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As we head into autumn, this is the time to start booking your flu jab to protect yourself against one of the nastiest seasonal illnesses.

Some people are eligible for a free flu vaccination, but even if you have to get a private jab at your local pharmacy, many people think it is worth it to reduce the risk of contracting the nasty infection.

Here are some of the reasons why you should get a flu vaccination, if you can.

You are eligible for a free jab

Those who are over the age of 65, have some long-term health conditions, live in a care home, live with someone who has a weakened immune system, is a frontline health and social care worker, is the main carer for an older or disabled person, is pregnant, or between the ages of two and 16 will be able to receive the flu jab for free.

This is because they are more at risk of becoming seriously ill from getting the flu. Among the complications that can occur, particularly among vulnerable people, are pneumonia; inflammation of the heart, brain or muscle tissues; and failure of multiple organs at once.

It can even lead to sepsis, which is an extreme reaction to an infection and can be life-threatening. In trying to respond to the infection, the body begins to damage itself, with symptoms including severe breathlessness, disorientation, a high or very low temperature, loss of consciousness or fast breathing.

Gives milder symptoms of the flu

Whether you are eligible or not for a free jab, people opt for the flu vaccination as it reduces their chance of becoming ill or, at least, gives them milder symptoms if they do get it.

Though flu does not always make patients seriously ill, it does have some unpleasant symptoms. These include fever, an aching body, exhaustion, headaches, cough, sore throat, loss of appetite, diarrhoea, tummy pain, nausea or vomiting, and difficulty sleeping.

The difference between a common cold and the flu is it affects more parts of the body than simply the nose and throat, and you do not feel well enough to carry on with your daily activities.

Many people, particularly those who are busy or have family to look after, are not able to take time to recover when they get ill, so want to avoid feeling really poorly if they can help it.

Even if they do contract the flu, vaccinations can reduce the risk of having to go to the doctor for help by up to 60 per cent, as the symptoms can be managed at home.

Indeed, vaccinated patients who had been hospitalised had a 26 per cent lower risk of being admitted into an intensive care unit and a 31 per cent reduced risk of death than those who had not received the jab.

The vaccination is so effective that in 2019-2020, it is thought to have prevented 7,000 deaths and 100,000 hospitalisations around the world.

Slows down the spread of the flu

Not only does the vaccination protect the patient and those closest to them from getting ill, it also helps to slow down the spread of the flu.

Subsequently, the more people who are immunised against the virus, the fewer people will come into contact with it and become ill. Without vaccinations, however, it can spread rapidly, putting those particularly at risk of complications in danger.

Protects newborn babies

If there are lower incidences of the flu in public, this means there is lower risk to newborn babies, who would, otherwise, be extremely vulnerable to the illness.

Pregnant mothers are also encouraged to get the vaccination as this protects their babies during the first few months of their life, at a time when they are too young to be vaccinated themselves.

In fact, a recent study showed it can reduce the risk of flu in babies younger than three months’ old by as much as a half.

For the majority of people who have ongoing prescription needs, their local pharmacy is there for them and in most cases is unlikely to be going anywhere. If they need a prescription dispensed, they only need to travel a short distance to get it.

Pharmacies do far more than dispense medicine, however; they provide some advice for minor ailments, offer over-the-counter non-prescription medications to help with conditions and can even self-prescribe through initiatives such as the Pharmacy First scheme.

Beyond the services they provide, they are also just a community pillar; if you need help, they are often the first place to go as even if they do not have the service you need, they can generally point you to the place that does.

However, not everywhere is quite so fortunate, with some rural areas becoming “pharmacy deserts” where people need to travel further to access vital services.

What can you do if you live in a pharmacy desert or are spending enough time in one that you need to access your prescriptions without delay?

What Is A Pharmacy Desert?

A pharmacy desert is an area where there is a lack of pharmacies relative to the population, with the term originating in the United States as an analogue to the related issue of food deserts.

Whilst there have been attempts to quantify a pharmacy desert in terms of pharmacies per 100,000 people or per 10 miles, the best description of one is that it is any area where there are not enough pharmacies and chemists relative to the population.

In rural areas, that might mean having to travel several villages over to the nearest town, or for urban areas it could involve having to wait in long queues or facing potential shortages of medications in high demand.

Given that for many medications running out or being forced to ration doses can be exceptionally dangerous, there are thankfully options you can take if you are living in a pharmacy desert for long enough that this might be an issue.

The first is to follow the same types of precautions you would if going on holiday; inform your doctor and see if it would be possible to get enough of your prescription supplied in advance to ensure you have enough for as long as you are there without having access to a pharmacy.

Similarly, take advantage of time spent with a pharmacist, reviewing medications you are taking with them, discussing adverse effects and ensuring that every time you travel somewhere with a pharmacy that you get your prescription ready. You can get your prescription dispensed at any NHS pharmacy, after all.

Delivery is an option as well, with many pharmacies offering an option to request that prescriptions be taken to your door, particularly if you are on recurring prescriptions, have a prescription prepayment certificate or qualify for free prescriptions.

Finally, make sure you have a supply of other basic essential medicines such as NSAID painkillers, a first aid kit and other medicines you expect you will need.

In a lot of cases when a pharmacy prescription is delivered or dispensed, one of the first and biggest pieces of advice is about alcohol consumption when taking the medication.

Whilst the harms that can be caused by alcohol are understood and neither doctors nor pharmacists are going to recommend drinking, it is also something that if consumed in moderation (ie less than 14 units a week spread over at least three days) the general risks associated with it can be mitigated and avoided.

An occasional glass of wine with a meal is unlikely to cause long-term harm, except with certain conditions and when taking certain medications, since alcohol can change how they work.

If you want to continue to drink, consult your GP or seek advice from your local pharmacy first to ensure that the two mixing together will not cause problems.

Why Can Alcohol And Prescription Medication Cause Problems?

Whilst we do not often think of it that way, alcohol is a drug, and like any other drug, it can have serious side effects when it interacts with other medications.

It is a depressant, and most people who have drunk to excess at least once know that it can impair both mental and physical function, as well as reduce the sensation of pain.

This does not just include recreational drinking either; some cough medicines and painkillers have alcohol as an active ingredient as well.

Generally, when alcohol interacts with another medication (and according to the National Institute of Health And Care Excellence over 300 medications interact with alcohol) it either stops them from working effectively, intensifies the side effects or intensifies the effects of alcohol.

The effects can vary wildly depending on which medication is prescribed, the level of alcohol taken and the individual themselves.

Sometimes the effects are merely unpleasant, such as nausea, feeling sleepy, slowed reactions or a lower tolerance for alcohol (and all the potential risks outside the scope of medication).

However, in other cases, it can be extremely dangerous to drink alcohol with prescription medications in your system. A doctor will generally ask about your drinking habits before prescribing certain medications, but it is always a good question to ask if you are uncertain.

Certain types of antibiotics, most notably metronidazole and tinidazole, interact strongly with

alcohol, causing serious side effects such as an irregular heartbeat, hot flashes, dizziness, headaches and stomach pains.

As well as this, prescription painkillers (and some stronger over-the-counter cold and flu remedies) cause significant side effects when mixed with alcohol, with tramadol and codeine potentially causing severe drowsiness and intoxication.

Statins, a cholesterol-lowering medication used to treat a range of cardiovascular diseases, can be extremely dangerous when taken together, particularly for people who drink regularly.

Interactions with antidepressants such as SSRIs can cause drowsiness, and dizziness and can have unpredictable side effects, caused due to alcohol’s depressant qualities.

Sedatives such as diazepam can lead to unconsciousness, coma and even a dangerously slow heart rate, which can cause slower breathing, hypoxia and even death.

Drinking in moderation does not affect every medication, but if you wish to continue drinking or expect to drink whilst the prescription course is ongoing you should ask your GP first and be on the lookout for potential side effects.

When you receive a prescription from a GP or community pharmacist, a lot of considerations go into ensuring it is safe, effective and fit for purpose.

This includes checking your medical history, any potential allergies or intolerances, and being mindful of other medications you are taking, in case there are any reports of adverse interactions between the new drug and any you are already taking.

For example, whilst some over-the-counter painkillers can be taken together, aspirin and ibuprofen should not be taken together because they can increase the risk of stomach bleeding and kidney damage.

However, it is not just other medications that can interact with each other but also some foods and drinks, which can cause drugs to either not work as effectively or increase the risk of an overdose effect despite taking the right amount.

This is why, if you take the anticoagulant warfarin, you need to avoid avocados and leafy green vegetables such as spinach and broccoli, which can complicate meal planning for people taking the medicine for high blood pressure.

One of the most common examples of a food or drink interacting with medication is grapefruit juice, to the point that a label warning that you should not take a medication with grapefruit is something that a lot of people have seen, including people who take warfarin.

Exploring why this is the case can also help explain other interactions and provide safer ways to eat what is otherwise a relatively healthy citrus fruit.

What Makes Grapefruit Harmful With Some Medications?

According to the National Institute of Health and Care Excellence, at least 100 medications interact with grapefruit juice in some way, to the point that the fruit has its own page simply so its interactions can be listed even though it otherwise has no clinical use.

The first discoveries about grapefruit juice were made by accident in 1989 when performing a blind test of certain drug interactions.

Typically 200ml or the equivalent of a whole grapefruit is enough to cause issues, but it is important to understand why this is the case to ensure you avoid any major issues.

Whilst there are some strange and unusual exceptions to this, there are two main ways in which grapefruit interacts with medication.

The first is that it acts as an inhibitor of certain enzymes, stopping certain drugs from being metabolised properly. As dosages are designed based on typical levels of absorption, this can lead to a much higher dosage of a drug than expected in the body.

This is part of the reason why it is dangerous to take grapefruit juice with warfarin, but it also affects statins, benzodiazepines and some antiretrovirals such as ritonavir.

Conversely, it can also affect medications by blocking the transporter cells that move the

compound from the intestines into the blood.

This has the complete opposite effect of enzyme blocks in that it means that not enough of the drug is in the body, stopping its effectiveness and potentially causing major problems.

The most concerning example of this is clopidogrel, an antiplatelet medicine that reduces stroke and heart attack risk. This medication not working effectively could put people in danger so grapefruit should be avoided.

Whilst there are medicinal discoveries taking place on an almost daily basis, whenever a doctor prescribes a medicine to collect from a local pharmacy, it is the most effective and safest treatment for a particular condition available on the market and much better than simply having the disease.

In modern medicine, there is no instance where the cure is worse than the disease, but this was not always the case. Previously, there were some particularly suspect medicines sold as cures for certain conditions, but they were just as likely to cause as much harm if not more.

Here are some medical discoveries important not only in their own right but also because they replace the previous frontline treatment.

Penicillin

One of the most important medications ever made, whilst penicillin has saved countless lives since its discovery in 1928 and its more widespread use starting in the 1940s, what is just as important not necessarily as commonly discussed is that it also replaced a truly toxic concoction for many conditions.

Bacterial infections such as syphilis were commonly treated using mercury, which is a particularly poisonous compound that can cause brain damage, kidney failure and damage to the circulatory system, often masked by the typical symptoms of syphilis and similar diseases.

Once alternative options became available, not only were previously life-threatening infections readily treatable but the dangers of mercury were consequently reduced as well.

It did take a lot longer but eventually the rise of composite resin materials replaced mercury amalgam in dental fillings as well.

Epinephrine

Better known simply as adrenaline, epinephrine is a life-saving medication used to restart the heart after cardiac arrest and to open the airway after an allergic reaction causes an anaphylactic shock.

It can also be used to treat asthma, which made it far better than the previous popular option of asthma cigarettes, which inexplicably were recommended as late as the 1990s despite one of the biggest legal settlements in human history proving without question that cigarettes are harmful.

The worst part about this recommendation is that cigarettes are far more likely to make asthma worse as the smoke acts like an irritant.

Antihistamines

A loose group of medications that are primarily used to treat hay fever and other nasal allergies, antihistamines provide vital relief for many people during the spring and summer months when pollen is at its highest.

It can also help with motion sickness, more general nausea and the itchiness that comes with hives and insect bites.

When it comes to allergies though, their discovery in the 1930s was rather vital as one of the alternatives that had been used up to that point was cocaine.

Cocaine was in a lot of medications in the 19th century, with cocaine cough drops even being recommended for children. However, one particularly unusual use was a spray solution directly up the nose that would be used to treat hay fever.

Thankfully, much safer alternative medications would become available that lacked the dangerously addictive qualities possessed by what is now a Class A drug, and antihistamines were one of the key steps towards a safer medical world.

Erectile dysfunction is one of those conditions that can draw cruel humour from some, but is no laughing matter for sufferers. But over the last 25 years, the use of Viagra has been a huge game changer for huge numbers of men and their partners across the world.

Even so, the problem of erectile dysfunction has not gone away and many will feel a sense of stigma about seeking help. What we can do in our pharmacy is provide your prescribed medication while treating you with dignity and discretion. You can believe us when we have seen it all, concerning all manner of medical issues people might feel embarrassed about.

Hopefully, more men here in Scotland will follow the lead of their English counterparts, who, it appears, have been seeking more help. This is certainly one of the most likely conclusions to be drawn from new data provided by the NHS Business Services Authority, which has revealed a sharp rise in erectile dysfunction drug prescriptions.

These show that 4,574,010 prescriptions were issued in England last year, the highest figure on record.

Perhaps not surprisingly, this sort of story attracted the most attention from the tabloids, with the Sun reporting comments by TV pharmacist Thorrun Govind, who said: “Twenty years ago men wouldn’t have discussed erectile dysfunction.”

She added: “When Viagra first came out it was a bit sensational but, now there are cheaper alternatives, it is more accessible and there is less stigma.”

Of course, it doesn’t matter what paper you read (if any at all) when it comes to erectile dysfunction. Ultimately, for all the ‘nudge nudge, wink wink’ attitudes of those who consider this (or sex generally) a matter of smut or humour, it is, ultimately, an important part of life. None of us would be here without it, for starters.

Men who suffer from erectile dysfunction must be brave enough to see medical experts, who will be only too willing to help. It is not just a matter of having a bit of fun behind closed doors; it can save and grow marriages, improve mental health and, in some cases, enable couples to fulfil their ambitions of becoming parents.

Seeking help can also be crucial in finding out the root causes of erectile dysfunction. In some cases, this can be down to health factors that you should deal with in their own right, such as diabetes, obesity, heart disease, or smoking.

Indeed, one study in the US has indicated that regular exercise like running can help tackle erectile dysfunction. This would make some sense, since such exercise will help improve fitness, easing off obesity and improving cardiovascular health, thus directly helping with causal factors associated with erectile dysfunction.

Acknowledging the problem may not be easy, but when there is the possibility of getting medication that can help tackle the issue in the bedroom and a chance to deal with wider medical issues that could have more far-reaching consequences, it is important to be brave and seek help.

We will offer sympathy, professionalism and a practical approach every step of the way, helping you to tackle one of the most challenging issues any man can face.

If you are prescribed a particular medication from a local pharmacy, it is because it is the best way to help recover or manage a condition.

A lot of care is taken with prescriptions because of the power of the medications involved, and this is why you will have regular follow-ups with your GP or community pharmacist to ensure it is working as expected for you.

One aspect of prescription medications that can sometimes be surprising is how certain medications can be prescribed that would otherwise be extremely illegal to possess.

The one that is perhaps best known in recent years is cannabis, which whilst a Class B drug when used recreationally is sometimes prescribed as a treatment, most commonly for extremely rare debilitating forms of epilepsy in strictly controlled doses and conditions.

The very public case of Alfie Dingley led to a change in the law that allowed doctors to prescribe medicinal cannabis. However, it is not the only example of a drug classified under the Misuse of Drugs Act that is regularly prescribed to treat specific conditions.

Cocaine

Whilst the legacy of the Class A drug cocaine when it comes not only to its illegal recreational use but also the trade surrounding it is well-known, it has been and continues to be prescribed to this day albeit for extremely rare uses.

Whilst “cocaine drops” were somewhat infamously available over the counter as a toothache cure for children, it is commonly used as a local anaesthetic, a numbing agent and a vasoconstrictor, although in all three cases, this is both rare and almost exclusively limited to surgery.

It can sometimes be used as a diagnostic test for Horner syndrome. Given that cocaine causes the pupils to dilate, if someone is given cocaine eye drops and one eye dilates less than the other, then it is often a sign of damage to the sympathetic trunk.

Heroin

Opiates in general are heavily controlled due to their highly addictive qualities, but they are prescribed on occasion when a severe level of pain relief is required and other painkillers simply are not working.

The most common of these is codeine, otherwise a Class B drug, which is available either on its own on prescription or in a much lower dose mixed with paracetamol under the name co-codamol.

Heroin, supplied under the name diamorphine, is usually prescribed for severe pain. Due to the well-known addictive qualities of the Class A drug, it is most widely used in palliative care.

Because, by definition, palliative care is only used to relieve pain in the case of terminal or inoperable conditions, the concerns about addiction are less pronounced, and the benefits to quality of life given the limited duration of it are seen as far more important.

It is rarely used to help treat pain after operations, as well as managing pain in cases of heart attacks, physical trauma and severe chronic pain.

In a very small number of cases, it has been prescribed to heroin addicts as an alternative to methadone if it has not helped with the extreme withdrawal symptoms that come with heroin abuse.

Summer is many people’s favourite time of year for all sorts of reasons, ranging from the sunshine and long daylight hours to the chance to play summer sports like tennis. But for some, this is an extra special occasion.

The summer is wedding season and while not everyone who gets married will choose to do it at this time of year, there are obvious reasons for doing so. These include the greater likelihood of a nice sunny day for the pictures and good weather on honeymoon, unless of course, you are jetting off to somewhere that’s sunny all year round.

However, there is one aspect of the timing of your wedding that could cause a problem whenever in the year you have it – your period.

According to Brides.com, there is much to be said for planning your wedding around your period, since if it happens soon before your wedding then you will be clear of it and in a happier place as you marry and head off on honeymoon.

However, you may find that because of errors in timing, a period coming later or earlier and throwing your calculations out of sync, or constraints on the availability of your wedding venue, you will be due to be on your period when the big day arrives.

Some may consider this manageable, such as if your periods are usually light. But having a tampon in under a big dress, plus the risk of any blood getting on a pristine white garment on the day when it will be photographed loads of times, may make the prospect anything but appealing.

Beyond that, there is the issue of sex. Not every woman wants or likes to have sex during their period, so your wedding night and honeymoon may not be as much fun as you hoped. Nor do you want to deal with blood and tampons while dashing to the airport.

For all these reasons, you might want to consider taking a period delay pill, which means you can enjoy the day and the start of married life before menstruation starts.

The pill works through the use of norethisterone, an artificial hormone that acts in the same way as progesterone in delaying menstruation.

During your cycle, it is the drop-off in progesterone after ovulation – if fertilisation does not occur – that leads to the womb lining falling away and the period starting. This means that by maintaining high levels of a hormone that needs to be low for menstruation to happen, you can delay it.

However, not everyone can take this pill. In particular, it is not designed for those taking the combined oral birth control pill. If you are using other forms of contraception, or not using any as you hope to get pregnant soon, you can take it.

There may be other occasions when you might need this pill too. After all, you might be a bridesmaid instead and find that you, too, will handle the day a lot better without period cramps, the risk of leakage and all the other issues that come at that time of the mon

Whilst the use of medical cannabis on prescription is still limited to relatively rare conditions and the benefits of cannabidiol are continuing to be researched, cannabis is one of the world’s oldest medications.

Its effects were noted in the Ebers Papyrus, one of the world’s oldest medical textbooks, there are references to its effects in China that potentially date back 10,000 years and many ancient traditions from Greece to India reference its painkilling properties.

Whilst its use is limited to a few conditions in the UK in situations where other treatments cannot be used, it has historically been used for a wide range of different conditions.

Even its historic use in the UK for medicinal purposes is nearly two centuries old, and much of the research of the doctor who helped bring cannabis to the English-speaking world mirrors the case that started to bring change in the UK hundreds of years later.

From Limerick To Calcutta

Born in the Irish city of Limerick, William Brooke O’Shaughnessy started his medical journey in Scotland, later moving to Calcutta after getting his degree in order to further his interest in Indian folk medicine.

Ancient Indian medical traditions use cannabis for a wide variety of conditions. Besides pain and headaches, particularly the pain of childbirth, ‘bhang leaf’ was also used to help with a variety of gastrointestinal disorders and in the relief of insomnia.

The psychoactive properties were known and treated by some philosophers of the era as part of the healing action.

Dr O’Shaugnessy became an Assistant Surgeon and later Professor of Chemistry at the College of Calcutta, and wanted to test the effects of ‘bhang’ in a controlled, medical environment.

Up to that point, cannabis was barely known in Europe outside of the somewhat clandestine use of “hasheesh” by Soldiers in the French port city of Marseilles, so Dr O’Shaughnessy’s experiments started to get significant attention.

He tested it on animals and then started to find it was effective for treating pain, stomach cramps and muscle spasms, the latter of which made it effective in treating certain rare and intense types of epilepsy.

His first major success, and the one that garnered cannabis increased attention in Europe, was successfully treating a patient with rheumatism and then halting a young child’s convulsive fits, both using cannabis resin.

The biggest success, and the one that would be most associated with him when it came to medical cannabis, was his treatment of rabies and tetanus symptoms using cannabis resin.

Given that rabies and tetanus are very different diseases with symptoms and causes that are distinct from each other, cannabis did not actually cure either condition.

Instead, it was used to relieve the convulsions and spasms associated with both conditions and helped reduce suffering, even if it would not ultimately keep them alive.

He returned to England in 1841 and continued his research, alongside the telegraphy research that ultimately granted him a knighthood before he passed away in January 1889 at the age of 79.

The biggest challenge cannabis would have in the century following Sir William’s death was vindicating and validating his work, and cases such as Alfie Dingley’s highlight the life-changing effect it can have.