Home' Australian Pharmacist : Australian Pharmacist July 2012 Contents 578 Australian Pharmacist July 2012 I ©Pharmaceutical Society of Australia Ltd.
Continuing Professional Development
The articles in this series are independently researched and compiled by PSA commissioned authors and peer reviewed.
KNOWLEDGE IN PRACTICE
Knowledge in practice
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-
• Promote and contribute to the
optimal use of medicines
• Address primary health needs
Competency standards (2010)
addressed: 4.2.1, 4.2.2, 4.2.3, 6.1.1,
6.1.2, 7.1.2, 7.1.3, 7.1.4, 7.2.2
To answer Knowledge in practice
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
The challenge of applying what you
learn to pharmacy practice!
Knowledge in practice is designed to
be di cult 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 L (ed). Australian Pharmaceutical Formulary
and Handbook, 22nd Ed. Canberra: Pharmaceutical
Society of Australia, 2012.
2. Rossi S (ed). Australian Medicines Handbook.
Adelaide: Australian Medicines Handbook Pty Ltd;
3. National Prescribing Service [online]. At: www.nps.
4. Merck Manual of Diagnosis and Therapy [online].
5. Product information -- available from various
sources, e.g. MIMS, APP Guide or online on
6. Royal College of Pathologists of Australasia. RCPA
Manual [online]. At: www.rcpamanual.edu.au
7. Therapeutic Guidelines Series. eTG complete [CD-
ROM]. Melbourne: Therapeutic Guidelines Limited.
Question 1: Appropriate use
Additional reference: NPS. Prescribing Practice
Review 57: antibiotic resistance and respiratory tract
infections. NPS; 2012. At: http://tinyurl.com/82bdc3t
Which of the following statements
about antibiotic use is the MOST
a) A person who is prescribed amoxycillin
500 mg three times a day for severe
acute bacterial rhinosinusitis
should have the repeat prescription
b) Antibiotics, in combination with oral
corticosteroids, can be bene cial
in a patient who has a severe acute
exacerbation of COPD, even if caused
by a viral infection.
c) The recommended treatment for
severe pharyngitis associated with
glandular fever is amoxycillin 500 mg
three times a day for 10 days.
d) Acute rhinosinusitis is most often
caused by Haemophilus in uenza
or Streptococcus pneumoniae and
should be treated with amoxycillin 500
mg three times a day for seven days.
Question 2: Onychomycosis
Mr OM, 52 years old, 76 kg, is a regular
customer of yours. He has chronic
hepatitis C, contracted as a result of
previous IV drug use, but is now 'clean'.
He had a heart attack last year and,
since then, has completely changed his
lifestyle. He has become a vegan and now
avoids all acidic and ca eine-containing
drinks based on his naturopath's
recommendation. His cardiologist and GP
accept these choices due to the overall
improvement in his lifestyle.
Today Mr OM comes in with a written
request from his GP seeking your
recommendation for an appropriate
'I have diagnosed Mr OM with
onychomycosis on the fourth digit of
his left hand which has been resistant
to multiple courses of topical therapy.
The diagnosis has been con rmed by the
pathology lab. Mr OM's cardiologist is
happy with his current progress and does
not want to change any of his current
medicines. Could you recommend an
appropriate antifungal agent for Mr OM?'
Mr OM's other medicines are:
• Ramipril 10 mg each morning
• Simvastatin 20 mg at night
• Aspirin 100 mg each morning
• Clopidogrel 75 mg each morning
• Pantoprazole 40 mg each morning
• Frusemide 40 mg each morning
• Atenolol 50 mg daily
His BMI is 23.5 kg/m2. Pathology results
from last week were:
• Serum creatinine: 108 micromol/L
• Serum potassium: 4.9 mmol/L (3.8--4.9
• GGT: 45 units/L (<50 U/L)
• ALP: 95 units/L (25--100 U/L)
• ALT: 283 units/L (<35 U/L)
• AST: 199 units/L (<40 U/L)
• Bilirubin: (direct) 17 micromol/L (<7
Which of the following is the
MOST APPROPRIATE antifungal to
recommend for Mr OM?
a) Griseofulvin 1 g once daily for 12
b) Itraconazole liquid 100 mg twice daily
for one week, repeated after three
c) Terbina ne 250 mg once daily for six
d) Ketoconazole 200 mg once daily for six
A score of 1 out of 2 attracts .5 CPD credits.
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