Home' Australian Pharmacist : Australian Pharmacist December 2014 Contents Australian Pharmacist December 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. Anaphylaxis
Additional reference: Horn JR, Hansten PD. The
dangers of beta-blockers and epinephrine.
Pharmacy Times 2009;75(5):31. At: http://tinyurl.
Mrs Peterson presents a prescription
for Epipen (adrenaline) 300 mcg. She
tells you that she recently had a severe
allergic reaction to a bee sting and
had to be admitted to hospital. Her
doctor has told her to keep an Epipen
with her whenever she is outdoors.
While dispensing the prescription, you
see in her medication history that she
takes enalapril 10 mg three times a
day, Toprol-XL (metoprolol controlled-
release) 190 mg once daily, frusemide
20 mg daily and metformin 850 mg
Which of the following points regarding
Mrs Peterson’s Epipen therapy is
a) Because Mrs Peterson is taking
metoprolol, she is unlikely to respond to
adrenaline and, instead of using Epipen
(adrenaline), she should take a first-
generation antihistamine in the event of
another bee sting.
b) Because Mrs Peterson is taking
metoprolol, to avoid a hypertensive
crisis it may be advisable for her to use a
reduced dose of adrenaline.
c) In the event of another bee sting,
Mrs Peterson may not respond to
adrenaline and it would be advisable to
call an ambulance as soon as possible.
d) After using Epipen (adrenaline),
Mrs Peterson should check her blood
glucose levels carefully, as she may need
a temporary reduction in her dose of
Question 2. Hyperlipidaemia
You are asked to do a Home Medicines
Review (HMR) for Mr Campbell (68 years
old) after his discharge from hospital, where
he was treated for pyelonephritis. He has a
history of hypertension, hyperlipidaemia,
angina, type 2 diabetes and asthma.
Mr Campbell is slightly overweight, but
tells you that he follows a healthy diet,
quit smoking five years ago, drinks an
occasional beer, enjoys gardening and goes
for a walk on most days of the week.
His current medications are:
• Accuretic 20/12.5 (quinapril 20 mg,
hydrochlorothiazide 12.5 mg) 1 daily
• Lipex (simvastatin) 20 mg 1 daily
• Anginine (glyceryl trinitrate) 600 mcg
1 when necessary
• Cardizem CD (diltiazem controlled-
release) 180 mg 1 daily
• Diabex XR (metformin controlled-
release) 1 g 1 daily
• Aspirin 100 mg daily
• Symbicort 200/6 (budesonide 200 mcg,
eformoterol 6 mcg) 1 inhalation twice
daily and 1 inhalation when necessary
• Cephalexin 500 mg 6-hourly (10-day
Other information provided by the
referring doctor includes:
• Blood pressure: 132/85 mmHg
• HbA1C: 6.8% (<7%)
Total cholesterol: 6.5 mmol/L
• LDL-C: 2.8 mmol/L (<2 mmol/L)
• Triglycerides: 5.2 mmol/L (<2 mmol/L)
• HDL-C: 0.9 mmol/L (>1 mmol/L)
Which one of the following recommendations
regarding Mr Campbell’s lipid-lowering
therapy is MOST appropriate?
a) Increase Mr Campbell’s dose of simvastatin
to 40 mg daily.
b) Add fenofibrate 145 mg daily to
Mr Campbell’s regimen.
c) Add colestipol 5 g twice daily to
Mr Campbell’s regimen.
d) Add gemfibrozil 600 mg twice daily to
Mr Campbell’s regimen.
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: CAP141212F-G
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