An Introduction To The Foot and Its Common Problems in the Adult

By David R. Tollafield

The Institute of Chiropodists and Podiatrists are excited and proud to have commissioned this dynamic and important handbook, by way of an introduction to everything you need to know about the adult human foot.

The challenging subject of foot and lower limb mechanics is admirably clarified and easy to follow in this 180-page paperback, Pocket sized book. Well- illustrated, clear and informative, this book will appeal to podiatrists and foot health practitioners at all levels, whether you are new to the anatomy and workings of the foot or as a reference for reminder. This book will also appeal to other professions and healthcare professionals who have an interest in the foot.

David worked closely with IoCP board members during his talented creation of this seminal publication, including Bill Liggins, Consultant Podiatric Surgeon and Editor of the IoCP journal ‘Podiatry Review’, and the Chair of the IoCP and medicines specialist Gaynor Wooldridge.

The Institute’s Director of Education, Consultant Podiatrist Martin Harvey, commented; “This book will be of inestimable value as an aide memoir for the experienced and essential reading for the student of the foot as well as other healthcare professionals. It is neither patronising to the experienced nor needlessly complex for the newcomer. A genuine Tour de Force”

Written by Helen Rawse

To read this article please click here https://iop-uk.org/wp-content/uploads/2023/07/Bullous-Pephigoid.pdf

Case Notes is a regular feature in the IoCP quarterly publication – Podiatry Review. Every member will have seen unusual patients and/or will have unusual conditions which will be of interest to the readership, colleagues and peers.

Case Notes is an expansion on your own medical notes ensuring you do not identify the patient, unless you have written consent.

We welcome all submissions of your findings to be featured in our Podiatry Review, please contact media@iop-uk.org for more information or to submit your case!

Health Education England, along with the Foot Health Consortium are launching a consultation to seek the views of stakeholders on a draft set of standards for the foot health practitioner and podiatry support workforce.

The consultation will be open from Monday 23 November 2020 – midday Friday 15 February 2021.

The Standards have been developed to support the NHS to effectively use the full skills mix of the foot health workforce to meet demand by providing a clear understanding of the footcare treatments that foot health practitioners and the podiatry support workforce can safely perform. The needs and safety of patients is central in this work.

We would therefore value your feedback about the standards via the consultation and look forward to hearing your comments and suggestions as we take this vital and important next step.

Please visit the HEE consultation webpage for the consultation survey link and two important documents that will help you respond to the consultation.

The Consultation on standards for the non–regulated foot health workforce sets out the background to the work to develop the Standards. It then explains more about how the Standards have been developed and how it is proposed they will be used. The draft Standards on which we are seeking your feedback have been published alongside this consultation document.

Visit the HEE website for the Standards and Consultation document that will accompany the consultation

In 2019, we gathered as a Consortium of Foot Health Leaders to address the problem of the falling recruitment numbers on traditional routes into podiatry. The priority of the Consortium is to develop a foot health career ladder and educational resources that will support and increase the number of podiatrists and podiatry support workers working in the NHS.

The work of the Consortium has enabled a better understanding of the workforce that provides foot care, with the aim of optimising this workforce for the benefit of those who use the services of any practitioner, in England, who work in this arena.

These Foot Health Education and Training Standards are the result of a year’s work to increase the supply of podiatrists in the NHS workforce. We also want to ensure that the NHS recognises the knowledge and skills of the wider foot care support workforce.

The Institute of Chiropodists & Podiatrists has agreed with HMCA to offer discounted rates for medical plans, dental plan, hospital cash plans, travel plan, income protection and vehicle breakdown products.

Are you paying too much for your present private medical plan? Why not take a look at the HMCA plans and compare the benefits and subscriptions offered? You may transfer to HMCA at any age and without a medical examination; there will be no break in protection and there is a 14 day money-back guarantee.

 

HMCA only offer medical plans to membership groups and can offer up to a 40% discount off the underwriter’s standard rates. This is a comprehensive plan which provides generous cash benefits for surgery and other charges

 

Who are HMCA? – HMCA has specialised in providing benefits and services to associations and professional groups since the 1970s. HMCA is authorised and regulated by the Financial Conduct Authority.

For further information and quotations contact HMCA by telephone on 01423 799949 or visit the exclusive HMCA Institute of Chiropodists & Podiatrists website here: https://www.hmca.co.uk/icp

HMCA/S PLC (trading as Hospital and Medical Care Association, HMCA and HMCA Members) is authorised and regulated by the Financial Conduct Authority (FRN:307587). HMCA/s PLC is a company registered in England, company number: 01362094, registered office: Beech Hall, Knaresborough, North Yorkshire, HG5 0EA.

By

Kevin Watts BSc(Hons) RN, BSc(Hons), BSc(Hons), MInstChP, Dip Pod Med.

Member of the Institute of Chiropodists & Podiatrists

Podiatrist & Nurse

 

Background

As practitioners who care for the lower limb and associated structures, we are all responsible to take a full medical history of our patients. An important part of this history concerns us listing and having a basic knowledge of medication. The areas that we need to understand are; drug use, contraindications and possible side-effects.

If a patient is on a certain medication then this can give us an indication of their health and well-being. Different types of medication can indicate different conditions but if the medication strength is increased / decreased, can all provide part of a valuable picture. Many patients are on medication that may impact on our treatment procedures and preparation such as anticoagulants.

The Author has set out to provide a basic template of medication that can allow for quick and easy reference by the practitioner. The list is certainly not exhaustive, but does include many drugs that we may come across whilst in practice. All information has been taken from various sources and if there is any doubt about a medication, then it is very important to investigate it. Medication information sources can be   drug information leaflets, robust pharmaceutical publications such as the British National Formulary (BNF) and suitably qualified medical professionals. Online sites can be used but do so with caution.

 

Thanks to Steph & Louise at the Fane Foot Clinic in Peterborough,

for their valued input and constructive criticism.

BASIC MEDICATION LIST

 

The list does not provide all details about the medication but does provide a basic knowledge. This knowledge can be built on and the list added to as the practitioner identifies new medication. It is important to remember that some side-effects may effect different patients to varying degrees, whilst others may not experience side-effects at all. This document is to be used as a ‘memory jogger’ only, not for formal advice for a patient, not to recommend or to prescribe from. It is aimed as a fun, knowledge building exercise.

 

NAME	DRUGS USE	WARNINGS & PRECAUTIONS	POSSIBLE SIDE EFFECTS
Adacal-D3	Contains vitamin D and calcium for healthy teeth and bones.	Allergic to peanut, soya, vitamin D or calcium carbonate.	Constipation, rash, wheezing, swelling etc. Kyowa Kinn Ltd (2017).
Apixaban	To prevent blood clots from forming in the body.	Hypersensitivity, hepatic disease, abrupt discontinuation, prosthetic heart valve etc.	May cause bleeding and swelling, tiredness due to anaemia, nausea etc. Bristol-Myers (2019).
Allopurinol	Gout, kidney stones, reduces Uric acid build up	Avoid alcohol, people with infections, care= diabetes, heart failure, high BP, Chemotherapy	May impair reactions, driving. Teva UK, (2019).
Amitriptyline	Symptoms of depression.	Patients who have shown prior sensitivity. During acute phial Infarction.	All patients must be monitored for suicide risk. Crescent Pharma Ltd (2019).
Amlodipine (Calcium channel blocker)	Widens blood vessels / improves blood flow. Used for high BP, angina and coronary disease	Patients must be 6yrs+, certain other blood pressure medications especially simvastatins.	Oedema, palpitations, fatigue, flushing (reddening of limbs) wheezing, breathlessness etc. Actavis (2018).
Atenolol (beta-blocker)	To treat angina and hypertension.	Cardiogenic shock, 2nd, 3rd degree heart block.	Cardiac failure, fatigue, Cardiac failure, fatigue, bradycardia, dizziness and cold hands and feet. Crescent Pharma Ltd (2016).
Amiodarone	Antiarrhythmic.	Only used for arrhythmias.	Nausea, vomiting, fatigue, constipation, Accord Healthcare Ltd (2017).
Amoxicillin	Antibiotic for chest infections, pneumonia, urinary tract infections, ear infections.	Allergic reaction, liver / kidney problems etc.	Diarrhoea, may cause nausea and vomiting. Multipharm (2019).
Aspirin	Pain relief, swelling and pain reduction, anti-inflammatory, blood thinner etc.	Generally safe to take 16years+.	Nausea, vomiting, stomach pain, bleeding more difficult to control etc. Aspar Pharmaceuticals Ltd (2018).
Atorvastatin	To lower bad cholesterol & fats such as LDL	Avoid alcohol, high cholesterol foods.	Muscle breakdown, liver function, may increase blood sugars. Pfizer Ltd (2019).
Baclofen	Muscle relaxation and reduces muscle spasms, pain and muscle stiffness.	Chronic kidney disease, disorders of neck and sphincter mechanism etc.	Drowsiness, may affect balance etc. TEVA UK Ltd (2016).
Bisoprolol (beta-blocker)	Hypertension, affects the heart & circulation for better blood flow.	AV block, slow heart rhythm.	Fatigue, shortness of breath, headache, fever, chest pain etc. Sandoz Ltd (2019).
Bendroflumethiazide	A diuretic used to treat high blood pressure. Reduces oedema.	Addison`s disease, hypercalcaemia, hyponatraemia etc.	Dizziness, dry mouth, fatigue, headaches etc. Accord (2020).
Bumetanide	Diuretic which increases urination, to fight oedema.	Low salt diet, kidney problems, first 3 months of pregnancy etc	Dehydration, low BP, high blood sugar levels, muscle cramps, joint pain etc. Teva UK Ltd (2018).
Buscopan	Relieves muscle cramps in the stomach, intestine, bladder etc.	Enlarged bowel, paralytic / obstructive ileus etc.	Dry mouth, increased heart rate, may effect urination etc. Sanofi (2019).
Certirizine Hydrochloride	An antihistamine for hay fever relief	Allergic reaction to product or hydroxine, breastfeeding.	Drowsiness, alcohol / tranquilisers may increase drowsiness. Fannin (UK) (2015).
Co-Amoxiclav	Antibiotic (used in combination) for respiratory tract infection, UTIs, dental, joint & bone infections.	Drug allergy to penicillin, liver / kidney problems etc.	Rash, nausea / vomiting, diarrhoea, thrush etc. Milpharm Ltd (2018).
Codeine (opioid)	Pain medication for mild / moderately severe pain.	Allergic to drug, severe bronchial asthma or hypercarbia	Bloating, chills, blurred visions, dizziness, constipation, tachycardia etc.
Clopidogrel	Prevention of atherosclerotic events in peripheral heart disease.	Active bleeding	Abdominal pain, diarrhoea, gastro-intestinal bleeding etc. Torrent Pharma UK Ltd (2018).
Co-Codomol	Mixture of Paracetamol & Codeine. Treats aches / pain, muscular pain, headaches. Usually taken other drugs do not work.	Codeine and Paracetamol must not be taken together due to excess dosage.	Skin rash, sensitivity, shortness of breath, sedation and dizziness etc. Mercuary Pharma (2018).
Citalopram	Antidepressant.	Poorly controlled epilepsy.	Dry mouth, anxiety, drowsiness, Dry mouth, anxiety, drowsiness nausea, sleep problems etc. Aurobindo Pharma Ltd (2017).
Carvedilol	High blood pressure, heart failure.	Asthma, cardiogenic shock, bradycardia etc.	Nausea, peripheral coldness etc. Milpharm Ltd (2017).
Colchicin	To treat gout. Familial Mediterranean Fever (FMF).	Pregnancy and breast feeding, Avoid grapefruit. Kidney / liver problems.	Allergic reaction, Stomach ache, bloody stools etc. Accord (2019).
Colecalciferol	Vit D to help calcium absorption / low phosphate levels in blood	High calcium levels	Allergic to medication, rash etc. Swiss Caps GmbH (2019).
Deltaparin (injection)	To treat / prevent blood clots from forming.	Severe liver / kidney failure, trauma, with other medication such as aspirin, warfarin etc.	Injection site reaction, haematoma, itching, allergic reactions etc. Pfizar Ltd (2015).
Digoxin	Used to treat heart failure, AF by making the heart beat stronger.	Intermittent heart block, 2nd degree heart block, VF, myocarditis etc	Dizziness, fainting, fast / slow heartbeat, blood in stools etc. Accord (2018).
Diltiazem	Calcium channel blocker for high Blood pressure, angina and certain heart arrhythmias, hyperthyroidism.	Low blood pressure.	Dizziness, weakness, tiredness, nausea, flushing etc. Sanofi (2018).
Diazepam	Muscle relaxant, anxiety and for difficulty sleeping etc.	Allergic reaction, mental illness, severe sleeping problems, alcohol and drug abuse etc.	Drowsiness, confusion, tiredness, nausea, vomiting, etc. TEVA UK Ltd (2019).
Doxazosin	Hypertension, to improve urination in men (benign prostate hyperplasia)	Micturition syncope, postural hypotension, overflow bladder, anuria.	Chest pain, arrhythmias, hypotension, nausea, muscle complaints etc.
Dexamethasone	Corticosteroid medication for rheumatic problems, skin diseases, asthma, allergies, chronic obstructive lung disease etc.	Avoid live virus vaccines	Blurred vision, rapid weight gain, mood changes, and acne, dry and thinning skin etc. Trotwood Pharma Ltd (2017).
Edoxaban	Inhibitor of activated factor X thus preventing prothrombin being converted to thrombin which prolongs clotting time.	Active bleeding, gastro-intestinal ulceration, high risk of bleeding etc.	Anaemia, haemorrhage, nausea, skin reactions etc. Daiichi Sankyo UK Ltd (2019).
Eplenerone	Aldosterone blocking agent. Aldosterone produced by the body to control blood pressure and heart function. Used for heart failure etc.	Kidney / liver disease, medication containing lithium, tacrolimus or cyclosporin for skin conditions.	Nausea, vomiting, itching, back pain, Dehydration, sore throat etc. Accord Healthcare (2019).
Ferrous Sulfate	Helps to treat and prevent Iron deficiency.	Sickle cell anaemia, stomach ulcer etc.	Nausea, vomiting, diarrhoea, wheezing etc. Actavis (2019).
Ferrous Fumarate	To increase iron levels to maintain red blood cell production. To prevent iron deficiency anaemia.	Stomach / duodenal ulcer, inflammatory bowel conditions, ulcerated colitis etc.	Heartburn, nausea, vomiting, Darker stools, diarrhoea / constipation etc. Mercury Pharmaceuticals Ltd (2015).
Folic Acid	Type B Vitamin which helps the body to make new cells and helps to prevent changes to DNA that may lead to cancer. Used to treat certain types of anaemia.	May need tests to satisfy Folic Acid use if you have Kidney disease, infection, pernicious anaemia (B12 deficiency) and alcoholism.	Appetite loss, nausea, bloating, bad taste in mouth, sleep disturbance, depression etc. Crescent Pharma Ltd (2018).
Finasteride	To treat urinary problems concerned with enlarged prostate.	Allergic to medication and not for use by females.	Chills, cold sweats, confusion, dizziness, light-headedness when standing. Cipla (EU) Ltd (2018).
Flucloxacillin	To treat skin and soft tissue infections. Respiratory tract infections etc.	Contraindications to other meds, penicillin allergy.	Rash, itchy skin, purpura (black heads on the skin) etc. Milpharm Ltd (2017).
Furosemide	Oedema.	Dehydration, hypovolaemia, renal failure, liver cirrhosis, may effect blood pressure.	Gout, dermatitis, electrolyte disturbances, bone marrow depression, tinnitus / hearing loss, hypersensitivity etc. Crescent Pharma Ltd (2016).
Gabapentin	For nerve pain and epilepsy.	Drug allergy, pain drug dependency.	Sleepy, dizziness etc. Brown and Burk UK Ltd (2017).
Gliclazide	Treats type2 diabetes, lowers blood sugar through increasing insulin production.	Drug allergy, ketoacidosis, breast feeding, need to stop pre-surgery.	Hypoglycaemia, lethargy, dizziness, headaches etc. Milpharm Ltd (2017).
Isosorbide Mononitrate	Prevents angina / chest pain in coronary heart disease patients, nitrates widen blood vessels.	Aortic stenosis, cardiac tamponade, cardiomyopathy, anaemia etc.	Arrhythmias, flushing, headaches, nausea, vomiting, drowsiness, hypotension. Relochem Ltd (2016).
Haloperidol	Antipsychotic for schizophrenia. Normally taken at night.	Dementia, Parkinson`s, central nervous conditions.	May feel drowsy or less alert. Crescent Pharma Ltd (2019).
Lansoprazole	Reduces stomach acid, heart burn, indigestion etc.	Liver problems, allergic reaction to other meds, pregnancy & breast feeding.	Headache, diarrhoea, stomach pain etc. PLIVA Pharma Ltd (2017).
Lisinopril (Ace inhibitor).	Used to treat hypertension and increase survival after a heart attack.	Drug sensitivity.	Dizziness, hypotension, increased blood urea. Headaches etc. Actavis (2017).
Levothyroxine	Helps to support / replace hormone secreted by the thyroid.	Thyrotoxicosis,	Increased pulse, increased BP, fever, fainting, difficulty / laboured breathing etc. Actavis (2018).
Lorazopam	For anxiety & sleep related problems.	Chest / breathing problems, liver & kidney problems etc.	Sleepiness, drowsiness etc. Genethics Europe Ltd (2018).
Loratadine	Treats hay fever, conjunctivitis, eczema, hives, food allergies etc.	Severe liver failure, known allergy etc.	Headaches, feeling tired / drowsy, nausea etc. Teva Uk Ltd (2016).
Losartan	High blood pressure and heart failure, to protect kidneys if you have kidney disease and diabetes.	Allergic reaction, low blood pressure.	Anaemia, hypoglycaemia, postural disorders, vomiting and nausea etc. APL Swift Services Ltd (2018).
Mebeverine	Relief of IBS, is anti-spasmodic and relaxes muscles around the gut.	Paralytic ileus.	Rashes but rare. Mylan Products Ltd (2016).
Metformin	For treating Type 2 diabetes, lowers blood sugars, improves how the body uses insulin.	Hypersensitivity, chronic heart failure, Severe renal disease.	Nausea, loss of appetite, metallic taste in mouth, diarrhoea etc. Consilient Health ltd (2010).
Nicorandil	Used to prevent and treat Angina chest pain. Increases blood flow to the heart.	Hypotension, heart failure, kidney problems, pulmonary oedema etc.	Headaches, weak / dizziness, nausea, hypotension etc. Dexcel Pharma Ltd (2016).
Nitrofurantoin	Antibiotic for UTIs and kidney infections	Diabetes, kidney disease, anaemia & vitamin B deficiency	Nausea, headaches, appetite loss, etc. Mercury Pharmaceuticals Ltd (2019).
Odansetron	Sleeping tablet to treat insomnia.	Allergic reaction, liver or kidney problems, myasthenia (muscle weakness) etc.	Headaches, fatigue, dizziness, constipation etc. Cadila Pharmaceuticals Ltd (2019).
Omeprozole	Acid reduction in stomach, for indigestion, heart burn, acid reflux.	Medication allergy.	Nausea, constipation, stomach pain etc. AstraZenecar Ltd (2017).
Paracetamol	Treats pain & fever / pyrexia	Known allergy, Patients-50kg – 500mg. Above 50kg can take 1g. Do not exceed daily dose.	Nausea, vomiting and constipation. Galpharm Healthcare Ltd (2019).
Prednisolone	A corticosteroid – for allergies, skin infections / disorders, blood disorders.	Infections, breast feeding, pregnancy,	Stomach issues, insomnia, increased restlessness etc. Co-pharma (2017).
Prozac	Restores chemical imbalance in the brain to reduce depression, anxiety or OCD.	Drug allergy, suicidal thoughts must be closely monitored may need medication review.	Fidgety, restlessness, anxiety, diarrhoea, headaches, irregular heart rate etc. Accord (2019).
Pregabalin	For nerve pain, epilepsy, anxiety.	Medicine addiction, allergic reaction, pregnant, breast feeding, poor kidney function etc.	Headaches, sleepiness, diarrhoea, increased appetite. Generics (UK) Ltd (2018).
Quinine Sulphate	Nocturnal leg cramps & Malaria.	Optic neuritis, tinnitus, Haemoglobinuria.	Abdominal pain, hearing loss, skin reactions etc. Wockhardt UK Ltd (2018).
Rivaroxaban	For treating / preventing blood clots in certain patients with AF. Initial treatment of DVT, pulmonary embolism.	Drug allergy, kidney problems caused by liver disease, liver problems, brain surgery, TIA etc.	Mild bleeding, allergic reaction, black / tarry stools, shortness of breath, headaches, chest pain, fatigue etc. Bayer AG (2019).
Rivastigmine	Improves function of nerve cells to the brain. Used to treat dementia.	Known allergy, comes as a tablet or patch. If allergic to patch must not take oral.	Nausea, vomiting, dizziness, headaches, abdominal pain, depression. Rosemount Pharmaceuticals Ltd (2019).
Ranolozine	Chronic angina (chest pain), improves blood flow to the heart.	Medication allergy, hypotension etc.	Constipation, dizziness, nausea, light headedness etc. Menarini International (2017).
Ramipril	Used to treat high blood pressure and heart failure. Often prescribed following a heart attack. Helps to prevent strokes / heart attacks and kidney problems.	Medication allergy, hypotension etc. Pregnant, can cause low blood sugars so diabetics need to regularly check BMs.	Dry irritating cough, dizziness, light headedness, hypotension etc. Crescent Pharma (2018).
Simvastatin	To lower cholesterol I you have been diagnosed with high blood pressure. Prevents heart disease and strokes.	Drug allergy, do not take with grapefruit, Pregnancy.	Very few side-effects. Hypersensitivity. Crescent Pharma (2018).
Spirolactone	Fluid retention, oedema in heart failure, Reduces salt absorption & maintains potassium levels.	Drug allergy, hypotension etc.	Irregular heartbeat, dizziness, constipation, headaches, nausea etc. Accord (2020).
Stemitil	Corrects chemical imbalances in the brain which in turn helps to prevent nausea and vomiting.	Adrenal tumour, dementia patients as can increase stroke risk, breast feeding as can be passed on to the infant etc.	Low bp, dizziness, drowsiness, dry mouth, skin rashes, shaking / twitching etc. Sanofi (2015).
Tamsulosin	Reduces tension in the smooth muscle of the prostate & urethra, allowing	Severe liver function, hypersensitivity, postural hypotension etc.	Constipation, nausea, rash, weakness, vomiting etc. Actavis (2017).
Trajenta (Linagliptin)	To treat Type 2 diabetes mellitus	Medication allergy, pancreatic problems.	Headaches, nausea, joint pain, back pain etc. Boehinger Ingelheim (2019).
Tramadol	Treats moderate to severe pain.	Allergic reaction, suffer with seizures, kidney / liver problems etc.	Unpleasant withdrawal symptoms, tiredness, drowsiness etc. Milpharm Ltd (2018).
Warfarin	Anticoagulant: used to treat blood clots and DVTs, pulmonary embolism and stroke prevention in those with AF.	High INR, pregnancy, high blood pressure.	Heavier bleeding, joint pain & swelling, red / brown coloured urine, black / bloody stool. Sun Pharmaceutical (2019).
Zopiclone	Sleeping tablet to treat insomnia.	Allergic reaction, liver and kidney problems, myasthenia gravis (muscle weakness) etc.	Metallic taste in the mouth, dry mouth, daytime sleepiness. Merkle GmbH, Graf-Arco Strase (2018).

 

References.

Accord Healthcare Ltd, (2017) Amiodarone 100mg Tablets, Amiodarone 200mg Tablets (Amiodarone Hydrochloride) [Leaflet]. North Harrow: Accord Healthcare Ltd.

Accord Healthcare Ltd, (2019) Colchicine Tiofarma 500 mcg Tablets [Leaflet]. North Harrow: Accord Heathcare Ltd.

Accord Healthcare Ltd, (2019) Eplenerone 25mg film-coated tablets, Eplenerone 50mg film-coated tablets [Leaflet]. North Harrow: Accord Healthcare Ltd.

Accord, (2020) Bendroflumethiazide 2.5mg and 5mg Tablets [Leaflet]. Barnstable: Accord.

Accord, (2018) Digoxin 62.5 mcgs, 125 mcgs and 250 mcgs tablets [Leaflet]. Barnstable: Accord.

Accord, (2019) Prozac Fluoxatine 20mg Capsules (Fluoxatine Hydrochloride) [Leaflet]. Barnstable: Accord.

Accord, (2020) Spirolactone 25mg, 50mg and 100mg tablets [Leaflet]. Barnstaple: Accord.

Actavis, (2018) Amlodipine 5mg and 10mg tablets Amlodipine mesilate monohydrate [Leaflet]. Barnstaple: Actavis.

Actavis, (2019) Ferrous Sulfate 200mg tablets [Leaflet]. Barnstaple: Actavis.

Actavis, (2018) Levothyroxine 50 micrograms and 100 micrograms tablets [Leaflet]. Barnstable: Actavis.

Actavis, (2017) Lisinopril 2.5mg, 5mg, 10mg and 20mg tablets [2017]. Barnstaple: Actavis.

Actavis, (2017) Pamsvax XL 400 micrograms Capsules tamsulosin hydrochloride [Leaflet]. Hafnarfjour: Actavis.

APL Swift Services (Malta) Ltd, (2018) Losartan potassium 25mg film-coated tablets [Leaflet]. Birzobuggia: APL Swift Services (Malta) Ltd.

Aspar Pharmaceuticals Ltd, (2018) Aspirin Tablets 300mg [Leaflet]. London: Aspar Pharmaceuticals Ltd.

AstraZeneca UK Ltd, (2017) Losec MUPS 10mg gastrointestinal tablets / 20mg gastrointestinal tablets / 40mg gastrointestinal tablets omeprazole [Leaflet]. Luton: AstraZeneca Ltd.

Aurobindo Pharma Ltd, (2017) Citalopram 10mg film-coated tablets Citalopram 20mg, Citalopram 40mg [Leaflet]. South Ruislip: Aurobindo Pharma Ltd.

Aurobindo Pharma Ltd, (2020) Naproxen Tablets BP 250 mg Naproxen Tablets 500 BP mg [Leaflet]. South Ruislip: Aurobindo Pharma Ltd.

Bayer AG, (2019) Xeralto 10mg film-coated tablets rivaroxaban [Leaflet]. Leverkusan: Bayer AG.

Boehringer Ingelheim International GmbH, (2019) Trajenta 5mg film-coated tablets Linagliptin [Leaflet]. Rhein: Boehinger Ingelheim International GmbH.

Bristol Laboratories Ltd, (2018) Doxazosin 1mg, 2mg and 4mg [Leaflet]. Berkhampsted: Bristol Laboratories Ltd.

Bristol-Myers, (2019) Eliquis 2.5mg film coated tablets apixaban [Leaflet]. Dublin: Bristol-Myers Squibb/Pfizer EEIG.

Brown and Burk UK, (2017) Gabapentin Brown and Burk 100mg Capsules [Leaflet]. Middlesex: Brown and Burk Ltd.

Cadila Pharmaceuticals (Europe) Ltd, (2019) Odansetron 4mg and 8mg Tablets [Leaflet]. Harrow: Cadila Pharmaceuticals (Europe) Ltd.

Cipla (EU) Ltd, (2018) Finasteride 5mg film coated tablets [Leaflet]. Surry: Cipla (EU) Ltd.

Co-pharma, (2019) Predisolone Tablets BP 1mg and 5mg [Leaflet]. Watford: Co-pharma.

Consilient Health Ltd, (2010) Glucient SR 500mg prolonged-release tablets metformin hydrochloride [Leaflet]. Dublin: Consilient Health Ltd.

Crescent Pharma Ltd, (2019) Amitriptyline Tablets 25mg [Leaflet]. Overton: Crescent Pharma Ltd.

Crescent Pharma Ltd, (2016) Atenolol Tablets 25mg, 50mg, and 100mg [Leaflet]. Overton: Crescent Pharma Ltd.

Crescent Pharma Ltd, (2016) Furosemide Tablets 20mg and 40mg [Leaflet]. Overton: Crescent Pharma Ltd.

Crescent Pharma Ltd, (2018) Folic Acid 5mg Tablets [Leaflet]. Overton: Crescent Pharma Ltd.

Crescent Pharma Ltd, (2019) Haloperidol Tablets 0.5mg, 1.5mg. 5mg, 10mg, and 20mg [Leaflet]. Overton: Crescent Pharma Ltd.

Crescent Pharma Ltd, (2018) Ramipril 1.25mg, 2.5 mg.5mg.and 10 mg [Leaflet]. Overton: Crescent Pharma Ltd.

Crescent Pharma Ltd, (2018) Simvastatin 10mg, 20mg & 40mg [Leaflet]. Overton: Crescent Pharma Ltd.

Daiichi Sankyo UK Ltd, (2019) Lixiana 15mg, Lixiana 30mg, Lixiana 60mg film coated tablets [Leaflet]. Plaffenhofen: Daiichi Sankyo Europe GmbH.

Dexcel Pharma Ltd, (2016) Nicorandil 10mg Tablets & Nicorandil 20mg [Leaflet]. Daventry: Dexcel Pharma Ltd.

Dexcel Pharma Ltd, (2019) Risperidone 0.5mg, 1mg, 2mg, 3mg, 4mg, 6mg Film-coated [Leaflet]. Daventry: Dexcel Pharma Ltd.

Fannin (UK) Ltd, (2020) Cetirizine Hydrochloride 5mg Tablets [Leaflet]. Wellingborough: Faninn (UK) Ltd.

Galpharm Healthcare Ltd, (2019) Paracetamol 500mg Tablets [Leaflet]. Braunton: Galpharm Healthcare Ltd.

Generics UK Ltd, (2018) Alendronic Acid 70mg Tablets sodium alendronate [Leaflet]. Potters Bar: Generics UK Ltd.

Generics UK Ltd, (2018) Pregabalin Mylan 25mg hard capsules [Leaflet]. Potters Bar: Generics UK Ltd.

Genethics Europe Ltd, (2018) Lorazepam 1mg and 2.5mg Tablets [Leaflet]. Nicosia: Genethics Europe Ltd.

Kyowa Kinn Ltd, (2017) Adacal –D3 Chewable Tablets Calcium carbonate (1500) and vitamin D3 (400I.U) [Leaflet}. Kyowa Kinn Ltd.

Menarini International, (2016) Renexa 375mg prolonged release, 500 prolonged release, 750 prolonged release Ranolazine [Leaflet]. Luxambourg: Menarini International.

Merkle GmbH,Ludwig-Merkle-Strasse, (2018) Zopliclone 3.75 mg, 7.5mg Tablets [Leaflet]. Blaubaran: Merkle GmbH.Ludwig-Merkle-Strasse.

Mercury Pharmaceuticals Ltd, (2015) Ferrous Fumarate 210mg Tablets [Leaflet]. London: Mercury Pharmaceuticals Ltd.

Mercury Pharmaceuticals Ltd, (2019) Macrobid 100mg Prolonged-release Capsules Nitrofurantoin [Leaflet]. London: Mercury Pharmaceuticals Ltd.

Mercury Pharmaceuticals Ltd, (2018) Zapain 30mg, 500mg Tablets Codeine Phosphate / Paracetamol [Leaflet]. London: Mercury Pharmaceuticals Ltd.

Milpharm Ltd, (2019) Amoxicillin 250mg Capsules and Amoxicillin 500mg Capsules (Amoxicillin) [Leaflet]. South Ruislip:

Milpharm Ltd, (2017) Carvedilol 3.125mg, Carvedilol 6.25mg, Carvedilol 12.5mg, Carvedilol 25mg film-coated [Leaflet]. South Ruislip: Milpharm Ltd.Ltd.

Milpharm Ltd, (2018) Co-amoxiclav 500mg/125mg film-coated tablets (Amoxicillin / Clavulanic acid) [Leaflet]. South Ruislip: Milpharm Ltd.

Milpharm Ltd, (2017) Gliclazide 80mg Tablets (gliclazide) [Leaflet]. South Ruislip: Milpharm Ltd.

Milpharm Ltd, (2017) Flucloxacilllin 250mg Capsules BP, Flucloxacillin 500mg Tablets [Leaflet]. South Ruislip: Milpharm Ltd.

Milpharm Ltd, (2018) Tramadol 50mg capsules Tramadol hydrochloride [Leaflet]. South Ruislip: Milpharm Ltd.

Mylan Products Ltd, (2016) Colofac Tablets 135mg Mebeverine hydrochloride [Leaflet]. Potters Bar: Mylan Products Ltd.

Noumed Life Sciences Ltd, (2018) Ranitidine 150mg Tablets, Ranitidine 300mg Tablets (ranitidine hydrochloride) [Leaflet]. Maidenhead: Noumaed Life Sciences Ltd.

Pfizer Ltd, (2015) Deltaparin Fragmin 10,000 IU/0.4 ml, 12,500 IU/0.5ml [Leaflet]. Kent: Pfizer Ltd.

Pfizer Ltd, (2019) Atorvastatin 10mg, 20mg, 40mg & 80mg film-coated tablets [Leaflet]. Kent: Pfizer Ltd.

PLIVA Pharma Ltd, (2017) Lansoprazole 15mg gastro-resistant tablets, Lansoprazole 30mg gastro-resistant tablets [Leaflet]. Castleford: PLIVA Pharma Ltd.

Relonchem Ltd, (2016) Relosorb XL 60mg Tablets Isosorbide 5-momnitrate [Leaflet]. Widnes: Relonchem Ltd.

Rosemont Pharmaceuticals Ltd, (2019)  Rivastigmine Rosemont 2mg/mL Oral Solution [Leaflet]. Leeds: Rosemont Pharmaceuticals Ltd.

Sandoz Ltd, (2019) Bisoprolol Fumarate 1.25mg, 2.5mg, 3.75mg and 7.5mg Film coated Tablets [Leaflet]. Camberley: Sandoz Ltd.

Sanofi, (2019) Buscopan 10mg tablets (hyoscine butylbromide) [Leaflet]. Guildford: Sanofi.

Sanofi, (2018) Tildiem 60mg Modified-Release Tablets Diltiazem hydrochloride [Leaflet]. Guildford: Sanofi.

Sanofi, (2015) Stemetil 5mg Tablets prochlorperazine maleate [Leaflet]. Guildford: Sanofi.

Swiss Caps GmbH, (2019) Fultium-D3 800 IU Capsules (Coleraciferol) [Leaflet]. Huddersfield: Internis Pharmaceuticals Ltd.

Sun Pharmaceuticals Ltd, (2019) Warfarin 0.5,1,3 and 5mg Tablets (Warfarin Sodium) [Leaflet]. Hoofddorp: Sun Pharmaceuticals Ltd.

TEVA UK Ltd, (2019) Allopurinol 100 and 300mg tablets [Leaflet]. Eastbourne: TEVA UK Ltd.

TEVA UK Ltd, (2016) Baclofen 10mg Tablets [Leaflet]. Eastbourne: TEVA UK Ltd.

TEVA UK Ltd, (2018) Bumetanide 1mg and 5mg Tablets [Leaflet]. Eastbourne: TEVA UK Ltd.

TEVA UL Ltd, (2019) Diazepam 2mg, 5mg, and 10mg Tablets [Leaflet]. Eastbourne: TEVA UK Ltd.

TEVA UK Ltd, (2016) Loratadine 10 mg Tablets [Leaflet]. Eastbourne: TEVA UK Ltd.

Trotwood Pharma Ltd, (2017) Dexamethasone 500mcg Dexamethasone 2mg Tablets [Leaflet]. Odiham: Trotwood Pharma Ltd.

Wockhardt UK Ltd, (2020) Codeine Phosphate 15mg and 30mg Tablets [Leaflet]. Wrexham: Wockhardt Uk Ltd.

Wockhardt UK Ltd, (2018) Quinine Sulfate 300mg Coated Tablets [Leaflet]. Wrexham: Wockhardt UK Ltd.

Dear members,

We have sourced some protective visors for your use. The visors are being printed by students in Hertfordshire using 3D printers. The students are creating the visors for frontline staff who cannot obtain, afford and/or access PPE.

The Institute of Chiropodists and Podiatrists, as well as The College of Foot Health, are proud to support the students efforts by covering costs of materials. Please note the visors available via The Institute are being sold on at cost price and no profit is being made by either us or the students involved.

Alternative visors and PPE equipment is available via our trusted trade partners as set out in May newsletter.

If you would like to order a pack of 10 visors, cost £10 per pack, and help support the students efforts please email info@iop-uk.org

Stay Safe.

The Institute of Chiropodists and Podiatrists Position Statement

 

 Since the lockdown began, Chiropody and Podiatry services have been exempt from premises closure and it may be reasonable to assume that exemption holds for domiciliary treatments as well. We have attempted to help members with our suggested ‘traffic light’ system of stop, proceed with caution and go, whilst advising that all specific laws concerning COVID-19 should be rigidly adhered to. We have also advised members of the College of Foot Health to adhere to these standards as well. The Prime Minister’s announcement, asking people where possible to return to work, does not appear to materially change the caution that we advise members to exercise, as they will naturally be treating patients within a closer proximity than social distancing stipulates. We still regard it as essential that you have the PPE documented by Gov.uk regarding: ‘COVID-19: how to work safely in domiciliary care in England‘ and also ‘Guidance on the use of personal protective equipment (PPE) for non-aerosol generating procedures (APGs)‘ as well as ‘COVID-19: personal protective equipment use for aerosol generating procedures‘  Please note that we are unable to confirm that any form of drilling, be that unfiltered, vacuum or spray is NOT an ‘aerosol generating procedure’ due to variations in drills, their technology and patients personal hygiene and other  situation-specific variable factors. Note the dictionary definition: “An aerosol (abbreviation of “aero-solution”) is a suspension of fine solid particles or liquid droplets in air or another gas. Aerosols can be natural or anthropogenic. Examples of natural aerosols are fog, mist, dust, forest exudates and geyser steam”

In short, please follow the newly revised official dictum of “Stay Alert. Control The Virus. Save Lives”

 

28th April 2020

Dear Colleagues,

As we enter another week in this strange world in which a sub-microscopic bundle of RNA has hijacked Humanity, there are at least some green shoots on the horizon in respect of falling infection indicators.

 

The most commonly asked question from practitioner colleagues is “When should I return to work?” and that question encompasses several issues. First, naturally, is a question in return – “are you fit to return to work?”. You need to ensure above all else that you do not become a vector of infection yourself. The recently announced extension of testing, which as you know the Institute has been lobbying for since day 1, helps in that respect because you are eligible as a ‘key worker’. Then, “can you safely return to work, do you have the correct PPE?”. For that, some colleagues have stocks of PPE as routine, but if you do not the PPE market currently has been likened to ‘the wild west’ and ‘the international arms market’ – with justification because some of the dealers we have come across have inflated prices some 10 TIMES for masks for example.

 

Additionally, some colleagues have worried about their indemnity insurance cover – “is it still valid?” for example, which I am happy to report it is, provided you adhere to the IOCP ‘Traffic Light’ guide we have agreed with insurers, see our website www.iop-uk.org. Then other colleagues have asked whether it is mandatory for them to undergo testing before recommencing work, if they do not fall into the current required category for testing of ‘symptomatic or in contact with symptomatic individuals’ – in respect of this I have kept in close contact with our statutory regulating body the HCPC and their Chief Executive, John Barwick’s, most helpful letter of today’s date to me forms the specific answer to that. The letter is copied in to the end of this document.

 

I hope that the above answers a few of the commonest queries, and on a lighter note I must say how much myself and a couple of other Directors of the IOCP; Bev Wright and Caroline McCartney are enjoying the webinars we are collaborating on providing – see our website and Facebook about our wed-inars and fri-inars (on Wednesdays and Fridays if you have not guessed) . Good CPD, but for all that not too serious or pompous we trust (as if we would! Since the Institute was founded in 1938 I hope we have always kept in mind that the word “Pomposity” DOES NOT equal “Professional”).

 

Anyway, I will close by wishing you all the absolute best, stay safe and well and warmest regards. Martin Harvey.

 

Letter from Mr John Barwick, Chief Executive and Registrar HCPC:

 

Dear Martin

Thank you for your emails regarding the Government’s recent announcements concerning the extension of testing for key workers, and for sharing IOCP’s ‘traffic light’ guidance.

In response to your question whether testing will be a mandatory requirement for registered professionals, there is no mandatory requirement however we would expect any decision taken by a registrant to decide whether or not to seek a test to be taken in the context of standards 6.1 – 6.3 of the Standards of Conduct, performance and ethics. Guidance and advice is provided to registrants via our Covid-19 hub  https://www.hcpc-uk.org/covid-19/advice/applying-our-standards/managing-risk/

 As you note, the current testing only relates to antigen testing to determine whether you have the virus following presentation of symptoms rather than the antibody tests to determine whether you had the virus. Regarding the later, unfortunately I don’t have any further information regarding the government’s plans other than that is already in the public domain. We will however continue to update the Frequently Asked Questions section on our website to reflect questions regarding testing as the situation develops.

I hope this is helpful.

Kind regards

John Barwick

Chief Executive and Registrar

Now in its second year, The College of Foot Health Ltd, was established and fully accredited by the UK professional organisation The Institute of Chiropodists and Podiatrists to clearly announce and support the professional status of Foot Health Practitioners.

In more recent months our team have been working with Health Education England (HEE) on the Foot Health Consortium, established to set an agreed benchmark for training, standards, ethics and continuing professional development within the profession.

As a result of this and with the continuing growth and requirement for Foot Health Practitioners within our society/community, we are delighted to launch our dedicated social media pages specifically for Foot Health Practitioners. You can follow us now via twitter @TheCoFH and like our page @TheCoFH on Facebook, where we will be sharing all FHP related articles from our dedicated newsletter, information on CPD training, events and details on our online course to become an FHP.

Whilst the Coronavirus pandemic has changed the ways  in which we are all working, or not in many cases, people around the world are embracing and testing boundaries of modern technology. This is also true of our team at Head Office. As always the IOCP are committed to maintaining and offering our members the best possible service and support until such a time that we can start to go back to normal.

Therefore we have launched weekly Wednesday webinars, aptly dubbed “Wed-inars” to keep members and fellow podiatry colleagues in-touch and earning CPD during our period of downtime. It’s FREE, it’s for YOU!

Our first webinar was held on the 1st April and was warmly received by all attendees. If you missed it, a recording of the meeting can be found via our events pages or via our social sites.

The subjects are added to our events calendar on our website. You can register either via our Facebook page or by emailing info@iop-uk.org with the subject line “Wed-inar CPD”.

From the 17th April, we will be introducing FHP Fridays for our Foot Health Practitioner friends of The College of Foot Health. More details of these will be released shortly.

If you are a Podiatrist or a FHP and would like a specific topic covered please get in touch and we’ll see what we can do!

Stay Safe.