The following table lists some minor ailments that are commonly seen in the pharmacy with information on when you should refer the patient to the GP.
|
Minor Ailments |
When to Refer |
|---|---|
|
Cold |
Ear ache that is severe Vulnerable patient groups e.g. very young, very elderly, heart disease, lung disease, asthma Fever and cough that is persistent Chest pain Shortness of breath that can’t be explained |
|
Cough |
Longer than 2 weeks and not improving Chest pain Shortness of breath Wheezing Recurring cough present at night Whooping cough/croup Cough or wheezing that may be drug induced e.g. ace inhibitors and beta blockers Yellow, green, brown or blood stained phlegm/sputum Offensive or foul smelling phlegm/sputum |
|
Sore throat |
Dysphagia (difficulty in swallowing) Longer than 7-10 days Hoarseness persisting for more than three weeks Sore throat with a skin rash White spots, exudate or pus on the tonsils with a high temperature and swollen glands Recurrent bouts of infection Suspected adverse drug reaction e.g. carbimazole Failed treatment Breathing difficulties |
|
Ear wax |
Foreign body in the ear Pain Dizziness Tinnitus Treatment failure |
|
Headache |
Headache associated with recent head injury/trauma Children under 12 Associated with stiff neck, fever and or rash Sudden onset and or severe pain Suspected adverse drug reaction e.g. oral contraceptive pill Associated with drowsiness, blackouts, unsteadiness, visual disturbances or vomiting Recurring headaches |
|
Constipation |
Blood in the stools Pain on defecation Suspected drug induced constipation e.g. opiates, antidepressants With abdominal pain, vomiting or bloating Weight loss Failed treatment Change in bowel habit of more than 2 weeks |
|
Diarrhoea |
Persistent change in bowel habit Recent travel which was abroad Presence of blood/mucus in the stools Diarrhoea with severe vomiting and fever Signs of dehydration e.g. dry mouth, drowsiness or confusion, passing little urine, sunken fontanelle and eyes Longer than 3 days in older children and adults (longer than 1 day in babies under 1 years and 2 days in children under 3 years and elderly) Suspected drug induced diarrhoea e.g. antibiotics Severe abdominal pain |
|
Dyspepsia |
Unexplained weight loss Suspected drug induced dyspepsia e.g. ferrous sulphate, NSAIDs Persistent vomiting Persistent symptoms (more than 5 days) or recurring Black or tarry stools Severe pain Pain radiating to other areas of body e.g. arm Symptoms developing for the first time in patients aged 45 years or over Dysphagia (difficulty in swallowing) Failed treatment |
|
Haemorrhoids |
Blood in the stools With abdominal pain or vomiting Weight loss Persistent change in bowel habit Longer than 3 weeks |
|
Mouth ulcers |
Lasting longer than 3 weeks Suspected adverse drug reaction e.g. NSAIDS Crops of 5-10 or more ulcers Rash Diarrhoea With weight loss Involvement with other mucous membranes |
|
Cystitis |
Diabetics Immunocompromised patient Pregnant Men Children Elderly women Vaginal discharge Haematuria (presence of blood in the urine) With fever, nausea and or vomiting Pain or tenderness in the loin area Recurrent cystitis Failed treatment Longer than 2 days
|
|
Primary dysmenorrhoea |
Abnormal vaginal discharge Heavy or unexplained bleeding Showing signs of systematic infection e.g. fever Symptoms suggesting secondary dysmenorrhoea
|
|
Vaginal thrush |
Diabetics More than two attacks in the last six months Failed OTC treatment Pregnant Vulval or vaginal sores ulcers or blisters Vaginal discharge that is green-yellow or blood stained Vaginal discharge that is foul smelling Under 16 or over 60 years of age No improvement within 7 days of treatment Previous history of STD (sexually transmitted infection) or exposure to partner with STD Abnormal or irregular vaginal bleeding Any associated lower abdominal pain or dysuria
|
|
Athlete’s foot |
Not responded to the appropriate treatment Nail involvement Spreading to other parts of the foot Diabetics Signs of bacterial infection e.g. weeping, pus or yellow crusts |
|
Cold sores |
Longer than 2 weeks Lesions inside the mouth Eye is affected Immunocompromised patients Signs of secondary bacterial infection e.g. weeping, pus, yellow crust Babies and children Severe, widespread or worsening lesions Painless lesion |
|
Warts and verrucas |
Anogenital warts Facial warts Diabetics Immunocompromised patient Bleeding or itching Changed in size or colour OTC treatment that has been unsuccessful following 3 months of treatment |