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Practical Approach: Treating tennis elbow 24/02/2010
Practical Approach: Smoking cessation and psychoactive drugs 17/02/2010
Practical Approach: A persistent, barking cough 11/02/2010
Practical Approach: What to do about loss of libido 03/02/2010
Practical approach: A CD script from an independent prescriber 26/01/2010
Practical Approach - Complementary remedies for colds? 22/01/2010 It is the height of the cough and cold season at the Update Pharmacy.
Practical Approach: Changes to clopidogrel dispensing 13/01/2010
Practical Approach - What to do with an itchy ear 11/01/2010
At the Update Pharmacy, a young man with an itchy ear has been referred to pharmacist David Spencer, who asks him about it.
Practical approach: Recruitment: an unhappy applicant 17/12/2009
Practical approach: Problems with oral contraceptives 20/11/2009
Practical Approach: Analgesia for worsening pain in cancer 13/11/2009
Practical Approach: Cystic fibrosis therapy 06/11/2009
Practical Approach: Identifying and treating female hirsutism 30/10/2009
Practical Approach: A facial skin rash 22/10/2009
Practical approach: Statin prescribing 15/10/2009
Practical approach: going on the Hajj 08/10/2009
Practical approach: Getting relief from itchy legs 01/10/2009
Practical Approach: A burning rash: what is the likely diagnosis? 24/09/2009
Practical Approach: prescription medicines in Dubai 17/09/2009
Practical Approach: Communication skills 20/08/2009
Practical Approach: A persistent cough 14/08/2009
Practical Approach: A script-endorsing exercise 06/08/2009
Practical Approach: Is it meningitis? 30/07/2009
Practical Approach: Isotretinoin for a teenage girl 23/07/2009
Practical Approach: Insect bites? 25/06/2009
Practical approach: A mock medication review 11/06/2009
Practical Approach: A 'funny turn' 04/06/2009
Practical Approach: antihistamines for a horse 28/05/2009
Practical Approach: a cardiovascular check 21/05/2009
Practical Approach: Optimum dose timing 14/05/2009
Practical Approach: Exemption declarations 07/05/2009
Practical Approach: Hypertension headache? 30/04/2009
Practical Approach: Once-daily dose timing 23/04/2009
A Practical Approach: Respiratory infections 16/04/2009
A Practical Approach: Prescribing for a dog 09/04/2009
A Practical Approach: Complementary therapies 02/04/2009
A Practical Approach: A facial sore 26/03/2009
A Practical Approach: CD cupboard access 19/03/2009
A Practical Approach: Knobbly knuckles 12/03/2009
A Practical Approach: Asthma treatment 05/03/2009
A Practical Approach: Drinker's rash? 26/02/2009
A Practical Approach: Ibuprofen in the elderly 20/02/2009
A Practical Approach: Once-daily doses 12/02/2009
A Practical Approach: Lack of sleep 05/02/2009
A Practical Approach: Different types of cough 29/01/2009
A Practical Approach: A lunchtime emergency 22/01/2009
A Practical Approach: Strontium ranelate 15/01/2009
A practical approach: Heartburn 08/01/2009
A Practical Approach: Script charge queries 19/12/2008
A Practical Approach: Depression 12/12/2008
A Practical Approach: Stingy Prescriber? 08/12/2008
A Practical Approach: Risperidone side effects 12/11/2008
A Practical Approach: A mystery illness 06/11/2008
A Practical Approach: Painful toes 30/10/2008
Practical Approach: Invitation to work on a formulary
A Practical Approach: Just getting older? 16/10/2008
A Practical Approach: An MUR Request
A Practical Approach: Sexually transmitted infections 25/09/2008
Practical Approach: an unwanted medicine
A Practical Approach: Chloramphenicol Drops Sale
A Practical Approach: Unpaid locum
A Practical Approach: Endorsing Questions
A Practical Approach: Depression or Drunkenness?
A Practical Approach: Cranberry juice
A Practical Approach: Inhaler Non-compliance A mother returns six beclometasone 100mcg inhalers that her son had not used. What steps should the pharmacist take over the boy's non-compliance? A Practical Approach: Roundworm
A Practical Approach: Foot ulcer
A Practical Approach: Malaria prophylaxis 10/07/2008
A Practical Approach: Diabetes epidemic? 03/07/2008
A Practical Approach: Red Eye 27/06/2008
A Practical Approach: Leg Pain 20/06/2008
A practical approach: Dentists' prescriptions 12/06/2008
A Practical Approach: Worsening Asthma 06/06/2008
A Practical Approach: Non-medical prescribing 30/05/2008
Practical Approach: OTC Analgesics 22/05/2008
A Practical Approach: Drug problem 15/05/2008
Under pressure 30/04/2008
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A painter and decorator visits the pharmacy for OTC treatment for a painful arm. If this is tennis elbow, can it be treated with OTC medication or might a GP provide more effective treatment? And what might the prognosis be?
A local GP practice is concerned about the effect of smoking on the psychoactive drugs they prescribe, and equally the consequences of patients giving up smoking. So they ask the pharmacist to draw up some guidance on interactions between psychoactive drugs and smoking and stopping smoking.
A tired looking teeenager presents with a persistent, barking cough she has had for two weeks. Could it be whooping cough? What might the GP prescribe and why? And what is the prognosis for the girl's cough?
A female member of the pharmacy staff asks what might cause a loss of sexual desire. Could drugs be the problem and how can the pharmacist help? Could herbal medicines be of use?
A locum dispenses a pharmacist independent prescriber's script for 24 co-codamol 8/500 tablets. This results in a phone call from a Society inspector who says the supply may constitute an offence against the Misuse of Drugs Act 1971. Can you explain why? What could have been done to avoid the situation?
David Spencer, pharmacist at the Update Pharmacy, is drafting a note to send to local GP practices about a recent Drug Tariff change to clopidogrel, which appears to be causing some confusion among prescribers. He decides first to consult GP Mo Merali, to whose practice he supplies prescribing advice.
A careless comment from a counter assistant leads to a solicitor's letter and a claim for sexual discrimination. Pitfalls to be wary of when seeking new staff.
A woman patient is concerned that the low strength combined oral contraceptive that she has been taking for some yearsis affecting her mental and emotional state. What might the problem be and how might the pharmacist help?
The GP asks for advice initially on doses of long acting oral morphine and then for diamorphine hydrochloride by subcutaneous infusion for a terminally ill patient. Where exactly would the pharmacist find the required information?
Questions over Colomycin and Promixin lead to tips that will help you conduct MURs for cystic fibrosis patients
A young Asian woman asks about facial and body hair removal. What questions might the pharmacist ask, and what advice could be offered?
A livestock truck driver complains of a rash which is erythematous and scaly, with ring-like slightly raised lesions, on the man’s cheeks, chin and neck. What might the cause be and what treatments might the pharmacist recommend?
Local GPs say they are awash with advice on statin prescribing and they ask the pharmacist for clear and concise guidance. What key points should the pharmacist cover in their guidance?
What advice might a pharmacist include on vaccination, swine flu and prescription medicines in an information leaflet for patients planning a pilgrimage?
A woman customer asks for antihistamines for her itchy legs. The pharmacist establishes that she has no other symptoms or illnesses and suggests that it isn't an allegy at all. What might be causing the problem and what would be the next step?
An elderly lady has a slightly inflamed band down the right side of her chest, from just under her armpit to just above her navel. But with no spots. What is the likely cause?
A regular patient, who was the victim of a violent mugging, is escaping to Dubai on holiday. Can she take her prescription medicines for post traumatic stress disorder and pain?
A 73-year-old's misuse of medication leads the pharmacist to conside ways of overcoming barriers to effective communication while conducting an MUR
A man with "quite a bit of heartburn" is also complaining of persistent cough. What might be causing it and can the pharmacist help without a GP referral?
Manu Patel, the new pre-reg at the Update Pharmacy, is being introduced to the mysteries of endorsing prescriptions by pharmacist David Spencer.
A worried mother who brought her three-year-old son into the pharmacy the previous day with a runny nose and sore throat is now concerned he has meningitis.
A mother questions the use of isotretinoin for her daughter. What advice can the pharmacist offer on the restrictions associated with this treatment and what are the risks of depression?
A six-year-old boy has spots which a locum doctor thought were insect bites. Pharmacist David Spencer is not so sure. Could they be something more serious?
The pre-reg tries her hand at a mock medication review and is asked what points she should identify and what actions she should take.
A patient says he had a 'funny turn' but the pharmacist is concerned it is more serious. What was the likely cause of the episode and what treatment should be advised?
A stable owner asks for cetirizine for her horses but the locum pharmacist refuses to supply. Was she correct? And how might the situation be resolved?
A cardiovascular check for a customer on a repeat script for atenolol 50mg and enalapril 20mg daily reveals high blood pressure. What might the problem be and what advice might the pharmacist offer?
Pre-reg trainee Joanna is advising local GPs on optimum dose timings for hypoglycaemic agents, asthma treatments and NSAIDs with once-daily doses. What should she cover?
A district nurse presents some unsigned scripts for patients who are on benefit. Can pharmacy staff complete exemption declarations on behalf of patients?
Could a man with high blood pressure be suffering from hypertension headaches? If not, what else might his problem be?
Pre-reg Joanna is giving a talk to GPs about once-daily dose timings for anti-gastric secretion drugs and antidepressants. What are the main points she should cover?
A patient diagnosed with late onset asthma regularly presents scripts for antibiotics to treat a chesty cough. Could the problem have another underlying cause?
A doctor is unhappy about a vet's fees and asks the pharmacist to dispense a prescription for his dog that the he would write out himself. Can he do that?
David Spencer is asked for advice on the safety and efficacy of natural or alternative medicines in the treatment of osteoarthritis. What did the pharmacist advise and where did he find his information?
A sore on the gardener's face catches the pharmacist's attention. It doesn't hurt but seems to be spreading. What might it be and what is the pharmacist's advice?
A worried former pre-reg student asks David Spencer about the legal position over access to CD cupboards. What do the regulations say?
A fellow golfer shows David Spencer his hands. Beneath the skin over each knuckle is a white nodule. What might the problem be?
Pre-reg Joanna is puzzled by a prescription for a salbutamol MDI and a Pulmicort Turbohaler 200mcg. Why does she suggest contacting the asthma sufferer's GP?
An irate patient fumes over a practice nurse's comments about a rash. The pharmacist, who remembers that the customer has recently stopped taking the Pill, has a different view.
When collecting a repeat prescription, a patient's daughter mentions her mother's recent problem with reduced urinary output. She also requests ibuprofen for mum's arthritis but alarm bells ring in the pharmacy.
Pharmacist David Spencer has asked pre-reg trainee Joanna to give a presentation to GPs on timings for antihypertensive drugs taken once daily. What should she cover?
Some common causes of sleep disorder and advice the pharmacist might offer.
The pharmacist tutor has set a new pre-reg trainee a series of scenarios involving cough. Each symptom complex might point to a more serious disease, but which one?
The pharmacist is called to a young woman who has been taken ill in the pharmacy. What was the likely cause and what first aid actions should be taken by the staff?
A patient previously on sodium alendronate sparks debate by bringing in a prescription for strontium ranelate. How can the pharmacist query the prescription without antagonising the GP, who can be hostile?
Should the pharmacist advise a friend with chronic heartburn to see a doctor? What are the contributing factors and how can the pharmacist help?
Yetunde is having a difficult morning, with three patients each bringing in a script for multiple items. How much should she charge and why does one of the scripts need amending?
Mr Harris has asked for St John's wort tablets because he has heard they are as effective as prescription medicines at treating depression. Is he right and what should the pharmacist advise?
Ed Lively thinks his doctor should prescribe him cholesterol-lowering drugs and is asking pharmacist David Spencer whether he should complain. How should David reply?
A patient on Risperidone suddenly exhibits side effects - and suffers an outbreak of athlete's foot. What has happened and what should the pharmacist do?
A scout has returned from camp with what looks like an insect bite, but he develops flu-like symptoms. What was the diagnosis and likely treatment? 
A patient presents with painful and discoloured toes that have also been getting very cold. What is the diagnosis and how can the pharmacist help?
A new local GP asks for help with a practice formulary. What issues would the pharmacist have to consider before giving an answer?
A customer complains about feeling old and has noticed a rash and her skin getting blotchy. She wonders if she needs a holiday back home in the Caribbean. What might the pharmacist suspect the problem is? 
Mrs Booth has asked pharmacist David Spencer if she can have an MUR to explain all the different medicines she is taking. What changes might David recommend as a result?
A holiday in Crete, a fling with a waiter and a sudden panic about an STI. Which diseases may have been contracted and how can the pharmacist help this woman?
A 68-year-old diabetic declines her prescription for metformin which she says was making her ill. What steps should the pharmacist take?
A patient has been advised by an on-call GP to get chloramphenicol eye drops for her eighteen-month-old daughter's itchy eyes. What should relief pharmacist Lydia Allen do?
A pharmacist has reduced the hourly rate for a locum after the work was done - how can the underpayment be recovered and can the RPSGB help?
Trainee dispensing technician Yetunde has been given two prescriptions and is being tested on her knowledge of endorsing. What should her answers be?
Edward O'Mara's daughter-in-law is concerned that he is depressed - and possibly has a drinking problem - since the loss of his mother. What will pharmacist David Spencer do?
A medical student training for a marathon suffers recurrent bouts of cystitis. She wonders if cranberry juice really will help or if it is an old wives tale. What re-assurances can the pharmacist offer?
A worried mum asks for advice about protecting her children from canine roundworm infection. What help can the pharmacist offer?
A customer reports a nasty sore on an elderly neighbour's foot. The pharmacist has some advice on treatment.
The police arrest a man who has three bottles of Valoid tablets on him. What are the repercussions for the supplying pharmacists?
What advice can the pharmacist give on Malaria prophylaxis for a student backpacking through Asia to Australia and New Zealand?
Can the pharmacist explain what appears to be an outbreak of diabetes at a residential care home for the elderly?
A patient with sore eyes thinks he has conjunctivitis and is looking for treatment, but does pharmacist David Spencer agree with his diagnosis?
Sales assistant Claudine is looking for topical analgesics for her dad, who is getting nasty pains in his leg. But what is really causing the trouble?
A trainee dispensing technician is given a list of dentists' scripts and asked whether the prescription can be dispensed, or not, with the reasons in either case
Mr Harding's asthma has got worse: has he been given the wrong inhalers or is a change in his prescription to blame?
In response to questions on who can prescribe what, pharmacist David Spencer asks his dispensing technician to prepare a guide for everyone and he identifies six key headings.
David Spencer is holding a training session and his staff are full of questions about OTC analgesics - but what are the answers?
The pre-registration pharmacist trainee is seen being thrown out of a nightclub for taking ecstasy. What are the possible consequences for her career?
Senior medicines sales assistant Hannah is worried about her mother, who is feeling awful after her GP advised her to stop taking HRT. What should she do?
Evan Normans' BP was nearly 200/120 but tests all came back completely normal. The GP suspects other issues. Can pharmacist David Spencer help?
