Home' Australian Pharmacist : Australian Pharmacist December 2015 Contents Australian Pharmacist December 2015 I ©Pharmaceutical Society of Australia Ltd.
CONTINUING PROFESSIONAL DEVELOPMENT
Six weeks later, Brendan returns to your
pharmacy to update you on his progress.
He is very slowly recovering from his
CMV infection, and has been taking a
combination of multiple antivirals to try
and improve his condition. He is now
much more aware of this condition,
and will be more conscious to seek
medical attention more promptly should
he experience any similar symptoms in
the future. At present, he is still suffering
from some vision problems, but his
doctor and ophthalmologist are positive
that he will recover well. Brendan thanks
you for being so thorough, as you
allowed him to get to the bottom of
KEY LEARNING POINTS
Immunocompromised patients are at a higher risk of experiencing infections
which can have a significant impact on morbidity and mortality. In HIV patients,
cytomegalovirus (CMV) is a common opportunistic infection which can cause
symptoms such as visual field defects, diarrhoea and fatigue. It is integral that
pharmacists ascertain a detailed patient history in order to determine the most likely
cause of symptoms. This can assure that patients receive timely and appropriate care,
in order to increase their chances of recovery and wellness. Pharmacists can play an
integral role in both the detection of potential cases of CMV, and in the monitoring
and management of treatment adverse effects.
1. Chey WD, Kurlander J, Eswaran S. Irritable bowel syndrome:
a clinical review. JAMA 2015;313(9):949–58.
2. Fedewa A, Rao SS. Dietary fructose intolerance, fructan
intolerance and FODMAPs. Curr Gastroenterol Rep
3. Chassany O, Michaux A, Bergmann JF. Drug-induced
diarrhoea. Drug Saf 2000;22(1):53–72.
4. Santaella RM, Fraunfelder FW. Ocular adverse effects
associated with systemic medications: recognition and
management. Drugs 2007;67(1):75–93 .
5. Mayo clinic: dry eyes. 2015. At: www.mayoclinic.org/
6. Mayo clinic: sore throat – causes. 2013. At: www.mayoclinic.
7. NHS choices: sore throat – causes. 2014. At: www.nhs.uk/
8. Bosch AA, Biesbroek G, Trzcinski K, et al. Viral and bacterial
interactions in the upper respiratory tract. PLoS Pathog
9. NPS MedicineWise. Respiratory tract infections. 2012.
10. Boyce TG. Overview of gastroenteritis. In: MSD manual
(professional version). 2014. At: www.msdmanuals.com/en-
11. Pringle CR. Types of viral disorders. In: MSD manual
(professional version). 2013. At: www.msdmanuals.com/
12. MSD manual (professional version). Infectious diseases:
respiratory viruses. At: www.msdmanuals.com/en-au/
13. Kovacs JA, Masur H. Prophylaxis against opportunistic
infections in patients with human immunodeficiency virus
infection. N Eng J Med. 2000;342(19):1416–29.
14. Panel on opportunistic infections in HIV-infected adults
and adolescents. Guidelines for prevention and treatment
of opportunistic infections in HIV-infected adults and
adolescents: recommendations from the Centers for
Disease Control and Prevention, the National Institutes of
Health, and the HIV Medicine Association of the Infectious
Diseases Society of America; 2015. At: www.aidsinfo.nih.
15. Centers for Disease Control and Prevention. Morbidity and
mortality weekly report (MMWR): Recommendations on
prophylaxis and therapy for disseminated mycobacterium
avium complex for adults and adolescents infected with
human immunodeficiency virus. 2001. At: www.cdc.gov/
16. Wilkin A, Feinberg J. Pneumocystis carinii pneumonia: a
clinical review. Am Fam Physician 1999;60(6):1699–708.
17. Kaye KM. Cytomegalovirus (CMV ) infection (cytomegalic
inclusion disease). In: MSD manual (professional version).
2013. At: www.msdmanuals.com/professional/infectious-
18. Antibiotic Expert Group. Therapeutic guidelines: antibiotic,
version 15. Melbourne: Therapeutic Guidelines Ltd; 2015.
1. Which ONE of the following is
CORRECT? A common clinical
manifestation of cytomegalovirus
(CMV) infection is:
2, Which ONE of the following is
CORRECT? CMV infection is likely to
occur in immunosuppressed patients
with a CD4 count of less than:
a) 20 cells/mm3.
b) 30 cells/mm3.
c) 40 cells/mm3.
d) 50 cells/mm3.
3. Which ONE of the following is
CORRECT? Whilst undergoing
treatment with foscarnet, regular
a) Renal function tests every 2 weeks.
b) Weekly blood urea nitrogen check.
c) Creatinine check pre-treatment
d) Weekly opthamology review.
4. Which ONE of the following is
CORRECT? Ganciclovir may cause:
d) Electrolyte disturbances.
5. Which ONE of the following is
CORRECT? CMV retinitis:
e) Is a rare manifestation of the CMV
f ) Usually appears after 30 days from the
initial presentation of symptoms.
g) Can cause visual field defects.
h) Results in large black lesions on the eye.
Links Archive Australian Pharmacist November 2015 Australian Pharmacist January 2016 Navigation Previous Page Next Page