Learning Log

Name of pre-registration pharmacist: Date:

Case no. _11___/ 20

COUNSELLING OF MINOR AILMENTS

Please document your counselling in SOAP format (see below for details). Presentation slides are
accepted and should be enclosed with the log book.
SOAP – Subjective Objective Assessment Plan
The details of each section are:
Subjective: Refers to non quantifiable areas e.g. itch, redness over arm, fever.
Objective: Refers to quantifiable terms, e.g. duration of itch, temperature, weight loss over specific period etc.
Assessment: Refers to patient’s problem list, e.g. developed skin rash upon application of topical product.
Plan: State the recommendation(s) for solving the minor ailment identified above and the rationale behind your
recommendation. E.g. to discontinue the topical product and treat skin rash with an antihistamine, after due
assessment.

Subjective Often experienced giddiness, hunger, cold sweat

Usually have very light breakfast, heavy lunch and heavy dinner
Enjoy drinking soft drink and eating ice cream
Would like to learn how to use the glucose meter
Objective Female, 55 years old. Recent HbA1c is 8.6. Clinic BP 135/78
PMH: type 2 diabetes mellitus, hypertension
Concomitant medications: losartan 50mg om, bisoprolol 1.25mg om,
Novomix 30U bd
Assessment Uncontrolled diabetes with frequent hypoglycemic episodes. Need to buy
glucometer to do self-monitoring of blood glucose (SMBG), particularly with
each episode of giddiness, hunger, cold sweat.
Plan Pharmacologicals: continue to taking all medications correctly
Reinforce on taking insulin immediately before meal to prevent
hypoglycemia.
Non-pharmacologicals:
Buy glucometer to test blood glucose during episodes of giddiness, hunger,
cold sweat and if possible, before and after every meal (hypoglycemia is likely
to occur between meals). Record the blood glucose readings in the notebook
and show the doctor during every doctor’s visit.

Steps in using Freestyle Optium Neo glucometer

Step 1: wash your hand using warm soap water and dry them completely.
Step 2: Insert test strip by removing from foil packet. Insert the test strip with
side that has three black line into the strip port and push the test strips in
until it stops.
Step 3: Wipe down lancing area with an alcohol wipe (wait 30sec to 1min for
alcohol to dry completely).
 Step 4: Obtain a blood drop using lancing device.
Step 5: Touch the blood sample to the white area at the end of the test strip
until the meter begins the test.
The meter begins the test when 1) you hear the beeper (if ON), 2) display
window shows status bar, 3) display window shows the countdown.
At the end of the countdown, the blood glucose result shows on the display
window.
Step 6: Interpret results and record in the notebook. Hypoglycemia typically
occurs when the blood glucose is < 4.0mmol/L.
Step 7: the meter turns off automatically when strip is removed.
** Note: Put all blood-product and sharp objects into sharps container

Management of hypoglycemia:
When patient experiences symptoms of hypoglycemia, perform SMBG if
possible (hypoglycemia typically occurs when the blood glucose is <
4.0mmol/L). 15-15-15 rule: consume 15g of fast-acting carbohydrates, wait
for 15 minutes, if symptoms of hypoglycemia still persist/SMBG is still
<4.0mmol/L, to consume another 15g of fast-acting carbohydrates. If
symptoms of hypoglycemia still persist/SMBG is still <4.0mmol/L, see a doctor
immediately. 15g of fast-acting carbohydrates include half a cup of fruit juice
or soft drink, a few pieces of raisins or 1 tablespoon of honey syrup.

Choice of therapy:
Continue taking medications and do SMBG

Patient counselling:
Eat regular meals and if possible, eat small multiple meals throughout the day
to minimize blood glucose fluctuations. Eat well-balanced meals (one-half of
your meal portion is vegetable/fruit, one-quarter is carbohydrate
(rice/potatoes/noodles), one-quarter is protein (meat/fish/chicken)).
You can exercise at least 150 min per week on at least 5 days per week, at
least 30 min per session – this will help in weight loss and reduced insulin
resistance. Physical activities include brisk-walking, swimming or playing
badminton (aerobic exercises). Inform doctor if the hypoglycemia still occurs
frequently even after making adjustments to the diet.

Reviewed by: _____________________(Pharmacist/Preceptor)

Date: ________________
 Learning Log
Name of pre-registration pharmacist: Date:
Case no. _12___/ 20

COUNSELLING OF MINOR AILMENTS

Please document your counselling in SOAP format (see below for details). Presentation slides are
accepted and should be enclosed with the log book.
SOAP – Subjective Objective Assessment Plan
The details of each section are:
Subjective: Refers to non quantifiable areas e.g. itch, redness over arm, fever.
Objective: Refers to quantifiable terms, e.g. duration of itch, temperature, weight loss over specific period etc.
Assessment: Refers to patient’s problem list, e.g. developed skin rash upon application of topical product.
Plan: State the recommendation(s) for solving the minor ailment identified above and the rationale behind your
recommendation. E.g. to discontinue the topical product and treat skin rash with an antihistamine, after due
assessment.

Subjective Occasional irritation in his eyes, problems with long recovery from the
cataract surgery in his right eye
Objective Male, 70 years
PMH: Cataract in his left eye, cataract surgery in his right eye 1 year ago
Concurrent medications: loratadine 10mg om for his sensitive nose for 3
months
Assessment Dry eye, worsened by cataract surgery and loratadine use. Need to treat as
symptoms lower his quality of life and dry eye may delay his recovery from
eye surgery.
Plan Pharmacologicals:
Discontinue loratadine for now since prolonged anti-histamine use may lead
to reduced secretion and dry eyes.
Artificial tears: (+) dilute and remove allergens, preservative-free eye drops
preferred and used up to every hour
-Eye drops:
Multi-dose: (-) contain preservative which may irritates the eye surface and
may be harmful to cornea and tear film on prolonged used (+) less expensive,
can be kept one month after opening
Optrex Refreshing Eye Drops (distilled witch hazel 13%, preservative
benzalkonium chloride): (-) not as long lasting on the eye (+) can kept for 3
months after opening
Tears Naturale II (HPMC 3%, Dextran 70 0.1%, preservative Polyquad
0.001% ): (+) contain polymer that stabilizes the tear film and prevents tear
evaporation, long lasting on the eye (-) dextran 70 causes transient stinging
and blurring of vision
Genteal Lubricant Eye Drops (Hypromellose 0.3%): (+) contain polymer, long
lasting on the eye (+) sodium borate as disappearing preservative which
provides microbial protection while limits preservative toxicity
 Unit-dose: (+) no preservative (-) more expensive, discard after use
Tears Naturale Free (HPMC 3%, Dextran 70 0.1%): (-) dextran 70 causes
transient stinging and blurring of vision (+) contain polymer, long lasting on
the eye, discard 12h after opening
Refresh (PVA 1.4%, povidone 0.6%): (+) less viscous (-) not as long lasting on
the eye as other product
Refresh Plus (CMC 0.5%): (+)contain polymer, long lasting on the eye
-Nonmedicated ointment:
Duratear ointment (lanolin, petrolatum, mineral oil): (+) retained on the eye
longer than all eye drop products, well-tolerated (-) transient blurring of
vision hence can only be applied at night
Non-pharmacologicals:
Basic eye care: Patients should not rub their eyes because rubbing can cause
mechanical mast cell degranulation and worsening of symptoms.
Lid scrub with warm compress can alleviate eye irritation.
Choice of therapy: Genteal tears apply 1 drops to each eye every 4h when
necessary for dry eyes (during the day)
Duratear ointment apply to each eye at night
Discontinue loratadine for now. Resume if allergic symptoms come back
Patient counselling:
Discard the Genteal bottle one month after opening
You may use the eye drops more often than every 4h if you have frequent eye
irritation throughout the day, but preferably switch to the preservative-free
eye drops e.g. Tears Naturale Free to minimize the potential for toxicity.
You should see a doctor if there is no improvement in dry eyes symptoms
after 2 weeks of treatment, and if symptoms of sensitive nose are severe or
intolerable after discontinuation of loratadine.
Practise basic eye care
Patients may find it helpful to refrigerate the drops and/or use refrigerated
artificial tears before using these medications, as the cooling sensation helps
to relieve the irritation.
Wash hands before and after application.
Do not touch dropper tip to eyelids or other surfaces when placing drops in
eyes.
Avoid allergens and dust that may cause eye irritation.

Reviewed by: _____________________(Pharmacist/Preceptor)

Date: ________________
 Learning Log
Name of pre-registration pharmacist: Date:
Case no. _13___/ 20

COUNSELLING OF MINOR AILMENTS

Please document your counselling in SOAP format (see below for details). Presentation slides are
accepted and should be enclosed with the log book.
SOAP – Subjective Objective Assessment Plan
The details of each section are:
Subjective: Refers to non quantifiable areas e.g. itch, redness over arm, fever.
Objective: Refers to quantifiable terms, e.g. duration of itch, temperature, weight loss over specific period etc.
Assessment: Refers to patient’s problem list, e.g. developed skin rash upon application of topical product.
Plan: State the recommendation(s) for solving the minor ailment identified above and the rationale behind your
recommendation. E.g. to discontinue the topical product and treat skin rash with an antihistamine, after due
assessment.

Subjective 5-year history of worsening nasal congestion, sneezing and nasal itching.
Symptoms are year-round but worse during the haze season.
Objective Male, 22 years old student.
PMH: eczema in infancy
Assessment Persistent allergic rhinitis. Need to treat as the symptoms reduced his quality
of life and the symptoms are worsening
Plan Pharmacologicals:
First generation antihistamine (chlorpheniramine, diphenhydramine): (-)
drowsy, anticholinergic side effects (dry mouth, urinary retention), multiple
daily dose due to shorter duration of action (+) faster onset
Second generation antihistamine (loratadine, certirizine, fexofenadine): (+)
non-drowsy, once daily dosing, can take in the morning, longer duration of
action
Glucocorticoid nasal spray (mometasone furoate 0.05% nasal spray,
fluticasone furoate 27.5mcg nasal spray, triamcinolone acetonide 55mcg
nasal spray): (+) more effective than antihistamine, reserved for moderate to
severe symptoms which are non-responsive to anti-histamine treatment (-)
increased risk of oral infection possible epistaxis with prolonged usage, blood
in nasal mucous (-) does not help to relieve nasal congestion
Nasal saline irrigation: (+) minimal side effects, relief of rhinitis symptoms
Decongestant (pseudoephedrine, oxymetazoline): (+) effective for nasal
congestion (-) little effect on sneezing, nasal itching
Non-pharmacologicals:
Avoidance of allergens (not possible to avoid haze)
Frequently check local pollen counts and air quality index (not applicable to
this case)
Keep house and car windows shut on days with high levels of pollution and
 stay indoors as much as possible
Try not to do yard work or engage in outdoor sports
Wear a surgical mask or N95 face mask when outdoors
Choice of therapy: Fluticasone furoate 0.05% Triamcinolone acetonide
55mcg nasal spray two sprays into each nostril once daily, loratadine 10mg
OM, oxymetazoline 0.05% nasal spray 2 sprays drops 1 drop into each both
nostrils twice three times a day for at most 3 consecutive days. Rinse the nose
with saline nasal spray or irrigation, and blow out any nasal mucous before
nasal glucocorticoid is applied instilling the nasal drops or nasal sprays

Patient counselling:
Triamcinolone acetonide 55mcg nasal spray will help to reduce inflammation
of the nasal passages and consequently, control and relieve the symptoms of
sneezing and nasal itching. It, however, does not treat and prevent nasal
congestion. Intranasal corticosteroids work best when used every day.
Patients should be informed that they need to use the product for several
days before relief will be seen, however. It has to be used regularly and the
maximum effects will typically ~2-4 weeks to occur. Shake it well before use,
and remember to prime when using it for the first time. Common side effects
include nasal bleeding and sneezing.

Oxymetazoline 0.05% nasal drops can be used only when necessary to relieve
nasal congestion. Loratadine can be taken to relieve the symptoms of
sneezing and nasal itching when necessary, particularly before the full effect
of Triamcinolone acetonide 55mcg nasal spray sets in.
Seek medical attention if your allergy symptoms worsen while you are taking
nonprescription medications or symptoms do not improve after 2 weeks of
treatment or you develop signs and symptoms of secondary bacterial
infections (i.e thick nasal or respiratory secretions (mucus) that are not clear,
temperature greater than 38.5oC fever, shortness of breath, chest congestion,
wheezing, significant ear pain, rash)

Reviewed by: _____________________(Pharmacist/Preceptor)

Date: ________________
 Learning Log
Name of pre-registration pharmacist: Date:
Case no. _14___/ 20

COUNSELLING OF MINOR AILMENTS

Please document your counselling in SOAP format (see below for details). Presentation slides are
accepted and should be enclosed with the log book.
SOAP – Subjective Objective Assessment Plan
The details of each section are:
Subjective: Refers to non quantifiable areas e.g. itch, redness over arm, fever.
Objective: Refers to quantifiable terms, e.g. duration of itch, temperature, weight loss over specific period etc.
Assessment: Refers to patient’s problem list, e.g. developed skin rash upon application of topical product.
Plan: State the recommendation(s) for solving the minor ailment identified above and the rationale behind your
recommendation. E.g. to discontinue the topical product and treat skin rash with an antihistamine, after due
assessment.

Subjective Sharp pain in his legs, preparing for Triathlon, muscle pain, painful facial
expression
Sport enthusiast: running, biking and swimming for at least 3h every day for
the last two days
His symptoms started acutely after he left the gym this morning
Social drinker
Objective Male, 52y, swollen legs
PMH: GI ulcer
Assessment Strain. Need to treat as patient experiences uncomplicated muscle or tendon
injury and the pain lowers his quality of life. Help patient to get ready for the
triathlon.
Plan Pharmacologicals:
Oral NSAIDs: (+) anti-inflammatory, analgesic (-) Hx of GI ulcer and social
drinker, may increase risk of GI bleed and irritation
Paracetamol: (+) analgesic, little or no GI side effects (-) social drinker, may
increase risk of liver dysfunction, no anti-inflammatory effect
Aspirin: same as NSAIDs, also need high dose to achieve anti-inflammatory
effect
Counterirritants: (+) less systemic side effects; pain relief via nerve
stimulation, may reduce usage of oral pain reliever and reduce systemic side
effects further (-) no anti-inflammatory effect, greasy depending on
formulation, not as strong analgesic
Topical NSAIDs: (+) less systemic side effects, act locally in a manner similar to
systemic MOA, reduce the use of oral analgesic, stronger than
counterirritants (-) greasy depending on formulation
Non-pharmacologicals:
 RICE (rest, ice, compress and elevate): (+) promotes healing and reduce
swelling & inflammation of muscle and joint injuries (-) over icing may cause
skin irritation/damage, improper use of elastic support may worsen condition
Choice of therapy: Counterpain apply to affected area no more than 3-4
times every day and RICE: rest the injured area; ice the affected area as soon
as possible in 10 min increments, 3-4 times a day for 12-72h depend on
severity; compress area with elastic support or bandage; elevate area above
heart level 2-3 hours a day to reduce swelling and pain
Patient counselling:
 See doctor if musculoskeletal pain is more than 2 weeks without
treatment or pain persists more than 10 days with treatment
 Rub a thin layer, thick application will not make the product work
better
 Do not put tight bandage or dressing over an area treated with topical
products
 Do not use warming devices with topical products
 Wash hands after using topical products
 Do not ice affected area more than 10min increments and no more
than 3-4x/day to avoid skin irritation/injury. Ice should not be directly
applied onto the area of injury but covered in e.g. a piece of cloth
 Use appropriate elastic support or bandage to prevent further injury
 Participate in conditioning program to build muscle strength
 Daily stretch exercise
 Wear properly fitting shoes
 Eat well-balanced diet to nourish muscle
 Warm up before sports activity
 Do not overly strain or overexert during exercise to avoid injury
 Use/wear protective equipment as appropriate
 Avoid any extraneous exercise until fully recovered

Reviewed by: _____________________(Pharmacist/Preceptor)

Date: ________________
 Learning Log
Name of pre-registration pharmacist: Date:
Case no. _15___/ 20

COUNSELLING OF MINOR AILMENTS

Please document your counselling in SOAP format (see below for details). Presentation slides are
accepted and should be enclosed with the log book.
SOAP – Subjective Objective Assessment Plan
The details of each section are:
Subjective: Refers to non quantifiable areas e.g. itch, redness over arm, fever.
Objective: Refers to quantifiable terms, e.g. duration of itch, temperature, weight loss over specific period etc.
Assessment: Refers to patient’s problem list, e.g. developed skin rash upon application of topical product.
Plan: State the recommendation(s) for solving the minor ailment identified above and the rationale behind your
recommendation. E.g. to discontinue the topical product and treat skin rash with an antihistamine, after due
assessment.

Subjective A man wants to buy cough medicine for his 3 year-old son
Cough started two and a half weeks ago
Dry and tickly cough, no phlegm, not wheezing, drink normally, not eating as
much as usual, no fever. Cough frequently during the night
Had all his vaccinations
No pets
The man smokes outside as much as possible but sometimes smokes inside
the living room. He is worried for his child that he barely sleeps for the past
week.
Objective Nil
Assessment Dry cough. Need to treat as the symptoms are bothering and lower the
quality of life of both the child and parent. Advise the patient to take the child
to see doctor. He replied that he will take the child to see the doctor the day
after but right now he needs some medicine to relieve the cough.
Plan Pharmacologicals:
Rhinathiol promethazine cough syrup (carbocisteine, promethazine): (+) good
for both dry and wet cough since it contains both a mucolytic (carbocisteine)
and cough suppressant (promethazine) (-) may cause drowsiness and
paradoxical stimulation in children, used with caution (at low dose and
shortest duration possible) (-) contain alcohol
XPS-Bena expectorant (diphenhydramine, ammonium chloride, sodium
citrate): (-) more suitable for wet cough with chest congestion and thick
phlegm, not for dry cough (-) cause drowsiness and paradoxical stimulation in
children, used with caution (at low dose and shortest duration possible) (-)
contain alcohol
Tussidex forte linctus (dextromethorphan): (+) sugar and alcohol free (+)
 contain dextromethorphan (cough suppressant), good for dry, irritating cough
(-) drowsy
Wood’s peppermint children cough syrup (guaiphenesin): (+) alcohol free (-)
more suitable for wet cough with phlegm
Robitussin EX expectorant syrup (guaiphenesin): (-) contain alcohol (-) more
suitable for wet cough with phlegm
Prospan cough syrup (dried ivy leaf extract): (+) sugar and alcohol free (-)
more suitable for wet cough with phlegm
Non-pharmacologicals:
Ensure adequate fluid intake. Let the child drink warm tea with honey to
soothe the throat
Have enough rest
Eat a healthy diet including fruits and vegetables. Since his appetite is not
good, let him drink formula milk or eat liquid food (porridge) as good nutrition
is important to ensure prompt recovery.
Get proper amount of sleep
Advise the parent to refrain from smoking in the house as the cough may be
triggered by cigarette smoke
Choice of therapy: Tussidex forte linctus (dextromethorphan 15 mg/5 ml)
2.5ml three times a day when necessary for cough plus non-pharmacological
measures
Patient counselling:
Please take the child to see doctor since the cough is persistent and
prolonged (started more than 2 weeks ago)
Please go to A&E if develop more severe symptoms such as shaking chills,
high fever (>38.5oC), severe headache, neck stiffness, vomiting, abdominal
pain, difficulty breathing, chest pain, confusion

Reviewed by: _____________________(Pharmacist/Preceptor)

Date: ________________
 Learning Log
Name of pre-registration pharmacist: Date:
Case no. _16___/ 20

COUNSELLING OF MINOR AILMENTS

Please document your counselling in SOAP format (see below for details). Presentation slides are
accepted and should be enclosed with the log book.
SOAP – Subjective Objective Assessment Plan
The details of each section are:
Subjective: Refers to non quantifiable areas e.g. itch, redness over arm, fever.
Objective: Refers to quantifiable terms, e.g. duration of itch, temperature, weight loss over specific period etc.
Assessment: Refers to patient’s problem list, e.g. developed skin rash upon application of topical product.
Plan: State the recommendation(s) for solving the minor ailment identified above and the rationale behind your
recommendation. E.g. to discontinue the topical product and treat skin rash with an antihistamine, after due
assessment.

Subjective 4 moderate-sized bowel movements since the day before. Stool is watery.
Intact appetite, no nausea/vomiting, no fever, no blood in the stool, no pain
Feel bloated. Claimed that he ate the food that was left in the fridge for 3
days
Denied taking any laxative or herbal product or slimming tea
Objective Male, 24 years old, overweight, well, alert, NKDA, dry lip (a bit dehydrated)
No comorbid conditions
Assessment Acute diarrhea, most likely due to virus or bacteria (viral or bacterial
gastroenteritis) in contaminated food. Need to treat as the symptoms lower
his quality of life.
Plan Pharmacologicals:
Adsorbents (activated charcoal, kaolin): (+) bind to enterotoxin, improve stool
consistency, reduce flatulence (-) interact and reduce absorption of other
medicines; does not reduce the number of stools passed; temporary black
discoloration of stools, teeth and mouth (charcoal)
Antiperistaltic (diphenoxylate with atropine, loperamide): (+) reduce
frequency and duration of loose stools (-) may cause constipation and
dizziness, may rarely worsen invasive bacterial diarrhea, may rarely cause
ileus, constipation, abdominal distention
Probiotics (lactobacillus): (+) enhance immune response, restore normal GI
flora and reduce colonization by pathogenic bacteria (+) safe, few side effects
Non-pharmacologicals:
Fluid and electrolyte replacement (oral rehydration salt): (+) correction of
fluid loss and electrolyte imbalances (-) no effect on duration of diarrhea, may
not be necessary for mild diarrhea in healthy adult
Maintain regular diet
Maintain adequate fluid intake
Adopt hygienic practice: hand washing before eating or food handling, proper
 cleaning for kitchen and house, drink boiled water and eat fully-cooked food
Choice of therapy: Loperamide 4mg initially, then 2 mg after each loose stool
(max 8mg/day) for 2 days
Ultracarbon tablets 250mg: 2 tablets 3 times a day for 2 days
Lacteol fort (Lactobacillus bacillus): 1 sachet three times a day for 5 days
Do not need oral rehydration salts
Patient counselling:
Milk, ice-cream and sherbet should be avoided since they can reduce the
effectiveness of charcoal
Do not take any medicine within 2 hours of the activated charcoal. Taking
other medicine together with activated charcoal may prevent the other
medicine from being absorbed by the body.
Avoid cooked food that has been kept at room temperature for several hours
Seek medical attention immediately if you develop: severe vomiting or
dehydration, passage of multiple small-volume stools containing blood and
mucus, fever of 38.5oC or higher, passage of six or more unformed stools in
24h or symptoms does not improve after 48h despite treatment, severe
abdominal pain/distress, shortness of breath, decreased or no urine output
for more than 8h, unusual excitement, flushing of skin, blurred vision, severe
constipation with bloating
You may take ultracarbon tablet first, then take loperamide and lacteal fort
2h later.

Reviewed by: _____________________(Pharmacist/Preceptor)

Date: ________________
 Learning Log
Name of pre-registration pharmacist: Date:
Case no. _17___/ 20

COUNSELLING OF MINOR AILMENTS

Please document your counselling in SOAP format (see below for details). Presentation slides are
accepted and should be enclosed with the log book.
SOAP – Subjective Objective Assessment Plan
The details of each section are:
Subjective: Refers to non quantifiable areas e.g. itch, redness over arm, fever.
Objective: Refers to quantifiable terms, e.g. duration of itch, temperature, weight loss over specific period etc.
Assessment: Refers to patient’s problem list, e.g. developed skin rash upon application of topical product.
Plan: State the recommendation(s) for solving the minor ailment identified above and the rationale behind your
recommendation. E.g. to discontinue the topical product and treat skin rash with an antihistamine, after due
assessment.

Subjective Tingling sensation around her nose or lips, followed several hours later by
localized formation of small blisters which crusted. Now she feels a bit
painful.
She feels more painful when she is exposed to the sun. She is now using
sunblock.
Previously, she also had blisters around her mouth a few years ago but she
did not seek any treatment then and the condition was gone after a few days.
Objective Female, 38 years old, NKDA
Assessment Cold sores (herpes labialis). Need to treat as she feels painful and the blisters
significantly lower her quality of life.
Plan Pharmacologicals:
Acyclovir 5% cream: (+) stops the growth of herpes simplex virus and speeds
up the healing process (-) requires frequent applications, need to be initiated
within 72h from onset of symptoms to achieve maximal benefits. Apply 5
times daily, every 4 hours for 4 days.
Betadine antiseptic ointment (povidone-iodine 10%): (+) has soothing effects,
dabs onto cold sores and reduces symptoms (-) does not inhibit the growth of
virus and speed up the healing process
Medijel gel 15g (lidocaine HCL 0.66%w/w, Aminoacridine Hydrochloride
0.05%w/w): (+) numbs the area of pain, (-) does not eradicate the virus. To
use only when necessary up to 4 times daily for pain relief.
Non-pharmacologicals:
Choice of therapy: acyclovir 5% cream: apply a thin layer to the affected area
(only to lips and face) 5 times a day at the first sign of cold sore (e.g tingling,
pain, burning or blisters) and continue for at least 5 4 days. Each application
should be 4h apart.
Patient counselling:
 Wash and dry hands before and after use to prevent the spread of infection.
Temporary burning or stinging sensation after applying the cream, mild drying
or flaking of the skin.
Inform your doctor immediately if you experience any allergic symptoms (e.g.
rashes, itchiness, difficulty in breathing or eye swelling) or serious side effects
due to this medication, or if the cold sores appear on the eye
Consult a doctor if condition worsens or does not improve after 5 4 days of
use.
Do NOT:
●Kiss anyone
●Share forks, knives, spoons, glasses, towels, lip balm, or razors
●Give anyone oral sex
●Be in close contact with people with suppressed immune system
Treatments can help ease the symptoms of cold sores, but no treatment can
cure cold sores for good. Once you have the virus that causes cold sores, you
will have it for the rest of your life. That means that cold sores can keep
coming back. Luckily, symptoms usually get milder with time.
Avoid picking the scab or breaking blisters as this can cause secondary
infection and scarring.
Wear sunblock on your face and lips when outdoors

Reviewed by: _____________________(Pharmacist/Preceptor)

Date: ________________
 Learning Log
Name of pre-registration pharmacist: Date:
Case no. _18___/ 20

COUNSELLING OF MINOR AILMENTS

Please document your counselling in SOAP format (see below for details). Presentation slides are
accepted and should be enclosed with the log book.
SOAP – Subjective Objective Assessment Plan
The details of each section are:
Subjective: Refers to non quantifiable areas e.g. itch, redness over arm, fever.
Objective: Refers to quantifiable terms, e.g. duration of itch, temperature, weight loss over specific period etc.
Assessment: Refers to patient’s problem list, e.g. developed skin rash upon application of topical product.
Plan: State the recommendation(s) for solving the minor ailment identified above and the rationale behind your
recommendation. E.g. to discontinue the topical product and treat skin rash with an antihistamine, after due
assessment.

Subjective A woman wants to look for something to treat her daughter’s motion sickness.
They are going for 5-day cruise and the last time the daughter went on a cruise, she
was nauseous for the first 2 days.
The daughter was given some medicine on third day by the captain that made the
motion sickness go away but caused drowsiness.
Objective Female, 8 years old, NKDA
Assessment Motion sickness. Need to treat as the patient’s mother requests and the symptoms
will greatly lower her quality of life (continuous vomiting may lead to severe
headache, dehydration and electrolyte imbalance)
Plan Pharmacologicals:
Antihistamine (dimenhydrinate, cinnarizine, promethazine) (+) first-line for nausea
and vomiting, prevent motion sickness (-) sedation, dry mouth, headache,
tachycardia
Ginger (ginger tea, raw ginger, ginger supplements) (+) improve nausea (-) does not
reduce number of vomiting
Pyridoxine (vitamin B6) (+) improve nausea (-) does not significantly reduce number
of vomiting (Evidence is more in pregnant women)
Non-pharmacologicals:
Acupressure wrist band (Sea-band): (+) non-drowsy, drug-free, reusable, washable
(-) no more effective than placebo
Choice of therapy: Dimenhydrinate 25mg q6h (max 150mg/day), to be taken at
least 30 min before travel plus non-pharmacological
Patient counselling:
Don’t read during travel, keep the line of vision fairly straight ahead or focus on
distant objects
Don’t overeat, avoid spicy, oily food and alcohol
Avoid strong odours, particularly from food and tobacco smoke
Stay toward the top (preferably the deck) and midway between the bow and stern
of the ship where the motion cannot be felt as strongly
 Ask for seat over the wing or window seat, look out of windows
Breathe in fresh air if possible, open a window or stay outside on a ship’s deck.
Keep children occupied, playing games and looking out of the window can help.
Wearing Sea-band during the trip

Reviewed by: _____________________(Pharmacist/Preceptor)

Date: ________________
 Learning Log
Name of pre-registration pharmacist: Date:
Case no. _19___/ 20

COUNSELLING OF MINOR AILMENTS

Please document your counselling in SOAP format (see below for details). Presentation slides are
accepted and should be enclosed with the log book.
SOAP – Subjective Objective Assessment Plan
The details of each section are:
Subjective: Refers to non quantifiable areas e.g. itch, redness over arm, fever.
Objective: Refers to quantifiable terms, e.g. duration of itch, temperature, weight loss over specific period etc.
Assessment: Refers to patient’s problem list, e.g. developed skin rash upon application of topical product.
Plan: State the recommendation(s) for solving the minor ailment identified above and the rationale behind your
recommendation. E.g. to discontinue the topical product and treat skin rash with an antihistamine, after due
assessment.

Subjective Wants to buy some prenatal vitamin. She is trying to get pregnant.
Taking multivitamin now. Confused over many different combinations of vitamins.
Objective Female, 28 years old, NKDA. No comorbidities. No concomitant medications.
Assessment Health supplement for pregnancy. Need to give since the patient is in the child-
bearing age.
Plan Pharmacologicals:
Folic acid: (+) prevent major birth defects called neural tube defects to fetus’ brain
and spine.
Iron: (+) help the body make more blood to supply oxygen to the fetus
Calcium: (+) build fetus’ bones and teeth
Vitamin D: (+) works with calcium to help fetus’ bones and teeth develop and is
essential for healthy skin and eyesight
Non-pharmacologicals:
Increase in intake of food rich in iron (lean red meat, poultry, fish, beans and peas,
prune juice), calcium (milk, dairy products), vitamin D (milk fortified with vitamin D,
fatty fish such as salmon
Advise her to expose to the sun will help to convert a chemical in the skin to vitamin
D. Try letting the sun shine on your arms and legs twice a week for about five to 30
minutes. The best time to do this is between 10am and 3pm.
Choice of therapy: Folic acid tablet 5mg om, ferrous gluconate 240mg capsule 2
capsules om , calcium plus vitamin D tablet (calcium carbonate 450mg, vitamin D
200IU) 2 tablets om plus non-pharmacological measures
Continue taking her multivitamin Stop her current multivitamins and switch to New
Obimin film-coated tablets 1 tablet OM (used as pre-natal vitamin)
Patient counselling:
Take ferrous gluconate with water or juice on an empty stomach for better
absorption; however it may be administered with food if stomach discomfort
occurs; Do not take ferrous gluconate with cereals, dietary fiber, tea, coffee, eggs,
or milk.
 Take calcium and vitamin D tablets every morning after food.
Due to the iron and calcium content in New Obimin film-coated tablets, she may
experience constipation. To minimize constipation, increase consumption of fruits
and vegetables, and drink more fluids. Her stools may turn black or darken due to
the iron content in the tablet. Take the tablets at least 2 hours apart from antacids
and calcium-containing products e.g. dairy products to prevent interference in the
absorption of iron and calcium by the body.

Reviewed by: _____________________(Pharmacist/Preceptor)

Date: ________________
 Learning Log
Name of pre-registration pharmacist: Date:
Case no. _20___/ 20

COUNSELLING OF MINOR AILMENTS

Please document your counselling in SOAP format (see below for details). Presentation slides are
accepted and should be enclosed with the log book.
SOAP – Subjective Objective Assessment Plan
The details of each section are:
Subjective: Refers to non quantifiable areas e.g. itch, redness over arm, fever.
Objective: Refers to quantifiable terms, e.g. duration of itch, temperature, weight loss over specific period etc.
Assessment: Refers to patient’s problem list, e.g. developed skin rash upon application of topical product.
Plan: State the recommendation(s) for solving the minor ailment identified above and the rationale behind your
recommendation. E.g. to discontinue the topical product and treat skin rash with an antihistamine, after due
assessment.

Subjective A 29-year old mother comes to look for treatment for head lice for her daughter.
She thinks that her daughter got it from school.
Daughter complained about itching on her head.
When she tried to remove what we looked like dandruff from her daughter’s hair,
the gray/white speck was firmly attached to the hair shaft.
Objective Female, 6 years old

Assessment Uncomplicated case of head lice

Plan Pharmacologicals:
Malathion 0.5% lotion: (+) kill the lice by affecting their nervous system (-)
flammable
Olive oil: (+) a smothering agent that blocks the holes on the sides of lice to stop
their breathing, few allergies, inexpensive, pesticide-free (-) slow-acting
Tea-tree oil: (-) significant allergic reactions and possible liver toxicity
Non-pharmacologicals:
Fine-toothed nit comb: (+) remove the nits/eggs since none of the pediculicides kills
100% of the lice eggs
Choice of therapy: Malathion 0.5% lotion: Apply to dry hair until the hair and scalp
are wet. Leave it on for 12 hours before washing off with a non-medicated
shampoo; rinse and use a fine-toothed (nit) comb to remove dead lice and eggs.
The hair should be left uncovered and allowed to dry naturally, and heat sources
should not be used to dry the hair. Second application recommended only if live lice
are still present 7-9 days after treatment.
Following the treatment, the hair should be wet combed every three days for two
weeks to remove the dead head nits. To wet comb hair, you need to moisten the
hair with a hair conditioner and comb it from root to tip with a fine-toothed comb.
Patient counselling:
 Treat all close contacts and family members who may be infected.
Advise all other family members to avoid direct physical contact with the daughter
 in the meantime and not to share combs, brushes, towels and caps with her until
her head lice infestation is fully eradicated .
 Check for, and remove nits in bright light (preferably in the day under the sun).
 Remove all dead lice and nits with a fine-toothed comb (lice comb), tweezers, or
fingernails.
 Dip the lice comb in vinegar before combing it through the hair. Vinegar helps
loosen up the nits by making them less sticky.
 Disinfect all brushes, combs, and hair accessories in a lice shampoo solution, soapy
water, or alcohol for an hour or soak in very hot water (65 °C) for about 10 minutes.
 Wash all recently worn clothing and used bed linens, pillow cases, and towels in hot
water, and dry them in a hot dryer for at least 20 minutes. Dry clean or iron any
items that cannot be washed.
 Seal stuffed toys and other non-washable items in a plastic bag for 2 weeks or place
them in the freezer (in sealed plastic bags) for 12 to 24 hours. The lice will die
because they will have nothing to feed on.
 Cover furniture with a plastic cover for 2 weeks.
 Vacuum all carpets, rugs, mattresses, pillows, furniture, and car seats to remove lice
and eggs.
 Consult a doctor if there are signs of bacterial infection on the scalp

Reviewed by: _____________________(Pharmacist/Preceptor)

Date: ________________