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?
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?
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?
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?
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?
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 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 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?
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 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
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.
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?
Find the answers to the 14 scenarios in the second Practical Approach booklet by clicking here. If you would like a copy of the booklet then either email us with your name and address or send a stamped addressed envelope to C+D Pharmacy Projects, Riverbanks House, Angel Lane, Tonbridge, TN9 1SE.