FASTtrack is a new series designed for undergraduate pharmacy students. These easy to read books are intended to complement textbooks and reference books to assist students in preparing for examinations. Managing Symptoms in the Pharmacy provides the reader with information needed for common ailments likely to be encountered in a community pharmacy.
The book is specifically written for pharmacy students who will practice in the United Kingdom (UK). It is important to note the different medical culture (999 is the number to call in an emergency), guidelines (different risk factors for heart disease), spelling of medical terms (diarrhoea), and other differences between the UK and other countries. Most importantly, the UK has different approved therapeutic agents and has several therapeutic agents available to be dispensed by a pharmacist without a prescription. For example, hyoscine is a drug highlighted for motion sickness. In the United States (US) this drug is known as scopolamine, is available as a transdermal patch, and requires a prescription.
The book is organized into 34 chapters covering 10 different body systems (eg, central nervous system) or types of conditions (eg, fungal infections). The structure of the book is straightforward and uncomplicated with sections organized in a bullet format. Each chapter is laid out with causes of the ailment, epidemiology, signs and symptoms, differential diagnosis, circumstances for referral, treatment options and additional advice for patients. Each chapter concludes with self-assessment questions and examination tips structured to prepare students for the registration examination. The answers to the questions are listed at the conclusion of the book.
The book reviews several of the systems and symptoms a pharmacist may cover, but is not comprehensive. The book starts with a cardiovascular chapter detailing more therapeutically intensive diseases such as heart failure and angina, but does not cover other diseases seen in the pharmacy such as diabetes, asthma, and depression. Instead, most of the remaining chapters discuss more common ailments such as athlete's foot, constipation, and dandruff. While the structure of the book is easy to read, in many cases, the simplicity of the content causes the book to be at the same level of previously published books written for patients on self-care of the same ailments.
The book does incorporate many useful tables and charts for the student to use as a resource. For example, the indigestion chapter includes a table depicting the advantages and disadvantages of various antacid compounds and section about their interactions. Unfortunately, there are no references included. Additionally, the book often fails to highlight guidelines to assist the pharmacist in making recommendations that coincide with the standard of practice endorsed by specialty organizations and governmental agencies. The treatment section does not always differentiate which pharmacologic option provides the optimal therapy or recommended doses of the agents described.
The self-assessment questions at the end of every chapter provide the learner with at least one brief case example and 2 to 5 multiple-choice questions. The quality of the self-assessment questions did not appear to be at the level of board-preparation questions in the United States; however, these examinations are different. Each chapter also provides tips for taking examinations. I found most of the tips to be common sense in nature, but some may be of value to the learner who struggles with test taking.
Because this book contains information about agents available over-the-counter in the United Kingdom that are currently prescription only in the United States, this book could be used as a template for teaching pharmacists how to appropriately treat those conditions or refer to a physician for further care. The best example of this is simvastatin, a drug which has been reviewed by the US Food and Drug Administration for over-the-counter status. The book describes the drug and specifically states the licensed indications, licensing restrictions, and good practice recommendations from the Royal Pharmaceutical Society of Great Britain for the over-the-counter sale of their drug. This book may be a useful tool to assist in self-care questions if one is able to sort through the difficulties of being written for the UK. This book may provide value for learners in the UK: however, I believe it would have many limitations if used in a curriculum in another country.