Home' Australian Pharmacist : Australian Pharmacist June 2013 Contents 62
Australian Pharmacist June 2013 I ©Pharmaceutical Society of Australia Ltd.
KNOWLEDGE IN PRACTICE
To answer Knowledge in practice
Answers for Knowledge in practice
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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 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.
Additional references: Therapeutic Goods Administration. Sunscreens:
information for consumers. Nov 2012. At: http://tinyurl.com/
Australian Radiation Protection and Nuclear Safety Agency. About
ultraviolet radiation [revised Feb 2012]. At: http://tinyurl.com/
Which of the following scenarios
presents the MOST appropriate advice
based on the information in the
a) Amanda, a first-time mother, is
concerned about UV exposure for her
five-year-old son, Josh. You advise
Amanda that Josh will be equally
protected with UPF 50+ clothing or a
SPF 50+ sunscreen.
b) Charlie requests information on
buying imported sunscreens in
Australia, as he remembers seeing
UV ratings on sunscreens during a
recent trip to Hong Kong. You advise
Charlie that he should always
look for Australian-manufactured
products because other countries’ UV
ratings may be different and are not
standardised to Australian SPF ratings.
c) Kathy and Kerry like to go
bushwalking. They ask you about the
new SPF 50+ rating. You advise them
that, because it blocks out roughly
twice as much UV radiation as a SPF 30
sunscreen, they only need to reapply
it half as frequently, so they can get
more value from a single bottle.
d) Deb swims a lot, and asks whether
SPF 50+ sunscreens are more water
resistant than SPF 30+ sunscreens.
You advise her that this is the case –
water-resistant SPF 50+ sunscreens are
water resistant for 6 hours, whereas
water-resistant SPF 30+ sunscreens are
only water resistant for 4 hours.
Question 1. Advice
Question 2. Folate
Additional references: Parker S, Hanrahan P, Barrett C. Folate for
therapy. Aust Prescr 2013;36:52–5. At: http://tinyurl.com/apv32062a
Metz J. Appropriate use of tests for folate and vitamin B12 deficiency.
Aust Prescr 1999;22:16–8. At: http://tinyurl.com/apv32062b
Which of the following patients is
LEAST likely to benefit from folic acid
a) Mrs Hawker is planning to become
pregnant. Results of a recent blood
test included: serum folate – 46 nmol/L
(7-45 nmol/L), serum vitamin B12 –
520 pmol/L (120–680 pmol/L), mean
cell volume (MCV) – 85 fL (80–100 fL).
b) Mrs Kambah has a history of
ST-elevated myocardial infarction
and rectal adenoma, and a family
history of bowel cancer. She currently
has psoriasis, for which she is taking
methotrexate 5 mg a week and
applying betamethasone valerate
0.02% when necessary. She has no
gastrointestinal symptoms and her
recent laboratory results include:
homocysteine – 10 μmol/L (5–15
μmol/L), serum folate – 15 nmol/L
c) Mr Holt has a painful, inflamed tongue
(glossitis) and has recently had an
exacerbation of his rheumatoid
arthritis. He is currently taking
sulfasalazine 500 mg three times a
day and naproxen 500 mg twice daily.
His recent laboratory results include:
haemoglobin – 120 g/L (130–180 g/L),
serum folate – 4 nmol/L (7–45 nmol/L),
MCV – 104 fL (80–100 fL), serum
vitamin B12 – 150 pmol/L (120–680
d) Mr Dunlop has a family history
of dementia and prostate cancer.
He has recently been complaining
of tiredness, and his mood has been
depressed. His recent laboratory
results include: haemoglobin –
120 g/L, (130–180 g/L), red cell folate
– 150 nmol/L (360–1400 nmol/L), MCV
– 110 fL (80–100 fL), homocysteine
– 10 μmol/L (5–15 μmol/L), serum
vitamin B12 – 280 pmol/L (120–
Knowledge in practice
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