A balanced mix of categories is essential. We have different categories with the following ranges:

• 3.1. AYURVEDIC MEDICINES (See Below)
• 3.2. HERBAL MEDICINES ( See Below )
• 3.3. HOMEOPATHIC REMEDIES ( See Below )
• 3.4. DIAGNOSTICS ( See Below )

3.1. AYURVEDIC MEDICINES                                                                                 -------------------------------------------

In developing and producing content a number of specialist have reviewed the following information.

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Ayurvedic medicines were developed many years ago and documented in the languages of that era, leaving a disconnect with standardisation protocols. However, since the benefits are known, one just needs to work backwards and build the data.

As Ayurveda is getting  wider acceptance in India and abroad, Ayurveda Pharmocopoeia Committee constitued by Government of India has so far laid down quality standards for 418 single Ayurveda medicines in five volumes of Pharmocopea of India. Further, Ayurveda formulary of India has been published in two volumes laying down standards for 636 compound Ayurveda formulations. The work of laying formulations is a continuing process.

Ideal time for Ayurvedic treatment...monsoons..the season of rainbows and raindrops..the season when the true beauty of India comes alive...and the season uncovers a host of exotic holiday destinations in India. For half the year, form June to November, ther are copious amounts of rain. Traditional Ayurvedic texts bill Monsoon as the best season for Ayurvedic rejuvenating therapies. During Monsoon, the atmosphere is cool and dust free. Body will absorb the herbal oils and medications better during this season since the body pores will be open.

Ayurvedic procedures require proper guidance from a highly trained and skillful Ayurvedic practitioner. The details given here are for information purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek professional advice from a qualified Ayurvedic physician.

3.2. HERBAL MEDICINES
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In compiling this listing, we have contacted company members of the British Herbal Medicines Association (BHMA) who make licensed herbal medicines. The monographs of their products have been placed into 15 categories. We have chosen only to include licensed medicines because they have all been reviewed by the Medicines and healthcare products Regulatory Agency and meet its criteria for quality, safety, efficacy and manufacturing practice.
Herbal medicines, or phytotherapy, involves the use of parts of the plant - such as the leaf, root, bark, seed, flowers - or sometimes the whole plant. Chemically pure substances used in allopathic medicines which have been derived from plants rarely have therapeutic effects identical to those of the plant material from which they were obtained. In herbal medicines the overall therapeutic action depends on the combination of many natural constituents present in the plant. A few key constituents, possibly unidentified, may contribute most of the activity but their effect can be modified and diffused by the others.
The therapeutic effects of each plant are documented by the BHMA in the British Herbal Pharmacopoeia and the British Herbal Compendium. A close examination of the following categories will show that many of the remedies contain common ingredients.
Clivers, buchu, and uva ursi are used for their diuretic effects, while remedies for colds and coughs tend to contain garlic, echinacea and expectorants such as squill, lobelia or senega. Slimmers will find the products they are recommended contain bladderwrack (Fucus) or boldo, and those suffering from stress or having difficulty sleeping will be soothed by valerian, hops and passiflora.
Slippery elm is a well known indigestion remedy, while constipation is relieved with senna, aloes, cascara and frangula. Rheumatic aches and pains may be eased with celery seed and guaiacum resin, tiredness reduced by kola nut and damiana, and for the skin, arnica, calendula, burdock root and blue flag have useful healing properties.
Herbal medicines are prepared from dried plant materials or various extracts of them, and in some cases from the fresh plant. generally they are gentle in action and side-effects are rare. That is not to say they are completely safe in all circumstances; cautions are often stated on the labels and there are documented reports of interactions between prescribed medicines and herbal remedies bought over the counter. Many, but not all, herbal medicines may take time to achieve their full effect and customers should be advised to take their medicines for four to eight weeks. However, certain remedies, such as those for constipation can have an effect within a few hours. Patients should be counselled appropriately.
In March 2000, the then Medicines Control Agency issued a statement on St. John's Wort and its interactions with other medicines, on the advice of the committee on safety of medicines. As a result, the Department of Health is advising the public to seek advice from pharmacists or doctors if taking products containing St. John's Wort along with other medicines.
Medicines which the CSM has advised may interact with St John's Wort are : warfarin; digoxin; anti-convulsants(carbemazepine, phenobarbitone, phenytoin);theophylline;selective serotonin re-uptake inhibitors (SSRIs) (citalopram, fluoxetine, fluvoxamime paroxetine, sertraline); triptans (sumatriptan, naratriptan, rizatriptan, zolmitriptan); cyclosporin; HIV treatments (indinavir, nelfinavir, ritonavir, saquinavir, efavirenz, nevirapine); and oral contraceptives. Patients may be directed to NHS Direct for further information.

Relaxed days and nights....
More and more people lead such hectic lifestyles that they are aware of stress having a negative effect on them at home or at work. Or they may find that at the end of the day they are too wound up to go off to sleep easily - or even both.
Sleep seems to be affected by various influences and contols - by sleep and wake centres deep in the brain, by biological clocks, and by conditional behaviour - so it is not surprising that it can escape voluntary control.
It is estimated that up to a third of all adults experience insomnia, at least occassionally. Probably only a small percentage of these seek professional help, as many people are aware that few doctors are happy about precsribing sleeping tablets, because of a much greater understanding of the potential for developing tolerance to and dependence on such products. If people do use precsription sleeping tablets, there may also be a problem with the 'hangover effect' or drowsiness the following morning.
Stress has a positive part to play in life as long as it is in proportion to what is happening. The 'fight or flight' adrenaline rush associated with an acute episode of stress helps us to deal with it, and then sttle down againg. But if the effects of the adrenal gland response become chronic and produce chronic symptoms, then this is not so useful. Chronic stress can affect many different body systems, including blood pressure, the gastro-intestinal system, the immune system and the reproductive system.
For many years people have used traditional herbal products as part of a holistic approach to helping the body maintain a comfortable rhythm and balance. this may range from massaging or inhaling essential herbal oils, to drinking camomile tea made from dried blossoms, to taking herbs in tablet or capsule format.
Often when people come to ask a pharmacist for advice on insomnia they will already have tried the standard approaches of reducing caffeine intake, avoiding too much alcohol or nicotine in the evening, and making sure they exercise earlier in the evening rather than later. other routines like a warm bath, a quiet period reading, and a milky drink to boost the intake of trytophan (precurser of the central nervous system neurotransmitter seretonin) may help someone to wind down enough to fall asleep comfortably. we are often advised to keep the bedroom as a place of sleep, and not somewhere to watch TV or have a work desk. Darkness at bedtime is also important to allow our natural biological clocks to kick in.
It is worth mentioning these things, however, in case someone with insomnia problems has not considered these sleep hygeine recommendations.
Use of essential plant oils at bedtime is becoming increasingly popular. These can be added to a relaxing bath, vapourised in an oil burner to spread through a room, or a drop or two placed ona handkerchief under a pillow or on bed linen, (taking care this is not in contact with the skin or too near the face.) Essential oil of lavender is a favourite to use in this way. other oils which may lend themselves to use in a massage or bath include geranium, rose, and neroli.
the herbal products available are intended for fairly short-term use to help re-established disturbed sleep patterns, or to help keep calm and relaxed amidst today's hectic lifestyles. the majority of these products are lifestyles. The majority of these products are licensed as traditional herbal remedies, which makes it easier for both pharmacist and consumer to understand their uses, as the product packaging can show medicinal claims and indicate for whom the product is suitable.
Favourite herbs for use at night include lemon balm, wild lettuce, lime tree flowers, Californian poppy, skullcap, Jamaican gogwood, hops, valerian and camomile. there has been a fair amount of research into some of these herbs, including hops and valerian in particular. When investigating how herbal remedies may work, it can be difficult to pinpoint exactly which of the many substances in a herb are responsible for the effects.
The roots of the valerian plant are the useful parts of this plant which has been in use for at least 2000 years. some of the active ingredients have been identified (the volatile oil, the valepotriates and valerenic acid), and these may be involved in influencing the GABA (gamma amino butyric acid) functions in the brain. GABA binds to specific brain cell receptors, influencing sedation. The various active substances in valerian seem to be associated with increased levels of GABA in the brain, although the exact mechanisms are still not completely clear.
In many people's minds hops tend to be associated with beer drinking more than as a herbal remedy. However, there has been a long history of using hops other than just to flavour beer. it is said that hop pickers used to tire easily as a result of the transfer of hop resin from hand to mouth! today people still use hop pillows to sleep comfortably, or can find dried hops and hop extracts as ingredients in a variety of herbal tablets and capsules. Again, research still hasn't found the exact mechanisms of action in the central nervous system, but it may involve the same receptor sites in the brain that are targeted by the benzodiazepine family of precsription sedatives.
Favourite herbs for use during the daytime, to keep everything on an even keel, include lemon balm, camomile, lime tree flowers, oats, motherwort ans - one of the most popular - passionflower.
The passionflower, or Passiflora incarnata, originated in south America and came to Europe via the Spanish. it has become one of the most popular herbal calmatives, with the active principles believed to be flavonoids. As with other herbs, various studies have been done trying to pinpoint the active principles, but so far this question has not been completely answered - except that its actions may, like hops, involve the benzodiazepine receptors in the brain. A number of traditional herbal remedies use passionflower to help minimise nervous tension and help people deal with the stress and strain of every day life.
Camomile is often taken in the form of porridge or oatmeal liquid, while lime blossom can be used as a tea (or infusion) or a tincture. Lemon balm also lends itself to use as an infusion. Motherwort tends to be prepared as a tincture or in tablet form. Most of these herbs are available  in tablet or tincture form if this is preferred to an infusion.
As with any health concerns, if problems persist it is always sensible to discuss these with a doctor, but having such a variety of herbal remedies available mowadays provides a useful way for people to help get themselves back on track. generally herbal products tend to have fewer side effects than non-herbal prescription medicines, which adds to their popularity. However, if people are asking advice about using herbs, you should always check whether they are on any regular medication, to guard against possible interactions. Many manufacturers provide a helpline numberor have a technical department where information should be available about their products.

3.3. HOMEOPATHIC REMEDIES
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Homeopathy is a system of complementary medicines which was established by the German doctor Samuel Hahnemann in the late 18th century. The three principles of homeopathy are:
1. The law of similars: what a substance can cause at toxic levels in a healthy person, at homeopathic levels it can cure in a sick person when the illness manifests similar symptoms.
2. By refined or attenuated dilution together with succussion (violent shaking), the medicine's curative properties are enhanced, and all the poisonous or undesirable side effects are lost.
3. Homeopathic medicines are prescribed individually by the study of the whole person, according to their individual symptom picture.
Treating like with like (ie treating an illness with a substance that produces similar symptoms to those that the person has) means that, for example, the homeopathic treatment for a streaming cold would be Allium cepa (red onion), which causes a runny nose and streaming eyes when peeled.
In homeopathy there is no such thing as a specific remedy for a specific illness. Each remedy is selected to match patients' individual symptom pictures so people with the same illness may need different remedies. Remedy selection should take account of factors including the patient's temperament, whether they are thirsty, hot or better for movement, and the colour of any expectorations. On the other hand, patients with different diseases may all benefit from the same remedy.
Dilutions or potencies, as they are known, are possibly the most difficult to understand. With homeopathic remedies, the greater the dilution from the original substance, the higher the potency, and consequently the deeper the action. There are two scales of potency:
*The decimal scale, where one part of a tincture is added to nine parts of alcoholic solution. This gives a potency known as 1X. A potency of 6X, where the 1X dilution is performed six times in a row with succussion at each stage, is equivalent to one part in a million.
*The centesimal scale, where one part of a tincture is added to 99 parts of alcoholic solution, giving a potency of 1C. A potency of 30C, produced by dilution and succussion at each stage, is equivalent to one part in 1 followed by 60 noughts.
Homeopathy has been formally accepted, however, as safe and is recognised complementary therapy. In Britain it is recognised by Act of Parliament and all homeopathic medicines are available on prescription under the National Health Service. There are five specialist homeopathic NHS hospitals.
The Homeopathic Registration Scheme means that homeopathic medicines for human use can carry a registration number (prefixed HR) confirming the safety and quality but not efficacy of the product. This new scheme avoids the problems of proving efficacy for homeopathic medicines.

3.4. DIAGNOSTICS
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Key changes are taking place that will revolutionise the practice of community pharmacy. The quality agenda for the NHS will demand greater evidence of efficacy
and effectiveness - both of the drug and intervention - before the service is commissioned.
Community pharmacists will be providing new services and supplementing some of those provided by GP's. The pharmacy will be a one-stop establishment where people who are well have their health checked, get advice and buy preventative medicines.
Preventative medicines could include statins after a cholesterol test. Patients will have their conditions monitored by pharmacists and their medicines prescribed for them, for example, patients will have their glucose levels tested to screen for diabetes or monitor treatment. Thus near-patient testing will improve the management of short- and long-term conditions and the management of prescribed medicines.

1. Independent Prescribing
1.1.In this model, the prescriber will be the main point of contact with the patient and will be responsible for clinical management. There would be specialist prescribing to allow professionals such as family planning nurses to prescribe a limited range of medicines.
Pharmacist recommendation of non-prescription medicines is a type of independent prescribing. The number of drugs available for counter prescribing is expected to increase by 300 as more medicines are reclassified from prescription to pharmacy medicines.

2. Dependent (Supplementary) Prescribing
This model facilitates continuing care of the patient in two ways:
2.1. Initiation of therapy following medical diagnosis
2.2. Continuation or modification of the original prescription.

3. Prevention
Diagnostic testing can be used in preventative medicines by gathering evidence of a predisposition to a disease, leading to early diagnosis and risk assessment.
Patients could carry out some tests in their homes. Once diagnosed, the disease and treatment can be monitored.
Predisposition and preventative testing could include screening for CHD, hypertension and diabetes.

4. Initiation of Therapy following a medical diagnosis
Some pharmacists will be prescribing following diagnosis of hypertension, asthma, diabetes and osteoporosis, and for patients who need warfarin or helicobacter pylori eradication.

5. Monitoring
New developments in repeat prescribing will transfer responsibilities to community pharmacists and medication review will be part of the new pharmacy contract. Pharmacist can help control a chronic illness by:
Therapeutic drug monitoring
Biochemical monitoring
Anticoagulant clinics
Asthma and diabetes clinics
Chronic obstructive pulmonary disease clinics
Helicobacter pylori eradication clinics

A number of monitoring or diagnostic tests are already available, and this list is expected to grow exponentially as technological and legislative developments occur. Example include:

• Pregnancy
• Blood glucose
• Cholesterol, lipids and other CHD factors
• Glycated haemoglobin
• Micro-albuminuria
• Helicobacter pylori
• Haemostasis
• Urinary Tract infection
• Streptococcus A
• Glandular Fever
• Urea and electrolytes
• Osteoporosis

6. Pathway
The health and Social Care Act 2001 and the consultation documents that followed paved the way for the implementation of further work, such as lawful prescribing, clinical condition, medicines and clinical conditions, training and preparation.
New opportunities for diagnostics services include the following:
6.1. In-pharmacy diagnostic services
6.2. Sale of self-management kits
6.3. Disease management
6.4. Repeat prescribing and repeat dispensing
6.5. Medicines management and concordance

7. SUMMARY
Pharmacy-based near-patient testing improves the management of short- and long-term conditions and the management of prescribed medicines. following technological and new policy developments, this testing will be an opportunity for providing new pharmacy-based services on the back of existing OTC and dispensing roles.

A key change in healthacre in the last few decades has been the welcomed shift towards greater patient involvement with, and management of, their own health. This is probably best reflected in the increased use and availability of OTC clinical or diagnostic tests. Developments in technology, particularly microchip and monoclonal antibody technologies, allow a range of diagnostic tests, previously only available from clinical laboratories, to be offered OTC in user-friendly kits.
Twenty years ago, at the start of the 'near patient testing' revolution, doctors and pharmacists usually carried out tests for patients. Today patients are more likeley to buy a test to perform at home. This trend is set to continue as it has the potential to speed up the identification, and improve management of, many chronic conditions as well as being both cost-effective and convenient.
The challenge is to ensure that these testing systems really do improve patients' health. With easy to use, highly reliable testing systems there is still the potential for error. Patients can still produce inaccurate results and, perhaps more importantly, fail to make proper use of these results by seeking medical help or making appropriate changes to drug dosages. As the main suppliers of OTC diagnostic testing systems pharmacists provide an important role in this respect.
Some patients will need advice on how to perform tests. Instructions are always provided in the information accompanying the test but some patients may require additional help and advice. Many patients will require help to interpret their results. Quantitative tests such as blood pressure and blood glucose measurements are only useful when patients know how to interpret their results. Pregnancy tests are qualitative and therefore easier to interpret.
Action based on the test result is important. Failure to seek medical help or take appropriate action after an abnormal test result will certainly not improve the patient's health. Worse still, it may allow the condition to deteriorate. In some cases the appropriate action will be lifestyle based and patients must have this information. For example, a positive pregnancy test result means that the patient should consider taking folic acid in line with government guidelines and smokers should consider quitting. Pharmacists must communicate well when advising on test results. Above all, steps must be taken to ensure that patients are not worried unnecessarily. 

In compiling this listing, we have contacted company members of the British Herbal medicines Association (BHMA) who make licensed herbal medicines. The monographs of their products have been placed into 15 therapeutic categories.

An effective balance of roles is needed in order to optimise sales and profitability.

This mix needs to be continuously re-assessed to match changes in customer preferences, demographics and wider economic trends.

Discuss your needs with our dedicated team: specialrange@lucamtrade.com