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2017 HCHB_digital

its new OTC Learning

its new OTC Learning Pathway through ELearning and Pharmacy Today $67 (incl.GST) VOLUME 19 Introduction HEALTHCARE HANDBOOK incorporating the OTC products guide July 2017 - June 2018 Healthcare Handbook launches W elcome to the 2017 Healthcare Handbook, which this year has the addition of an OTC ELearning, continuing education component. Aimed at pharmacy technicians, assistants and retail assistants, the OTC ELearning programme is a 12-month course that runs in conjunction with Pharmacy Today. The idea behind the OTC ELearning continuing education is to enable pharmacy staff to upskill their knowledge and start to build a record of their education in pharmacy. This can be transferred if someone moves jobs or used to gain promotion within an existing pharmacy. Pharmacists can also easily ensure their staff are getting first-class training in a range of relevant subjects. How to complete the course Each month in Pharmacy Today there is a continuing education column at the back of the Retail Therapy section, aimed for pharmacy staff working on the shop floor. This provides information on treating some of the more common conditions presenting in pharmacy. This column will correlate to a condition in the Healthcare Handbook and, once you have read both, you can complete an online ELearning module at www.elearning.pharmacytoday.co.nz. Each successfully completed module will earn points and the opportunity to win a prize at the end of the 12-month course. After 12 modules have been successfully completed you will be issued a certificate from Pharmacy Today showing you have completed the course. Enjoy this year’s Healthcare Handbook and see each issue of Pharmacy Today for the corresponding continuing education column. The ELearning course is straightforward so your continuing education is hassle free. Page 4 HEALTHCARE HANDBOOK 2017-2018 Introduction

Asthma and COPD CONTINUING OTC EDUCATION Asthma present most of the time. During an “attack”, breathing becomes very difficult New Zealand has one of the highest prevalences of asthma in the world and over due to inflammation and contraction of the smooth muscle within the airway, 460,000 people regularly take medication for asthma. An estimated one in seven excessive mucous secretion, and swelling of the smaller airways. Permanent children and one in nine adults are affected, and only a small number of children damage of the airways can result from untreated asthma. appear to grow out of the condition. It is common for asthmatics to also suffer from hay fever or eczema, and/or to Common symptoms include wheezing (a whistling sound most obvious when have a family history of these conditions. breathing out), shortness of breath, tightness in the chest, difficulty speaking, and The cause of asthma is unknown; however, many common triggers have been a persistent dry cough (usually at night or after exercise). Over time this cough may identified, including animal dander (especially cats), cigarette smoke, cold air, become more productive. A cough may be the only symptom in young children. exercise, house dust mites, pollen, stress, strong perfume, viral infections (eg, a These symptoms may occur suddenly as an asthma “attack”, or they can be cold) and some medicines (eg, aspirin and NSAIDs). Asthma cannot be cured but TREATMENT OPTIONS Category Examples Comments Relievers Beta2-agonists (short-acting [PRESCRIPTION MEDICINE] bronchodilators) eg, salbutamol inhaler (Asthalin, SalAir, Salamol, Respigen, Ventolin) eg, terbutaline (Bricanyl) eg, salbutamol liquid (Ventolin) Preventers Corticosteroids [PRESCRIPTION MEDICINE] eg, beclomethasone (Beclazone, Qvar), budesonide (Pulmicort), fluticasone (Floair, Flixotide) Mast cell stabilisers and others [PRESCRIPTION MEDICINE] eg, nedocromil (Tilade), sodium cromoglycate (Intal Spincaps/Forte), montelukast (Singulair) Anticholinergic [PRESCRIPTION MEDICINE] bronchodilators or eg, ipratropium (Atrovent, Univent) long-acting muscarinic tiotropium (Spiriva), glycopyrronium antagonists (Seebri), umeclidinium (Incruse Ellipta), aclidinium (Bretaris) Symptom controllers [PRESCRIPTION MEDICINE] (long-acting beta2 eg, eformoterol (Foradil, Oxis), indacaterol agonists) (Onbrez), salmeterol (Meterol, Serevent) Combination therapy [PRESCRIPTION MEDICINE] eg, eformoterol + budesonide (Symbicort Smart, Vannair), glycopyrronium + indacaterol (Ultibro Breezhaler), ipratropium + salbutamol (Duolin HFA), salmeterol + fluticasone (RexAir, Seretide), tiatropium + olodaterol (Spiolto Respimat), umeclidinium + vilanterol (Anoro), vilanterol + fluticasone (Breo) Spacers eg, e-chamber, Volumatic Children aged six or less eg, e-chamber mask Reliever inhalers are used to treat the acute symptoms of asthma (ie, the difficulty in breathing). They provide relief within a couple of minutes. Most reliever inhalers are blue. Anyone using a reliever more than three times a week or waking at night with symptoms should go to the doctor. If a person finds his bronchodilator has become less effective, it may indicate worsening asthma and the need to initiate an action plan or to visit the doctor to review therapy. Preventer inhalers contain corticosteroids. They do not have an immediate effect, so nothing is felt after inhalation; however, when used regularly they reduce the underlying inflammation of the airways and help reduce the incidence and severity of asthma attacks and hospitalisations. Most preventer inhalers are either brown, orange or dark red. Reduce risk of oral thrush by using a spacer and rinsing the mouth with water after using inhaled corticosteroids (ICS). Mast cell stabilisers (ie, nedocromil, sodium cromoglycate) are not commonly used since they are less effective than ICSs. May be useful for preventing exercise-induced asthma. Sodium cromoglycate needs to be taken anywhere from four to eight times daily. They may take up to six weeks to take effect. Montelukast is a leukotriene receptor antagonist that may be used in addition to ICSs for an additive effect. Can be of benefit in exercise-induced asthma and in people who also have rhinitis. Special Authority needed. Ipratropium reduces mucous secretions and relaxes airway muscle. It is short-acting and has a slower onset of action than beta2-agonists so is used more in COPD, although certain asthma patients may benefit. Longer acting antimuscarinic bronchodilators include tiotropium, glycopyrronium, umeclidinium, and aclidinium. Long-acting bronchodilators. Do not treat the underlying inflammation but may be beneficial in mild to moderate asthma instead of using higher doses of ICS. Used in conjunction with an ICS. Not useful for acute asthma attacks since they do not open airways immediately. Do not exceed recommended dose. Combination agents may aid adherence to recommended preventative regimens. Dispense Ventolin ® The original blue inhaler that Kiwis know and trust 2 Help to improve delivery of MDIs to the lungs, reduce adverse effects of ICSs. Wash once a week with warm water and a squirt of detergent and allow to completely drip dry. This leaves a slight residue of detergent on the inside of the spacer which reduces static and stops the medicine in the inhaler sticking to the sides. Replace every six to 12 months (tiny scratches or abrasions can prevent the spacer working as effectively). Te Hã Ora: The Breath Of Life Te Hã Ora is New Zealand's National Respiratory Strategy launched in November 2015. Respiratory disease (including asthma, bronchiectasis, COPD, lung cancer, obstructive sleep apnoea, and pneumonia) affects almost 700,000 people in New Zealand but despite improvements in medical treatments and health care, respiratory illness rates here continue to worsen. Te Hã Ora aims to: • reduce the incidence and impact of respiratory disease in New Zealand • eliminate inequalities in respiratory health, particularly among Maori, Pacific peoples and low income families. The full National Respiratory Strategy document can be found at asthmafoundation.org.nz most people are able to manage it with medicine so that it does not interfere with their day-to-day life. Education is vital to help sufferers recognise symptoms of worsening asthma and to avoid severe attacks by taking early action. Symptoms that indicate worsening asthma include a dry, persistent cough, usually at night and after exercise, and increasing use of “reliever” medicine. Home-use of a peak flow meter (a device that measures maximum flow of air from the lungs) may help identify deteriorating lung function. Common treatment options include beta-2 agonists, corticosteroids, mast cell stabilisers, and leukotriene receptor antagonists. COPD (Chronic Obstructive Pulmonary Disease) COPD is an umbrella term used to describe several different progressive lung diseases, such as emphysema and chronic bronchitis. COPD is more likely to develop in people over the age of 40 and symptoms include breathlessness, coughing, and increased phelgm. The major difference between COPD and asthma is that COPD is generally irreversible, although most symptoms can be controlled and further deterioration in lung function prevented with early treatment. Some people have both COPD and asthma. Ninety per cent of people who develop COPD have previously smoked; other causes include environmental pollutants and genetic deficiencies (eg, Alpha-1 Antitrypsin Deficiency). Treatments include oxygen, antimuscarinics, beta-2 agonists, corticosteroids, theophylline, antibiotics, and pulmonary rehabilitation programmes. Initial assessment The majority of customers with asthma or COPD require life-long medications so will regularly come into your pharmacy to collect these. Pay attention to the way they usually look, and if you notice any deterioration in their health, breathing, or if talking or walking appears difficult, ask if they would like to talk to a pharmacist. Always involve a pharmacist in cold or flu medicine requests, as lung function can quickly become compromised with illness. Types of delivery devices and spacers Metered dose inhalers (MDIs) – also called “puffers” are the most common devices available for delivery of medications used to treat asthma or COPD. However, many Refer to PHARMACIST If someone collapses and appears to have difficulty breathing, CALL AN AMBULANCE IMMEDIATELY, whether or not the person is known to have asthma or COPD. All other people presenting with asthma symptoms should be referred to the pharmacist, who should: • ASSESS the severity of the episode and call 111 if severe • SIT the person down and get them to lean forward • TREAT with six puffs of a blue “reliever” inhaler, preferably through a spacer (use patient’s own if available) • HELP by calling an ambulance if the person does not improve • MONITOR for improvement and repeat doses if needed • ALL OK. Stay with them until they are free from wheeze, cough and breathlessness then refer them to their doctor. older and younger patients find them difficult to use since good coordination is required between activation of the MDI and inhalation. Most MDIs require regular cleaning, preferably weekly, and should be shaken before use. Dry powder inhalers are breath-activated inhalers. They require less coordination and there is no need to use a spacer. However, they may be unsuitable if the person’s ability to inhale is too weak. Nebulisers are machines that convert liquid into a mist that can be inhaled into the lungs. Spacers are specially designed plastic tubes that are designed to be used with MDI (puffer) inhalers. They bypass the need for patients to coordinate activation of the inhaler with inhalation, and also help prevent the occurrence of oral thrush. Spacers can be very helpful during an acute asthma episode and some are available fully funded (see Treatment options). Advice for customers • Ensure customers know what each inhaler is for and how to use them. • Advise people with asthma to use paracetamol instead of NSAIDs because NSAIDs may precipitate an asthma attack in some people. • Ensure they have talked with their doctor about what to do if their asthma worsens and they have an Asthma Self-management plan. • Treat allergies and avoid known asthma triggers wherever possible, including cigarette smoke. • Warm up and use a reliever before exercise if they get exercise-induced asthma. VENTOLIN Asthma Symptom Relief doesn’t need to involve an unpleasant aftertaste. 1 DISPENSE ALCOHOL FREE VENTOLIN 2 References: 1. Gillies J et al. NZ Med J. 2005:118(1220):79-83. 2. Ventolin Data Sheet, GSK New Zealand. Ventolin ® (salbutamol; available as an alcohol-free and CFC-free Inhaler,100mcg per actuation) is a Prescription Medicine. Ventolin is a short acting bronchodilator (selective beta-2 adrenoreceptor agonist) for relieving symptoms in patients with asthma and for bronchodilation in patients with reversible airways obstruction due to asthma, chronic bronchitis and emphysema. Ventolin is a partially funded medicine. Dosage: Acute bronchospasm – 1 or 2 puffs, Chronic therapy – may take up to 2 puffs four times daily. This medicine has risks and benefits. Contraindications: Hypersensitivity to this medicine or to any of its components. Warnings and Precautions: Increasing use to control symptoms indicates deterioration of asthma control. Under these conditions, the patient’s therapy plan should be reassessed. Hypokalaemia may occur, particularly in acute severe asthma, potentiated by xanthine derivatives, steroids, diuretics and hypoxia. Caution in hyperthyroidism, hypertension, cardiovascular diseases and diabetes. Avoid beta-blockers, tricyclic antidepressants, MAOIs, digitalis. Common Side Effects: Headache, mild tremor, mouth and throat irritation, tachycardia and peripheral vasodilation, paradoxical bronchospasm. Before prescribing Ventolin, please review the Data Sheet at www. medsafe.govt.nz. Ventolin is a registered trade mark of the GlaxoSmithKline group of companies. Marketed by GlaxoSmithKline NZ Limited, Auckland. Adverse events involving GlaxoSmithKline products should be reported to GSK Medical Information on 0800 808 500. TAPS DA1728IG/17MA/SLB/0001/17 Page VEN_XXXX_Ventoline 18 HEALTHCARE Strip Ad Marc HANDBOOK 17 V3.indd 1 2017 Common Disorders 17/03/17 Page 12:10 PM 19 » Colds - Treatment BONNINGTON’S IRISH MOSS ASPEN PHARMACARE Presentation: Cough Syrup, 200mL bottle Active Ingredients: Each 10mL contains: 1.7 mg menthol, 9 mg camphor, 240 mg liquorice extract, 13 mg carrageenan, 3.8 uL ipecacuanha Approved Indications: Soothes and relieves coughs and sore throats. Contraindications: None known Precautions: Use only as directed. If symptoms persist, see your doctor. Store below 30 degrees celsius. Adverse Effects: None known Directions: For adults and children over 12 years, take 10mls and repeat every 2 hours as needed. Price Band: $14-16 per 200mL bottle Medicine Classification: General Sale Each common condition includes: • General information • Initial assessment • Treatment options • Customer advice • When to refer to the pharmacist. CODRAL ALL IN ONE JOHNSON & JOHNSON (NEW ZEALAND) LTD Presentation: Capsules, 24s Active Ingredients: Day: Paracetamol 500mg, phenylephrine hydrochloride 5mg, dextromethorphan hydrobromide 10mg. Night: Paracetamol 500mg, chlorpheniramine maleate 2mg, dextromethorphan hydrobromide 10mg. Approved Indications: Temporary relief of cold and flu symptoms including headaches, body aches and pains, blocked and runny nose, fever, dry irritating coughs and sore throat. Contraindications: Do not use for children under 12 years; with other products containing either paracetamol or antihistamines. Precautions: Ask your doctor before using if you have high blood pressure, are taking antidepressants, have heart problems, are pregnant, are taking any other medicines to treat cough and cold. Adverse Effects: Phenylephrine may cause sleeplessness in some people. Chlorpheniramine maleate (night tablet) may make you drowsy. If drowsy, do not drive or operate machinery. Avoid alcohol. Keep to the recommended dose. Directions: Adults and children over 12 years: 2 green day capsules morning, midday and afternoon, and 2 red and white night capsules at bedtime. Allow 4-6 hours as necessary between doses. Maximum 6 day and 2 night capsules in 24 hours. Price Band: $10 - $20 and over Subsidy Conditions: Not subsidised Medicine Classification: Pharmacy Only Medicine CODRAL COLD & FLU JOHNSON & JOHNSON (NEW ZEALAND) LTD Presentation: Tablets, 24s and 48s. Active Ingredients: Paracetamol 500mg, codeine phosphate 9.5mg, phenylephrine hydrochloride 5mg. Approved Indications: Temporary relief of cold and flu symptoms, including headaches, fever, body aches and pains, blocked and runny nose, and sore throat. Contraindications: Do not use for children under 12 years; with other paracetamol-containing products. Precautions: Ask your doctor before using if you have high blood pressure, are taking antidepressants, have heart problems or are pregnant or breastfeeding, are taking any other medicines to treat cough and cold. Codeine can be addictive. Avoid alcohol. Adverse Effects: Phenylephrine may cause sleeplessness in some people. This medicine may cause drowsiness. If affected do not drive a vehicle or operate machinery. Keep to the recommended dose. Directions: For adults and children 12 years and over: take 2 day tablets every 4-6 hours as necessary. Maximum 8 tablets in 24 hours. Price Band: $10 - $20 and over Subsidy Conditions: Not subsidised Medicine Classification: Pharmacy Only Medicine CODRAL COLD & FLU + COUGH JOHNSON & JOHNSON (NEW ZEALAND) LTD Presentation: Tablets, 24s and 48s. Active Ingredients: Day: Paracetamol 500mg, phenylephrine hydrochloride 5mg, dextromethorphan hydrobromide 10mg. Night: Paracetamol 500mg, chlorpheniramine maleate 2mg, dextromethorphan hydrobromide 10mg. Approved Indications: Temporary relief of cold and flu symptoms including headaches, body aches and pains, blocked and runny nose, fever, dry irritating coughs, and sore throat. Contraindications: Do not use for children under 12 years; with other products containing either paracetamol or antihistamines. Precautions: Ask your doctor before using if you have high blood pressure, are taking antidepressants, have heart problems, are pregnant, are taking any other medicines to treat cough and cold. Adverse Effects: Phenylephrine may cause sleeplessness in some people. Chlorpheniramine maleate (night tablet) may make you drowsy. If drowsy do not drive or operate machinery. Keep to the recommended dose. Directions: Adults and children over 12 years: 2 green day capsules morning, midday and afternoon, and 2 red night capsules at bedtime. Allow 4-6 hours as necessary between doses. Maximum: 6 day and 2 night capsules in 24 hours. Price Band: $10 - $20 and over Subsidy Conditions: Not subsidised Medicine Classification: Pharmacy Only Medicine Page 224 HEALTHCARE HANDBOOK 2017-2018 OTC Products Using this handbook The front section of this handbook gives an overview of 75 of the most common conditions customers seek advice about from a pharmacy. These conditions are presented in alphabetical order and are usually in a two-page format (see above). Initial assessment When talking to a customer about a condition, it is important to be observant and not to bombard them with too many questions, especially if the answers are obvious. The initial assessment paragraph for each condition offers guidance about how to approach a customer or what specific symptoms to look for. Further details about the initial assessment are given over the page. When to refer to the pharmacist These are prompts for questions to ask your customer. If the answer is obvious or the answer already clarified during your initial assessment you do not need to ask the question again. Listen for responses that indicate that it would be more appropriate to refer the customer to the pharmacist. Treatment options: OTC products The Treatment Options Table in each chapter lists most currently available products for that condition. Products with an asterisk have abridged, but more detailed, product information in the OTC Products section (see left, for an example). Page 5

  • Page 1 and 2: HEALTHCARE HANDBOOK incorporating t
  • Page 3 and 4: 2017-2018 HEALTHCARE HANDBOOK PUBLI
  • Page 5: Index Common Disorders Acne--------
  • Page 9 and 10: Head and scalp • Condition of hai
  • Page 11 and 12: HELP KIDS BE THEMSELVES AGAIN NEW L
  • Page 14 and 15: NUROFEN ZAVANCE* IS ABSORBED UP TO
  • Page 16 and 17: Acne Acne is a common skin problem
  • Page 18 and 19: Allergies An allergy occurs when th
  • Page 20 and 21: Asthma and COPD Asthma New Zealand
  • Page 22 and 23: Baby Feeding Breastfeeding is best
  • Page 24 and 25: Bites and Stings Bites and stings c
  • Page 26 and 27: Bruises, Scars, Spider Veins Bruise
  • Page 28 and 29: Childhood Diseases and Immunisation
  • Page 30 and 31: Childhood Diseases and Immunisation
  • Page 32 and 33: Childhood Diseases and Immunisation
  • Page 34 and 35: Childhood Diseases and Immunisation
  • Page 36 and 37: Childhood Pain and Baby Teething Pa
  • Page 38 and 39: Colds A cold is a contagious viral
  • Page 40 and 41: Cold Sores Cold sores are fluid-fil
  • Page 42 and 43: Constipation Constipation is the te
  • Page 44 and 45: Contraception & Sexual Wellbeing Co
  • Page 46 and 47: Contraception: Emergency Emergency
  • Page 48 and 49: Coughs: Dry Coughs are called dry o
  • Page 50 and 51: Coughs: Productive Coughs are consi
  • Page 52 and 53: Cuts, Abrasions and Blisters This t
  • Page 54 and 55: Cystitis [Bladder Infection] Cystit
  • Page 56 and 57:

    Dandruff Dandruff is a common condi

  • Page 58 and 59:

    Dermatitis/Eczema Dermatitis is a g

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    Diabetes Diabetes is a condition in

  • Page 62 and 63:

    Diarrhoea and Vomiting Diarrhoea an

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    Dry Skin Dry skin is skin that lack

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    Ear Conditions Our ears allow us to

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    Eye Conditions Almost two-thirds of

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    Eye Conditions (continued) Type Sym

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    Eyes: Contact Lenses Contact lenses

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    Fever What is fever Fever is define

  • Page 76 and 77:

    Foot Care Common foot problems incl

  • Page 78 and 79:

    Fungal Infections: Superficial Supe

  • Page 80 and 81:

    Fungal Nail Infections (Onychomycos

  • Page 82 and 83:

    Gout Historically known as the “d

  • Page 84 and 85:

    Haemorrhoids Haemorrhoids (also cal

  • Page 86 and 87:

    Hair Loss Alopecia is the medical t

  • Page 88 and 89:

    Hay Fever Hay fever (also called in

  • Page 90 and 91:

    Hay Fever (continued) TREATMENT OPT

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    Headache Headaches are common and c

  • Page 94 and 95:

    Head Lice Head lice (pediculosis ca

  • Page 96 and 97:

    Heart Health Cardiovascular (CV) di

  • Page 98 and 99:

    Indigestion, Heartburn and Gastriti

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    Influenza Influenza (flu) is a comm

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    Influenza (continued) TREATMENT OPT

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    Iron Deficiency Iron is an essentia

  • Page 106 and 107:

    Irritable Bowel Syndrome Irritable

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    Menopause Menopause - the “change

  • Page 110 and 111:

    Migraine Migraines are a type of se

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    Muscular Aches, Pains and Tightness

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    Nappy Rash Nappy rash is a red rash

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    Oral Health Oral health disorders i

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    Osteoarthritis Osteoarthritis is th

  • Page 120 and 121:

    Osteoporosis Osteoporosis (meaning

  • Page 122 and 123:

    Period Pain and Endometriosis Perio

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    Poisonings Any substance that has t

  • Page 126 and 127:

    Pregnancy Tests and Supplements Hom

  • Page 128 and 129:

    Preventive Health There are certain

  • Page 130 and 131:

    Probiotics and Prebiotics Probiotic

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    Psoriasis Psoriasis is a long-term

  • Page 134 and 135:

    Scabies Scabies is a very contagiou

  • Page 136 and 137:

    Shingles Shingles (herpes zoster) i

  • Page 138 and 139:

    Sinus and Nasal Problems Sinuses ar

  • Page 140 and 141:

    Sleep Problems and Snoring Sleep is

  • Page 142 and 143:

    Smoking Cessation Almost 5000 New Z

  • Page 144 and 145:

    Sore Throat Sore throats are very c

  • Page 146 and 147:

    Strains and Sprains Sprains and str

  • Page 148 and 149:

    Sun Care Sunburn Sunburn occurs fro

  • Page 150 and 151:

    Sun Care: Eye Protection Protecting

  • Page 152 and 153:

    Sweating: Excessive (Hyperhidrosis)

  • Page 154 and 155:

    Toothache Toothache is the term use

  • Page 156 and 157:

    Travel Health (including Vaccinatio

  • Page 158 and 159:

    Travel Sickness Travel, or motion,

  • Page 160 and 161:

    Urinary Incontinence Urinary incont

  • Page 162 and 163:

    Urticaria (Hives) Urticaria refers

  • Page 164 and 165:

    Vaginal Health The vagina is a clos

  • Page 166 and 167:

    Varicose Veins and Support Stocking

  • Page 168 and 169:

    Vitamins and Dietary Supplements Vi

  • Page 170 and 171:

    Warts Warts are benign (non-cancero

  • Page 172 and 173:

    Weight Loss Obesity has reached epi

  • Page 174 and 175:

    Worms Pinworms (Enterobius vermicul

  • Page 176 and 177:

    Wound Care Our skin acts as a barri

  • Page 178 and 179:

    Wound Care (continued) Wound type M

  • Page 180 and 181:

    Glossary WHAT DOES THAT WORD MEAN?

  • Page 182 and 183:

    Chapter References (continued) Diar

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    Chapter References (continued) Gord

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    Significant learning opportunity: W

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    PharmacyToday A part of your everyd

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    OTC Medicines: Interactions When se

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    OTC Medicines: Interactions OTC Med

  • Page 194 and 195:

    OTC Medicines: Interactions OTC Med

  • Page 196 and 197:

    OTC Medicines: Interactions OTC Med

  • Page 198 and 199:

    OTC Medicines: Precautions OTC Medi

  • Page 200 and 201:

    OTC Medicines: Precautions OTC Medi

  • Page 202 and 203:

    OTC Medicines: Adverse Effects OTC

  • Page 204 and 205:

    Herbal Supplements: Interactions He

  • Page 206 and 207:

    Herbal Supplements: Interactions He

  • Page 208 and 209:

    Herbal Supplements: Interactions He

  • Page 210 and 211:

    Herbal Supplements: Interactions He

  • Page 212 and 213:

    Drugs in Sport Treating Athletes Me

  • Page 214 and 215:

    Drugs in Aviation AVIATION - PRECAU

  • Page 216 and 217:

    Drugs in Pregnancy Drug use in preg

  • Page 218 and 219:

    NZ Support Groups ADHD Association

  • Page 220 and 221:

    NZ Support Groups New Zealand AIDS

  • Page 222 and 223:

    HEAT or INFLAMMATION Unlike heat ru

  • Page 224 and 225:

    OTC Products Over-the-counter produ

  • Page 226 and 227:

    OTC Products Index Foot Care - Fung

  • Page 228 and 229:

    »» Acne CRYSTADERM CREAM AFT PHAR

  • Page 230 and 231:

    »» Childhood Pain and Baby Teethi

  • Page 232 and 233:

    »» Colds BONNINGTON’S IRISH MOS

  • Page 234 and 235:

    CODRAL RELIEF MAX STRENGTH COLD & F

  • Page 236 and 237:

    OTRIVIN JUNIOR GLAXOSMITHKLINE CONS

  • Page 238 and 239:

    DULCOLAX SANOFI CONSUMER HEALTHCARE

  • Page 240 and 241:

    BENADRYL MUCUS RELIEF DOUBLE ACTION

  • Page 242 and 243:

    »» Dandruff COCO-SCALP AFT PHARMA

  • Page 244 and 245:

    EAR CLEAR WILSON CONSUMER PRODUCTS

  • Page 246 and 247:

    »» Foot Care - Fungal Infections

  • Page 248 and 249:

    TELFAST ORAL LIQUID SANOFI CONSUMER

  • Page 250 and 251:

    NUROFEN ZAVANCE RECKITT BENCKISER (

  • Page 252 and 253:

    MOOV HEAD LICE SOLUTION DOUGLAS PHA

  • Page 254 and 255:

    GAVISCON DUAL ACTION LIQUID RECKITT

  • Page 256 and 257:

    CODRAL COLD & FLU + COUGH JOHNSON &

  • Page 258 and 259:

    »» Irritable Bowel Syndrome GASTR

  • Page 260 and 261:

    VOLTAREN EMULGEL GLAXOSMITHKLINE CO

  • Page 262 and 263:

    TURMERIC EXTRA STRENGTH GOOD HEALTH

  • Page 264 and 265:

    PREGNOSIS EARLY PREGNANCY TEST DIP

  • Page 266 and 267:

    »» Sexual Wellbeing - Contracepti

  • Page 268 and 269:

    SUDAFED PE SINUS DAY + NIGHT RELIEF

  • Page 270 and 271:

    NICORETTE INHALATOR JOHNSON & JOHNS

  • Page 272 and 273:

    STREPSILS PLUS LOZENGES RECKITT BEN

  • Page 274 and 275:

    TRAVACALM TRAVEL BAND WILSON CONSUM

  • Page 276 and 277:

    CRYSTADERM CREAM AFT PHARMACEUTICAL

  • Page 278 and 279:

    An ENHANCED ELearning Experience As

  • Page 280 and 281:

    Product Index ANIME LUBRICANT 50ML-

  • Page 282 and 283:

    Manufacturer’s Index AFT Pharmace

  • Page 284:

    Topiramate Actavis Topiramate 25mg,

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