Home' Australian Pharmacist : Australian Pharmacist November 2014 Contents Australian Pharmacist November 2014 I ©Pharmaceutical Society of Australia Ltd.
CONTINUING PROFESSIONAL DEVELOPMENT
KNOWLEDGE IN PRACTICE
The challenge of applying what
you learn to pharmacy practice!
Knowledge in practice is designed to
be difficult and aims to make you apply
information from articles in this month’s
Australian Pharmacist and other suggested
reading to the questions below, just as you
would for a client/patient. This section is not
meant to be easy. There are no simple clear-
cut answers to the questions. The standard
references listed below may be of use when
answering the questions.
1. Sansom LN, ed. Australian pharmaceutical
formulary and handbook, 22nd edn. Canberra:
Pharmaceutical Society of Australia; 2012.
2. Rossi S, ed. Australian medicines handbook.
Adelaide: Australian Medicines Handbook; 2014.
3. National Prescribing Service. At: www.nps.org.au
4. Merck Manual of Diagnosis and Therapy [online].At:
5. Product information – available from various
sources, e.g. MIMS, APP Guide or online on
6. Royal College of Pathologists of Australasia. RCPA
Manual. At: www.rcpamanual.edu.au
7. Therapeutic Guidelines Series. eTG complete
[CDROM]. Melbourne: Therapeutic Guidelines Limited.
Knowledge in practice
TO ANSWER KNOWLEDGE IN
Answers for Knowledge in practice can only be
submitted online through the PSA members-only
area of the PSA website at: www.psa.org.au
PSA members will receive instant feedback on
the correct answers with an explanation of why
the answer is correct. If you do not have member
access details for the PSA website, you can request
them via a link from the login page.
Question 1. Azole drug
Nadine, a 23-year-old regular customer
with type 1 diabetes, comes into the
pharmacy with prescriptions for Lantus
(insulin glargine) and Bactrim DS
(sulfamethoxazole and trimethoprim).
She has previously been using
Protaphane (isophane insulin) twice a
day and Actrapid (neutral insulin) before
meals. About two months ago Nadine
was diagnosed with depression and
prescribed Lovan (fluoxetine) 20 mg
daily. She tells you that, although her
diet has not changed, she has recently
been getting low readings (about
3–4 mmol/L) when she tests her blood
glucose levels. She has also been feeling
more tired than usual and has been
getting a few headaches. The doctor is
concerned that Nadine may be getting
‘hypos’ and has reduced her Actrapid
dose and changed her Protaphane to
Lantus. Today he has also prescribed
her some antibiotics for a urinary
Which of the following counselling points
is MOST appropriate?
a) Nadine should use her Lantus exactly
as she used Protaphane – morning and
night, shaking vigorously before use.
b) If she wants to reduce the number of
injections to be administered, Nadine can
mix the Lantus and Actrapid in the same
syringe and give them as a single dose.
c) Nadine’s recent hypoglycaemia may be
due to the Lovan , and she should be
made aware that, if she stops taking it,
her blood glucose levels may increase,
necessitating a higher dose of insulin.
d) The Bactrim DS may cause Nadine’s blood
glucose levels to increase, and she should
be aware that, when she stops taking it,
she might have to reduce her dose of
Question 2. Kidney stones –
Additional reference: Leslie SW. Hypercalciuria.
Medscape. At: http://tinyurl.com/apv33112a
Helen, a regular customer, tells you
that she has recently been in hospital
with kidney stones. She asks whether
changing any aspects of her diet might
help to reduce her risk of developing
kidney stones again. Helen is 43 years
old, is not overweight and takes no
medicines, apart from an occasional
dose of paracetamol for a headache.
Which of the following recommendations
for Helen is MOST appropriate?
a) Increase the amount of protein in herdiet.
b) Avoid drinking large quantities of orange
and grapefruit juice.
c) Minimise her dietary salt (sodium) intake.
d) Avoid dairy products to minimise her
dietary calcium intake.
Through successful completion of this activity, the
learner will demonstrate their ability to:
• Use readily available information sources to
access and select relevant and up-to-date
clinical and practice based information
• Promote and contribute to the optimal use of
• Address primary healthcare needs of patients.
Competency standards (2010) addressed: 4.2,
6.1, 7.1, 7.2 .
Accreditation number: CAP141111F-G
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