Symptoms in the Pharmacy PDF
Preview Symptoms in the Pharmacy
JohnBlenkinsopp/SymptomsinthePharmacy FinalProof 11.1.2005 8:49am pageiii Symptoms in the Pharmacy A Guide to the Management of Common Illness ALISON BLENKINSOPP BPharm,MRPharmS,PhD ProfessorofthePracticeofPharmacy DepartmentofMedicinesManagement KeeleUniversity,Staffordshire PAUL PAXTON MB,ChB,FRCGP,DRCOG GeneralPractitioner Cambridge AND JOHN BLENKINSOPP MB,ChB,BPharm,MRPharmS SeniorResearchFellow Department ofMedicinesManagement 1 KeeleUniversity Staffordshire fifth edition JohnBlenkinsopp/SymptomsinthePharmacy FinalProof 11.1.2005 8:49am pagei Symptoms in the Pharmacy JohnBlenkinsopp/SymptomsinthePharmacy FinalProof 11.1.2005 8:49am pageii JohnBlenkinsopp/SymptomsinthePharmacy FinalProof 11.1.2005 8:49am pageiii Symptoms in the Pharmacy A Guide to the Management of Common Illness ALISON BLENKINSOPP BPharm,MRPharmS,PhD ProfessorofthePracticeofPharmacy DepartmentofMedicinesManagement KeeleUniversity,Staffordshire PAUL PAXTON MB,ChB,FRCGP,DRCOG GeneralPractitioner Cambridge AND JOHN BLENKINSOPP MB,ChB,BPharm,MRPharmS SeniorResearchFellow Department ofMedicinesManagement 1 KeeleUniversity Staffordshire fifth edition JohnBlenkinsopp/SymptomsinthePharmacy FinalProof 11.1.2005 8:49am pageiv #1989,1995,1998,2002,2005AlisonBlenkinsopp,PaulPaxtonandJohnBlenkinsopp PublishedbyBlackwellPublishingLtd BlackwellPublishing,Inc.,350MainStreet,Malden,Massachusetts02148-5020,USA BlackwellPublishingLtd,9600GarsingtonRoad,OxfordOX42DQ,UK BlackwellPublishingAsiaPtyLtd,550SwanstonStreet,Carlton,Victoria3053,Australia TherightoftheAuthorstobeidentifiedastheAuthorsofthisWorkhasbeenassertedinaccordancewiththe Copyright,DesignsandPatentsAct1988. Allrightsreserved.Nopartofthispublicationmaybereproduced,storedinaretrievalsystem,ortransmitted,in anyformorbyanymeans,electronic,mechanical,photocopying,recordingorotherwise,exceptaspermittedby theUKCopyright,DesignsandPatentsAct1988,withoutthepriorpermissionofthepublisher. Firstpublished1989 Thirdedition1998 Reprinted1990,1992,1993 Reprinted1998,2000 Spanishtranslation1992 Fourthedition2002 Japanesetranslation1993 Reprinted2003(twice),2004 Secondedition1995 Fifthedition2005 Reprinted1996,1997 LibraryofCongressCataloging-in-PublicationData Blenkinsopp,Alison. Symptomsinthepharmacy:aguidetothemanagementofcommonillness/AlisonBlenkinsopp,PaulPaxton, JohnBlenkinsopp.–5thed. p.;cm. Includesbiblographicalreferencesandindex. ISBN1-4051-2222-6 1.Pharmacistandpatient.2.Symptoms.3.Drugs,Nonprescription. [DNLM:1.DrugTherapy–CaseReports.2.DrugTherapy–Handbooks.3.PharmaceuticalServices–Case Reports.4.PharmaceuticalServices.–Handbooks.5.Diagnosis–CaseReports.6.Diagnosis–Handbooks. 7.ReferralandConsultation–CaseReports.8.ReferralandConsultation–Handbooks.QV735B647s2005] I.Paxton,Paul.II.Blenkinsopp,John.III.Title. RS122.5.B542005 615.508–dc22 2004006862 ISBN1-4051-2222-6 AcataloguerecordforthistitleisavailablefromtheBritishLibrary Setin10/12.5ptSabonbyKolamInformationServicesPvt.Ltd,Pondicherry,India PrintedandboundintheUnitedKingdomby CommissioningEditor:AlisonBrown EditorialAssistant:ClaireBonnett ProductionEditor:FionaPattison ProductionController:KateCharman ForfurtherinformationonBlackwellPublishing,visitourwebsite: http://www.blackwellpublishing.com Thepublisher’spolicyistousepermanentpaperfrommillsthatoperateasustainableforestrypolicy,andwhich hasbeenmanufacturedfrompulpprocessedusingacid-freeandelementarychlorine-freepractices.Furthermore, thepublisherensuresthatthetextpaperandcoverboardusedhavemetacceptableenvironmentalaccreditation standards. JohnBlenkinsopp/SymptomsinthePharmacy FinalProof 5.7.2004 10:20pm pagev Contents Preface,vi PainfulConditions Headache,195 Introduction:Howtousethis Musculoskeletalproblems,210 book,1 Women’sHealth RespiratoryProblems Cystitis,225 Coldsandflu,17 Dysmenorrhoea,234 Cough,29 Vaginalthrush,243 Sorethroat,41 Emergencyhormonalcontraception, Allergicrhinitis,49 252 Respiratorysymptomsfordirect Commonsymptomsinpregnancy,258 referral,59 EyeandEarProblems GastrointestinalTractProblems Eyeproblems:thepainfulredeye,263 Mouthulcers,65 Commonearproblems,269 Heartburn,72 Indigestion,81 ChildhoodConditions Nauseaandvomiting,92 Commonchildhoodrashes,277 Motionsicknessanditsprevention, Colic,282 95 Teething,285 Constipation,100 Napkinrash,286 Diarrhoea,110 Headlice,293 Irritablebowelsyndrome,122 Threadworms(Pinworms),301 Haemorrhoids,130 Oralthrush,305 SkinConditions Insomnia Eczema/dermatitis,141 Insomnia,313 Acne,151 Athlete’sfoot,158 PreventionofHeartDisease Coldsores,165 Preventionofheartdisease,325 Wartsandverrucae,170 Scabies,175 Appendix:Summaryofsymptoms Dandruff,180 fordirectreferral,339 Hairloss,184 Psoriasis,188 Index,341 CONTENTS v JohnBlenkinsopp/SymptomsinthePharmacy FinalProof 11.1.2005 7:49am pagevi Preface This is the fifth edition of our book. Among the important changes since the last edition is the move of more medicines from the prescription-only medicine (POM) category to the pharmacy (P) medicine category. Omeprazole was the first proton pump inhibitor (PPI) to move to the P category in 2004. The move of simvastatin to over-the-counter (OTC) availability is another landmark change. Here,thepharmacist’sskillsinquestioningandexplaininginrelation to risk assessment for heart disease are paramount, as are links to otherhealth professionals. There have also been important changes in the National Health Service (NHS) since the last edition. In many areas NHS-funded community pharmacy Minor Ailment Schemes are now in operation. Under these schemes patients who are exempt from prescription charges can obtain free treatment from the pharmacy. Thus more people will consult the pharmacist for advice who previously con- sulted their doctor, and this role of the pharmacist may develop into independent prescribing. The existing schemes are well used, particularly for children’s minor illness. We have thus expanded our explanation of common childhood illnesses to enable the pharmacistto manage where appropriate, to reassureand referwhen necessary. ThesupplyofmedicinesunderPatientGroupDirections(PGDs)in communitypharmaciesisanotherkeychange.Itenablesthepharma- cisttosupply,ontheNHS,treatmentsthatwouldotherwisebePOMs. Examples include chloramphenicol eye drops for eye infections and trimethoprim for uncomplicated urinary tract infection. In response we haveextended our coverage ofeye conditions. The public will increasingly use their community pharmacy for advice and treatment. We have incorporated new case studies that test the boundaries of pharmacists’ professional judgement and fur- ther develop risk assessmentskills. The move towards partnership in medicines use (concordance) has developed further since the last edition. We believe this is just as relevanttoOTCastoPOMs.Thereforewehaverevisedtheintroduc- tiontostrengthenthepartnershipapproach.Wehavealsointroduced a patient perspective to some of our case studies and about specific issues (e.g. chronic conditions) where this can increase pharmacists’ vi PREFACE JohnBlenkinsopp/SymptomsinthePharmacy FinalProof 11.1.2005 7:49am pagevii understandingofhowthingslook‘fromtheothersideofthecounter’. We willwelcome feedbackfrom you on these changes. Systematicreviewsofpublishedevidencearecontinuingtocontrib- ute to pharmacists’ treatment choices, and their findings have been incorporated and updated into this edition. Evidence on benefits and potentialharmfrom herbalandothercomplementarymedicinescon- tinues to emerge; thus we extend our discussion on glucosamine and chondroitin in arthritic conditions, and on St John’s wort in depression. These changes mean that pharmacists at all stages of their career need practical information to help them in dealing with new areas of patient care and to ensure their knowledge is up to date. We have reviewedallofthepracticalcasestudiesandaddednewonestogivea better reflection ofcurrentissuesin practice. We have received many positive letters and comments from pharmacists (undergraduate students, pre-registration trainees and practising pharmacists) all over the world following the earlier edi- tionsofthebookandhavetriedtoactonourreaders’suggestions.We would like to thank all the pharmacists who contributed in this way andhopethatthepresenteditionwillmeettheneedstheyhavehelped usto identify. We would also like to thank Kathryn Coates and her network of mums,whoprovidedadviceonchildhoodconditionsandonwomen’s health, and on the sort of concerns and queries that they hoped their pharmacists would answer. Thanks also toCharlotte Purcell at Bradford School ofPharmacy. Alison Blenkinsopp PaulPaxton John Blenkinsopp PREFACE vii JohnBlenkinsopp/SymptomsinthePharmacy FinalProof 11.1.2005 7:49am pageviii
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