Home' Australian Pharmacist : Australian Pharmacist November 2012 Contents Australian Pharmacist November 2012 I ©Pharmaceutical Society of Australia Ltd. 845
This content is for information purposes only. The clinical information presented should not be
used to guide clinical advice/decisions without reference to the complete section of the APF.
What can I find out about...
You can nd all this and more in the complete
mouth ulcers manuscript in your APF.
See pages 529--532.
Visit www.psa.org.au to purchase your copy.
Accreditation number: CP120040e
This activity has been accredited for 0.25 hours of Group 2 CPD
(or 0.5 CPD credits) suitable for inclusion in an individual pharmacist's CPD plan.
When is referral for further investigation or management
of mouth ulcers recommended?
Based on the information in APF22, which of the following situations is
MOST likely to require referral?
a) A 6-year-old girl with a small cluster of yellowish-grey ulcers on the inside of her cheek.
b) A 28-year-old woman with ulcers that have joined together to form one large 1.5 cm ulcer that
has been present for a month.
c) A pregnant woman with a 2 mm white ulcer under her tongue.
d) A 21-year-old ex-smoker (recently quit) who has had two eruptions of mouth ulcers in the last
Enter your answer and claim 0.5 Group 2 CPD credits.
Visit www.psa.org.au and click submit answers.
What factors can increase the
risk of mouth ulcers?
The exact cause of mouth ulcers is not known,
but there are several factors that are thought
to trigger or exacerbate them. These include
localised physical trauma, hormonal factors,
emotional stress, chemical irritation and
Are topical corticosteroid
products likely to be
Systemic absorption of oral topical
corticosteroids is likely to be minimal.
However, in theory, prolonged use of
topical corticosteroids may produce
reversible systemic e ects including adrenal
suppression, alteration of glucose metabolism
and peptic ulcer activation
Can products containing
choline salicylate be used in
There is a theoretical risk of Reye's syndrome
associated with excessive use of oral gels
containing choline salicylate in children.
When used in a child, the product should
not be applied more than six times a day and
parents should be advised not to exceed the
recommended dose. In the UK these products
are now contraindicated for people under the
age of 16 years.
Jacki Baulch is the Senor Industrial
Officer, Pharmacy Division of APESMA
Intern employment contracts
By Jacki Baulch
All graduates will be asked to agree to an
employment contract when they start work.
It could be a letter or a long and legalistic
document. An employment contract reflects
the agreement between you and your
employer and, provided it meets minimum
standards, is a legally binding contract which
is enforceable under law. Contracts detail the
relationship between you and your boss and
specify your employment conditions. Before
you sign a contract you should know your
rights so you don't agree to something less
than the legal minimum standard.
When you have been offered an employment
contract you need to check it to make sure
it reflects what you agreed at the interview
and that it meets or betters the minimum
standards expressed in the Fair Work Act
(FWA); the relevant industrial award (usually
the Pharmacy Industry Award (PIA) 2010); and
the relevant enterprise agreement if there is
one for that workplace.
Terms and conditions of employment of
interns working in hospital / community
pharmacy are regulated by industrial awards
and agreements that are binding on these
employers. If employers do not at least meet
the requirements specified in the relevant
industrial award / agreement they can be
fined and be ordered to back pay what they
owe you. Employers are required to meet
the minimum standards specified in the
FWA. Minimum standards are known as
the National Employment Standards (NES)
-- they establish minimum entitlements to
matters such as leave entitlements; a 38 hour
week, etc. The relevant award or enterprise
agreement specifies the minimum salary
you can be paid -- the PIA that covers the
vast majority of employees working in
community pharmacies requires that an
intern in their first half of training be paid at
least $744.80 / week.
Your contract should not just contain things
such as pay and the NES, it should detail
whether your are employed for a fixed term
/ open ended period; your job / duties; your
overtime / penalty rate entitlements (these
are contained in the PIA) and the conditions
under which the contract can be terminated
Further information can be found at: www.
fwa.gov.au and www.fairwork.gov.au. The
Pharmacy Division of APESMA: www.apesma.
com.au can provide general information on
conditions of employment and employment
contracts. For members APESMA provides
a free employment contract review service.
An expert will check the minimums, and
explain the implications of the clauses and
conditions to you. Interns can enrol at any
time by visiting: www.psa.org.au/intern.
NATIONAL INTERN TRAINING PROGRAM
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