You are a pharmacist working in a community pharmacy. A 58-year-old female patient has come to the pharmacy seeking advice about her dry mouth.

To do

1. Explore the patient’s current symptoms.

2. You are expected to provide counselling information to this patient and answer any questions appropriately. You must provide relevant advice. Please be specific with potential diagnoses in order to achieve the marks.

You have 10 minutes.

You are Zofia Nowak (ZOH-fee-ah NOH-vahk)

Opening Statement: “I’ve got this horrible dry mouth and I’m struggling to cope with it.”

Patient Information

Name: Zofia Nowak

Age: 58

• Symptoms:

• “For at least 2 months my mouth has been really dry.”

• “Drinking more water doesn’t help at all.”

• “Well, it’s a bit personal but I’ve also been really constipated.”

• “I’ve been quite tired too - I keep dozing off in my chair.”

• Only if asked, “My eyes have been quite dry too now that you mention it.”

• Important negatives:

• “I’ve not been having to urinate more often - it’s been better since I started this new medication.”

• “I haven’t noticed any weight loss.”

• “I’ve not had any joint pain or aches.”

• No other symptoms

• Past medical history: 

• “I’ve been diagnosed with overactive bladder syndrome - it's been horrible, I was scared to go anywhere without a bathroom nearby.”

• Medication History: 

• “I take 5mg of oxybutynin in the morning and evening, it's really helped,” If asked, “I started it almost 3 months ago.”

• Allergies:

•  “I don’t have any allergies.”

• Lifestyle factors: 

• “Well they said losing weight can improve my overactive bladder so I’ve been eating lots of veg and I’ve cut out snacking.”

• “I haven’t been doing great at keeping hydrated. I don’t drink much fluid because I’m scared it’ll make my overactive bladder get triggered again.”

• “I stopped drinking alcohol years ago - I was never much of a drinker anyway.”

• “I’ve never smoked a day in my life.”

• “I try to go on a walk everyday.”

• “I work as a lollipop lady at a primary school.”

Questions to ask (use to prompt the student if they miss these areas):

1. What do you think is causing my symptoms? (Prompt them to give their thoughts as this is important to say the marks)

2. The medication has been a life-saver and I really don’t want to change it -   is there anything I can do to improve my symptoms?

1. NHS. (2023). Dry mouth. Available at: https://www.nhs.uk/conditions/dry-mouth/ (Accessed: 13 Mar. 2025).
2. National Institute for Health and Care Excellence (NICE). (2025). Palliative care - oral: Scenario: Dry mouth [online] Available at: https://cks.nice.org.uk/topics/palliative-care-oral/management/dry-mouth/ [Accessed 13 Mar. 2025].
3. NHS. (2024). Sjögren's syndrome. Available at: https://www.nhs.uk/conditions/sjogrens-syndrome/ [Accessed: 13 Mar. 2025].
4. TePe (2025). Dry Mouth. Available at: https://www.tepe.com/uk/tips--advice/common-conditions/dry-mouth [Accessed 13 Mar. 2025].
5. NHS. (2024). Side effects of oxybutynin. Available at: https://www.nhs.uk/medicines/oxybutynin/side-effects-of-oxybutynin/ [Accessed 24 Mar. 2025].
6. NICE. (2025). Oxybutynin: BNF content published by NICE. Available at: https://bnf.nice.org.uk/drugs/oxybutynin-hydrochloride/#side-effects [Accessed 24 Mar. 2025]