Pharmacists are now taking on wider roles. As well as supplying medicines, they give confidential medical advice and offer a variety of health services. Many pharmacies offer support programmes for giving up smoking or losing weight and provide information on sexual health and contraception. Many community pharmacies can now measure blood pressure, offer cholesterol-testing and even screen for diabetes.

Yes, often you can. Most pharmacists have a private consultation area which is signposted. Sometimes it's a quiet area near the counter and behind a screen. In other cases it's an actual room. You can go and sit down with the pharmacist and not be overheard by other customers.

It takes five years to become a pharmacist. That includes a four year degree course in pharmacy and a year of practical experience followed by an exam. There is a lot expertise and knowledge behind the counter on the high street.

Pharmacists are a good screening service and some people may find them more approachable than their doctor. They can often put peoples' minds at rest by diagnosing and providing a remedy for minor aliments. Perhaps, if more people talked to their pharmacist it would take pressure off GPs. The pharmacist is not a substitute for the doctor but by relying on their expertise a bit more, you might find you need to visit your GP a little less.

But what happens if my condition is serious? The pharmacist will always refer a customer to a doctor if they feel it is appropriate. Someone might approach their pharmacist with what they think is a trivial problem and not realise it is symptomatic of more serious condition. The pharmacist might recommend they speak to their GP, or, depending on the query, a dentist, midwife or another health expert, for example.

Yes. A recent BBC survey found that one in two patients don't take their medicines correctly. If you're unsure, talk to your pharmacist. You might think it's a silly question, like should tablets be taken before or after food? But this can be important so you should never be afraid to ask. The pharmacist can talk you through the medicines and explain what they're for and how to take them correctly.

They get asked about a wide range of minor ailments such as colds, coughs, viruses, stomach problems, children's health and women's health issues. It can be seasonal. During the summer, for instance, we get lots of questions asking how to deal with hay fever and other allergies. People are increasingly interested in learning more about complementary medicines and herbal remedies as well.

You can in some pharmacies. However, as most are open for long hours six days a week, it shouldn't be too difficult to pop back at a more convenient time.

Cough
Coughing is the natural way in which your body clears an irritant from the airways. When you have an infection or if you have an underlying problem, then you may cough excessively and this is one of the most common reasons for people to visit pharmacies.

What is it?
Coughs are generally classified into two main types – chesty or dry. Dry coughs are sometimes known as a tickly coughs where no phlegm or mucus is produced whilst a chesty coughs is the result of your body producing too much phlegm or mucus. There are two forms a chesty cough can take; the first is where the phlegm is coughed up, the second is where the phlegm remains attached to the lungs.

Who can get it?
Anybody… a cough is commonly a symptom caused by a viral infection such as a cold or flu but it can be caused by a number of illnesses and conditions including asthma, bronchitis, and more rarely lung cancer. Occasionally some medicines can also cause a cough. Consult with your pharmacist about the medication you are taking and whether coughing could be a potential side-effect – they may be able to recommend something more suitable for you.

How long will it last?
Coughs caused by cold or flu will generally last two or three days. Stronger viral infections such as bronchitis can take up to a few weeks to clear up. If a cough lasts more than a couple of weeks after the initial infection you should visit your GP.

How is it treated?
As the cause of a cough is usually a viral infection which is cleared up by your immune system, it is usually self-limiting and resolves by itself. If treatment is required it is usually based upon relieving the symptoms of a cough.

Drinking plenty of fluids is recommended, especially for children, as this can make the mucus easier to cough up and can help soothe a dry throat. The use of steam inhalation can also help in a similar fashion but should be used carefully.

There are also different types of cough medicines aimed at relieving the symptoms of the different types of cough. These can be purchased at the pharmacy and your pharmacist will be able to advise on the suitability of these for you. Types include cough suppressants and expectorants.

Coughs are often accompanied by other symptoms in cold and flu, such as headaches, fever, and aches and pains and often cough medicines are available in combination with other medicines such as analgesics (painkillers) or decongestants to help with these.

What should I not do?
Since some combination cough mixtures already contain analgesics such as paracetamol, it is important not to overdose on these inadvertently by using other analgesics at the same time.

Lung Cancer Awareness Month
November is Lung Cancer Awareness Month. You may have noticed health professionals including pharmacists raising awareness of the disease which sees 37,000 people diagnosed every year, in the UK. Rarely, a cough is a symptom of a more serious condition such as lung cancer, however, early diagnosis is key to increasing survival rates. You should see your GP straight away if you have any of the following symptoms:

• A cough that doesn’t go away after two to three weeks
• Worsening of a long-standing cough
• Persistent chest infections
• Coughing blood
• Unexplained persistent breathlessness
• Unexplained persistent tiredness or lack of energy
• Unexplained persistent weight loss
• Persistent chest and / or shoulder pain

What is conjunctivitis?
Conjunctivitis is an inflammation of the thin, transparent layer (the conjunctiva) that lines the inner eyelid and covers the white part of the eye. Conjunctivitis is quite common and although rarely serious it is irritating and can be very uncomfortable. It usually affects both eyes, although may start in one before spreading to the other. There are several causes. Allergy is a common cause – if you have hay fever your conjunctiva may become inflamed. The chlorine in swimming pools or getting shampoo in your eyes can also cause mild irritant conjunctivitis. But the two most common types are bacterial and viral conjunctivitis.

What causes it?
Bacterial conjunctivitis is an infection caused by bacteria that may come from your own skin or upper respiratory tract or they may be caught from another person with conjunctivitis. Viral conjunctivitis is often associated with the common cold.

What are the symptoms?
The usual symptoms are red watery eyes, inflamed inner eyelids, blurred vision, a gritty feeling in the eyes and, sometimes, a sticky discharge that can cause your eyelids to stick together, particularly when you wake up.

How is it treated?
To remove any crusts or stickiness, clean your eyes with tepid (lukewarm) water, using a clean piece of cotton wool or gauze for each wipe. Clean your eyes from the bridge of your nose to the outer eye.

Bacterial conjunctivitis is usually treated with antibiotic drops or ointment, such as chloramphenicol which can now be obtained from your pharmacist on prescription from your doctor. Antibiotics do not help with viral forms but the irritation can be relieved by bathing your eyes with preparations available from your pharmacy.

What should I not do?
Avoid rubbing your eyes as this makes the inflammation worse. It is also important in bacterial conjunctivitis that you don't spread the infection from one eye to the other or to other people. Keep your hands away from your eyes, thoroughly wash your hands before applying eye medications and do not share towels, facecloths, cosmetics or eye drops with others.

What if it doesn’t clear up?
See your doctor if:
There is no improvement within a few days.
Your eyesight is affected – apart from blurring due to the mucus discharge.
Symptoms change (for example, light starts to hurt your eyes).
Spots or blisters develop on the skin near the eye.
Discomfort or pain becomes worse (mild soreness rather than pain is usual with common conjunctivitis).

Contact lens caution
Do not wear contact lenses when you have conjunctivitis. You should usually stop wearing lenses for a short period while your eyes heal, and your optician should go over the proper cleaning and handling methods with you before you start wearing them again.

Coronary heart disease (CHD) is the biggest killer in the UK and leads to the death of more than 110,000 people in England every year. Research links the rise in CHD with the rise in obesity. One in five of us is now obese, an increase of over 50% in the last decade.

What is coronary heart disease?
The coronary arteries are large blood vessels that supply the heart with blood and oxygen. Over time these arteries can become narrowed by cholesterol that gradually builds up on their walls. As the artery narrows the heart becomes less efficient and the risk of a heart attack increases.

Who is at risk?
The following are ‘risk factors’ that can increase the chance of an individual developing CHD.

• People who take little or no exercise
• Smokers
• People who have a stressful lifestyle
• Those with a diet rich in saturated fats
• Those with a diet low in antioxidants
• Obese people
• Men or Women over 65
• Heart disease runs in the family

How can I reduce the risk of developing CHD?
All of us can change our lifestyles to reduce the risk of CHD. By eating at least five portions of fruit and vegetables a day and lowering your fat, sugar and salt intake you can significantly reduce your CHD risk.

Giving up smoking – perhaps the single most important way to improve your health and reduce the likelihood of serious conditions such as CHD and lung cancer. Take more exercise, but if you haven’t done any exercise for a long time or have other medical conditions start gradually and talk to your pharmacist first.

Some patients may also benefit from taking a low dose of a medicine called simvastatin to reduce cholesterol. Your pharmacist will be able to advise if this would be appropriate for you.

How do I know if I’m at risk?
Many pharmacies now have the ability to measure your weight (sometimes called Body Mass Index or BMI), cholesterol and blood pressure. By looking at these measurements, your lifestyle and family history the pharmacist will be able to give you appropriate advice about how to reduce your risk of developing CHD. The pharmacist can also help you with getting the most from the medicines you may be taking.

What are the symptoms of CHD?
The most common symptom is chest pain. If you have chest pain when exercising or feel short of breath when resting then see your Doctor straight away.

If I’m diagnosed - what treatment is available?
Each patient will have treatment tailored individually for them. For most, the treatment would include a medicine to reduce cholesterol, known as a statin, as well as a medicine to lower blood pressure. Some patients may also benefit from taking a low dose aspirin but not everyone, so check with your pharmacist first.

According to Diabetes UK there are currently over 2 million people with diabetes in the UK with another 750,000 who are yet to be diagnosed.

What is diabetes?
Diabetes mellitus occurs when the body doesn’t produce enough insulin. Insulin is a hormone that helps the body use glucose (sugar) in the blood and when there isn’t enough the levels become too high.
There are two forms of diabetes, Type 1 or insulin dependent diabetes and Type 2 non-insulin dependent diabetes. In Type 1 the body cannot produce any insulin whilst in Type 2 the body makes some insulin but not enough.

Who can get it?
Type 1 diabetes has a genetic link and is more likely to develop if family members have it. It is not as common as Type 2 diabetes and usually occurs before reaching 40. Type 2 diabetes also has a genetic link and the risk grows as you become older, but is also associated with being overweight or obese, high blood pressure and high cholesterol.
Pharmacists can advise you on ways of reducing your chance of developing diabetes later in life and offer guidance in leading a healthy lifestyle.

Could I be diabetic?
The most obvious symptoms of diabetes include becoming more thirsty and needing to go for a wee more often. If you are losing weight for no other reason and are more tired than normal these can also be signs of diabetes. At many pharmacies you can check your blood glucose level by doing a simple test which can help diagnose diabetes.

How is it treated?
People with Type 1 diabetes will need to use insulin injections to manage their diabetes, whilst those with Type 2 diabetes may be able to control their diabetes with a change in lifestyle such as eating a healthy diet and exercising regularly. If this cannot control the diabetes then diabetic medicines such as tablets can be used. Tablets are not the same as insulin; they work in different ways to lower blood glucose levels – for example by stimulating the pancreas to produce more insulin, or by helping the body to use the insulin that it does produce more effectively. For people who do not yet have diabetes, or for those who do and want to reduce the chance of further complications, regular exercise combined with a healthy diet, and weight loss for those who are overweight can be beneficial. If you have questions or concerns about your diabetes medication or are finding it difficult to lose weight then ask your pharmacist for advice.

How can tell if the treatment is working?
It is important to monitor your health when you have diabetes and if treatment is working well then your blood glucose levels will need to be as normal as possible, so regular checks of your blood glucose, blood pressure and cholesterol levels are essential. People with diabetes can also sometimes have problems with their feet and eyes so if you’re buying eye drops or foot cream from a pharmacy make sure you mention you have diabetes.

Myth Buster
Many people believe that eating sugary foods or chocolate causes diabetes but this is not strictly true. A diet which is high in fat and sugar can lead to being overweight and this is linked to the risk of developing diabetes.

What is eczema?
Eczema, sometimes called dermatitis, refers to a group of skin conditions which can affect all age groups. In the United Kingdom, atopic eczema, the most common form, affects about 10-20 per cent of schoolchildren and 3-5 per cent of adults in the UK and it is getting increasingly common.

What are the symptoms?
The main symptom is itchiness. The skin is likely to be dry, sometimes red and painful. In more severe forms the skin can crack and weep or bleed and the itching can be almost intolerable. Eczema most commonly appears where the skin creases, such as on the inside of elbows and wrists or behind the knees – although in varicose eczema, caused by poor circulation, it appears on the lower legs. It also affects babies' faces and what is known as ‘cradle cap’ is a form of eczema.

What causes it?
There are a number of different types of eczema, which may look similar but have very different causes and treatments, so it is vital to see your GP initially so that you have a correct diagnosis.

Atopic eczema is the commonest form of eczema and is closely linked with asthma and hayfever. Other types of eczema are caused by irritants such as chemicals and detergents. Causes of some types of eczema are as yet unknown but links with environmental factors and stress are being explored.


How is it treated?
A wide range of treatments is available, either over the counter at the pharmacy, or on prescription from a doctor.

You can help to control the condition yourself by trying to avoid scratching, wearing cotton clothing to keep the skin cool and allow it to breathe, avoiding synthetic fabrics and wool as they can irritate. Using non-biological washing powders and avoiding fabric softeners, can also help to reduce itching. If you can, avoid stress and any known triggers.

Most important of all is to have an effective skin care routine. Even when eczema is under control you need to use emollients to keep the skin moisturised and avoid dryness. Emollients reduce water loss from the outer layer of your skin by covering it with a protective film, which also helps to keep infections out. They are safe to use as often as required and are available in various forms: ointments, creams and lotions.
Topical corticosteroid (steroid) preparations can quickly bring the eczema under control and are the main treatment even in small children. Your pharmacist will be able to advise you on how to use these products correctly. For most people with mild to moderate eczema, treatment with a mild steroid (hydrocortisone 1% cream or ointment) for one to two weeks is sufficient to bring symptoms under control. Your pharmacist can explain the differences between the preparations available and which one is most suitable for you.

A very wide range of products for eczema can be bought from pharmacies. Some of them are cheaper to buy this way, rather than on a prescription. Ask your pharmacist for advice on the different products and how to use them. It may be necessary to try several before the most suitable one is found. Your pharmacist will also be able to help you with this.

Fish oils, such as cod liver oil and evening primrose oil are also thought to help control eczema, and vitamins C and E are important for maintaining healthy skin. Tea-tree oil is a good antiseptic and has antibacterial effects, so can help to calm inflammation in some cases.

Top tip
Do not try more than one new treatment at a time – or you won’t know which one worked.

What is epilepsy?
Epilepsy is a neurological condition that causes people to have seizures with varying degrees of severity. A seizure is a sudden surge of electrical activity in the brain that usually affects people for a short time. There are around 40 different types, ranging from brief moments of absence to unconsciousness and convulsion. Absence seizures are common in children and they can appear to be daydreaming or not concentrating.

What causes epilepsy?
The cause is unknown in six out of ten people, but it can be caused by brain damage during birth, from a severe blow to the head, from a stroke that starves the brain of oxygen or from an infection such as meningitis.

How is it treated?
There is no cure for epilepsy but many people have their seizures successfully controlled with anti-epileptic drugs (AEDs). AEDs are used to prevent seizures from happening – they cannot stop seizures while they are happening.

A number of anti-epileptic drugs are available. There is likely to be some trial and error before the most suitable one is found and the right dosage established.

How can I tell if my medicines are working?
The clearest indication will be a reduction in frequency of seizures. It is important to take the medicines regularly because missing doses can cause some people to have seizures. If you find it difficult to remember to take your medication, talk to your pharmacist as there are aids available.

Are there side effects?
Some medicines may make you feel drowsy. If you need to buy other medicines over the counter or you are thinking of using a complementary therapy, talk to your pharmacist first before trying anything new because some medicines affect how others work. If you experience mild side effects talk to your pharmacist. If they are more severe, contact your doctor but don’t just stop taking a drug without medical advice as you could have a seizure.

What else should I do or not do?
Taking anti-epileptic drugs (AEDs) doesn't necessarily mean you can't drink alcohol, but AEDs can make you more sensitive to the effects of alcohol and alcohol can exaggerate some side effects of AEDs. If your AEDs make you feel sleepy, dizzy or light -headed for example, alcohol might make this worse.

If you notice that your epilepsy medication looks different – perhaps the tablets change colour or shape or maybe the packaging looks different then talk to your pharmacist. It’s important in some cases that your Doctor prescribes the same brand of medicine. Many pharmacists keep patient medication records and can help with queries about prescriptions and some can help review your medications (called a medicines use review).
If you’re thinking of starting a family women with epilepsy are strongly recommended to take folic acid before they get pregnant, but at a 5mg strength that is only available on prescription. Check with your pharmacist that you are taking the correct strength.

Did you know?
If you live in the UK and take anti-epileptic drugs, you do not have to pay prescription charges.

Head lice
The prevalence of head lice has increased within the last 30 years, according to research. Every year, around three million people in the UK catch them with one in 10 primary school children having a bout of head lice at some stage.

What are they?
Head lice are tiny grey-brown, wingless insects, which live by sucking blood from the scalp. Their eggs are known as nits and they are laid glued to the base of hairs, and look like tiny white specks.

Who is mostly likely to get them?
They are most common in schoolchildren, particularly between the ages of four and 11, but anyone with hair can catch them. They are caught by close hair to hair contact.

How can I tell if I have head lice?
An itchy scalp can indicate the presence of head lice and sometimes you can spot them in the hair. They can be detected by wet combing hair using a special fine-toothed comb available from your local pharmacy.

How do I get rid of the condition?
There are three main ways: insecticides which kill head lice and their eggs; dimeticone, a silicone-based lotion that kills head lice by coating them; and wet combing, which is a non-chemical treatment. You pharmacist can explain the advantages and disadvantages of each method. There is usually a good response to treatment, but reinfestation may occur if treatment is not completed correctly.

Is the pharmacist the only one who can advise me about head lice?
Pharmacy staff are qualified to advise on the treatment of head lice and their daily contact with the public means they are able to provide advice and information about suitable treatments.

I feel embarrassed about having head lice, can I talk to the pharmacist in private?
Yes, your local pharmacy may have a consultation area and you can arrange to speak with the pharmacist in private there. Pharmacists are asked questions about head lice all the time and they will treat your problem in a professional manner.

Did you know?
Head lice cannot jump, fly or swim – they move from head to head by walking (at an average speed of around 10cm per minute).

What is migraine?
A migraine is a persistent severe headache often associated with nausea, vomiting and sensitivity to light or sound and sometimes visual disturbances known as aura. They can characteristically last for 4 to 72 hours and are often throbbing affecting one side of the head. It is three times more common in women than in men and can also occur in children and it is thought that up to 6 million people suffer from migraine in the UK.

What causes it?
The exact cause is unclear, but there is thought to be a genetic link as 80% of people who suffer with migraine headaches have a family history of migraines.

Migraines can be triggered by a wide variety of trigger factors or a combination of trigger factors and these can include eating certain foods such as chocolate, cheese, caffeine and citrus fruits or drinking alcohol, in particular red wine. Sleeping too much or having too little sleep can also be a trigger factors along with hormonal changes in women, stress, smoking, skipping meals and being dehydrated. Loud noises, strong lights or intense smells and also medication including the contraceptive pills can all trigger an attack.


How is it treated?
It is important to have migraine diagnosed by a doctor when you get one for the first time. Once diagnosed there are various options available to tackle a migraine attack when one occurs. Some people find resting in a dark room or sleeping works best for them, whilst for others a snack or a meal can help. If these do not work for you, or are not practical, then painkillers such as paracetamol, aspirin or ibuprofen alone or in combination with codeine can help to control the pain. Painkillers are most effective when taken at the onset of a migraine attack. For people who feel sick or nauseous combinations of painkillers with anti-sickness medicines can help, but remember to speak to your pharmacist as not all medicines are suitable for everyone.

When painkillers and anti-sickness medicines are not controlling the migraine attacks then stronger medicines available from the pharmacy can help. The pharmacist may have to ask you a few questions to assess whether these products are suitable for you. If the options above do not help, or if your pharmacist feels the headaches may be caused by something more serious then your pharmacist may refer you to your doctor who can prescribe from a larger range of medicines to treat migraine.

Trigger factors and symptoms vary widely from person to person and a treatment that works well for one person may be completely ineffective for another so if a treatment does not work do not give up. Your pharmacist can help you work out a management plan tailored specially for you.

Can migraines be prevented?
You can reduce your chances of suffering a migraine by finding out which trigger factors affect you and by cutting down or eliminating them. Drug treatment is also an option for people who suffer frequent migraine attacks and various medicines such as propranolol, pizotifen or amitritptyline can help prevent migraines occurring. These are all prescription medicines and you will need to see your doctor to obtain these medicines.

Foot care
Summer has finally arrived and now is the time when you are most likely to give your feet a bit of an airing. However, for many people, the embarrassment of their feet can mean they would rather keep their feet under wraps. Our pharmacist Ruth Wakeman takes a look at two of the most common foot problems, sweaty feet and Athlete’s Foot

Who is most likely to have sweaty feet?
Anyone can get sweaty feet especially teenagers going through puberty or people with high levels of stress in their life. Your lifestyle can also affect your feet – if you have to stand all day, pressure exerted on your feet will cause them to sweat more. Hot weather can also make your feet sweat more than usual.

How can I stop them from sweating?
Avoid wearing socks or tights in artificial materials, wearing shoes made from synthetic materials can increase the likelihood of future foot problems so avoid these and if possible wear open toed shoes to allow the air to circulate.

Your local pharmacy will have a range of foot care products which can help your feet to stay fresh and cool. There are also cooling foot sprays available which can help refresh your skin and keep them odour free.

What is Athlete’s Foot?
It is a fungal infection that leads to dry, itchy, inflamed skin which can blister and peel. Athlete’s Foot is extremely infectious and sufferers must take precautions to stop spreading the infection to others. Your pharmacist will be able to give you confidential advice on how to treat Athlete’s Foot.

Who can get Athlete’s Foot?
Anyone can get Athlete’s Foot. To minimise your chances of infection it is important that you dry your feet properly after a bath or a shower. Walking barefoot in communal areas such as gyms, swimming pools, showers and changing rooms can make it easier to contract Athlete’s Foot.

To prevent re-infection – disinfect your bath/shower after use and do not share towels or socks/shoes. Wearing flip-flops can also prevent re-infection in communal wet areas.

How is Athlete’s Foot treated?
There are a variety of anti-fungal treatments at your pharmacy including topical azoles, Terbinafine, Tolnaftate, Undecenoates. The products come in sprays, powders and creams and your pharmacist will be able to advise you which one is best for you. If one treatment doesn’t seem to work well for you, ask your pharmacist to recommend a different course of treatment. It is important to continue the treatment for at least a week after the skin has improved to ensure that the infection has gone.

Change your shoes daily, as it can take one or two whole days for them to dry out completely. A shoe-spray from your pharmacy can help to remove any infection still in the shoe.

For a whole range of answers to different foot problems, your pharmacist is able to provide you with advice and will have further literature on your particular conditions.

Hypertension (High blood pressure)
It is thought that about one in four adults in the UK has high blood pressure, a major risk factor of stroke and heart disease. Up to one third of people with high blood pressure do not know they have the condition, yet diagnosis is easy to obtain from your local pharmacy.

What is hypertension?
Blood pressure is a measure of the force exerted by circulating blood around the walls of the blood vessels. When blood pressure remains consistently high, this is known as hypertension.

What causes it?
In about 90% of people who have high blood pressure, there is no clear cause, but it is thought that smoking, obesity, high alcohol consumption, lack of exercise and diet can all increase the risk of developing hypertension. If a member of your family has hypertension you are also more likely to develop it too.

More rarely, hypertension can also result from a disease or a medical factor. Hypertension is more commonly associated with patients with kidney problems or diabetes, and pregnant women. Taking medication such as steroids and the contraceptive pill can also result in hypertension.

What are the symptoms?
Unfortunately the majority of people with hypertension will not experience any symptoms at all, so it is easy for this disease to go undetected. Rarely, in severe hypertension, people may experience headaches, confusion, blurred vision, drowsiness and loss of consciousness.

To find out whether you have high blood pressure, visit your local pharmacy where they may be able measure your blood pressure and give you professional advice about purchasing a blood pressure monitor for self-testing and on ways to lower your blood pressure.

How is it treated?
Lifestyle changes are important in reducing blood pressure. Your pharmacist will usually have information leaflets to help reduce the risk of developing high blood pressure.

It is recommended that you reduce excess weight by taking up regular exercise and eating a healthy diet low in fat. It is also very important to cut the amount of salt that you have in your diet by keeping an eye on the salt content in the food that you buy. Some medicines, such as effervescent tablets, contain high levels of salt so these will also have to be monitored. Guidelines say that adults should eat no more than 6g of salt a day. These levels are lower for children and babies, and you can see your pharmacist for more information. Cutting down on drinking and smoking is also advisable.

When necessary, hypertension can be treated by your GP who has a large range of medicines called antihypertensives to choose from. The type you will be prescribed will depend on your medical history and may involve combinations of different antihypertensives. These medicines work in different ways including widening and relaxing arteries, decreasing your pulse rate or causing the body to get rid of excess water and salt.

Your local pharmacist is an expert in medicines and will be able to explain to you the effects of any antihypertensive you are prescribed.

The products sold in a pharmacy can make you feel better, but if they’re taken incorrectly some can be extremely harmful. Pharmacists and their staff have the product knowledge and skills to make sure you buy the medicines that are right for you – but to give you the best advice they may need some extra information.

Questions
The questions you may be asked are used to find out what product best suits your needs from the huge range at the pharmacist’s disposal and to ensure that you don’t take something that could actually cause you harm.

Who is the medicine for?
The pharmacist will need to know if the medicine is for someone who is under 12, pregnant, breast feeding or elderly because they are highly likely to have particular requirements – for example, many medicines aren’t suitable for the under-12s, and some have ingredients that could harm an unborn child or small baby. The elderly are very likely to be taking more than one medicine and some medicines can’t be taken together.

What are the symptoms?
Some more serious conditions can be hidden by symptoms that appear to be for less serious problems. For example meningitis, malaria and some other conditions have similar symptoms to ‘flu, but they can be fatal if they’re not identified early enough.

How long have you had these symptoms?
Usually minor symptoms clear up within a couple of days but if they last longer, keep coming back or, if they seem unusually severe it could be a sign of something more seriously wrong. Your pharmacist will be able to advise you if you need to see your GP or another healthcare professional.

What action has already been taken?
You may already have tried a remedy or seen your GP, and may not have had any relief. The pharmacist will need to find out what you have tried, and what advice you have already been given, if any. They don't want to offer the same product if it has not worked in the first place.

Are you taking any other medication for this or any other reasons?
If you are taking medicines long term, for example to keep your blood pressure down or to ease arthritis pain, it’s easy to forget about it when you’re looking for something to relieve your cold. But it could be important – for example, some medicines for depression can react with decongestants. Other people with stomach ulcers can do a lot more damage if they take something that contains aspirin.

Requests for medicines by name
If you ask for a medicine by name, perhaps because you’ve used it before, the pharmacist or a counter assistant may still ask you some questions or give you advice proactively. This may be because a medicine can do some damage if you take it constantly or too often. Alternatively, they may be able to suggest something that might be more effective.

Depression is a surprisingly common condition, in fact more people see their GP for depression than for any other reason. It is estimated that 7 – 12% of men and 20 – 25% of women suffer from depression at some point in their lives [BBC Health].

What are the symptoms of depression?
Depression can manifest itself in a number of different ways. Most commonly sufferers will feel unhappy and dejected, have low self esteem with feelings of inadequacy, hopelessness and inability to cope or make decisions. They may also find they lose interest in life and don’t enjoy the things they used to, perhaps avoiding other people and often feeling irritable. Trouble sleeping and always feeling exhausted are also common symptoms and sometimes sufferers have thoughts of suicide. Your local pharmacy may be able to provide information leaflets on the signs and symptoms of depression and contact details of self help groups where you can obtain further information and support.

What are the treatments?
Anti-depressants are very effective in the relief of the symptoms of depression although the way they work is not fully understood. There are many different types of drugs available today and they can be split into four main types but the newer drugs, SSRIs and SNRIs generally have fewer side effects.

Sometimes patients benefit from talking therapies (cognitive behavioural therapy) or counselling. Many studies have also shown the benefits of exercise when treating depression.

Natural remedies such as St John’s Wort can also be helpful but can interact with other medication. Ask your pharmacist before taking St Johns Wort, they are experts in medicine and can advise you about taking combinations of medicines and/or herbal products.

When will I feel an effect?
Anti-depressants generally take up to 2 weeks to start working and it can take around 6 weeks before they become fully effective. Talking therapies are generally slower to produce results than medication, sometimes a sufferer may be prescribed medicines as well as therapy.

What should I not do?
Stopping medication suddenly or too early is the most common reason for depression returning. Anti-depressants must be taken every day and given a chance to work. Your pharmacist can advise you of the correct way to take your medication. Even if you start to feel better you must continue with your course of drugs to prevent a recurrence of the depression.

What are the possible side effects?
You may notice some side effects when you start taking your medication but most people find that the side effects lessen after a week or so as the body gets used to the medication. Talk to your pharmacist if you have any concerns about side effects.

What are STIs?
Sexually transmitted infections (STIs) include chlamydia, syphilis, and gonorrhoea – there are about 25 in all. They can be passed on through intimate contact, for example during sexual intercourse or through genital contact with an infected partner.

What causes them?
Most STIs are caused by bacteria (chlamydia or gonorrhoea) and viruses (HIV, genital herpes).

Symptoms
Symptoms can include itching, swelling or redness around the vagina or penis, unusual discharge from the vagina or penis, pain during sex or when passing urine or pains in the lower abdomen. Some infections, such as chlamydia, may have no symptoms or symptoms may subside, fooling you into thinking that an infection has cleared up. Unfortunately, this may not be the case and if you do not receive treatment the infection may remain and cause long term complications for your health as well as the risk that you may pass the infection on to someone else.

How can I tell if I have an STI?
You can find helpful leaflets or get confidential advice at your local pharmacy. If you think you may have an infection, or have had unprotected sex, you can be tested and have advice from your GP, your local family planning clinic or your local GUM clinic. You don’t need a GP referral to make an appointment at a GUM clinic and you can find your nearest one from www.condomessentialwear.co.uk/get-help or call the NHS free and confidential sexual health helpline: 0800 567 123. Alternatively, you can contact NHS Direct on 0845 4647.

Tests may include taking swabs, blood or urine samples but the recent development of newer tests means that some infections, including chlamydia, can be detected from a urine test. These are sent to a laboratory for testing and the results are usually available within a week. Chlamydia testing using urine samples is also available at some pharmacies.

Treatment
Most sexually transmitted diseases (STIs) can be treated with a short course of antibiotics. These include chlamydia, gonorrhoea, syphilis and urinary tract infections.

It is important to treat STIs, as untreated infections can lead to serious complications, such as pelvic inflammatory disease, ectopic pregnancy or infertility. Men can also experience inflammation and discomfort of the testicles or prostate gland.

Prevention
Simple measures can reduce the risk of catching STIs – such as using a condom. This can help prevent the spread of HIV and reduce the risk of most other STIs for both men and women. Once diagnosed with an STI, If you have a positive diagnosis of an STI, it is important that your current and past sexual partners are notified and treated, in order to reduce the risk of spreading and re-infection and it is wise to wait until you have the ‘all clear’ before having sexual intercourse again..

Did you know?
Between 1996 and 2005 diagnoses of STIs increased by 59% – diagnoses of genital chlamydia rose by 206%, gonorrhoea by 55% and syphilis by a massive 1,949%.
Chlamydia is implicated in more than 50% of cases of pelvic inflammatory disease, which can lead to ectopic pregnancy and infertility in women. It may also be associated with fertility problems in men.

What is emergency contraception?
The ‘morning after’, or emergency contraceptive pill, is a form of birth control used to prevent pregnancy after unprotected sex. It can be used in many situations, for example if a condom or diaphragm becomes dislodged or if you forget your usual method of contraception. The morning after tablet can be taken up to 72 hours after unprotected sex however it is more effective the earlier it is taken. Taking the ‘morning after’ tablet within 24 hours of unprotected sex prevents approximately 19 out of 20 pregnancies.

How does it work?
The tablet will prevent an egg being released (ovulation), delay it until a safe time or prevent implantation of an egg that has already been fertilised.

How effective is it?
It is very effective but the longer the delay after sex has taken place the less effective it might be. It is about 95 per centeffective if taken within 24 hours, but it is not known how effective it will be if taken after 72 hours.

Is it safe for me?
Emergency contraceptive tablets have no long-term or serious side effects, and emergency contraception is safe for almost every woman to use. However, if you are taking other medicines or complementary medicines such as St John’s Wort, you do need to tell the pharmacist – you may need some advice tailored to your circumstances. If the tablet does not work or you are already pregnant, there is no evidence to suggest that it will harm your baby.

Are there side effects?
You might find yourself feeling queasy and occasionally women vomit after taking emergency contraceptive tablets. You might also get a headache, feel tired or dizzy, have some lower abdominal pain, or find your breasts are more tender than usual. If you do feel this way, it should stop within a day or two. Some women also experience some unexpected bleeding – this is not dangerous and should clear up by the time you have your next period. The tablets might also cause your next period to come early or late.

If you vomit within two hours of taking the tablet you should ask your pharmacist for advice. They may recommend you take a repeat dose, and that you take a medicine to stop you vomiting again.

How can I buy the tablet from a pharmacist?
If you are 16 or over, you can ask the pharmacist for emergency contraception. Just ask for a word in private with the pharmacist. Many pharmacies have a consultation area where the pharmacist can talk to you in private. The pharmacist will need to ask you some questions to make sure that the morning after tablet is suitable for you. It is also available on prescription from your doctor, hospital or local contraception or sexual health clinic.

Myth

Some people say you can only take emergency tablets once. That's not true, although it isn’t suitable for use on a regular basis as it’s not as effective as other methods of contraception, and doesn’t protect you against sexually transmitted infections.

If you are worried about this or any other side effects ask your pharmacist – you’ll be getting good advice.

How your pharmacist can help put you in control of your asthma
If you have got asthma, you’re not alone. There are around 5.2 million asthma sufferers in the UK. Help is available from a variety of sources including your local pharmacy.

Who can answer questions about asthma medicines?
Pharmacists can answer any questions you may have about your asthma medicines and can also check to see if you are able to use your inhaler easily. If you find it difficult to use your inhaler, or feel that it is not controlling your symptoms, talk to your pharmacist about changing to something that is easier for you to use.

I’ve got a blue and a brown inhaler – what’s the difference?
The blue “reliever” inhaler quickly relaxes the muscles surrounding the narrowed airways. This allows the airways to open wider, making it easier to breathe again. The brown “preventer” inhaler controls the swelling and inflammation in the airways, stopping them from being so sensitive and reducing the risk of severe attacks.

Why do I get through my inhalers more quickly sometimes?
If you seem to run out medicines before your next prescription it could be because you’re using your blue “reliever” inhaler more often. Sometimes that can be a sign that your asthma isn’t very well controlled. Ask your pharmacist for advice if you have to use more “puffs” of the blue inhaler than usual.

Is there an easier way to get my repeat medication?
If it’s hard to organise collecting your regular prescription from the doctor there is now a new repeat dispensing NHS pharmacy service that might help. With repeat dispensing you do not need to visit the GP surgery every time you need further supplies of medicines. This new service, available to patients in England, means that you can get your repeat medication direct from the pharmacy for a number of months. If this sounds like a service that would help you then talk to your pharmacist about whether this is available in your area.

Will smoking make my asthma worse?
If you’re a smoker and have asthma you’ve got a good incentive to quit. Smoking worsens asthma and counteracts asthma medication by worsening the inflammation of the airways that the medicine tries to ease. However mild or severe your asthma is, stopping smoking can reduce your symptoms, making asthma easier to manage. So when you are ready to stop your pharmacist can offer you advice and support in confidence if you wish.

How do I know if my medicines are working?
Finding yourself short of breath during the day or if your asthma wakes you up at night it could mean your asthma isn’t as well controlled as it could be. Next time you’re in your local pharmacy take a minute to talk to your pharmacist and find out if you’re getting the most from your medicines.

IBS
Irritable bowel syndrome or IBS is a common digestive disorder, and is thought to affect roughly one in five people. It is more likely to affect people between the ages of 20 and 30 and is more common in women. People experience IBS differently and symptoms can fluctuate from being mild to severe at other times. It is a condition that can be controlled, but it is important to get a medical diagnosis to rule out other possible causes of the symptoms.

Once diagnosed, there are a number of effective options available which can help to minimise the impact of IBS on your life. For most people, the severity of IBS will decrease over time.

What are the symptoms?
People with IBS can experience one or more of a range of symptoms but the syndrome can be broadly divided into four main types depending on the predominant symptom – abdominal pain, diarrhoea, constipation or diarrhoea alternating with constipation. Other symptoms can include excess wind, nausea, and indigestion.

What causes IBS?
The exact cause is unknown but it is thought that stronger than normal muscle contractions in the bowel wall have a role to play. These contractions may be worse if you are stressed or after eating food especially if you are intolerant to those foods. IBS can also develop after a gastro-intestinal infection.

How is it treated?
Unfortunately there is no cure for IBS but a combination of lifestyle adjustments and, if required, medication and advice from your pharmacist may help

Changes to diet are an important way to help prevent and reduce symptoms of IBS and in general a healthy balanced diet with fruit, vegetables and plenty of water can be helpful. If diarrhoea is the main problem, then irritant foods such as alcohol, spices, tea, coffee and also the artificial sweetener sorbitol should be avoided. For constipation it is important to have a diet with plenty of fibre which can be found in fruits and vegetables. Exercising regularly will also help reduce stress and help maintain bowel movements. If possible, paying attention to which foods are triggering the IBS and avoiding them will also lead to improvements.

If medicines are required and IBS has already been diagnosed by a doctor then your pharmacist can help you with choosing the best ones for you. For diarrhoea, loperamide or diphenoxylate can provide relief in the short term but should not be used regularly.

In patients with constipation to which a change in diet has not helped, then bulk-forming laxatives such as Fybogel can help, other types of laxatives such as lactulose may also be useful but patients need to be wary of using stimulant laxatives such as senna which can cause rebound constipation if used for too long. If pain, cramping or wind are problems then antispasmodic medicines, such as mebeverine and peppermint oil, may help. If lifestyle changes and medicine treatments do not give you sufficient relief, talk to your pharmacist. He or she will refer you to your doctor if necessary.

Mythbuster
Many people believe that IBS can lead to bowel cancer but there is no link between IBS and bowel cancer.

What is period pain?
Period pains are cramping abdominal pains that occur just before or during a woman’s monthly period. This type of pain can affect around 80% of women at some point in their lives. The medical term is dysmenorrhea – and primary dysmenorrhoea is the common type. It often occurs in teenagers and women in their 20's. Secondary dysmenorrhoea is less common. This usually begins when women are between 30 and 45 years of age and may be associated with an underlying problem.

Symptoms of painful periods
Cramping pains in the lower abdomen are the most common symptom but they are sometimes accompanied by lower back pain, nausea or headaches and even vomiting, diarrhoea, constipation or feeling faint.

The pain can last up to two to three days and tends to happen in the first few days of the period, coinciding with the time of heaviest blood flow but period pains do not cause any damage to the uterus (womb).

What causes period pain?
The cause is unclear but chemicals produced in the lining of the womb – prostaglandins – may be responsible. Prostaglandins help the womb to contract and shed its lining during a period. In women with period pain prostaglandins may build up excessively, or the womb may be extra sensitive to the prostaglandins.

Treatment
Although you can’t prevent period pains, there are several options to help relieve them.

• A warm bath can be soothing and you may find it helpful to press a hot water bottle – not too hot – against your abdomen, and your lower back if you have pain there. During the day, self-heating packs warmed in a microwave may be a convenient alternative.
• Moderate physical exercise can also be helpful for relieving pain, and may even help prevent period pain.
• Analgesics such as paracetamol or anti-inflammatory drugs like ibuprofen can also provide relief. Anti-inflammatories work by decreasing the level of prostaglandins. These drugs are not suitable for everyone – for example, people with asthma or indigestion problems may not be able to take them – so ask your pharmacist about what would be best for you.
• TENS (transcutaneous electronic nerve stimulation) devices – where small electrodes are placed on the abdomen to stimulate the nerve in the pelvic area – may be helpful. Your pharmacist can also tell you more about this.

When to see your doctor
Up to 15% of women have period pains severe enough to interfere with their daily activities. You may need to see your doctor if your symptoms are particularly severe, change or if you notice any other symptoms associated with your periods.


What not to do
Don’t delay taking medicines until the pain gets severe. Starting to take medicines when you first need them is usually far more effective than leaving it too late. Your pharmacist is an expert on medicines and how to use them, so although you can help and mostly treat yourself, for something like period pain that will need regular repeated treatment, it’s worth a quick consultation with your pharmacist so that you get things right.