2017 HCHB_digital

CONTINUING OTC EDUCATION
decrease the appearance of acne, and help symptoms of Crohn’s disease or
ulcerative colitis. Flatulence may be an issue and it may not be suitable for people
with a yeast allergy or those who are immunocompromised.
S. cerevisiae is another probiotic yeast with strong antioxidant activity that
may help reduce pain associated with IBS.
Streptococcus salivarius
S. salivarius K12 and M18 are oral cavity probiotics which are have activity
against bacteria implicated in bad breath, gingivitis (see Oral Health), and tooth
decay. K12 also helps stimulate antiviral immune defenses and reduce episodes
of otitis media.
S. thermophiles has been widely used in the dairy industry in the production
of milk, cheese and yoghurt since the 1900s. Live cultures of S. thermophiles can
help people who are lactose-intolerant digest dairy products.
Safety of probiotics
Although probiotics are generally considered safe and cause few side effects,
assessments are ongoing into the safety and toxicity of these substances.
Reassuringly, yoghurt, cheeses, and many other foods that contain live cultures
(probiotics) have been eaten for centuries with few reported ill effects. However,
people with a weakened immune system or a serious illness have a reduced
ability to fight infection and may be vulnerable to infection from probiotics, and
should avoid them.
Probiotics: foods versus supplements?
The form of the probiotic (ie, as a powder, tablet, capsule, or food) generally does
not matter as long as it contains at least 7–9 billion colony forming units (CFU)
per dose, although recommended dosage for different strains varies.
As a general rule, most foods do not contain enough organisms or the content
varies widely from batch to batch as a result of the manufacturing process or
storage. Choose commercially prepared probiotic products from a reputable
company that guarantees a specific number of organisms at the time of purchase,
and ensure storage requirements are adhered to. Products stored for long periods
of time or improperly stored may contain few live and active organisms to start
with.
Prebiotics
Prebiotics are non-digestable food ingredients. They are mostly obtained from
carbohydrate fibres called oligosaccharides. Sources of prebiotics include whole
grains, bananas, onions, garlic, honey and artichokes. Prebiotics can increase
the number of beneficial bacteria in the intestine by stimulating their growth.
A prebiotic combined with a probiotic is called a symbiotic – a substance that
contains both live bacteria and the fuel it needs to survive.
Prebiotics available in New Zealand mostly contain inulin or oligofructose.
Both are effective for the treatment of constipation. Inulin can also lower
Refer to
PHARMACIST
The following questions aim to identify customers who would
benefit from further input from a pharmacist. Your initial assessment
may have already provided some answers. Decide if any further
questions still need to be asked and refer any “yes” answers to a
pharmacist.
• Does the person have any other health conditions (eg,
immunosuppression, cancer, is pregnant or breastfeeding)?
• Does the person take any regular medicine that has been
prescribed by a doctor?
• Is the person wanting a probiotic for a very young child or an
elderly person?
• Does the person have any symptoms of concern (eg, blood in the
faeces, unexplained weight loss, inconsistent bowel movements)?
• Has the person recently travelled to a developing country?
• Have probiotics been tried before without success?
• Does the person have any allergies to milk or lactose?
triglycerides and is included in several meal replacement formulae or weight loss
products as it suppresses hunger by making people feel full. A kiwifruit extract is
also available that contains prebiotics, dietary fibre to bulk up and improve the
water-retaining properties of the faecal mass, and enzymes. The main side effect
of prebiotics is bloating and flatulence.
Initial assessment
Ask questions to ensure you select the correct species and strain of probiotic
for your customer's condition. Refer any "yes" answers from the Refer to
Pharmacist questions to a pharmacist.
Advise customers to take probiotics with food to take advantage of the
increased alkalinity of the stomach (and therefore ensure better survival of the
probiotic) and to separate the administration of probiotics and antibiotics by at
least two hours. Discard all products once they are past their expiry date.
• Store probiotics strictly according to the storage requirements on the label.
Now you can complete
your ENHANCE modules on
your phone or tablet
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