Minor Ailments Scheme: Tayside Pharmacists Formulary for Common Health Issues, Lecture notes of History

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(formerly known as Direct Supply of Medicines)

FORMULARY

April 2006

Pharmacists Formulary

Contents Introduction ii

 - Tayside Pharmacists Formulary - 

• Section 1 Gastrointestinal Notes ii
  • ƒ Indigestion
  • ƒ Gripes/Colic/Wind Pain - Paediatric
  • ƒ Constipation
  • ƒ Constipation - Paediatric
  • ƒ Diarrhoea
  • ƒ Diarrhoea - Paediatric
  • ƒ Haemorrhoids
  • ƒ Mouth ulcers
• Section 2 Respiratory
  • ƒ Hay Fever
  • ƒ Allergy - Paediatric
  • ƒ Cough
  • ƒ Nasal Congestion
  • ƒ Cough/Congestion - Paediatric
  • ƒ Sore Throat
• Section 3 Central Nervous System
  • ƒ Pain
  • ƒ Pain - Paediatric
    • ƒ Headache
    • ƒ Musculoskeletal Disorders
    • ƒ Dysmenorrhoea
• Section 4 Infection
  • ƒ Fungal
    • ƒ Vaginal Candidiasis
    • ƒ Athlete's Foot

Tayside Pharmacists Formulary - 1

Guidance on when bulk packs should be used has been provided marked "DT" or ex {pack size}.

Reimbursement of items supplied outwith this formulary cannot be guaranteed.

Page iv

Tayside Pharmacists Formulary - 1

Section 1 Gastrointestinal

Indigestion

BNF Section 1.1.1 Aluminium and magnesium containing antacids

Co-magaldrox SF Suspension 195/220/5 300ml/500ml

BNF Section 1.1.3 Other drugs for dyspepsia and gastro-

oesophageal reflux disease

Gaviscon®^ SF Liquid 200ml/500ml Gaviscon®^ 500 Tablets 20

BNF Section 4.6 Drugs used in Nausea & vertigo

Domiperidone 10 tabs

Paediatric - Gripes/Colic/Wind Pain

Gaviscon Infant Sachets Infacol Liquid

15 twin sachets 50ml

When to refer to GP

Symptoms are persistent (longer than 5 days) or recurrent Pain is severe or radiating Blood in vomit or stools Pain worsens on effort Persistent vomiting Treatment has failed (no improvement in symptoms after 5 days) Adverse drug reaction is suspected Associated weight loss Children Alarm symptoms: Difficulty in swallowing

Tayside Pharmacists Formulary - 1

Diarrhoea

BNF Section 1.4 Antimotility drugs

Loperamide 2mg Capsules (8-12caps) 18 PGD ex 30

BNF Section 9.2.1.2 Oral rehydration therapy

Dioralyte®^ Oral Powder 10

Dioralyte®^ Relief Oral Powder 6

Rehidrat®^ Oral Powder 10

Paediatric - Diarrhoea

Dioralyte®^ Oral Powder 6

Dioralyte®^ Relief Oral Powder 6 Rehidrat®^ Oral Powder 6

When to refer to GP

Children < 1 year: diarrhoea of duration greater than 1 day Children < 3 years: diarrhoea of duration greater than 2 days Adults and children > 3 years: duration of diarrhoea greater than 3 days In severe cases referral should be recommended immediately. Association with severe vomiting and fever. Suspected drug-induced reaction to prescribed medicine History of change in bowel habit Presence of blood or mucus in the stools

Tayside Pharmacists Formulary - 1

Haemorrhoids

BNF Section 1.7.1 Soothing haemorrhoidal preparations

Anusol®^ Cream 23g Anusol®^ Ointment 25g

Anusol®^ Suppositories 12/ Anusol Plus HC®^ Ointment 15g

Anusol Plus HC®^ Suppositories 12

When to refer to GP

Duration of longer than 3 weeks Presence of blood in the stools Change of bowel habit (persisting alteration from normal bowel habit) Suspected drug-induced constipation Associated abdominal pain/vomiting

Mouth Ulcers

Current practice is to encourage self-care

BNF Section 12.3.1 Drugs for oral ulceration & inflammation

Hydrocortisone Pellets 2.5mg 20

BNF Section 12.3.2 Oropharyngeal anti-infective drugs

Miconazole Oral Gel 15g

BNF Section 12.3.4 Mouthwashes

Chlorhexidine Mouthwash 300ml

When to refer to GP

Duration of longer than 3 weeks Associated weight loss Involvement of other mucous membranes Rash Suspected adverse drug reaction Diarrhoea

Tayside Pharmacists Formulary - 1

Paediatric - Allergy

Chlorphenamine Syrup 2mg/5ml 150ml

When to Refer to GP

Wheezing or shortness of breath, Tightness of chest Persisting painful ear or sinuses Purulent conjunctivitis Failed medication (no improvement in symptoms after 10 days)

Cough and Nasal Congestion

BNF Section 3.9.1 Cough Suppressants

Pholcodine Linctus 5mg/5ml 100ml/200ml DT

BNF Section 3.9.2 Expectorants and demulcent cough

preparations

Simple Linctus 100ml/200ml DT Simple SF Linctus 100ml/200ml DT

BNF Section 3.10 Systemic Nasal Decongestants

Pseudoephedrine 30mg/5ml Elixir 100ml Pseudoephedrine 60mg Tablets 12

BNF Section 12.2.2 Topical Nasal decongestants

Xylometazoline 0.1% Nasal Drops 10ml Sodium Chloride 0.9% Nasal Drops 10ml

Tayside Pharmacists Formulary - 1

Paediatric - Cough and Nasal Congestion

Simple Paediatric SF Linctus 100/200ml DT Sodium Chloride 0.9% Nasal Drops 10ml

When to refer to GP

Cough lasting 2 weeks or more Sputum yellow, green, rusty or blood stained Chest pain Shortness of breath Wheezing Whooping cough or croup Recurrent nocturnal cough Suspected adverse drug reaction (e.g. ACE inhibitors) Failed medication (no improvement in symptoms after 5 days)

Sore Throat

Current practice is to encourage self-care

Benzydamine Mouthwash 300ml Benzydamine Spray 30ml

When to refer to GP

Sore throat lasting a week or more Recurrent bouts of infection Hoarseness of more than three weeks duration Difficulty in swallowing (dysphagia) Failed medication (no improvement in symptoms after 7 days)

Tayside Pharmacists Formulary - 1

Musculoskeletal Disorders

When to refer to GP

Suspected fracture Possible adverse drug reaction - falls, bruising Head injury Medication failure Arthritis Severe back pain Back pain (and-or pins and needles/numbness) radiating to the leg.

Dysmenorrhoea

When to refer to GP

Presence of abnormal vaginal discharge Abnormal bleeding Symptoms suggest secondary dysmenorrhoea Severe inter-menstrual pain (mittelschmerz) and bleeding Failure of medication (no improvement after two cycles treatment) Pain with a late period (possibility of an early pregnancy) Presence of fever

Tayside Pharmacists Formulary - 1

Section 4 Infection

Fungal Infections

Vaginal Candidiasis

BNF Section 7.2.2 Anti-infective drugs

Canesten®^ Combi 1 pack Clotrimazole Vaginal Tablets 500mg 1 Clotrimazole Vaginal Cream 10% 5g PGD

BNF Section 5.2 Anti-Fungal drugs

Diflucan®^ one 1cap

When to refer to GP

Recurrent Infection Failed medication Pregnancy Diabetes

Athlete's Foot

Current practice is to encourage self-care

Clotrimazole Cream 1% 20g Miconazole Cream 2% 30g

When to refer to GP

Severe, affecting other parts of the foot Signs of bacterial infection Unresponsive to appropriate treatment Diabetic patients Involvement of toenails

Tayside Pharmacists Formulary - 1

Parasitic Infection

Threadworms

BNF Section 5.5.1 Drugs for Threadworms

All family members should be treated at the same time, even if

they have no symptoms, to prevent reinfection.

Mebendazole 100mg Tablets 2 PGD

Pripsen®^ Oral Powder 2

When to refer to GP

Infection other than threadworm suspected Recent travel abroad Medication failure

Head Lice

BNF Section 13.10.4 Parasiticidal Preparations

Follow policy for the control of head louse infection in Tayside.

Issued by Tayside Health Board Communicable Disease

Department.

1 st^ line

Malathion 0.5% Liquid (Derbac M®, Quelleda M®) 50ml/100ml Malathion 0.5% Lotion (Prioderm®, Suleo-M®) 50ml/100ml

2 nd^ line

Phenothrin 0.5% Liquid (Full Marks®) 50ml/100ml Phenothrin 0.2% Lotion (Full Marks®) 50ml/100ml

Tayside Pharmacists Formulary - 1

Section 5 Urinary Tract Disorders

Cystitis

No products currently in Pharmacists Formulary

Encourage self-care

When to refer to GP

All men, children Fever, nausea/vomiting Loin pain and tenderness Haematuria Vaginal discharge Duration longer than 2 days Pregnancy Recurrent cystitis Failed medication

Section 6 Skin

Acne

Current practice is to encourage self care

Benzoyl Peroxide 2.5% Aquagel 40g Benzoyl Peroxide 5% Aquagel 40g Benzoyl Peroxide 10% Aquagel 40g

When to refer to GP

Acne in the very young Severe acne, Acne causing scarring Failed medication (no improvement in 2 months) Suspected drug-induced acne

Tayside Pharmacists Formulary - 1 When to refer to GP

If indication is outwith P licence Evidence of infection (weeping) Severe condition; badly fissured/cracked skin, bleeding Failed medication (no improvement after 7 days) No identifiable cause (unless previously diagnosed as eczema) Duration of longer than 2 weeks

Section 7 - Eye

BNF Section 11.8.1 Tear deficiency, ocular lubricants and

astringents

Hypromellose eye drops 10ml Lacrilube ointment 3.5g

NB: See also under section 2 Respiratory.

Sodium Cromoglicate 2% Eye Drops 5/10ml For treatment of hayfever symptoms.

When to refer to GP

If condition lasts longer than 2 weeks, refer to GP Pain or signs of infection ie: Purulent discharge