Symptoms in the Pharmacy: A Guide to the Managemen t of Common Illnesses and Disease Prevention

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.

Preface ix
Introduction and How to Use This Book xi
About the Companion Website xxv
Chapter 1 The Consultation 1
Requests for treatment 1
Developing consultation skills 7
Decision making and risk assessment 15
Record keeping and communication 16
Antimicrobial stewardship and consultation skills 18
Chapter 2 Respiratory Problems 29
Coughs and colds 29
Cough 45
Sore throat - pharmacy first 58
Acute sinusitis - pharmacy first 73
Allergic rhinitis (hay fever) 82
Respiratory symptoms for direct referral 91
Chapter 3 COVID- 19 and Long COVID 97
Covid- 19 97
Long COVID 104
Chapter 4 Gastrointestinal Tract Problems 113
Mouth ulcers 113
Heartburn 121
Indigestion 132
Nausea and vomiting 141
Motion sickness and its prevention 143
Constipation 146
Diarrhoea 160
Irritable bowel syndrome 173
Haemorrhoids 184
Chapter 5 Skin Conditions 197
Eczema/dermatitis 197
Acne 210
Common fungal infections 217
Cold sores 229
Excessive sweating - hyperhydrosis 233
Sunburn 235
Warts and verrucae 238
Infected insect bites - pharmacy first 245
Scabies 252
Dandruff 255
Psoriasis 259
Chapter 6 Painful Conditions 267
Musculoskeletal problems 267
Headache 290
Shingles - pharmacy first 308
Post- herpetic neuralgia 315
Herpes zoster vaccines 315
Toothache 317
Chapter 7 Women's Health 323
Uncomplicated urinary tract infection - pharmacy first 323
Urinary incontinence 334
Dysmenorrhoea 343
Premenstrual syndrome 350
Menorrhagia 352
Menopause 355
Vaginal thrush 366
Pharmacy contraception service 375
Desogestrel (DSG) OTC 381
Emergency hormonal contraception 388
Common symptoms in pregnancy 396
Chapter 8 Men's Health 403
Lower urinary tract symptoms 403
Erectile dysfunction 408
Hair loss 413
Chapter 9 Older People, Frailty and Falls Prevention 419
Frailty 420
Preventing falls 420
Contents vii
Chapter 10 Eye and Ear Problems 427
Working in partnership with optometrists 427
Eye problems: the red eye 428
Eye problems: the dry eye 436
Common ear problems 443
Chapter 11 Childhood Conditions 451
Common childhood rashes and infections 451
Acute otitis media - pharmacy first 464
Impetigo - pharmacy first 477
Infantile colic 481
Teething 484
Nappy rash (napkin dermatitis) 484
Head lice 490
Threadworm (pinworm) 496
Oral thrush (oral candidiasis) 501
Chapter 12 Insomnia and Mental Wellbeing 511
Insomnia 511
Mental wellbeing 519
Suicidal thoughts and suicide prevention 523
Chapter 13 Prevention of Heart Disease 531
What is cardiovascular disease? 532
What is cardiovascular disease risk? 533
Community pharmacy blood pressure check service 540
Smoking cessation and nicotine replacement therapy 543
Physical activity, diet and weight 547
Chapter 14 Malaria Prevention 559
Significance of questions and answers 560
Practical points 566
Chapter 15 Pharmacogenomics 569
Pharmacogenomics in the pharmacy 569
Appendix: Summary of Symptoms for Direct Referral 581
Index 583