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Community Pharmacy Case

1. The pharmacist dispensed Ventolin evohaler and Serrin tablets to a woman presenting with cough, dry and irritated throat, and chest tightness to relieve her bronchial and throat symptoms. 2. For a man complaining of hemorrhoids and difficulty cleaning the anal area, the pharmacist dispensed Daflon tablets to improve hemorrhoid signs and Xyloproct ointment to relieve pain and itching. 3. An old man presenting with dizziness and postural imbalance received Tanakan, Methycobal, and Merislon to improve circulation, nerve function, and relieve vertigo.

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282 views19 pages

Community Pharmacy Case

1. The pharmacist dispensed Ventolin evohaler and Serrin tablets to a woman presenting with cough, dry and irritated throat, and chest tightness to relieve her bronchial and throat symptoms. 2. For a man complaining of hemorrhoids and difficulty cleaning the anal area, the pharmacist dispensed Daflon tablets to improve hemorrhoid signs and Xyloproct ointment to relieve pain and itching. 3. An old man presenting with dizziness and postural imbalance received Tanakan, Methycobal, and Merislon to improve circulation, nerve function, and relieve vertigo.

Uploaded by

vicky_law_2
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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COMMUNITY PHARMACY

CASE PRESENTATION

CASE 1
A woman, presented to the pharmacy asking for
something for cough and her throat is dry and
irritating. She also had chest tightness, she
wanted something which can help to dilate
bronchial airway. At this point the patient is
referred to the pharmacist and the pharmacist
dispensed following:
1. Ventolin evohaler (Salbutamol 100 mcg), 2
puffs four times a day
2. Serrin (serratiopeptidase), 2 tablets three
times a day, after meal.

Salbutamol

provide short-acting bronchodilation

relaxing muscles in the airways

fast onset of action

commonly used for asthma, chronic


bronchitis

Serratiopeptase

a proteolytic enzyme of Serratia


species source.

eliminates inflammatory edema and


swelling

Comment:

Ventolin evohaler was dispensed here to


relieve the symptom of chest tightness. The
pharmacist has also demonstrated
instruction of use and handling the Ventolin
evohaler.

The pharmacist did not dispense any cough


medicine for the patient as she suspected
the cough was due to her dry and irritated
throat.

Thus, serrin tablet was given to relieve such


irritation

Meanwhile, the pharmacist also advised


the patient to drink more warm water or to
take honey to soothe the throat.

CASE 2
A man complained of having hemorrhoid. He
claimed that he was unable to clean the area
around anus appropriately and causes itchiness.
The pharmacist dispensed as below:
1. Daflon.500mg (diosmin 450 mg, hesperidin 50
mg), 2 tablets daily in the divided dose.
2. Xyloproct (Lidocaine base 50 mg,
hydrocortisone acetate 2.5 mg, Aluminium
subacetate 35 mg, Zinc oxide 180 mg), Apply thin
layer several times a day. Max: 6 g/day

Daflon

a phlebotonic drug and a vascular


protecting agent

It reinforces venous tone by prolonging the


vasoconstrictor effect of noradrenaline on
the vein wall. Thus, decreases venous
capacitance, venous distensibility and
venous emptying time

It significantly improves signs and


symptoms of hemorrhoid

eg, anal irritation, pain or discomfort,


bleeding, a lump or swelling in the anus

Xyloproct

Indication: relieve pain and discomfort of


haemorrhoids (piles), itching, cracking or tearing of
the anus, inflammation of the rectum and anus
(back passage), and post-operation pain

Lidocaine has analgesic effects, reduces pain and


itching.

Hydrocortisone has anti-inflammatory properties,


reduces the redness and swelling

also contains aluminium subacetate and zinc oxide,


which have astringent and disinfectant properties.

They help in skin protection and healing

Comment:

Besides treating the signs and symptoms of the


haemorrhoids it is important that the patient
ensure good toilet hygiene.

Eg: gently clean the area around the anus with


warm water at least once a day and after
passing a motion.

Use moist towels such as wet tissues or baby wipes


to gently pat, rather than rub dry to avoid
irritation to the swollen tissues.

Sit in warm bath esp after going to the toilet

Also keep stools soft and easy to pass by eating


plenty of food containing fibre and drinking
enough water every day

CASE 3
An old man presented to the pharmacy asking for
something to treat dizziness and he has postural
imbalance as he always bang into people while
walking. Before dispensing the following medication,
the pharmacist checked his blood pressure:

1. Tanakan tablet (Gingko biloba extract 40 mg), 3


tablets per day, to be taken with food or just before
the meal
2. Methycobal (Mecobalamin 500 mcg), 1 tablet
three times a day
3. Merislon (Betahistine mesylate 6mg), 1-2 tablets
three times a day, to be taken with food.

Tanakan

active ingredient: gingko biloba

helps in blood circulation

also indicated for cerebral circulatory insufficiency.

Methycobal

Vitamin B12 is an essential nutrient for normal body


functioning,

helps in maintenance of proper function of nerve cells


and brain chemistry

Merislon

active ingredient: betahistine mesylate.

relieve vertigo and dizziness associated with Menieres


disease

also improves cerebral circulation, increasing blood


flow in the internal carotid artery.

CASE 4
A young girl complained of vomiting and having
indigestion. She also suffered from diarrhea. The
pharmacist dispensed following:
1. Motilium (Domperidone 10 mg), 1 tablet three
times a day before meal
2. Uphalyte Oral Rehydration Salts (NaCl 525 mg,
Na bicarbonate 425 mg, KCl 375 mg, glucose
anhydrous 6.25 g), 1 sachet after diarrhea
3. Lacto GG (Lactobacillus rhamnosus strain GG),
1 capsule a day

Motilium

To relieve nausea by blocking dopamine receptors


at the chemoreceptor trigger zone (CTZ)

indicated for vomiting

a Group B poison, which need to be sold with the


prescription

Uphalyte

indicated for treatment of water & electrolyte


depletion associated with diarrhea, vomiting &
excessive sweating

the girl was having diarrhea as well as vomiting,


she must have significant water and electrolyte
depletion

rehydration and replenishment of electrolytes are


important as they are the essential molecules to
maintain normal body functions.

Lacto GG probiotic

Contains 20 billion live bacteria per


capsule

it was dispensed to the girl as she has


frequent diarrhea problems.

able to colonise the human intestine


and form a protective barrier of
good bacteria in the intestines and
to support the natural immune
defences.

Thus it is useful as prophylaxis of


diarrhea and vomiting.

CASE 5
A man has been smoking for a couple of year, he
smoked about 10 cigarettes a day. He came to the
pharmacy as he wishes to quit smoking. The
pharmacist dispensed following:
Champix (Varenicline tartrate 0.5mg), Day 1-3: 0.5
mg once daily. Day 4-7: 0.5 mg twice daily. Day 8end of treatment: 1 mg twice daily.
The duration of this smoking cessation treatment is 12
weeks

Champix

It partly stimulates the nicotine receptors to mimic


the effect of nicotine on the body. Thus, it both
reduces the urge to smoke and relieves
withdrawal symptoms

also partially blocks the receptors and prevents


nicotine from attaching to the receptors. This
blocks the effect of nicotine in people who give in
to temptation and have a cigarette.

If successfully stopped at 12 week, an additional


course of 12 week treatment may be considered.
Champix dosing should start 1-2 week before the
quit date.

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