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Adler-Pharmacy, Rhaunen
by Johannes Jaenicke
Ask you pharmacist- healthy traveling -
travelling servicein a community pharmacy
www.adler-apotheke.info
introducing
Mrs AD, 45 years old
She is a customer of …
introducing… the Adler-Pharmacy in Rhaunen
… she knows our location
… she knows the team
Does she know, we are offering travel advice??
introducing
Of course she knows!!
Because …
advertising
… she reads the local newspaper
… she gets post from us
… she visits our pharmacy
… she s online
… everywhere she gets our message:
With the help of your pharmacistyou be well and keep well in your holidays
She now knows that she can choose …
…between 5 different service modules for travellers
advertising
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service modules for travelers
malaria prevention
vaccination
sun protection
travel kits
individual travel advice
malaria preventionprevent mosquito bites
… a map presenting regions with high risk of malaria
… products to help avoiding bites like repellents or screens
… general advice: do s and don ts
malaria prevention
“anti-malarials”
… advice about medical treatment of malaria
… adequate stock of “anti-malarials”and cheaper reimported alternatives
vaccination
a list of all necessary vaccinationfor safe travelling
individual checkof the vaccination card
time table for revaccination
adequate stock of vaccinesoffering cheaper reimported vaccines
sun protectiondetermination of the individual skin type
and natural given sun-protection-time
sun protection
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sun protection
Mrs AD burns easily & tans minimallyShe has a sun sensitive skin of type II
Skin type II = 10 minutes natural given sun-protection-time
sun protectionRecommendation of a sunscreen with sun protection factor
according to the skin type, the holiday region, the duration of staying in the sun and allergies
sun protectionMrs AD …
• has skin type II
• will be staying 8 weeks in Tanzania & Rwanda
• wants to visit mount Kilimanjaro (19,000 feet high)
• will stay in the sun the whole day(adventure tour)
• is generally healthy, no allergies
sun protectionWhat is a SPF?
• Sunscreens are rated or classified by the strength of their SPF
• SPF numbers can range from 2 - > 50 and refer to the product s ability to deflect the sun s burning UVB-rays (not UVA!)
• A sunscreen`s SPF rating is calculated by comparing …
the amount of time needed to produce a sunburn on sunscreen protected skin
to the amount of time needed to cause a sunburn on unprotected skin
sun protectionMrs AD …
• has skin type II
= 10 minutes natural given protection time = she turns red after 10 minutes of exposure to the sun
if a sunscreen is rated with SPF 2
she can stay 2 x 10 minutes in the sun, without getting red
if a sunscreen is rated with SPF 15
she can stay 15 x 10 minutes in the sun, without getting red
sun protection
Sunscreens breaks down and rub off with normal wear.
So it has to be reaplied to keep up the protection(approximately every 2 hours).
The maximum-protection time is not getting longerby reapplying sunscreen
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sun protection
to recommend sunscreen, you have to bear in mind …
• a sun protection factor according to the skin type and the duration of staying in the sun
• a sun protection factor according to the holiday region (sun intensity, altitude, temperature,…)
• activity level (perspiration)
• possible allergies
sun protectionMrs AD …
• has skin type II= 10 minutes natural given protection time
• will stay in the sun up to 8 hours a day with a lot of movement
• will visit hot countries with a high altitude and near to the equator
sun protection
UV radiation increases estimated 4% per 1,000 feet of elevation gain. Therefore, at higher elevations, you should more conscientiously apply and reapply sunscreen
altitude
sun protection
Sun intensity becomes greater the close you are to the equator
latidute
High levels of either will trigger increased perspiration, diminishing the sunscreen potential of effectiveness
Temperature, humidity, high activity
sun protectionMrs AD …
• Needs a sunscreen with a high SPF of 50 = 500 minutes of sun-protection according to her skin type. It should although protect her against UVA-rays
• Because of the high altitude & whole day activity, she should apply the sunscreen every day and reapply it every 2 hours
sun protection
How much sunscreen should a person apply
• recommended is one ounce for full body-body coverage = amount that would fit in a shot glass
• apply sunscreen to all exposed skin. Think of treating your nose, ears, (for sandal weares) the top of your feet
• reapply sunscreen every 2 hours
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sun protectionMrs AD …
• will be staying 8 weeks
in Tanzania & Rwanda.
• She needs an minimum
amount of 7 bottles (200 ml)
of sunscreen (to apply every
day and reapply every 2
hours).
sun protectiongeneral advice to use sunscreen, in order to
prevent sunburn and skin aging and skin cancer
sun protection
On dry skin between 20-30 minutes before sun exposure.. Reapply every 2 hour, especially when sweating (dry up before), after swimming or regular contact to vegetation or rock surfaces (abrasion)
When should sunscreen be applied/reapplied
Every day, that includes extended time outdoors (even cloudy days) and especially between 10 am – 4 pm. Sand, water ,snow and ice reflect 80% of UV rays. Take care!
When should sunscreens be used
sun protectionMrs AD …
• wants to use insect repellents
(malaria!) and sunscreen.
Can she use both at the
same time?
• She was in Goa 5 years ago
and still got one old sunscreen
at home. Can she use it?
sun protection
Always sunscreen first, repellent second. Apply sunscreen 20-30 minutes before outdoor activity, after that time you can apply the repellent.
Use sunscreen and insect repellent at the same time?
Unless indicated by their expiration date, the FDA requires that all sunscreens be stable and at their original strength for at least 3 years
Does sunscreen lose its strength after some time?
sun protectionAfter sun lotions and products for the
treatment of sunburn
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sun protection
It my take up to 24 hours before the full damage is visible
Sunburn is dangerous
It will heal, possibly with some peeling, within a few days. Treat it with cool baths, moisturizers or over-the-counter hydrocortisone creams.
Treatment of “first degree” sunburn
sun protection
Treatment of “second degree” sunburn
They blister. Do not break them – they are a natural protective mechanism to heal the affected area.
Large area affected? Headache? Fever? Seek medical help!
A layer of gauze may be used to cover the area until healed
Never forget!
Be sure to protect your skin from the sun while it heals and thereafter
sun protectionMrs AD …
• never use medication with
acetylsalicylicacid to lessen
the pain of sunburn. It should
not be taken when malaria or
dengue fever is a possibility.
• ibuprofen is considered a safe
alternative
travel kitsindividual travel kit including recommended medication
appropriate for the holiday region
Mrs AD …
travel kits
• travelling in africa overland,
away from tourist routes
• is divorced, tries to get her
mind off during holidays
• preferring where possible to
take “natural” or alternative
remedies
travel kits“must have” (basic version)
• analgesic (pain relief) medicine such as paracetamolor ibuprofen. Be careful to use acetylsalicylic acid
• insect repellent & “anti malarials” & thermometer
• sunscreen & hydrocortisone cream
• anti-bacteria gel for hand washing without water
• diarrhoea medicine, e.g. loperamide-tablets & electrolyte replacement powder
• antiseptic solution for cleaning wounds or bites
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travel kits“must have” (basic version)
staying away from usual tourist routes means there areonly few medical facilities and doctors
• she therefore needs antibiotics and strong painrelievers (presciption needed) for an emergency
• also some mineral & vitamine-tablettes can be usefull
travel kits“should have” (extended version)
• antihistamine tablets for bites, stings or allergies
• bandages, band aids, plasters, gauze and gauze rollswith adhesive tape
• safety pins, scissors and tweezers, a syringe & needle (you may not be allowed to carry these in your cabin luggage)
• antiemetic tablets or drops (natural medicine possible)
travel kits“can have” (all included version)
• cold and flu tablets & throat lozenges (air-condition)
• eye lubricant drops
• motion sickness tablets (natural medicine possible)
• laxative for constipation
• ear drops & nose spray
• drops against eye inflammation
travel kits“can have” (all included version)
• ear plugs
• antacid tablets for heartburn
• water purification tablets
• antifungal creme
travel kitschecklist for look through medicine cabinet at home
to stock up the travel kit
travel kitsoffering help to fill in forms regarding entry requirements
for certain countries for controlled drugs like strong pain relievers e.g. morphine
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travel kitscompression socks,
preventing thrombosis during long flight
individual travel advicetips concerning long distance flights
especially thrombosis prophylaxis, dry eyes, dry mucous membranes, earaches, motion sickness and jetlag
individual travel adviceList of German speaking doctors to consult abroad
individual travel adviceaddress of the German embassy abroad
and general safety information from the foreign country
individual travel adviceSafety informations from Tanzania (exampels)
• pirates attack and highjack ships
• terror attacks possible, be carful at public locations
• robbing/kidnapping by alleged taxi-drivers, use
registered taxis (yellow, green or blue stripes)
• do not go for a walk at night
Safety informations from Rwanda (exampels)
• handgranate attacks in 2010/11 in Kigali
• no traveling to the border area of Kongo/Rwanda
individual travel adviceadvice to prevent insect bites
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individual travel adviceoptimizing medical therapy (like insulin, cortisone or
contraceptives) with regard to time change
individual travel adviceDo s and don ts
concerning foreign food and drinkable water
• “Cook it, wash it, peel it or forget it”
• be careful with fruits, you have not peeled by yourself
• eat freshly cooked (hot) food: no buffets, no cold plates
• avoid unpasteurized dairy products (cheese, ice, yogurt).
Careful with anything containing milk products
• be careful when eating seafood: it can go bad quickly, avoid
fish organs and shellfish (shrimps, oysters, …)
• no raw meat (take your steak well done)
individual travel adviceFood hygiene
individual travel advice
individual travel adviceFood hygiene
• “Buy bottled water” (make sure the cap has not
been tampered with). Use it also for brushing your
teeth.
• no ice cubes in your drinks
• if you get no bottled water, you can boil it before
drinking
• water purification tablets and ceramic filters are
available
individual travel advicethe best tips
Never forget to wash you hands before eating or touching food
(e.g. use hand sanitizers, you can also use them to wipe the cutlery)
Don t become obsessed with food safety(take necessary measures, use your common sense
and enjoy eating while traveling)
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individual travel advice
Special tips for Mrs AD
• Before your 8 week trip – let a dentist check your teeth
• Use always repellents and sleep under a screen, to avoiodmosquito bites
• Don t take a bath in a river or a lake (risk of bilharziosis)
calculating costscosts
• Software(program based on CRM-Data – crm.de): 218 $/year
• Team trainingbasic training (2 days): 433 $
refresher training (1 days): 240 $ / 2 years
• Advertisementlocal newspaper (4x): 174 $
flyer, poster: free – included in CRM membership
twitter, social networks, website, pharmacy-tv: free of direct costs
mailing (4x): 581 $
calculating costscosts
• Personnel costs during the time of giving travel advice½ hour pharmacist: 22 $
• Storage costs, especially to have vaccines on stockLoss of interest: 131 $/year
= Costs calculated (5-year plan, 1 Expert): 5974 $
calculating costs
• Charges for independent travel advice (combined with a voucher for products of a travel kit)
• Profit from selling or restocking a travel kitCalculated: on average an 43 $ travel kit means a profit of 13 $
Charge: 29 $ for ½ hour advice (7 $ voucher included)
• Profit from selling vaccinesCalculated: on average 2 vaccines per advised Person means a profit of 23 $
profit
calculating costs
• Profit from selling sunscreen and other travel productsCalculated: on average a profit of 7 $
= Profit calculated 44 $ / case
Costs (5 year plan, 1 Expert) of 5974 $ means you need 137 customers in 5 years booking travel advice
= 27 customers / year.
Realistic??
profit
calculating costs
Positive image to your customer and doctors
Mrs AD will statistically tell 5 people, how good your travel service is
How much is this worth?
profit
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Adler-Pharmacy, Rhaunen
by Johannes Jaenicke
thank youfor your attention
travelling servicein a community pharmacy
www.adler-apotheke.info