Home' Australian Pharmacist : Australian Pharmacist March 2015 Contents Australian Pharmacist March 2015 I ©Pharmaceutical Society of Australia Ltd.
CONTINUING PROFESSIONAL DEVELOPMENT
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, 23rd edn. Canberra:
Pharmaceutical Society of Australia; 2015.
2. Rossi S, ed. Australian medicines handbook.
Adelaide: Australian Medicines Handbook; 2015.
3. National Prescribing Service. At: www.nps.org.au
4. Merck Manual of Diagnosis and Therapy.At: www.
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.
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. Vortioxetine
Additional reference: Commonwealth of Australia.
AusPAR: Vortioxetine hydrobromide. 2014. At:
Dr Curran, a local GP, calls you to discuss
Mr Magdy Tudehope, a regular patient
at both your practices. Magdy is 72 years
old and has stable atrial fibrillation.
He was diagnosed with depression six
years ago after his wife died suddenly,
and has had three relapses since then.
Magdy’s current medications are:
• digoxin 125 micrograms daily
• warfarin 5 mg daily (stable over the
• terbinafine 250 mg daily (started
2 weeks ago for severe toenail
He does not take any over-the-counter
(OTC) or other medicines, apart from an
occasional dose of paracetamol.
Dr Curran asks you if the new
antidepressant, vortioxetine, would be
suitable for Magdy, as the rep was in last
week and said it was effective for relapse
prevention in depression.
Which of the following is the MOST
appropriate advice for Dr Curran?
a) Vortioxetine is suitable for Magdy, as it
has no potential interactions with his
current medicines and is approved for
relapse prevention in depression.
b) Vortioxetine has no proven benefit
over other antidepressants for relapse
prevention, and the dose for Magdy is
likely to be too low for any benefit.
c) Vortioxetine is likely to prevent relapse
of Magdy’s depression, but you would
recommend changing the warfarin to
dabigatran if vortioxetine is prescribed.
d) Vortioxetine is not suitable for Magdy, as
it is a P-glycoprotein inhibitor and may
increase his digoxin serum levels and risk
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: CAP150303E
KNOWLEDGE IN PRACTICE
Health promotion – Sunscreens, December
2014, page 47.
The article Sunscreens in the December
issue of Australian Pharmacist misinterpreted
recent research into nanoparticle
sunscreens. The article incorrectly stated
that research published in ACS Nano1
demonstrated that ‘although nanoparticles
are absorbed by the body, the body has the
capacity to both identify and remove the
particles before they enter the blood stream’.
The study in question exposed human
immune cells (called macrophages) to zinc
oxide nanoparticles to see how they would
respond. Researchers showed that if human
immune system was directly exposed to
nanoparticles, it could, within limits, absorb
the nanoparticles and break them down.
However, study did not look at whether the
particles were absorbed through the skin
and into the bloodstream following normal
dermal application of sunscreens.
Importantly, current advice from both the
Therapeutic Goods Administration and the
Cancer Council indicates that nanoparticles
found in sunscreens are unlikely to pose
safety concern following normal dermal use.
The potential for titanium dioxide and zinc
oxide nanoparticles in sunscreens to cause
adverse effects depends primarily upon the
ability of the nanoparticles to reach viable
skin cells. To date, the current weight of
evidence suggests that titanium dioxide and
zinc oxide nanoparticles (commonly used
sunscreen active ingredients) do not reach
viable skin cells, but remain on the surface of
the skin and in the outer layer of the skin that
is composed of non-viable cells.2,3,4
Australian Pharmacist apologises for any
confusion caused as a result of this article.
1. James S, Feltis BN, de Jonge M, Sridhar M et al. Quantification
of ZnO nanoparticle uptake, distribution, and dissolution
within individual human macrophages. ACS Nano
2. Therapeutic Goods Administration. Literature review on the
safety of titanium dioxide and zinc oxide nanoparticles in
sunscreens. 2013. At: www.tga.gov.au/literature-review-safety-
3. Therapeutic Goods Administration. Sunscreens: Information
for consumers. 2014. At: www.tga.gov.au/community-qa/
4. Cancer Council Australia. Nanoparticles and sunscreen. 2014.
Links Archive Australian Pharmacist February 2015 Australian Pharmacist April 2015 Navigation Previous Page Next Page