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

432 Pages·2018·10.6 MB·English

by  Alison Blenkinsopp

Alison Blenkinsopp
Martin Duerden
John Blenkinsopp
Eighth Edition
SYMPTOMS
IN
PHARMACY
THE
A Guide to the Management
of Common Illnesses
Symptoms in the Pharmacy

Symptoms in the
Pharmacy
A Guide to the Management
of Common Illnesses
8th Edition
Alison Blenkinsopp OBE
BPharm, FFRPS, PhD
ProfessorofthePracticeofPharmacy
SchoolofPharmacyandMedicalSciences
UniversityofBradford
UK
Martin Duerden
BMedSci, MB BS, DRCOG, DipTher,
DPH, FRCGP
GeneralPractitionerandHonorarySeniorResearchFellow
CentreforHealthEconomicsandMedicinesEvaluation
BangorUniversity
UK
John Blenkinsopp
MB,ChB,BPharm,MRPharmS
ChiefMedicalOfficer
AviperoLtd
UK
Thiseditionfirstpublished2018
©2018JohnWiley&SonsLtd
EditionHistory
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LibraryofCongressCataloging-in-PublicationData
Names:Blenkinsopp,Alison,author.|Duerden,Martin,author.|Blenkinsopp,John,author.
Title:Symptomsinthepharmacy:aguidetothemanagementofcommonillnesses/by
AlisonBlenkinsopp,MartinDuerden,andJohnBlenkinsopp.
Description:Eighthedition.|Hoboken,NJ,USA:Wiley-Blackwell,[2018]|
Includesbibliographicalreferencesandindex.|
Identifiers:LCCN2017060730(print)|LCCN2017061257(ebook)|ISBN9781119317975(pdf)|
ISBN9781119318002(epub)|ISBN9781119317968(pbk.)
Subjects:|MESH:DrugTherapy|PharmaceuticalServices|Diagnosis|Referraland
Consultation|Handbooks
Classification:LCCRS122.5(ebook)|LCCRS122.5(print)|NLMQV735|DDC
615.5/8–dc23
LCrecordavailableathttps://lccn.loc.gov/2017060730
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CoverImage:©PiotrZajc/Shutterstock;©Sentavio/Shutterstock
Setin10/12ptSabonLTStdbyAptaraInc.,NewDelhi,India
PrintedandboundinSpainbyGraphyCems
10 9 8 7 6 5 4 3 2 1
Contents
Preface vii
Introduction:HowtoUseThisBook ix
AbouttheCompanionWebsite xxv
Chapter1 RespiratoryProblems 1
Coldsandflu 1
Cough 18
Sorethroat 29
Allergicrhinitis(hayfever) 38
Respiratorysymptomsfordirectreferral 47
Chapter2 GastrointestinalTractProblems 53
Mouthulcers 53
Heartburn 60
Indigestion 69
Nauseaandvomiting 78
Motionsicknessanditsprevention 81
Constipation 85
Diarrhoea 95
Irritablebowelsyndrome 108
Haemorrhoids 116
Chapter3 SkinConditions 127
Eczema/dermatitis 127
Acne 138
Commonfungalinfections 146
Coldsores 158
Wartsandverrucae 162
Scabies 170
Dandruff 174
Psoriasis 179
vi Contents
Chapter4 PainfulConditions 187
Headache 187
Musculoskeletalproblems 205
Chapter5 Women’sHealth 219
Cystitis 219
Dysmenorrhoea 228
Premenstrualsyndrome 235
Menorrhagia 237
Vaginalthrush 240
Emergencyhormonalcontraception 249
Commonsymptomsinpregnancy 257
Chapter6 Men’sHealth 261
Lowerurinarytractsymptoms 261
Erectiledysfunction 266
Hairloss 269
Chapter7 EyeandEarProblems 275
Eyeproblems:Theredeye 275
Eyeproblems:Thedryeye 281
Commonearproblems 286
Chapter8 ChildhoodConditions 293
Illnessesaffectinginfantsandchildrenupto16years 293
Infantilecolic 299
Teething 302
Nappyrash(napkindermatitis) 303
Headlice 309
Threadworm(pinworm) 315
Oralthrush(oralcandidiasis) 320
Chapter9 Insomnia 327
Difficultysleeping 327
Chapter10 PreventionofHeartDisease 339
Preventionofheartdisease 339
Chapter11 MalariaPrevention 359
AppendixA:SummaryofSymptomsforDirectReferral 369
AppendixB:ResourceandReferenceGrid 371
Index 387
Preface
This is the eighth edition of our book and appears 28 years after the first.
Dr Martin Duerden has joined us as co-author and we wish Dr Paul Paxton
wellinhisretirement.Paulwasinstrumentalintheoriginaldevelopmentofthe
ideas and format for the book and made a major contribution over the years.
The update in this edition comes at an exciting time for pharmacists in the
UnitedKingdomwithincreasingemphasisontheirclinicalrole.
Amongthechangesinthisneweditionare
(cid:2) A more explicit emphasis on the evidence base for ‘over-the-counter’
medicines and a clearer explanation of the book’s approach and evidence
sources
(cid:2) A visual display of the guidelines, systematic reviews and other reliable
sourcesofinformationusedtoupdatethebook
(cid:2) Greater highlighting of ‘red flag’ symptoms/signs and explanation of their
significance
(cid:2) AreworkedIntroductionwithconsiderationof
◦ how community pharmacy teams fit within a changing NHS landscape as
asourceoffirstcontactcare
◦ increasingdigitalintegrationofcommunitypharmaciesintowiderprimary
care
(cid:2) NewsectionsonErectileDysfunctionandMalariaPreventiontoreflectrecent
POMtoPchanges
As for previous editions,we have received positive and constructive feedback
and suggestions from pharmacists (undergraduate students, pre-registration
traineesandpractisingpharmacists)aswellasformalreviewersandhavetried
toactonyoursuggestions.Wehavecontinuedtoaddmoreaccountsbypatients
to our case studies.We thank all the pharmacists who sent us comments and
wehopeyoulikethenewedition.
We once again thank Kathryn Coates and her network of mums, who
provided advice on the sort of concerns and queries that they hope their
pharmacistscananswer.
AlisonBlenkinsopp
MartinDuerden
JohnBlenkinsopp

Introduction: How to Use
This Book
Everyworkingday,peoplecometothecommunitypharmacyforadviceabout
minor ailments and symptoms. Recent research found that the proportion
of general practice and emergency department (ED) consultations for minor
ailments potentially suitable for management in community pharmacy was
around 13 and 5%, respectively. Encouraging self-care is a good thing, and
withincreasingpressureondoctors’andnurses’workload,itislikelythatthe
community pharmacy will be even more widely used as a first port of call for
minor illness. There are often local initiatives to encourage this. Members of
the public present to pharmacists and their staff in a number of ways,which
include
(cid:2) Requestingadviceaboutsymptomsandappropriatetreatment
(cid:2) Askingtopurchaseanamedmedicine
(cid:2) Requiringgeneralhealthadvice(e.g.aboutdietarysupplements)
(cid:2) Askingabouteffects/symptomsperceivedtorelatetoprescribedmedicines
The pharmacist’s role in responding to symptoms and overseeing the sale of
over-the-counter(OTC)medicinesissubstantialandrequiresamixofknowl-
edge and skills in diseases and their treatment. In addition, pharmacists are
responsibleforensuringthattheirstaffprovideappropriateadviceandrecom-
mendations.Keyskillsareasfollows:
(cid:2) Differentiationbetweenminorandmoreserioussymptoms
(cid:2) Listeningskills
(cid:2) Questioningskills
(cid:2) Treatmentchoicesbasedonevidenceofeffectiveness
(cid:2) Theabilitytopasstheseskillsonbyactingasarolemodelforotherpharmacy
staff