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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, 23rd edn. Canberra:
Pharmaceutical Society of Australia; 2015.
2. Rossi S, ed. Australian medicines handbook.
Adelaide: Australian Medicines Handbook; 2015.
3. NPS MedicineWise. 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. Vitamin D
Additional reference: Glendenning P. Measuring vitamin D. Aust Prescr 2015;38:12–5 . At: http://tinyurl.com/
You have recently carried out home medicine reviews (HMRs) on four patients. Which of
the following clinical scenarios contains the MOST appropriate recommendation?
a) Mrs Hope (45 years old) has a history of
hypertension, Graves’ disease, ulcerative
colitis and type 2 diabetes. Her current
medications are: ramipril 5 mg daily,
carbimazole 5 mg daily, mesalazine 1 g
twice daily, metformin 1,000 mg daily, and
dapagliflozin 5 mg daily. Following a recent
blood test showing 25-hydroxyvitamin D
(25(OH)D) = 45 nmol/L, she has just been
commenced on colecalciferol 25 mcg daily.
Recommend that Mrs Hope have her
25(OH)D levels checked after 4 weeks,
and thereafter every 6 months.
b) Mrs Waddington (60 years old) has a
history of hypertension, heart failure and
hyperlipidaemia. She has been diagnosed
with borderline hypocalcaemia [corrected
calcium 2.13 mmol/L (2.15–2.60 mmol/L)].
Her 25(OH)D concentration is 55 nmol/L.
Her current medications are: ramipril
5 mg daily, atenolol 50 mg daily, aspirin
100 mg daily, bumetanide 1 mg daily, and
simvastatin 20 mg daily.
Mrs Waddington on colecalciferol
50 mcg daily.
c) Mrs Jones (56 years old) has a history of
hypothyroidism, angina and trigeminal
neuralgia. Her current medications are:
thyroxine 100 mcg daily, glyceryl trinitrate
600 mcg when required, metoprolol 50 mg
twice daily, and carbamazepine CR 800 mg
twice daily. Her most recent TSH was
0.8 mIU/L (0.4–5 mIU/L).
Recommend testing Mrs Jones’s
25(OH)D level and, if it is <50 nmol/L,
commencing her on vitamin D
d) Mrs Smith (70 years old) has a history of
hypothyroidism, COPD, hypertension and
osteoporosis. Her current medications are:
thyroxine 100 mcg daily, tiotropium 18 mcg
daily, ramipril 5 mg daily, alendronate
70 mg weekly and calcium carbonate
600 mg daily. Following a recent blood test
showing 25(OH)D = 40 nmol/L, she has
just been commenced on colecalciferol
25 mcg daily.
Recommend checking Mrs Smith’s
25(OH)D level after 3 months and, if
her 25(OH)D is ≥50 nmol/L, ceasing the
vitamin D supplement.
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: CAP150606F
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