CPD: Obstetrics, gynaecology and urinary tract disorders

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Articles here relate to obstetrics, gynaecology and urinary tract disorders and relate to chapter seven of the British National Formulary

Dealing with urinary tract infections

December 2011

This article looks at symptoms of urinary tract infections, when to refer, the organisms involved, risk factors, sample collection, diagnosis and testing, complications, treatment and prophylaxis. 

Menorrhagia and its management

Over-the-counter tranexamic acid is likely to become available from some pharmacies in the next month, so pharmacists are more likely to be asked about heavy menstrual bleeding. Sally Haynes gives an overview of menorrhagia

Basics of enteral nutrition in adults

Enteral feeding is increasingly common in both primary and secondary care and a variety of products can be prescribed. Helen Campbell, Peter Turner and John Sexton give an overview of what enteral nutrition involves, the products available and special considerations needed in enterally-fed patients

What can be done for overactive bladder?

Overactive bladder, which is set to become more common as the population ages, can be a distressing and embarrassing condition with a significant impact on quality of life. But the symptoms and management are not always well understood and this can lead to inappropriate or misguided treatment. Mark Thomas and Alistair Rogers summarise the clinical aspects of the condition and its management options, with emphasis on current pharmacotherapy

Giving advice on contraception

Two articles looking at some of the different forms of contraception that are available.

• Giving advice on short-acting contraception
• Giving advice on long-acting contraception

Advice on emergency contraception

Sarah Pillai takes a practical look at dealing with requests for emergency contraception in the pharmacy

Case studies from the British National Formulary for Children — urinary tract infections

A four-year-old girl presents with a 24-hour history of urinary frequency and dysuria. Examination is unremarkable apart from mild suprapubic tenderness. She has idiopathic hypoparathyroidism, but there is no other medical history of note. A urine sample is positive for leucocyte esterase and nitrite on dipstick testing.

Solifenacin is minimally effective for overactive bladder (POEM)

Is solifenacin (Vesicare) useful in the management of overactive bladder syndrome

Remedying calcium and phosphate problems in chronic kidney disease

As renal function declines, a variety of metabolic disturbances manifest themselves. Some patients will have altered biochemistry when their renal impairment is fairly mild, but by the time renal failure has become severe most patients have abnormal serum calcium and phosphate levels, falling vitamin D levels, and rising levels of parathyroid hormone.

Managing anaemia in renal failure

Anaemia is a common problem in chronic kidney disease , leading to substantial morbidity and mortality if untreated. Over the past decade, effective management has become possible using safer intravenous iron preparations and genetically engineered erythropoiesis-stimulating agents

Infertility

The provision of fertility services is increasing in the NHS. These articles outline the causes and diagnosis of infertility in men and women and consider procedures and drugs used to promote conception

• Causes and diagnosis
• Treatment

Men's health

The disparity between men’s and women’s health matters has been described as one of the biggest, but until recently one of the least-recognised, health inequalities. Two of a series of three articles on diseases or conditions unique to men, more prevalent in men, more serious among men, for which risk factors are different for men or for which different interventions are required for men.

• Prostatitis, BPH and prostate cancer
• Erectile dysfunction and other problems

Renal failure

With the number of patients requiring treatment for renal failure increasing significantly, two articles review drugs that can cause kidney failure and outline the different types of renal replacement therapy available for patients with renal failure. Drug dosing in these patients is also summarised

• (1) How drugs can damage the kidney
• (2) Options for renal replacement therapy

Drug dosing in the renally impaired adult

An overview of how renal impairment can affect prescribinng

Hormone replacement therapy

• Hormone replacement therapy: (1) an overview
• Hormone replacement therapy: (2) risks and benefits

Obstetrics

Two articles discussing the physiological changes that take place in a woman’s body during pregnancy and drugs used around the time of labour, covering those used in routine practice as well as those used to manage certain high risk group

• The physiological changes
• The drug options

Pregnancy

• (1) Overview of pregnancy
• (2) General principles of drug use in pregnancy
• (3) Drug use in pregnancy: part 1
• (3) Drug use in pregnancy: part 2
• (4) General care of pregnant women
• (5) Nutrition in pregnancy
• (6) Complementary therapies in pregnancy

Herbal therapeutics (9) Women’s health

Continuing our series on European herbal products, this article considers evidence for the efficacy and safety of herbal medicines used for various conditions experienced by women and for which over-the-counter treatment is usually appropriate

Herbal therapeutics (6) Benign prostatic hyperplasia

This article considers evidence for the efficacy and safety of herbal medicines used to improve symptoms associated with benign prostatic hyperplasia

Introduction to urinary incontinence

This article addresses the pathophysiology of urinary incontinence and gives a brief discussion of some of the available non-drug and drug treatments

A comparison of newer drug treatments for urinary incontinence

A look at the newer drug treatments for urinary incontinence in detail, and presents clinical data in order to draw comparisons on the relative efficacy of each

Management of incontinence

People with incontinence are usually embarrassed by the problem and find it hard to seek help. Some hide it for many years. This article examines ways in which pharmacists can help such people, both by selling incontinence aids and by giving helpful advice about drug treatment

Renal disease

A series of four articles considering the management of renal disease

• (1) Acute renal failure
• (2) Managing chronic renal disease
• (3) Renal replacement therapies
• (4) Immunosuppression after renal transplant