Home' Australian Pharmacist : Australian Pharmacist August 2012 Contents 662 Australian Pharmacist August 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.
CAP120808g and CAP120808h
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. Paracetamol
You are the only pharmacist in a country
hospital. At 2:30 pm you receive a call
from the new emergency department
registrar regarding Jane, a 21-year-old
woman who has been to the hospital
in the past following low-grade self
harm. She has informed the registrar
that she took 50 paracetamol tablets
at approximately 10 am. She weighs 72
kg and her only regular medication is
an oral contraceptive. She now regrets
her actions and is cooperative with
medical sta . Blood has been drawn for
LFTs, INR, serum chemistry and urgent
paracetamol levels. However, it needs to
be transported to the laboratory at the
regional hospital, a two-hour drive away.
A courier is on the way and is due to arrive
in one hour.
What is the MOST appropriate
advice to give?
a) Sodium citrate should be administered
to alkalinise the urine and aid
b) The ingested overdose of paracetamol
would already have caused irreversible
liver damage. Jane should be
transferred to the regional hospital
and assessed for suitability for liver
c) Jane's paracetamol level will need
to be con rmed four hours after
presentation to ascertain the need
for acetylcysteine. In the meantime,
decontamination with activated
charcoal is recommended.
d) Antidote treatment with acetylcysteine
should be administered immediately.
Question 2. Head Lice
Additional reference: Malcolm CE, Bergman JN.
Trying to keep ahead of lice: A therapeutic challenge.
Skin therapy letter. 2006;11(10):1--6. At: www.
Mrs Bennett asks to speak to the
pharmacist. Her six-year-old daughter
Alison has been scratching her head
and she thinks she still has head lice.
This is the fourth time Mrs Bennett has
had to treat Alison for head lice in the
past four weeks. Upon inspection of
Alison's hair, the pharmacist con rms
the presence of live Pediculus humanus
capitis. Mrs Bennett has used permethrin
1% lotion on three occasions. The rst
time Mrs Bennett used the lotion,
she applied conditioner to Alison's hair
rst in order to make it easier to remove
the lice. The other times she used the
treatment, Mrs Bennett applied the lotion
to Alison's dry hair for approximately 10
minutes before rinsing with warm water.
She repeated the same procedure seven
Which of the following
recommendations is MOST
a) It is not advisable to treat Alison again
as she is likely to be experiencing
a hypersensitivity reaction due to
excessive use of permethrin. Alison's
mother should be advised to wash
Alison's hair regularly to reduce the risk
b) The head lice have probably developed
resistance to permethrin 1%. Permethrin
5% lotion should be recommended and
the application should be repeated after
c) The permethrin 1% lotion should be
used again and the application should
be repeated after seven days.
d) The head lice have probably developed
resistance to permethrin. Maldison
0.5% should be recommended and the
application should be repeated after
seven to 10 days.
A correct answer attracts 0.5 CPD credits
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