Pharmacy Assistant - Green Cross Publishing

assistant
pharmacy
Issue 2 Volume 1 • summer 2008 Pharmacy assistant is Part sPonsored by an educational grant from
• SUN PROTECTION
Active advice on
staying safe
• DRUG INDUCED
PHOTOTOXICITY
Know the signs
• MALNUTRITION
How to recognise
the symptoms
• HAY FEVER
Causes, prevention
and treatments
• Q&A
Mary Forde
• PRODUCT NEWS
• CROSSWORD
Win e50

25
YEARS OF
Supporting Pain Education in Pharmacy
Since its launch 25 years ago,
Nurofen has been providing fast
effective relief from pain for both
adults and children.
To celebrate the 25th anniversary,
Nurofen held a series of eight
educational evenings, nationwide
which were attended by over 450
pharmacy assistants.
The theme of the evenings was
‘Spotlight on Pain’ and the focus of
the meetings was to educate
pharmacy staff on providing
responsible pain management and
advice to customers on the various
types of analgesics available over
the counter. Specifically, the
meeting addressed the following
two key areas:
General pain management
understanding pain with a focus on
key pain types including headaches
and migraine, back, joint and
muscle pain, dental, cold and flu
and pain in children.
Communication skills training
key tips on how to effectively
communicate with customers and
how to deal with difficult scenarios
that may arise in the pharmacy
setting.
Nurofen also launched The Nurofen
Training Handbook which is a
quick reference guide to pain
management.
If you didn’t attend the Nurofen
Pharmacy Training evenings but
would like to get a copy of the
Nurofen Training Handbook please
contact 01 6188 437 or email
nurofen@fleishmaneurope.com
to request a copy.
The Nurofen Handbook contains the following information:
• Pain – The Basics
• Treatment of Pain
• WWHAM Checklist
• Headaches & Migraine
• Back, Joint & Muscle Pain
• Dental Pain
• Cold & Flu
• Children & Pain
In addition, the pack contains pull out cards which include
the WWHAM checklist and key facts on the Nurofen product
range that can be used as a quick point of reference when
serving customers.
Pic A.- Speakers Declan Kerins, Pharmacist and Mark Mortell, Communications Specialist, pictured with Jennifer Shannon, Product Manager, Nurofen.
Pic B. - Gemma Warren, Health Express Pharmacy, Ailesbury, speaker Declan Kerins and Carol Warren, Health Express Pharmacy, Ailesbury.
Pic C. - Jacqueline Leddy and Lorraine Lawlor, Galtymore Pharmacy, Drimnagh.

pharmacy
assistant
Issue 2 Volume 1 • s ummer 2008
This, the second issue of Pharmacy Assistant, is packed with
even more information than the first issue. We had a very
positive response to that first issue and have taken on some of
your suggestions but would still welcome any ideas for future
issues.
As we head into the long awaited summer we can expect to
see people attending pharmacies with all manner of seasonal
illnesses. Whether it is sunburn, hay fever, insect bites or food
poisoning from poorly prepared barbecues summer time can
almost be as bad as winter for some of our customers.
Unfortunately sunburn doesn’t have just short term effects.
The long term effects in terms of aging wrinkly skin is bad
enough but we Irish take far too many risks in terms of the sun:
risks which are often fatal.
For information on how best to advise your customers when
it comes to enjoying sunshine without risk, turn our article on
sun protection.
An often overlooked side effect of sun worship occurs when
it is combined with taking medication. Our excellent article on
photosensitivity outlines the issues involved in drug induced
phototoxicity.
In the midst of all the joy and partying that comes with
summer it is easy to overlook a problem that is much more
common then we would imagine: malnutrition which can be
especially prevalent among the elderly. The article, How to
recognise malnutrition provides an invaluable insight into this
perennial problem.
Our article on hay fever gives a timely reminder of the
causes, treatments and methods of prevention.
This issue also sees a new section: a round up of topical
news issues, which relate to pharmacy.
We hope you enjoy the summer edition of Pharmacy
Assistant, Please forward any comments or suggestions to
maura@greencrosspublishing.ie
Pharmacy Assistant is
produced by GreenCross
Publishing as a supplement
to Irish Pharmacist.
GreenCross Publishing is a recently established
publishing house which is jointly owned by Graham
Cooke and Maura Henderson.
Graham can be contacted at graham@
greencrosspublishing.ie
Maura at maura@greencrosspublishing.ie
contents
© Copyright GreenCross Publishing 2008
The contents of Pharmacy Assistant are protected
by copyright. No part of this publication may
be reproduced, stored in a retrieval system, or
transmitted in any form by any means – electronic,
mechanical or photocopy recording or otherwise
– whole or in part, in any form whatsoever for
advertising or promotional purposes without the
prior written permission of the editor or publishers.
2
3
7
10
13
15
16
17
News
AdVIce oN suN protectIoN
The Irish, possibly the fairest skinned
of all nationalities, are one of the worst
offenders when it comes to risking
their health by failing to protect
themselves from the harmful effects of
the sun.
How to recogNIse
mAlNutrItIoN
severe malnutrition is easily
recognised but less severe forms may
be more difficult to identify.
drug INduced pHototoxIcIty
A surprising array of commonly used
drugs, food additives, and other
products contain photoreactive
agents, resulting in chemical reactions
that can cause a person to become
photosensitive.
HAy feVer – cAuses, preVeNtIoN
ANd treAtmeNts
If we catch it early we can help offset
the worst effects of hay fever.
product News
Q & A
Mary Forde from Milltown, Dublin
crossword
DIsClAIMer
The views expressed in Pharmacy Assistant are
not necessarily those of the publishers, editor or
editorial advisory board. While the publishers,
editor and editorial advisory board have taken
every care with regard to accuracy of editorial and
advertisement contributions, they cannot be held
responsible for any errors or omissions contained.
pharmacy assistant
1

2
news
YouTube video highlights overregulation
by EU
A video has been launched on
YouTube (www.youtube.com/
watch?v=5JOBY0KDERY), which
points to the questionable attempt
to regulate vitamins and minerals
as if they were more dangerous
substances than cigarettes, alcohol and
commonly available pharmaceutical
medicines. The video directs people to
www.saveoursupplementsireland.com,
where they will be able to access simple
guidelines for e-mailing TDs and MEPs, as
well as find out facts about the efficacy
and safety of vitamins.
According to the website, as health
authorities in countries such as Ireland
struggle to cope with the increasing
burden of healthcare costs arising
from escalating rates of disease, much
Holiday ‘binge tanning’ increasing skin
cancer risk
A new survey by Cancer
Research UK has identified
a worrying trend for ‘binge
tanning’ among young
people going on vacation this
summer. According to the
results, 36 per cent of 15–24year-olds
spend over five
hours in the sun each day on
their main summer holiday.
Additionally, 32 per cent
said they would be happy to
increase their time in the sun
if they did not feel tanned
enough towards the end of
their break.
As well as spending extra
time in the sun, young people
said they are prepared to
go to many other lengths
if they do not feel tanned
enough towards the end of
their holiday. A further 29
per cent said they would
use sunscreen with a low
protection factor, with 19 per cent
happy to go without sunscreen
altogether and 15 per cent using
products like baby oil to speed up the
tanning process.
Meanwhile, 17 per cent of those
surveyed think that sunburn is all part
pharmacy assistant
of this increase in disease is directly
related to poor dietary and lifestyle
practices. People who take responsibility
for their health are more likely to
eat a healthy balanced diet - and to
supplement their diet. They are, contends
the site less likely to be a burden on the
health service, because their overall intake
of nutrients ensures optimum health. In
addition, the site claims that despite much
scaremongering to the contrary, not a
single death or serious adverse reaction
has been recorded in this country as a
result of taking vitamin supplements over
the past 40 years. Yet, says the site, they
are to be regulated under the EU Food
Supplements Directive as if they were
more dangerous than alcohol, cigarettes
or paracetamol, all of which remain
of getting a tan, with 11 per cent saying
they would be prepared to burn if they
did not feel sufficiently tanned towards
the end of their holiday.
While the problem is particularly
prevalent among the under 25s, the
25–34-year-olds also show a tendency
towards ‘binge tanning’ with 19 per
freely available and impose an enormous
economic burden on the State.
“I am outraged that the EU, supported
by our government, is threatening to
undermine my right to choose to protect
my health,” said one consumer Cathy
Doyle. “While any Tom, Dick or Harry can
buy enough paracetamol to damage their
liver, smoke enough cigarettes to cause
lung cancer, or drink enough alcohol to
seriously damage their liver, I am to be
denied access to the levels of vitamins
and minerals that I know are essential
for keeping me away from doctors and
hospitals. It makes absolutely no sense
that people like me who want to take
responsibility for our own health are
going to be prevented from doing so
under these daft EU regulations.”
cent of this age bracket admitting to
spending over five hours in the sun.
Tanning, it would appear, is very
important to young people – of the
under 25s surveyed, 39 per cent said
they would feel upset if they came back
from their summer holiday without a
tan.

activeadvice
on sun protection!
Most Irish people
are aware of
the dangers of
ultraviolet (UV)
radiation during
the summer
months and indeed
year round as UV
is a constant in our lives and is a well
known cause of premature ageing and
different types of skin cancers.
As such most people are
quite diligent in following
the SunSmart Code during the
summer months when they are more
likely to be aware of the sun in the
form of heat (infra red radiation).
However, in general we cannot
feel the UVA and UVB rays which
are responsible for the 2 to 3 million
Child dressed
according to the
SunSmart code
non-melanoma skin cancers, and over
130,000 malignant melanomas, that occur
globally each year. Frequent sun exposure
and sunburn in childhood appear to set the
stage for high rates of melanoma later in
life.
In Ireland our changing lifestyle and
sun-seeking behaviour throughout the
year through foreign travel coupled with
increased exposure in summer months
are responsible for much of the increase
in skin cancers; with over 6,400 new cases
reported last year.
Melanoma accounts for about 4-5 per
cent of all skin cancer cases and it accounts
for most of the skin cancer-related deaths in
Ireland. It is the second highest cancer
diagnosed in the 30-45 year age group and
the third highest in the 25-40 age group.
This type of tumour has the most rapid rise
in incidence doubling every ten years and, if
not detected early, has a very high mortality
rate.
Prevention
With these facts in mind it is important to
remember the age old adage: prevention is
better than cure. Key recommendations:
• Remember that UV radiation is at its peak
between the hours of 10am and 3pm.
• Don't be fooled by cold and cloudy days
– you can still get sunburnt.
• Remember that UV radiation can damage
Sunbeds and
sunlamps increase
your risk of skin
cancer. If you want
to protect your skin,
don’t use them
pharmacy assistant
3

4
your skin all year round and not just in the summer
months.
Apply sunscreen
• All exposed areas of skin should be covered
in waterproof, broad spectrum SPF 30+-50+
sunscreen, containing photo- stable filters that
provide efficient protection against both UVA and
UVB rays. The current EU recommendation that all
sunscreens should provide a ratio between UVB
and UVA protection of less than, or equal to, three
is paramount when choosing your sunscreen.
• Providing UVA ultra protection with a UVB/UVA
ratio of 2.5, Anthelios by La Roche-Posay currently
provides the best photo-protection available due
to its patented Mexoryl filtration system and is
strongly recommended by dermatologists. Also
La Roche-Posay currently donates €1 of every sale
of Anthelios 50+ Fluid Extreme to the Irish Cancer
Society.
• Always apply sunscreen about 20 minutes before
venturing outside to allow absorption time.
• Remember to cover easily overlooked areas
including the chin, throat, ears and backs of the
hands.
• Use 50+ stick on sensitive areas: lips, nose and
eyelids.
• Take sunscreen in your bag and reapply regularly.
• Remember to reapply the sunscreen every 2 hours
while out in the sun and always reapply if you have
been in the water or are sweating heavily.
Protect your eyes
Photokeratitis is sunburn damage to the cornea
of the eye caused by UV radiation. This painful
condition can be associated with temporary vision
loss for up to 48 hours. It is thought that UV exposure
may contribute to other eye conditions including
cataracts, pterygium and age-related macular
degeneration and even melanomas of the eye.
Suggestions on protecting your eyes:
• Always wear wraparound sunglasses or goggles.
Aim for a snug fit, so that sunlight can't shine over
the top or sides of your eyewear. Choose eyewear
that meets the European Standards: EN 174 , EN
1836
• This means that the glasses will block 95 per cent of
UV radiation.
• Sunglasses and goggles can be fitted with
prescription lenses, if necessary. See your
optometrist for more information.
• Brimmed hats can block at least half of UV radiation
from reaching the eyes.
Protect your children
Children also need the highest sun protection
available.
• Instil good habits early. If you protect your child
from a young age, they will learn to be SunSmart
by example.
• Apply sunscreen to your children. Choose sensitive
skin formulas suitable for children such as Dermo
Pediatrics by La Roche-Posay, which is tolerance
tested on sensitive and atopy prone skin under
dermatological and paediatric control.
• Cover kids up with as much clothing as possible such
as teeshirts with collars, shorts and hats with neck
flaps to protect the face, neck and head.
pharmacy assistant
• Toddlers are great imitators, and are more likely to
wear their sunglasses if you lead by example and
wear yours.
• Make sure you buy sunglasses that meet the
European Standards: EN 174, EN 1836.
• Sunglasses for children should have plastic instead
of glass lenses for safety reasons.
SunSmart Code
For the best way to protect your skin follow the Irish
Cancer Society SunSmart Code
1. Cover Up
2. Use Sunscreen
3. Seek Shade
4. Protect Your Eyes
5. Avoid Sunbeds
and Sunlamps
• Wear a wide-brimmed hat or a hat
with a neck flap to protect your
neck.
• Wear a tee-shirt or other shirt with
a close-weave material.
• Make sure it is a broad-spectrum
sunscreen with UVA and UVB
protection.
• Use a sunscreen with an SPF of 15
or higher and high UVA protection.
• Put sunscreen on 20 minutes
before you go out into the sun.
• Reapply sunscreen every two
hours.
• Put it on more often if you have
been swimming or sweating.
• Staying in the shade is one of the
most effective ways of reducing
exposure to ultraviolet radiation.
• Any shade will do. It can be from a
building or a portable umbrella.
• Plan your outdoor activities to
avoid exposure to ultraviolet
radiation when it is at its highest,
between 11am and 3pm.
• Wear sunglasses that give a high
protection against UV rays. Look at
the label and check the standard:
BS Standard (BS 27 24 19 87) or
European Standard (EN 1836).
• Sunbeds and sunlamps increase
your risk of skin cancer. If you want
to protect your skin, don’t use
them.
For more information on how to be SunSmart and prevent skin
cancer, call the National Cancer Helpline on Freefone 1800 200
700 or visit; www.cancer.ie/sunsmart . The Helpline is staffed by
specialist nurses and is open weekdays from 9am-7pm Monday-
Thursday and Fridays from 9am-5pm

*SPF ≤ 2.5. Except spray SPF 50 (SPF / PPD ≤ 3)
ANTHELIOS XL
With La Roche-Posay thermal spa water
SUNCARE INNOVATION
Anti-UV on the surface
Anti-cellular damage deep within the epidermis
On the skin’s surface
filter out a maximum of UV-rays thanks to Mexoryl SX and XL
Photostable UVB-UVA protection
UVA Ultra* protection: stricter requirement than the European Standard (SPF ≤2.5)
Efficacy demonstrated by 17 clinical studies on UVA-induced skin disorders.
Deep with the epidermis
Protect against cellular damage with Senna Alata extract
Innovation: The active extract of Senna Alata, a tropical plant which has developed a smart self-defense
system against UV-rays, naturally completes the filtering action to protect effectively against cellular damage.
€1 donation*
* To the Irish Cancer Society when you buy
Anthelios Fluide Extreme 50+
National Cancer Helpline Freephone 1800 200 700

Fresubin ®
A new generation of taste...
Has
ENTERAL NUTRITION
For further information please contact Fresenius Kabi:
3B Fingal Bay Business Park, Balbriggan, Co Dublin.
Date of preparation: January 2008
EN/2008/SIPS/005

nutrition
how do we recognise
malnutrition?
As so many issues surrounding nutrition become more
and more topical, we must not forget to look at the
ever increasing problem of malnutrition in society.
It is reported that malnutrition affects up to 60 per
cent of patients admitted to hospitals, which must
lead us to believe that it frequently goes undetected
and untreated in the community.
So, how can we define malnutrition? There is
no generally accepted definition, but it can be
summarised as a poor nutritional state, most
commonly under nutrition due to shortage of
energy or deficiency of all or certain nutrients.
It is well documented that poor nutrition has a
significant negative effect on the quality of life of
patients; this is particularly true of elderly patients.
Poor nutrition can:
- delay wound healing
- reduce a patient’s response to therapy
- decrease a patient’s resistance to infection.
The provision of oral nutrition supplements is
an effective means of enabling patients to meet
their nutritional requirements, thereby improving
associated problems, such as poor wound healing
and reducing the incidence of infections, depression
and fatigue (Breslow 1993, Martyn et al 1998). While
these and many other problems can be commonly
associated with the acute hospital setting, there
are studies that show the impact in the community
setting also. Studies have indicated that when
compared with non-malnourished patients,
malnourished patients have:
- a six per cent higher GP consultation rate
- require nine per cent more prescriptions
- have a 25 per cent higher hospital admission rate
(Martyn et al 1998).
Whereas severe malnutrition is easily recognised,
less severe forms of malnutrition may be more
difficult to identify.
In order to treat the underlying malnutrition we
pharmacy assistant 7

8
have to be able to detect it in the first
place. Over the last number of years
there have been a number of tools
designed to help identify malnutrition
in a clinical setting. The malnutrition
universal screening tool - MUST - was
developed for use in the clinical setting
by the British Association of Enteral and
Parenteral Nutrition. But even without
the use of these tools, there are a
number of simple questions that you can
ask that will help to identify patients who
are at risk:
• Has the patient reported a poor
appetite?
• Do they often have difficulty
with eating or chewing food?
• Have they lost interest in food
over the last few months?
• Have they stopped eating as
much as before?
• At mealtimes, do they often
drink instead of eating food?
• Were they eating a balanced
diet and are they now only
managing a light diet?
• Do they often feel full very
quickly when they first start
eating?
• Do they look thin?
• Are their clothes loose?
• Is their jewellery loose eg
wedding band?
Even by asking these simple and
quick questions, you can easily assess a
patient whose dietary patterns may have
changed. It is important to look for these
indicators as they can be a very subtle
way of letting us know if someone is
losing weight and therefore at risk.
A pharmacist or pharmacy assistant
pharmacy assistant
is in an ideal position to ask these
questions. Patients seldom present
saying ‘I am malnourished’. They usually
present with a range of other complaints
or issues – patients or carers often ask
for something as simple as a ‘tonic or
something to give them a boost’.
Once we have taken the first step in
identifying a malnourished individual
or a person ‘at risk’ of malnutrition, we
must next take action. If the person is
unable to eat a healthy balanced diet,
one of the easiest ways to provide them
with additional nutrition is through the
use of oral nutritional supplements. Oral
nutritional supplements provide a very
effective way of providing a significant
amount of protein and calories to
someone who may not be able to take
sufficient amounts from foods and their
normal diet. It is thought that up to 50
per cent of elderly do not meet their
energy requirements every day and
oral nutritional supplements such as
Fresubin Protein Energy can provide up
to 600kcals and 40g protein in only two
cartons a day. If a patient has a higher
fibre need, Fresubin Energy Fibre may
be ideal in providing energy/calories,
protein and dietary fibre.
Another vital issue in the provision of
balanced diet is the supplementation
of vitamins and minerals (trace
elements).The Fresubin range of oral
nutritional supplements can provide the
recommended requirements of vitamins
and trace elements in two or three tetra
cartons per day.
Of course, there is little point in
providing a supplement that does not
have an appealing taste. The Fresubin
range has recently been reformulated to
match the great taste of Fresubin Protein
Energy, which lives up to its slogan of
‘the best tasting sip feed ever!...from
If the person
is unable to eat a
healthy balanced
diet, one of the
easiest ways to
provide them with
additional nutrition
is through the use
of oral nutritional
supplements
Fresenius Kabi.
If we can start to look at how we
assess and identify these patients on
a regular basis, only then can we start
to actively treat them. The common
belief that prevention is better than cure
still prevails, let us not wait until these
patients are suffering from a variety
of malnutrition related illnesses. With
the Fresubin range of oral nutritional
supplements malnutrition can be a thing
of the past.
Bairbre Hickie, RGN, Fresenius Kabi Ireland

See the Difference
fibre can make in supporting your
nutritionally compromised patients
Fortisip Multi Fibre’s unique MF6TM blend of
fibres is clinically proven to reduce laxative use,
relieve constipation, reduce the incidence of
diarrhoea and improve gut transit for patients
requiring nutritional support. 1-4
Recommend Fortisip Multi Fibre and
see the difference for yourself.
For advice, samples or more information, call
Freephone 1800 923 404.
Nutricia, Block 1, Deansgrange Business Park, Deansgrange, Co. Dublin. | Tel: +353 1 289 0283 | Fax: +353 1 289 0255 | Email: info@ncc.nutricia.ie
References: 1. Vandewoude MFJ et al. Age and Ageing 2005; 34: 120–4. 2. Trier E et al. J Pediatr Gastroenterol Nutr 1999; 28(5): 595–6. 3. Silk DB et al. Clin Nutr 2001; 20(1): 49–58.
4. Elia M et al. Alimentary Pharmacology & Therapeutics. 2008; 27:120-145.

10
pharmacy assistant
C
hemicals that produce a photoreaction
(reaction with exposure to UV light) are called
photoreactive agents or, more commonly,
photosensitizers. After exposure to UV
radiation either from natural sunlight or from
an artificial source such as tanning booths,
these photosensitizers cause chemical
changes that increase a person’s sensitivity
to light, causing the person to become
photosensitized. Medications, food additives,
and other products that contain photoreactive
agents are called photosensitizing products.
Photoreactive agents can cause both acute
and chronic effects. Acute effects, from shortterm
exposure, include exaggerated sunburnlike
skin conditions, eye burn, mild allergic
reactions, urticaria, abnormal reddening of
the skin, and eczema-like rashes with itching,
UV radiation from
natural sunlight
can cause chemical
changes that increase
a person’s sensitivity
to light, causing the
person to become
photosensitized.
drug induced
phototoxicity
SeVerAl CoMMoNly USeD DrUgS CAN CAUSe PhotoSeNSItIVe reACtIoNS. the USe
of A hIgh leVel broAD-SPeCtrUM SUN ProteCtIoN hAS beeN ShoWN to PreVeNt
PhototoxIC erytheMA CAUSeD by kNoWN PhotoSeNSItISINg DrUgS
swelling, blistering, oozing, and scaling of the
skin. Chronic effects from long-term exposure
include prematurely ageing skin, stronger
allergic reactions, cataracts, blood vessel
damage, a weakened immune system, and
skin cancer.
Everyday medications
Widely used medications containing
photoreactive agents include antihistamines,
used in cold and allergy medicines;
nonsteroidal anti-inflammatory drugs
(NSAIDs), and antibiotics, including the
tetracyclines and the sulphonamides, or
‘sulpha’ drugs.
In photoallergic reactions, which generally
occur due to medications applied to the skin,
UV light may structurally change the drug,

causing the skin to produce antibodies. The result is an allergic
reaction. Symptoms can appear within 20 seconds after sun
exposure, producing eczema-like skin conditions that can
spread to nonexposed parts of the body. But sometimes,
photoallergic reactions can be delayed.
Other regularly used products that can cause photoallergic
reactions include ibuprofen, digitoxin, doxepin, amiodarone,
trimethoprim, chlorpropamide, piroxicam, doxycycline,
promethazine, chlorpromazine.
Phototoxic reactions, which do not affect the body’s
immune system, are more common
than photoallergic reactions. These
reactions can occur in response to
injected, oral or topically applied
medications.
In phototoxic reactions, the drug
absorbs energy from UV light and
releases the energy into the skin,
causing skin cell damage or death.
The reaction occurs from within a
few minutes to up to several hours
after UV light exposure. Though
sunburn-like symptoms appear
only on the parts of the body
exposed to UV radiation, resulting
skin damage can persist.
Long lasting effects
For example, Dr Henry Lim,
reported in the March 1990 issue
of the Archives of Dermatology that
several patients previously exposed
to photoallergens continued to
have phototoxic skin eruptions
up to 20 years after discontinuing
medication use, even though they
avoided further exposure to the
photoallergens.
Frequently prescribed
medications that cause phototoxic
reactions include tetracycline
antibiotics, NSAIDS, and
amiodarone.
Because drug-induced
photosensitivity disorder
symptoms mimic sunburns,
rashes and allergic reactions,
many cases go unreported. Also,
although research has shown that
the numbers of photosensitized
individuals may be high, most
people do not associate the sun’s
light with the development of their
skin eruptions.
In phototoxic
reactions, the drug
absorbs energy from
UV light and releases
the energy into the
skin, causing skin cell
damage or death.
Brand Name Generic Name Therapeutic Class
Advil
Advil Cold & Flu
Nurofen
Nurofen Plus
Nurofen Cold & Flu NSAID, (non steroidal anti-inflammatory)
Brufen ibuprofen
Solfen antiarthritic
Melfen
Bufigen
Codafen
Lanoxin digitoxin antiarrhythmic
Sinequan doxepin antidepressant
Cordarone amiodarone antiarrhythmic
Bactrim
Duobact trimethroprim antibiotic
Septrin
Tri-Minulet
Diabinese chlorpropamide antidiabetic (oral)
Feldene piroxicam NSAID, antiarthritic
Vibramycin doxycycline antibiotic
Phenergan promethazine antihistamine
Although those with fair skin are more susceptible to
photosensitizing, it is not uncommon for dark-skinned
individuals to have chronic photodermatitis.
People infected with HIV, or immunosuppressed patients,
are also more susceptible to photosensitive disorders so they
need to exercise special care in UV light exposure.
Photo-recall
What is termed a ‘photo-recall’ can take place when a nonphotoreactive
product prompts the repeat of a previous
reaction to a photoreactive agent.
Photoreactive products can also aggravate existing skin
problems like eczema, herpes, psoriasis and acne, and can
inflame scar tissue. They can also precipitate or worsen
autoimmune diseases, such as lupus erythematosus and
rheumatoid arthritis.
In a recent clinical study carried out by Professor Nishigori, the
use of Anthelios 50+ was shown to prevent phototoxic erythema
caused by photosensitising treatments including doxycycline,
dacarbazine, and chlorpropamide.
Common photosensitizes
The Table below lists just some of the more commonly used drugs
that can cause photosensitivity reactions in some people:
Clonazine
per-medication. emesis, schizophrenia
Largactil
chlorpromazine
schizophrenia
La Roche-Posay is the no.1 photo protection recommended by over 25,000 dermatologists
worldwide. The efficacy of La Roche-Posay Anthelios has been demonstrated through
20 studies and a new clinical study proves the efficiency of La Roche-Posay Anthelios XL
SPF50+ in the prevention of photo-toxic reactions in 95% of patients tested.*
* Source: C. Nishigori, Division of Dermatology, Clinical Molecular Department, Kobe, Japan, 2006
pharmacy assistant
11

HOT
TOPIC
hay
causes, prevention and treatment
The hay fever season is
well and truly upon us,
and while the rest of us
are beginning to relish
the warmer days and the
longer evenings, for hay
fever sufferers this time
of year is the one they
dread the most. But help
is at hand.
Hay fever, also known as allergic rhinitis and
allergic conjunctivitis, can in fact occur at any
time of the year but typically plagues people
in spring and early summer. It is caused by
what we breathe in; mainly grass pollen,
but also tree and weed pollens and mould
spores, which can also be introduced into our
system through the eyes.
causes
Hay fever tends to run in allergy prone
families. It usually starts in early teens, peaks
in the 20s and begins to ease off in early
middle age. It is thought to affect about
one in seven Irish people. although people
living in the countryside are more open to
attacks, the pollution in built-up urban areas
combined with pollen can make matters
worse. contrary to popular belief, diet
has very little impact on hay fever. (There
is no evidence that milk exacerbates the
condition.) Besides pollen, other triggers
include dust mite, mould spores and family
pets or farm animals.
When the nose and eyes of susceptible
people are exposed to pollen, special white
blood cells produce antibodies prompting
the release of histamine, which causes the
symptoms of hay fever.
fever
sympToms
The most common symptoms are:
• Runny or blocked nose
• Watery, itchy eyes
• Itchy ears, mouth and throat
• sneezing
• Wheezing (often called hay
‘asthma’) when pollen counts are
high
other symptoms include:
• Fatigue and general lethargy
• unsettled sleep
• Loss of concentration
• Loss of smell/taste
• cough
• Headache
pRevenTIon
Keeping an eye on pollen levels
(known as the pollen count) and
finding out how to minimise exposure
are essential parts of the battle against
hay fever. symptoms usually begin
when the pollen count exceeds 50.
TIps
• When the pollen count is high
people prone to hay fever should
stay indoors as much as possible.
pharmacy assistant 13

• Bedroom windows should be kept closed in the morning
and evening as these are times when the pollen count is
particularly high.
• Bed clothes should be washed regularly in very hot water;
a mattress protector should be used and the mattress
vaccumed on a regular basis.
• For those who have to venture out, it can sometimes help to
put some Vaseline around the inside of the nose.
• Wrap-around sunglasses will help prevent pollen attacking
the eyes.
• Car windows should be kept closed.
• Keep away from parks and open fields, again particularly in
the early evening.
• Avoid putting out washing when the pollen count is high.
• When planning a garden, try and choose low risk plants.
• Before venturing into the garden sprinkle it with a fine spray
of water in order to dampen down air pollen.
• It seems obvious but at all costs avoid cutting the grass!
• Animals often pick up pollen when they are outside so it is
worth rubbing them down with a damp towel when they reenter
the house.
• On fine days head for the seaside for some guaranteed relief.
TreATmenT
In recent years the medicines available have not just become
more effective but also have less side effects.
Anti-histamines - anti-histamines and nasal sprays are the
first line of attack. Unlike the old anti-histamines, the newer
generation do not cause drowsiness. Anti-histamines are
relatively cheap and start working within a few hours. They inhibit
the effect of histamines, which are released on foot of an allergic
reaction – it is the histamines release that causes the symptoms
of hay fever. They will relieve sneezing, a runny nose, watery eyes,
and itchy ears and palate.
Steroids - these are very effective in treating nasal symptoms.
They suppress the allergic response in the first place and help
reduce inflammation. Where possible they should be started at
least seven days prior to the start of the hay fever season. They
are very effective when combined with an anti-histamine in the
first week.
Nasal decongestants - these are effective for mild symptoms.
They should be used only in the short term, three to five days at
most, as overuse can cause rebound and so ultimately make the
problem worse. That said, a short sharp dose will help unblock
the nose.
Sodium cromoglycate (nose spray or eye drops) - this is
effective in relieving mild to moderate symptoms but less so
in treating more severe attacks. Treatment should be initiated
before the onset of the pollen season. It is useful in treating
children.
De-sensitisation treatment or immunotherapy - in cases of
severe, long-term hay fever, immunotherapy or desensitisation
treatment may be an option. An allergy specialist will gradually
introduce small amounts of the substance that the patient is
allergic to. A small amount of an allergen such as pollen or a fungi
is injected into the body and the allergic reaction is monitored.
Alternative therapies - There is anecdotal evidence that some
herbal remedies, homeopathy and acupuncture may help relieve
or prevent hay fever symptoms, but there is little scientific
research to back this up.

productnews
Losing weight with Go-Cal 1,000
Go-Cal 1,000, a natural food supplement,
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beat cravings and break bad food habits
in order to lose weight. It can reportedly
help combat these common dieting
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a combination of natural ingredients
that have been formulated to support
a variety of weight-loss programmes
including low carb and low GI diets.
Go-Cal 1,000 contains six key
ingredients, including green tea,
apple cider vinegar (a highly effective
metabolic accelerator, appetite
suppressant and kidney cleanser),
dandelion root and nettle leaf extract
(both safe and gentle diuretics), Acetyl
(N)-L-Tyrosine (an energy booster)
Bounce Back with
Vitaberry!
Vitaberry, a
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fortified with
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Containing a
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blend of vitamins
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well as blueberry,
holy basil, lemon
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berry, Vitaberry is an ideal supplement for all adults.
One capsule taken daily with a meal can help maintain
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damaging effects of free radicals, which are believed to
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For centuries blueberries have been regarded as
one of the most valuable health foods in Sweden. Now
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Vitaberry is the easy way to ensure the daily intake
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and Chromium Picolinate (a craving
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Using Go-Cal 1,000 as part of a healthy
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dieter’s fatigue and the feeling of hunger
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being realistic about weight loss.
Go-Cal 1,000 is distributed by
Naturalife. For further information
please visit www.naturallife.ie
Udo’s Oil for a bikini body
As the summer season gets into full swing,
savvy folks are preparing their bodies for
the sun from the inside out. A poor diet
and hectic lifestyles can contribute to dry
skin, uneven skin tone, spots, ageing and
weather damage. However, the blend
of ingredients in Udo’s Oil reportedly
helps make skin soft, velvety and supple.
Working from the inside out, it evens out
skin tone, reduces age and weather marks
and gives skin an all over glow.
The EFAs contained in Udo’s Oil protect
genes from damage and support cell build-up, which helps slow
down the ageing process in the body and helps prevent wrinkles.
Taking Udo’s may also help skin tan more rapidly and evenly.
Udo’s Oil also has beneficial effects for those suffering from
premenstrual syndrome by targeting the endocrine system, which
is responsible for hormone production. Taking Udo’s Oil can help
balance this system, helping it function more efficiently, thus easing
many of the common ailments associated with PMS, including
problem skin.
Udo’s Oil, which is celebrating its tenth year on sale in Ireland, is
organic and 100% natural, making it suitable for all ages. Its blend of
ingredients include omega 3 and omega 6 essential fatty acids (EFAs)
extracted from cold pressed certified organic flax, sesame, sunflower,
evening primrose seeds, rice and oat germ.
“Most women think that avoiding all fat is the path to true health,
but in reality there are two substances that can only be found in fat
that are just as necessary to our survival as proteins, carbohydrates,
vitamins and minerals,” said Udo Erasmus, international authority
on fats, oils, cholesterol and human health says. “Omega 3 and 6 are
essential fatty acids – every living cell in the body needs these fats,
but the body cannot make them on its own. By taking Udo’s Oil daily,
your body is getting the perfect ratio of these fats, which will help
with a range of functions, including improving your skin, hair and
nails.”
Udo’s Oil can easily be used in many dishes - poured over pasta,
mixed with cottage cheese to make a spread, or yoghurt and chives
for a vegetable dip. It is compatible with all foods and can be taken
with yoghurts, juices, shakes and smoothies. It can also be added
to salad dressings. Udo’s Oil is available quality health food stores
and selected pharmacies. For further information please visit www.
udoerasmus.com or call 0404 62444.
pharmacy assistant
15

16
Q&A Mary
Why did you choose to
work in a pharmacy?
A family friend offered me
a job for the summer after
Third Year. I didn’t know if
I would like it but I did it
and decided to continue
on with it.
What traits do you look for
in your colleagues?
Honestly, a team player and
fun to work with!
What traits do you look for
in a boss?
Fairness and easy to
approach.
When and where were you
happiest?
On holidays last year in
Lanzarote.
What would your super
power be?
Smiling!
What is the worst job
you’ve done?
Working in a newsagents.
What trait do you most
dislike in others?
Laziness.
So you use alternative
medicine and if so, what
kind?
No.
Cat or dog?
Cat.
pharmacy assistant
Forde is 25 years old and has been working in
Milltown Pharmacy for the past three years where
she is currently training as a pharmacy technician.
She has worked in the industry both part time and
full time since she was 16.
What keeps you awake at
night?
Nothing – I’m a good sleeper!
Who or what makes you
laugh?
My best friend, especially on
a night out!
Who or what is the greatest
love of your life?
My boyfiriend who I’ve been
with for five years!
How do you relax?
Socialising with friends or
watching TV.
Favourite TV/radio
programme?
CSI.
Favourite composer/
entertainer/rock
group?
Tommy Tiernan
Favourite film
and book?
Film: Atonement and book: PS
I Love you.
What is your motto?
Live every day as if it’s your
last!
How would you like to be
remembered?
As a good person.
Tell us a joke
What’s a monkey with a
bomb? A ba-boom! (Not
great I know!)

CROSSWORD SPOnSORED
ACROSS
1 American curse, in short (4)
4 Capable Abel maybe (4)
7 President Eisenhower (3)
9 Join college (5)
10 Tibetan ox (3)
12 Storehouse (5)
14 Most important movie maker, perhaps (9)
18 Powerful beam (5)
19 Rag that infuriates bulls (3)
20 Hangman’s rope (5)
22 Bath (3)
23 Reserve a paperback, perhaps (4)
24 Pip for growing flowers etc (4)
BY
1 2 3 4 5
7 8 9 10
DOwn
1 Inexpensive (5)
2 Knight’s tale (3)
3 East European cars (6)
5 Marshy offshoots of lakes in USA (5)
6 Large species of deer (3)
8 weather found in light bulb (7)
11 Air Traffic network (acronym) (3)
13 Absorbent with holes (6)
15 Beer (3)
16 wireless receiver (5)
17 Tendency to be stylish perhaps (5)
19 Steal (3)
21 Order of the British Empire (3)
Be in with a chance to win the Pharmacy Assistant
Crossword. Send your completed crossword with your
name and address to the Editor, Pharmacy Assistant,
GreenCross Publishing, Lower Ground Floor, 5
Harrington Street, Dublin 8 or fax 01 4789764. The first
correct entry will receive a cheque for e50.
name:
Address:
Email:
11 12
13 14 15 16
17
18 19 20
22 23
6
21
LAST ISSUE’S CROSSwORD
AnSwERS
ACROSS: 1. Slow 3. Ogre 7.
Offal 9. Ink 11. Mamma 13.
Firebombs 17. Canal 18. Bid 19.
Mafia 21. Arc 22. Acre 23. Sand
DOWN: 1. spoof 2: off 3.
Grimm 4. elk 5. Alabama 8.
Amen 10. nab 12. Molars 14. ICI
15. Radar 16. Scald 18. FCA
Congratulations to
the winner of the
first ever Pharmacy
Assistant crossword.
Beverly Wheeler,
Kilcoole Pharmacy,
Co Wicklow.
pharmacy assistant
17

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