Community Pharmacy (Australian and New Zealand Edition)

Front cover
Inside front cover
Community Pharmacy
Copyright page
Table of Contents
Preface
Preface to the UK edition
Introduction
	Communication skills
	Approaches to differential diagnosis
	Clinical decision making
	Key steps in the process
		1. Formulating a diagnosis based  on the patient and the initial presenting complaint
		2. Asking questions
			Nature of the pain
			Location of the pain
			Severity of pain
		3. Confirming facts
	Product-based requests
	Documentation
How to use this book
	Key features of each chapter
	Self-assessment questions
	Elements included under  each condition
		Arriving at a differential diagnosis
		Primer for differential diagnosis
		Trigger points indicative of referral
		Evidence-based non-prescription medicines and practical prescribing  and product selection
		Hints and tips boxes
		References, further reading and web sites
Acknowledgements
UK acknowledgements
Useful websites
1 Respiratory system
	In this chapter
	Background
	General overview of the anatomy  of the respiratory tract
		Upper respiratory tract
			Nasal cavity
			Pharynx
			Larynx (voice box)
		Lower respiratory tract
			Trachea and bronchi
			Lungs
	History taking and physical exam
	Cough
		Background
		Prevalence and epidemiology
		Aetiology
		Arriving at a differential diagnosis
		Clinical features of acute viral cough
		Conditions to eliminate
			Acute cough
				Laryngotracheobronchitis (croup)
				Upper airways cough syndrome
			Chronic cough
				Chronic obstructive pulmonary disease (COPD)
				Asthma
				Medicine-induced cough or wheeze
			Rare causes of cough
			Productive coughs
				Heart failure
				Bronchiectasis
				Tuberculosis
				Pneumonia
				Carcinoma of the lung
				Legionnaire’s disease
			Non-productive coughs
				Gastro-oesophageal reflux disease
				Lung abscess
			Spontaneous pneumothorax (collapsed lung)
		Evidence base for  non-prescription medicines
			Expectorants
			Mucolytics
				Summary
			Cough suppressants (antitussives)
			Pholcodine
			Dextromethorphan
			Dihydrocodeine
			Antihistamines
			Demulcents
			Summary
		Combination cough mixtures
			Cough medicine for children
		Practical prescribing and product selection
			Cough expectorants
				Guaifenesin
			Mucolytics (bromhexine)
			Cough suppressants
				Pholcodine
				Dextromethorphan
				Dihydrocodeine
				Codeine
				Antihistamines
				Demulcents
	References
	Further reading
	Web sites
	The common cold
		Background
		Prevalence and epidemiology
		Aetiology
		Arriving at a differential diagnosis
		Clinical features of the common cold
		Conditions to eliminate
			Influenza
			Rhinitis
			Acute rhinosinusitis
			Otitis media
		Evidence base for non-prescription medicines
		Antihistamines
		Systemic and topical sympathomimetics
			Multi-ingredient preparations
			Alternative therapies
				Zinc lozenges
				Vitamin C
				Echinacea
				Vapour inhalation
				Saline sprays
		General summary
		Practical prescribing and  product selection
			Antihistamines
			Sympathomimetics
			Systemic sympathomimetics
				Phenylephrine
				Pseudoephedrine
			Topical sympathomimetics
				Ephedrine and phenylephrine
				Oxymetazoline, xylometazoline and tramazoline
	References
	Further reading
	Web sites
	Sore throat
		Background
		Prevalence and epidemiology
		Aetiology
		Arriving at a differential diagnosis
		Clinical features of sore throat
		Conditions to eliminate
			Streptococcal sore throat
			Glandular fever (infectious mononucleosis)
			Trauma-related sore throat
			Medicine-induced sore throat
			Laryngeal and tonsillar carcinoma
		Evidence base for  non-prescription medicines
			Local anaesthetics
			Antibacterial, antifungal,  and antiviral agents
			Antiinflammatories
			Analgesia
			Aspirin and salt water gargles
		Practical prescribing and product selection
			Local anaesthetics (lignocaine, benzocaine)
			Lignocaine
			Benzocaine
		Antiinflammatories (benzydamine  and flurbiprofen)
			Benzydamine
			Flurbiprofen
	References
	Further reading
	Web sites
	Rhinitis
		Background
		Prevalence and epidemiology
		Aetiology
		Arriving at a differential diagnosis
		Clinical features of intermittent  allergic rhinitis
		Conditions to eliminate
			Persistent allergic rhinitis
			Infective rhinitis
			Vasomotor rhinitis (intrinsic rhinitis)
		Non allergic rhinitis with eosinophillia syndrome (NARES)
		Rhinitis of pregnancy
		Rhinitis medicamentosa  and drug-induced rhinitis
			Nasal blockage
			Nasal foreign body
		Evidence base for  non-prescription medicines
			Allergen avoidance
			Medicines
				Systemic therapy: antihistamines
				Topical therapy
			Intranasal medicine
				Corticosteroids
				Antihistamines
				Mast cell stabilisers
				Anticholinergics
				Decongestants
			Ocular medicine
				Mast cell stabilisers (sodium  cromoglycate, lodoxamide)
				Antihistamines (levocabastine, antazoline, pheniramine, azelastine, ketotifen)
			Sympathomimetics (naphazoline, tetrahydrozoline)
		Summary
		Practical prescribing and product selection
			Systemic antihistamines (cetirizine, levocetirizine, loratadine, desloratadine  and fexofenadine)
			Cetirizine
			Levocetirizine
			Loratadine
			Desloratadine
			Fexofenadine
		Nasal corticosteroids (beclomethasone, fluticasone, budesonide, triamcinolone)
			Beclomethasone
			Fluticasone
			Budesonide
			Triamcinolone
		Nasal antihistamines
			Azelastine
			Levocabastine
		Ocular antihistamines
			Antazoline and pheniramine
			Azelastine, ketotifen, levocabastine
			Mast cell stabilisers
				Ocular and nasal sodium cromoglycate
				Lodoxamide eye drops
			Sympathomimetics
				Ocular sympathomimetics
		Naphazoline
			Phenylephrine
			Tetrahydrozoline
		Complementary therapies
	References
	Further reading
	Web sites
	Self-assessment questions
		Case studies
	Answers to multiple choice questions
2 Ophthalmology
	In this chapter
	Background
	General overview of eye anatomy
		The eyelids
		The sclera and cornea
		The iris, pupil and ciliary body
		The lens
		The retina
	History taking and the eye exam
	Red eye
		Background
		Prevalence and epidemiology
		Aetiology
		Arriving at a differential diagnosis
		Clinical features of conjunctivitis
		Conditions to eliminate
			Episcleritis
			Scleritis
			Keratitis (corneal ulcer)
			Uveitis
			Subconjunctival haemorrhage
			Acute closed-angle glaucoma
		Evidence base for  non-prescription medicines
			Viral conjunctivitis
			Bacterial conjunctivitis
			Allergic conjunctivitis
		Practical prescribing and  product selection
			Products for bacterial conjunctivitis
				Chloramphenicol eye drops and ointment
				Propamidine and dibromopropamidine isethionate
				Sulfacetamide
			Products for allergic conjunctivitis
				Antihistamines (levocabastine, azelastine, ketotifen, antazoline, pheniramine)
				Mast cell stabilisers (sodium cromoglycate  and lodoxamide)
			Sympathomimetics
				Naphazoline
				Phenylephrine
				Tetrahydrozoline
		References
		Further reading
		Web sites
	Eyelid disorders
		Background
		Prevalence and epidemiology
		Aetiology
		Arriving at a differential diagnosis
		Clinical features of blepharitis
		Clinical features of styes
		Conditions to eliminate for blepharitis  and styes
			Contact or irritant dermatitis
			Blepharitis and styes unresponsive to therapy
			Orbital cellulitis
			Chalazion
			Entropion
			Ectropion
			Basal cell carcinoma
		Evidence base for  non-prescription medicines
		Practical prescribing and product selection
			Blepharitis
			Styes
		Further reading
		Web sites
	Dry eye (keratoconjunctivitis sicca)
		Background
		Prevalence and epidemiology
		Aetiology
		Arriving at a differential diagnosis
		Clinical features of dry eye
		Conditions to eliminate
			Blepharitis
			Sjögren’s syndrome
			Bell’s palsy
			Medicine-induced dry eye
			Ectropion
			Rosacea
		Evidence base for  non-prescription medicines
		Summary
		Practical prescribing and product selection
			Hypromellose and carmellose
			Polyvinyl alcohol
			Carbomer 980
			Wool fats
			Lecithin
	References
	Further reading
	Web sites
	Self-assessment questions
		Multiple choice questions
		Case studies
	Answers to multiple choice questions
3 Otic conditions
	In this chapter
	Background
	General overview of ear anatomy
	History taking and physical exam
	Ear wax impaction
		Background
		Prevalence and epidemiology
		Aetiology
		Arriving at a differential diagnosis
		Clinical features of ear wax impaction
		Conditions to eliminate
			Trauma to the ear canal
			Foreign bodies
		Evidence base for  non-prescription medicines
		Summary
		Practical prescribing and product selection
			Cerumenolytics
			Dichlorobenzene with chlorbutol
			Carbamide peroxide
			Docusate
			Sodium bicarbonate
			Sodium chloride spray
			Complementary therapies
		References
		Further reading
		Web sites
	Otitis externa
		Background
		Prevalence and epidemiology
		Aetiology
		Arriving at a differential diagnosis
		Clinical features of otitis externa
		Conditions to eliminate
			Perichondritis
			Trauma
			Otalgia (earache)
			Malignant tumours
			Dermatitis
		Evidence base for  non-prescription medicines
		Practical prescribing and product selection
			Acetic acid plus isopropyl alcohol
			Propylene glycol diacetate
			Glycerol plus isopropyl alcohol
		References
		Further reading
		Web sites
	Self-assessment questions
		Multiple choice questions
		Case studies
	Answers to multiple choice questions
4 Central nervous system
	In this chapter
	Background
		General overview of CNS anatomy
		History taking
		Headache
			Background
			Headache classification
			Prevalence and epidemiology
			Aetiology
			Arriving at a differential diagnosis
			Clinical features of headache
			Tension-type headache
			Migraine
				Headache with aura (classic migraine)
				Headache without aura (common migraine)
			Cluster headache
			Conditions to eliminate
				Rhinosinusitis
				Eye strain
				Medication overuse headache
				Glaucoma
				Meningitis
				Subarachnoid haemorrhage
				Temporal arteritis
				Conditions causing raised  intracranial pressure
				Trigeminal neuralgia
				Depression
			Evidence base for  non-prescription medicines
				Metoclopramide and paracetamol
				Prochlorperazine
			Summary
			Practical prescribing and product selection
				Metoclopramide plus paracetamol
				Prochlorperazine
				Complementary therapies
		References
		Further reading
		Web sites
	Insomnia
		Background
		Prevalence and epidemiology
		Aetiology
		Arriving at a differential diagnosis
		Clinical features of insomnia
		Conditions to eliminate
			Insomnia in children
			Medicine-induced insomnia
			Underlying medical conditions
			Depression
		Evidence base for  non-prescription medicines
			Sleep hygiene
		Medicines
			Diphenhydramine
			Doxylamine
		Summary
		Complementary therapies
		Practical prescribing and  product selection
			Diphenhydramine
			Doxylamine
		References
		Further reading
		Web sites
	Self-assessment questions
		Multiple choice questions
		Case studies
	Answers to multiple choice questions
5 Women’s health
	In this chapter
	Background
	History taking
	Cystitis
		Background
		Prevalence and epidemiology
		Aetiology
		Arriving at a differential diagnosis
		Clinical features of acute  uncomplicated cystitis
		Conditions to eliminate
			Pyelonephritis
			Vaginitis
				Chemical vaginitis
			Sexually transmitted infections
			Medicine-induced cystitis
			Oestrogen deficiency
		Evidence base for  non-prescription medicines
			Alkalinising agents
			Hexamine hippurate
			Cranberry juice
		Practical prescribing and product selection
			Urinary alkalinisers
			Hexamine hippurate
		References
		Further reading
		Web sites
	Vaginal discharge
		Background
		Prevalence and epidemiology
		Aetiology
		Arriving at a differential diagnosis
		Clinical features of thrush
		Conditions to eliminate
			Bacterial vaginosis
			Trichomoniasis
			Cystitis
			Recurrent thrush
			Atrophic vaginitis
			Medicine-induced thrush
			Diabetes
			Pregnancy
			Chemical and mechanical irritants
		Evidence base for  non-prescription medicines
		Practical prescribing and product selection
			Topical imidazoles (clotrimazole,  butoconazole, miconazole)
			Fluconazole
			Nystatin
		References
		Further reading
		Web sites
	Primary dysmenorrhoea (period pain)
		Background
		Prevalence and epidemiology
		Aetiology
		Arriving at a differential diagnosis
		Clinical features of PD
		Conditions to eliminate
			Secondary dysmenorrhoea (e.g. Endometriosis)
			Dysfunctional uterine bleeding
			Pelvic inflammatory disease
			Endometrial carcinoma
		Evidence base for  non-prescription medicines
			Non-steroidal antiinflammatories
			Simple and compound analgesics
			Combined oral contraceptives
			Non-drug treatments
		Practical prescribing and product selection
			Ibuprofen
			Diclofenac
			Mefenamic acid
			Naproxen
			Codeine + paracetamol ± doxylamine
		References
		Further reading
		Web sites
	Premenstrual syndrome
		Background
		Prevalence and epidemiology
		Aetiology
		Arriving at a differential diagnosis
		Clinical features of PMS
		Conditions to eliminate
			Primary dysmenorrhoea
			Mental health disorders
		Evidence base for  non-prescription medicines
		Practical prescribing and product selection
			Vitamin B6 (pyridoxine)
			Calcium
		Heavy menstrual bleeding (menorrhagia)
			Background
			Prevalence and epidemiology
			Aetiology
			Arriving at a differential diagnosis
			Clinical features of HMB
			Conditions to eliminate
				Medicine-induced menstrual bleeding
				Endometrial and cervical carcinomas
			Evidence base for  non-prescription medicines
			Practical prescribing and product selection
				Mefenamic acid
		References
		Further reading
		Web sites
	Self-assessment questions
		Multiple choice questions
		Case studies
	Answers to multiple choice questions
6 Gastroenterology
	In this chapter
	Background
	General overview of the anatomy of the GI tract
		Oral cavity
		Stomach
		Liver
		Gall bladder
		Pancreas
		Small intestine
		Large intestine
	History taking and  the physical exam
	Conditions affecting the oral cavity
		Background
		The physical exam
	Mouth ulcers
		Background
		Prevalence and epidemiology
		Aetiology
		Arriving at a differential diagnosis
		Clinical features of minor aphthous ulcers
		Conditions to eliminate
			Major aphthous ulcers
			Herpetiform ulcers
			Trauma
			Oral thrush
			Herpes simplex
			Medicine-induced ulcers
			Squamous cell carcinoma
			Erythema multiforme
			Behçet’s syndrome
			Hand, foot and mouth disease
		Evidence base for  non-prescription medicines
			Triamcinolone acetonide 0.1% in Orabase
			Antibacterial agents (e.g. chlorhexidine)
			Products containing anaesthetic or analgesics
			Choline salicylate
			Protectants
		Practical prescribing and  product selection
			Triamcinolone acetonide 0.1% in Orabase (Triamcinolone 0.1% in Orabase)
			Choline salicylate
			Local anaesthetics (lignocaine  and benzocaine)
			Antibacterial agents (e.g. chlorhexidine)
			Orabase protective paste
		References
		Further reading
		Web sites
	Oral candidiasis (thrush)
		Background
		Prevalence and epidemiology
		Aetiology
		Arriving at a differential diagnosis
		Clinical features of oral thrush
		Conditions to eliminate
			Leukoplakia
			Mouth ulcers and squamous cell carcinoma
			Lichen planus
		Evidence base for  non-prescription medicines
		Practical prescribing and product selection
			Miconazole gel
			Nystatin drops
		References
		Further reading
		Web sites
	Gingivitis
		Background
		Prevalence and epidemiology
		Aetiology
		Arriving at a differential diagnosis
		Clinical features of gingivitis
		Conditions to eliminate
			Periodontitis
			Spontaneous bleeding
			Medicine-induced gum bleeding/hypertrophy
		Evidence base for  non-prescription medicines
		Practical prescribing and product selection
			Chlorhexidine gluconate
			Povidone–iodine
			Cetylpyridinium
			Sodium perborate
			Hydrogen peroxide oral cleanser
		References
		Further reading
		Web sites
	Dyspepsia
		Background
		Prevalence and epidemiology
		Aetiology
		Arriving at a differential diagnosis
		Clinical features of dyspepsia
		Conditions to eliminate
			Peptic ulceration
			Medicine-induced dyspepsia
			Irritable bowel syndrome
			Gastric carcinoma
			Oesophageal carcinoma
			Atypical angina
		Evidence base for  non-prescription medicines
			Antacids
			Alginates
			H2 antagonists
			Proton pump inhibitors
		Summary
		Practical prescribing and  product selection
			Antacids
			Alginates
			H2 antagonists
			Famotidine
			Ranitidine
			Proton Pump Inhibitors
		References
		Further reading
		Web sites
	Diarrhoea
		Background
		Prevalence and epidemiology
		Aetiology
		Arriving at a differential diagnosis
		Clinical features of acute diarrhoea
		Conditions to eliminate
			Giardiasis
			Irritable bowel syndrome
			Medicine-induced diarrhoea
			Ulcerative colitis and Crohn’s disease
			Malabsorption syndromes
			Faecal impaction
			Colorectal cancer
		Evidence base for  non-prescription medicines
			Oral rehydration therapy
			Rice-based ORT
			Other electrolyte solutions and soft drinks
			Loperamide
			Diphenoxylate
			Adsorbants (kaolin, pectin, chalk)
			Codeine
			Rotavirus vaccine
		Summary
		Practical prescribing and product selection
			ORT
			Loperamide
			Diphenoxylate
		References
		Further reading
		Web sites
	Constipation
		Background
		Prevalence and epidemiology
		Aetiology
		Arriving at a differential diagnosis
		Clinical features of constipation
		Conditions to eliminate
			Medicine-induced constipation
			Irritable bowel syndrome
			Pregnancy
			Functional causes in children
			Depression
			Colorectal cancer
			Hypothyroidism
		Evidence base for  non-prescription medicines
		Summary
		Practical prescribing and product selection
			Bulk-forming laxatives (e.g. ispaghula husk, psyllium, and sterculia)
				Ispaghula husk
				Psyllium
				Sterculia
			Stimulant laxatives (e.g. bisacodyl, glycerol, senna, sodium picosulfate)
				Bisacodyl
				Glycerol suppositories
				Senna
				Sodium picosulfate (Dulcolax SP)
			Osmotic laxatives (e.g. Lactulose, magnesium salts, sorbitol, macragols)
				Lactulose
				Magnesium salts (e.g. Epsom Salts)
				Sodium citrate
				Sorbitol
				Macrogols
			Stool softeners (liquid paraffin, docusate sodium, poloxamer)
				Liquid paraffin
				Docusate sodium
				Poloxamer
		References
		Further reading
		Web sites
	Irritable bowel syndrome
		Background
		Prevalence and epidemiology
		Aetiology
		Arriving at a differential diagnosis
		Clinical features of IBS
		Conditions to eliminate
			Constipation and diarrhoea
		Evidence base for  non-prescription medicines
			Hyoscine
			Antispasmodics (peppermint oil)
		Summary
			Alternative treatments
		Practical prescribing and product selection
			Hyoscine butylbromide
			Peppermint oil
		References
		Further reading
		Web sites
	Haemorrhoids
		Background
		Prevalence and epidemiology
		Aetiology
		Arriving at a differential diagnosis
		Clinical features of haemorrhoids
		Conditions to eliminate
			Dermatitis
			Medicines
			Conditions causing rectal bleeding
			Anal fissure
			Ulcerative colitis and Crohn’s disease
			Upper GI bleeds
			Colorectal cancer
		Evidence base for  non-prescription medicines
			Diet
			Pharmacological interventions
			Anaesthetics (lignocaine, benzocaine  and cinchocaine)
			Astringents (zinc, hamamelis extract, allantoin, aluminium acetate)
			Antiinflammatories (hydrocortisone)
			Protectorants (e.g. shark liver oil)
			Other agents
		Summary
		Practical prescribing and  product selection
		References
		Further reading
		Web sites
	Abdominal pain
		Background
		Prevalence and epidemiology
		Aetiology
		Arriving at a differential diagnosis
		Conditions affecting the upper abdomen
			Left upper quadrant pain
				Dyspepsia/gastritis
				Splenic enlargement or rupture
			Right upper quadrant pain
				Acute cholecystitis and cholelithiasis
				Hepatitis
				Ulcers
			Pain affecting both right and left  upper quadrants
				Acute Pancreatitis
				Renal colic
				Myocardial ischaemia
				Herpes zoster (shingles)
			Conditions affecting the lower abdomen
				Irritable bowel syndrome
				Diverticulitis
				Intestinal obstruction
				Appendicitis
				Conditions affecting women
			Diffuse abdominal pain
				Gastroenteritis
				Peritonitis
		Evidence base for non-prescription medicines and practical prescribing  and product selection
		Further reading
		Websites
	Self-assessment questions
		Multiple choice questions
		Case studies
	Answers to multiple choice questions
7 Dermatology
	In this chapter
	Background
		General overview of skin anatomy
			The epidermis
			The dermis
			The hair
			Sebaceous glands
			Sweat glands
		History taking
		Physical examination
		Hyperproliferative disorders
			Background
		Psoriasis
			Background
			Prevalence and epidemiology
			Aetiology
			Arriving at a differential diagnosis
			Clinical features of plaque psoriasis
			Clinical features of scalp psoriasis
			Conditions to eliminate for  plaque psoriasis
				Pustular psoriasis
				Seborrhoeic psoriasis (also known as  flexural psoriasis)
				Guttate psoriasis (also known as  rain-drop psoriasis)
				Erythrodermic psoriasis
				Tinea corporis
				Lichen planus
				Pityriasis rosacea
			Medicine that can trigger or  aggravate psoriasis
			Conditions to eliminate for scalp psoriasis
				Seborrhoeic dermatitis
				Tinea capitis (fungal infection of the scalp)
			Evidence base for  non-prescription medicines
				Emollients
				Keratolytics
				Coal tar
				Dithranol
			Practical prescribing and product selection
				Emollients
				Tar-based products
				Dithranol
		References
		Further reading
		Web sites
	Dandruff (pityriasis capitis)
		Background
		Prevalence and epidemiology
		Aetiology
		Arriving at a differential diagnosis
		Clinical features of dandruff
		Conditions to eliminate
			Seborrhoeic dermatitis
			Contact dermatitis
			Tinea capitis
		Evidence base for  non-prescription medicines
			Coal tar
			Selenium sulfide
			Zinc pyrithione
			Piroctone olamine
			Ciclopirox olamine
			Imidazoles (ketoconazole, miconazole)
		Practical prescribing and product selection
			Coal tar products
			Selenium sulfide
			Zinc pyrithione
			Piroctone olamine
			Ciclopirox olamine
			Ketoconazole
			Miconazole
		References
		Further reading
	Seborrhoeic dermatitis
		Background
		Prevalence and epidemiology
		Aetiology
		Arriving at a differential diagnosis
		Clinical features of seborrhoeic dermatitis
		Conditions to eliminate
			Atopic dermatitis
			Psoriasis
			Pityriasis versicolor (meaning bran-like scaly rash of various colour)
		Evidence base for  non-prescription medicines
		Practical prescribing and product selection
			Cradle Cap Lotion
		References
		Further reading
		Web sites
	Fungal infections
		Background
		Prevalence and epidemiology
		Aetiology
		Arriving at a differential diagnosis
		Clinical features of tinea infections
			Athlete’s foot
			Tinea corporis
			Tinea cruris
		Conditions to eliminate
			Tinea faciei
			Tinea manuum
			Psoriasis
			Dermatitis – allergic and contact forms
		Evidence base for  non-prescription medicines
			Allylamines
			Benzoic acid
			Imidazoles
			Tolnaftate
			Undecenoates
		Summary
		Practical prescribing and product selection
			Imidazoles (clotrimazole, econazole, miconazole, ketoconazole, bifonazole)
			Bifonazole
			Clotrimazole
			Econazole
			Ketoconazole
			Miconazole
			Terbinafine
			Tolnaftate
			Undecenoates
			Benzoic acid (e.g. Whitfield’s ointment, Benzoic Acid Compound Ointment APF)
		References
		Further reading
		Web sites
	Fungal nail infection (onychomycosis)
		Background
		Prevalence and epidemiololgy
		Aetiology
		Arriving at a differential diagnosis
		Clinical features of distal subungual onychomycosis (DSO)
		Other conditions to eliminate
		Evidence base for  non-prescription medicines
		Practical prescribing and  product selection
			Miconazole tincture
			Amorolfine
		References
		Further reading
		Web sites
	Hair loss
		Background
		Prevalence and epidemiology
		Aetiology
		Arriving at a differential diagnosis
		Clinical features of androgenetic alopecia
		Conditions to eliminate
			Telogen effluvium
			Post-partum
			Stress
			Nutritional factors
			Underlying endocrine disorder
			Fungal scalp infection (tinea capitis)
			Alopecia areata
			Traction alopecia
			Medicine-induced causes
			Trichotillomania
		Evidence base for  non-prescription medicines
		Summary
		Practical prescribing and product selection
			Minoxidil
		References
		Further reading
		Web sites
	Warts
		Background
		Prevalence and epidemiology
		Aetiology
		Arriving at a differential diagnosis
		Clinical features of warts
			Common warts
			Plantar warts
		Conditions to eliminate
			Plane warts (flat warts or verruca plana)
			Molluscum contagiosum
			Corns
			Seborrhoeic keratoses (Seborrhoeic warts; Basal cell papillomas)
			Basal cell carcinoma
		Evidence base for  non-prescription medicines
		Summary
		Practical prescribing and product selection
			Salicylic acid products
			Glutaraldehyde
			Podophyllum resin
			Home cryotherapy
		References
		Further reading
		Web sites
	Corns and calluses
		Background
		Prevalence and epidemiology
		Aetiology
		Arriving at a differential diagnosis
		Clinical features of corns
		Clinical features of calluses
		Conditions to eliminate
			Plantar warts
			Bunions
		Evidence base for  non-prescription medicines
		Practical prescribing and product selection
		References
		Further reading
		Web sites
	Scabies
		Background
		Prevalence and epidemiology
		Aetiology
		Arriving at a differential diagnosis
		Clinical features of scabies
		Conditions to eliminate
			Allergic contact dermatitis
			Dermatitis herpetiformis
			Dishydrotic eczema (Pompholyx)
			Insect bites
		Evidence base for  non-prescription medicines
		Summary
		Practical prescribing and product selection
			Permethrin
			Benzyl benzoate
			Crotamiton
		References
		Further reading
		Web sites
	Acne vulgaris
		Background
		Prevalence and epidemiology
		Aetiology
		Arriving at a differential diagnosis
		Clinical features of mild acne vulgaris
		Conditions to eliminate
			Rosacea
			Medicines causing acne-like skin eruptions
			Perioral dermatitis
			Polycystic ovary syndrome
		Evidence base for  non-prescription medicines
			Benzoyl peroxide
			Salicylic acid and sulfur
			Azelaic acid
			Complementary and alternative treatments
		Summary
		Practical prescribing and product selection
			Benzoyl peroxide
			Azelaic acid
		References
		Further reading
		Web sites
	Cold sores
		Background
		Prevalence and epidemiology
		Aetiology
		Arriving at a differential diagnosis
		Clinical features of cold sores
		Conditions to eliminate
			Impetigo
			Angular cheilitis
		Evidence base for  non-prescription medicines
		Summary
		Practical prescribing and product selection
			Aciclovir
			Hydrocolloid patch
			Idoxuridine and lignocaine
			Povidone–iodine
		References
		Further reading
		Web sites
	Eczema and dermatitis
		Background
		Prevalence and epidemiology
		Aetiology
		Arriving at a differential diagnosis
		Clinical features of ACD and ICD
		Conditions to eliminate
			Discoid dermatitis
		Dishydrotic eczema (pompholyx)
			Fungal infections
			Psoriasis
			Urticaria
		Evidence base for  non-prescription medicines
			Emollients
			Steroids
		Practical prescribing and product selection
			Emollients
			Hydrocortisone
			Clobetasone
		References
		Further reading
		Web sites
	Sunburn and sun protection
		Background
		Prevalence and epidemiology
		Aetiology
		Arriving at a differential diagnosis
		Clinical features of malignant melanomas
		Evidence base for  non-prescription medicines
		Practical prescribing and product selection
			Chemical sunscreens
			Physical sunscreens
		Further reading
		Web sites
	Bites and stings
		Background
		Prevalence and epidemiology
		Aetiology
		Evidence base for  non-prescription medicines
		Practical prescribing and  product selection
			Local anaesthetics
			Bufexamac
			Hydrocortisone
			Antihistamines (e.g promethazine, dexchlorpheniramine)
			Aluminium sulfate
		References
		Web sites
	Self-assessment questions
		Multiple choice questions
		Case studies
	Answers to multiple choice questions
8 Musculoskeletal conditions
	In this chapter
	Background
	General overview of  musculoskeletal anatomy
	History taking
	Acute low back pain
		Background
		Prevalence and epidemiology
		Aetiology
		Arriving at a differential diagnosis
		Clinical features of acute low back pain
		Conditions to eliminate
			Causes of low back pain not related  to back pathophysiology
				Sciatica
				Malignancy
				Infection
		Chronic causes of low back pain
			Osteoarthritis
			Inflammatory arthropathies
		Evidence base for  non-prescription medicines
			Conservative treatment
			Analgesics (paracetamol, NSAIDs,  e.g. aspirin, ibuprofen)
			Compound analgesics
				Codeine/dihydrocodeine
				Antihistamines (doxylamine)
				Caffeine
			Topical therapy
				NSAIDs
				Rubefacients
				Capsaicin
				Enzymes
		Summary on topical products
		Complementary therapies
			Herbal remedies
			Acupuncture
			Massage therapy
			Superficial heat and cold
			Glucosamine
			Chondroitin
			Copper
			Arnica
		Summary
		Practical prescribing and product selection
			Paracetamol
			Aspirin
			Non-steroidal antiinflammatories (ibuprofen, diclofenac, mefenamic acid, naproxen)
			Topical NSAIDs (e.g. ibuprofen, piroxicam, diclofenac, benzydamine, ketoprofen)
			Rubefacients
		References
		Further reading
		Web sites
	Activity-related/sports-related soft tissue injuries
		Background
		Prevalence and epidemiology
		Aetiology
		Arriving at a differential diagnosis
		Clinical features of soft tissue injury
		Shoulder-specific conditions
			Rotator cuff syndrome
			Frozen shoulder
		Elbow-specific conditions
		Knee-specific conditions
			Ligament damage
			Runner’s knee (chondromalacia)
		Ankle- and foot-specific conditions
			Ankle sprains
			Achilles tendon injuries
			Plantar fasciitis
			Common muscle strains
				Thigh strains
			Conditions to eliminate
				Delayed onset muscle soreness
				Shin splint syndrome
				Bursitis
				Stress fractures
				Gout
				Carpal tunnel syndrome
				Repetitive strain injury
				Drug-induced myopathy
		Evidence base for non-prescription medicines and practical prescribing and product selection
		References
		Further reading
		Web sites
	Self-assessment questions
		Multiple choice questions
		Case studies
	Answers to multiple choice questions
9 Paediatrics
	In this chapter
	Background
	History taking
	Head lice
		Background
		Prevalence and epidemiology
		Aetiology
		Arriving at a differential diagnosis
		Clinical features of head lice
		Conditions to eliminate
			Dandruff
			Seborrhoeic dermatitis
			White piedra
		Evidence base for  non-prescription medicines
		Practical prescribing and product selection
			Permethrin
			Pyrethrins with piperonyl butoxide
			Maldison
			Dimethicone
		References
		Further reading
		Web sites
	Threadworm (Enterobius vermicularis)
		Background
		Prevalence and epidemiology
		Aetiology
		Arriving at a differential diagnosis
		Clinical features of threadworm
		Conditions to eliminate
			Other worm infections
			Contact irritant dermatitis
		Evidence base for  non-prescription medicines
		Practical prescribing and product selection
			Mebendazole
			Pyrantel
		References
		Further reading
		Web sites
	Colic
		Background
		Prevalence and epidemiology
		Aetiology
		Arriving at a differential diagnosis
		Clinical features of colic
		Conditions to eliminate
			Acute infection
			Intolerance to cow’s milk protein
			Gastro-oesophageal reflux disease (GORD)
		Evidence base for  non-prescription medicines
		Practical prescribing and product selection
			Simethicone
		References
		Further reading
		Web sites
	Atopic dermatitis
		Background
		Prevalence and epidemiology
		Aetiology
		Arriving at a differential diagnosis
		Clinical features of atopic dermatitis
		Conditions to eliminate
			Seborrhoeic dermatitis
			Psoriasis
			Herpes simplex complications
		Evidence base for  non-prescription medicines
			Avoiding irritants
			Emollients
			Antihistamines
			Corticosteroids
		Practical prescribing and product selection
			Emollients
			Sedating antihistamines
			Dexchlorpheniramine
			Trimeprazine
			Promethazine
		References
		Further reading
		Web sites
	Fever
		Background
		Prevalence and epidemiology
		Aetiology
		Arriving at a differential diagnosis
		Clinical features of fever
		Conditions to eliminate
			Upper respiratory tract infections
			Roseola infantum (sixth disease)
			Glandular fever
			Urinary tract infection
			Medicine-induced fever
			Meningitis
			Pneumonia
		Evidence base for  non-prescription medicines
		Practical prescribing and product selection
			Paracetamol
			Ibuprofen
		References
		Further reading
		Web sites
	Infectious childhood conditions
		Background
		Meningitis
		Glandular fever
		Chicken pox
		Molluscum contagiosum
		Impetigo
		Measles
		German measles (rubella)
		Mumps
		Web sites
	Nappy rash
		Background
		Prevalence and epidemiology
		Aetiology
		Arriving at a differential diagnosis
		Clinical features of irritant nappy rash
		Conditions to eliminate
			Secondary infections
			Seborrhoeic dermatitis
			Psoriasiform nappy eruptions
		Evidence base for  non-prescription medicines
		Practical prescribing and product selection
		References
		Further reading
		Web sites
	Self-assessment questions
		Multiple choice questions
		Case studies
	Answers to multiple choice questions
10 Specific product requests
	In this chapter
	Background
		Motion sickness
			Prevalence and epidemiology
			Aetiology
			Evidence base for  non-prescription medicines
			Practical prescribing and product selection
				Antihistamines
				Dimenhydrinate
				Pheniramine
				Promethazine
				Hyoscine hydrobromide
				Ginger
		References
		Further reading
		Web sites
	Emergency hormonal contraception
		Background
		Aetiology
		Evidence base for  non-prescription medicines
		Practical prescribing and product selection
		Assessing patient suitability
		Levonorgestrel EHC
		References
		Further reading
		Web sites
	Nicotine replacement therapy
		Background
		Prevalence and epidemiology
		Aetiology
		Evidence base for  non-prescription medicines
		Practical prescribing and product selection
			Nicorette
			Gum
			Inhalation cartridge
			Microtabs
			Patches
			Nicabate
				Patches
				Lozenges
				Gums
			QuitX
			Nicotinell
		Further reading
		Web sites
	Weight loss
		Background
		Prevalence and epidemiology
		Aetiology
		Evidence base for  non-prescription medicines
		Practical prescribing and product selection
		Orlistat
		Further reading
		Web sites
	Potential medicines  for re-classification
	Self-assessment questions
		Multiple choice questions
		Case studies
	Answers to multiple choice questions
Evidence Based Pharmacy Practice
	In this chapter
	What is evidence based practice?
	Myths about evidence based practice
		Evidence based practice is  ‘cookbook’ medicine
		There is no evidence for non-prescription medicines and CAM
		It is too hard to find the evidence
	What is good evidence?
		What is ‘bias’?
	Locating the evidence
		Formulating your question
		Identifying appropriate sources
			Other sources of information
		Searching appropriate sources
	Evaluating the quality of  the evidence
		Judging the quality of a systematic review
		Judging the quality of a randomised controlled trial
			Method of randomisation
			Method of blinding
			Follow up of participants
			Registration or publication of  the trial protocol
	Interpreting the evidence
		Size of the effect in the study
			Surrogate, clinical and patient  relevant outcomes
			Continuous versus dichotomous outcomes
			Statistical versus clinical significance
		Can I apply the results to my patients?
			What were the patients like in the study?
			What did they compare the drug to?
			How was the new drug used?
	Developing an evidence based personal formulary
		Selecting a ‘p-drug’
			Defining the patient problem and  specifying the therapeutic objective
			Making an inventory of possible treatments
			Selecting your p-drug based on criteria
		Having a back-up ‘p-drug’
	References
	Further reading
	Websites
	Medicines information centres
		Australia
		New Zealand
Answers to case study questions
	Chapter 1
		Case study 1.3
		Case study 1.4
	Chapter 2
		Case study 2.2
		Case study 2.3
	Chapter 3
		Case Study 3.1
		Case Study 3.2
	Chapter 4
		Case study 4.2
		Case study 4.3
		Case study 4.4
	Chapter 5
		Case Study 5.3
	Chapter 6
		Case study 6.3
		Case study 6.4
	Chapter 7
		Case study 7.3
		Case study 7.4
	Chapter 8
		Case study 8.2
		Case study 8.3
	Chapter 9
		Case study 9.2
		Case study 9.3
	Chapter 10
		Case study 10.1
		Case study 10.2
Abbreviations
Glossary of terms
Index
	A
	B
	C
	D
	E
	F
	G
	H
	I
	J
	K
	L
	M
	N
	O
	P
	R
	S
	T
	U
	V
	W
	X
	Z