answers 560Practical points 566Chapter 15 Pharmacogenomics 569Pharmacogenomics in the pharmacy 569Appendix: Summary of Symptoms for Direct Referral 581Index 583