Home' Australian Pharmacist : Australian Pharmacist June 2016 Contents Australian Pharmacist June 2016 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 the 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
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; 2016.
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.
After reading this article, pharmacists should be
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.
Competencies addressed: 4.2, 6.1, 7.1, 7.2 .
Accreditation number: CAP160606F
Roberta (28 years old, 58 kg) is a regular customer at
your pharmacy. She has been using Symbicort Turbuhaler
(eformoterol/budesonide 6/200 mcg) for asthma for several
years. She recently travelled to the United States for a holiday, and unfortunately
developed a large deep vein thrombosis (DVT) in her left calf on the flight home
two months ago. She was commenced on rivaroxaban 15 mg twice daily, which was
changed to 20 mg daily after three weeks on the initial dose. When the rivaroxaban
was first prescribed, a haematologist at the hospital told her that she would probably
need to take it for around six months in total. She has no other medical conditions and
takes no other medicines except for naproxen sodium 275 mg for period pain, which
she estimates she uses less than three times a year.
Roberta is concerned that she will become anaemic, as her last two periods have
been much heavier than her usual cycles, although not to the point that she has
had to change which menstrual products she uses. She has been reviewed by her
general practitioner (GP), who excluded any sinister causes of the heavier periods,
and believes that they are due to the rivaroxaban. Roberta’s ferritin and haemoglobin
levels were checked two days ago and were within normal limits. Her GP rings you for
advice regarding the management of her menorrhagia.
Which ONE of the following is the MOST appropriate recommendation to make to
Roberta’s general practitioner (GP)?
a) Roberta should take tranexamic acid 1,000 mg three times daily for the first five days of each
b) Roberta’s ferritin and haemoglobin levels should be monitored monthly; she should
commence iron supplementation if anaemia develops.
c) Roberta should commence Qlaira (dienogest with oestradiol) combined oral contraceptive.
d) Roberta should take naproxen sodium regularly three times daily for the first five days of
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