TEXT BOOK
,
,
,COMMUNITY
PHARMACY
,
, SIXTH EDITION
COMMUNITY
PHARMACY
SYMPTOMS, DIAGNOSIS AND TREATMENT
Paul Rutter PhD, SFHEA
Professor in Pharmacy Practice, School of Pharmacy and Biomedical
Sciences, University of Portsmouth, Portsmouth, UK
,Copyright © 2026, by Elsevier Limited. All rights are reserved, including those for text and data mining,
AI training, and similar technologies.
Publisher’s note: Elsevier takes a neutral position with respect to territorial disputes or jurisdictional claims
in its published content, including in maps and institutional affiliations.
First edition 2004
Second edition 2009
Third edition 2013
Fourth edition 2017
Fifth edition 2021
Sixth edition 2026
The right of Paul Rutter to be identified as author of this work has been asserted by him in accordance
with the Copyright, Designs and Patents Act 1988.
No part of this publication may be reproduced or transmitted in any form or by any means, electronic or
mechanical, including photocopying, recording, or any information storage and retrieval system, without
permission in writing from the publisher. Details on how to seek permission, further information about the
Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance
Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions.
This book and the individual contributions contained in it are protected under copyright by the Publisher
(other than as may be noted herein).
Notice
Practitioners and researchers must always rely on their own experience and knowledge in evaluating and
using any information, methods, compounds or experiments described herein. Because of rapid
advances in the medical sciences, in particular, independent verification of diagnoses and drug dosages
should be made. To the fullest extent of the law, no responsibility is assumed by Elsevier, authors,
editors or contributors for any injury and/or damage to persons or property as a matter of products
liability, negligence or otherwise, or from any use or operation of any methods, products, instructions,
or ideas contained in the material herein.
ISBN: 978-0-4432-4619-7
Content Strategist: Alexandra Mortimer
Content Project Manager: Ayan Dhar
Design: Miles Hitchen
Marketing Manager: Deborah Watkins
Printed in India
Last digit is the print number: 9 8 7 6 5 4 3 2 1
,Contents
Useful websites vii
Preface ix
Introduction xi
How to use the book xv
1 Making a diagnosis 1
2 Skills needed to facilitate clinical
reasoning 9
3 Respiratory system 17
4 Ophthalmology 55
5 Ear conditions 81
6 Central nervous system 103
7 Women’s health 133
8 Gastroenterology 167
9 Dermatology 223
10 Musculoskeletal conditions 293
11 Paediatrics 321
12 General Health 351
13 Specific product requests 369
Index 381
,
, Useful Websites
Evidence-based Medicine
National Institute for Health and Care Excellence https://www.nice.org.uk
Bandolier http://www.bandolier.org.uk
Centre for Reviews and Dissemination https://www.york.ac.uk/crd
Centre for Medicines Optimisation https://www.centreformedicinesoptimisation.co.uk/mtrac
Regional Drugs and Therapeutic Centre https://rdtc.nhs.uk
Medicines Information and Regulation
UK Medicines Information https://www.ukmi.nhs.uk/
Electronic medicines compendium https://www.medicines.org.uk/emc
NICE Clinical Knowledge Summaries https://cks.nice.org.uk/#?char=A
Medicines & Healthcare Products Regulatory Agency https://www.gov.uk/government/organisations/medicines-and-healthcare-
products-regulatory-agency
European Medicines Agency https://www.ema.europa.eu/ema
US Food and Drug Administration https://www.fda.gov
Therapeutic Goods Administration (Australian) https://www.tga.gov.au
UK Professional Bodies
Royal Pharmaceutical Society https://www.rpharms.com
British Medical Association https://www.bma.org.uk
Royal College of Nursing https://www.rcn.org.uk
British Dental Association https://www.bda.org
UK Regulators
General Pharmaceutical Council https://www.pharmacyregulation.org
General Medical Council https://www.gmc-uk.org
The Nursing and Midwifery Council https://www.nmc.org.uk
General Dental Council https://www.gdc-uk.org
Health and Care Professions Council https://www.hcpc-uk.org
General Optical Council https://optical.org
UK Pharmacy Organizations and Trade Bodies
National Pharmaceutical Association https://www.npa.co.uk
Community Pharmacy England https://cpe.org.uk
Guild of Healthcare Pharmacists https://www.ghp.org.uk
UK Clinical Pharmacy Association https://ukclinicalpharmacy.org
Association of the British Pharmaceutical Industry https://www.abpi.org.uk
The Proprietary Association of Great Britain https://www.pagb.co.uk
British Pharmaceutical Students Association https://www.bpsa.co.uk
,
,
,COMMUNITY
PHARMACY
,
, SIXTH EDITION
COMMUNITY
PHARMACY
SYMPTOMS, DIAGNOSIS AND TREATMENT
Paul Rutter PhD, SFHEA
Professor in Pharmacy Practice, School of Pharmacy and Biomedical
Sciences, University of Portsmouth, Portsmouth, UK
,Copyright © 2026, by Elsevier Limited. All rights are reserved, including those for text and data mining,
AI training, and similar technologies.
Publisher’s note: Elsevier takes a neutral position with respect to territorial disputes or jurisdictional claims
in its published content, including in maps and institutional affiliations.
First edition 2004
Second edition 2009
Third edition 2013
Fourth edition 2017
Fifth edition 2021
Sixth edition 2026
The right of Paul Rutter to be identified as author of this work has been asserted by him in accordance
with the Copyright, Designs and Patents Act 1988.
No part of this publication may be reproduced or transmitted in any form or by any means, electronic or
mechanical, including photocopying, recording, or any information storage and retrieval system, without
permission in writing from the publisher. Details on how to seek permission, further information about the
Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance
Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions.
This book and the individual contributions contained in it are protected under copyright by the Publisher
(other than as may be noted herein).
Notice
Practitioners and researchers must always rely on their own experience and knowledge in evaluating and
using any information, methods, compounds or experiments described herein. Because of rapid
advances in the medical sciences, in particular, independent verification of diagnoses and drug dosages
should be made. To the fullest extent of the law, no responsibility is assumed by Elsevier, authors,
editors or contributors for any injury and/or damage to persons or property as a matter of products
liability, negligence or otherwise, or from any use or operation of any methods, products, instructions,
or ideas contained in the material herein.
ISBN: 978-0-4432-4619-7
Content Strategist: Alexandra Mortimer
Content Project Manager: Ayan Dhar
Design: Miles Hitchen
Marketing Manager: Deborah Watkins
Printed in India
Last digit is the print number: 9 8 7 6 5 4 3 2 1
,Contents
Useful websites vii
Preface ix
Introduction xi
How to use the book xv
1 Making a diagnosis 1
2 Skills needed to facilitate clinical
reasoning 9
3 Respiratory system 17
4 Ophthalmology 55
5 Ear conditions 81
6 Central nervous system 103
7 Women’s health 133
8 Gastroenterology 167
9 Dermatology 223
10 Musculoskeletal conditions 293
11 Paediatrics 321
12 General Health 351
13 Specific product requests 369
Index 381
,
, Useful Websites
Evidence-based Medicine
National Institute for Health and Care Excellence https://www.nice.org.uk
Bandolier http://www.bandolier.org.uk
Centre for Reviews and Dissemination https://www.york.ac.uk/crd
Centre for Medicines Optimisation https://www.centreformedicinesoptimisation.co.uk/mtrac
Regional Drugs and Therapeutic Centre https://rdtc.nhs.uk
Medicines Information and Regulation
UK Medicines Information https://www.ukmi.nhs.uk/
Electronic medicines compendium https://www.medicines.org.uk/emc
NICE Clinical Knowledge Summaries https://cks.nice.org.uk/#?char=A
Medicines & Healthcare Products Regulatory Agency https://www.gov.uk/government/organisations/medicines-and-healthcare-
products-regulatory-agency
European Medicines Agency https://www.ema.europa.eu/ema
US Food and Drug Administration https://www.fda.gov
Therapeutic Goods Administration (Australian) https://www.tga.gov.au
UK Professional Bodies
Royal Pharmaceutical Society https://www.rpharms.com
British Medical Association https://www.bma.org.uk
Royal College of Nursing https://www.rcn.org.uk
British Dental Association https://www.bda.org
UK Regulators
General Pharmaceutical Council https://www.pharmacyregulation.org
General Medical Council https://www.gmc-uk.org
The Nursing and Midwifery Council https://www.nmc.org.uk
General Dental Council https://www.gdc-uk.org
Health and Care Professions Council https://www.hcpc-uk.org
General Optical Council https://optical.org
UK Pharmacy Organizations and Trade Bodies
National Pharmaceutical Association https://www.npa.co.uk
Community Pharmacy England https://cpe.org.uk
Guild of Healthcare Pharmacists https://www.ghp.org.uk
UK Clinical Pharmacy Association https://ukclinicalpharmacy.org
Association of the British Pharmaceutical Industry https://www.abpi.org.uk
The Proprietary Association of Great Britain https://www.pagb.co.uk
British Pharmaceutical Students Association https://www.bpsa.co.uk
