Home' Australian Pharmacist : Australian Pharmacist Nov 2013 Contents Australian Pharmacist November 2013 I © Pharmaceutical Society of Australia Ltd.
Australian integration model
for Malaysian trial
An Australian developed practice model
on integrating pharmacists in GP medical
centres going global.
A team of
researchers, Dr Chris
Professor Lisa Nissen
has been funded
by the Malaysian
Government to develop and evaluate
a model of pharmacist integration into
private healthcare clinics in Malaysia.
The study is in progress and will continue
until June 2016. The researchers, led by
Dr Vivienne Mak in Malaysia, recently
received funding from the Ministry of
Education Malaysia under the Exploratory
Research Grant Scheme to undertake
In Malaysia, there is no separation of the
medication dispensing and prescribing
function between medical doctors in
private primary healthcare clinics and
community pharmacies. Doctors in Malaysia
still prescribe and dispense medications
within their clinics. According to
Dr Vivienne there is an increasing role for
Malaysian pharmacists within the private
primary healthcare setting not only in
the dispensing process, but in providing
other professional pharmacist services.
Dr Vivienne said that the research had
garnered attention among policy makers
in Malaysia and discussions are underway
on the way forward for pharmacists and
general medical practitioners to work
together to improve patient care.
The study in Malaysia is based on
Dr Freeman’s study on the integration of a
pharmacist into a general practice medical
centre in Australia.
The Australian Pharmacy Liaison Forum
(APLF),of which PSA is a member,
has supported the AHPRA and the
National Boards submission regarding the
introduction of the Health Ombudsman Bill
2013 in the Queensland Parliament.
The Bill aims to to establish a health
ombudsman and provide a system
for dealing with complaints and other
matters relating to the health, conduct or
performance of health practitioners and
health organisations in Queensland. Under
the Health Practitioner National Law Act
2009, in most states and territories AHPRA
and the National Boards currently deal
with these matters where they relate to
Regulation at the state and territory
level compromises the national process
established by the National Registration
and Accreditation Scheme.
The AHPRA submission states that a
more rigorous administrative approach
within current arrangements would
meet the needs of the Bill and avoid any
unintended increased costs, fragmentation
or delays in how complaints are managed
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...
Counselling and cautionary
You can find all this and more in the complete
counselling and cautionary advisory labels
manuscript in your APF. See pages 5–31.
Visit www.psa.org.au to purchase your copy.
Accreditation number: CAP131111i
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.
What ancillary labels should I use?
Based on the information in the APF22, choose the CORRECT statement.
a) Label B is recommended for metformin because it can cause hypoglycaemia if taken on an
b) Label 8 (delete skin) is recommended for hydroxychloroquine because patients should be
encouraged to minimise their exposure to direct sunlight or sunlamps, and wear sunglasses
when in bright sunlight.
c) Label 4 is recommended for doxycycline because the calcium in yoghurt can reduce the
absorption of doxycycline.
d) Label 18 is recommended for rosuvastatin because constituents in grapefruit
can inhibit CYP3A4 isoenzymes and increase the bioavailability of rosuvastatin.
Enter your answer and claim 0.5 Group 2 CPD credits.
Visit www.psa.org.au and click submit answers.
Are pharmacists legally required to
use cautionary advisory labels?
Pharmacists are advised to use their knowledge
and professional discretion in deciding whether
to omit one or more ancillary labels for a specific
consumer or circumstance, apart from medicines
for which legislation requires certain labels
be used. Appendix K of the Standard for the
Uniform Scheduling of Medicines and Poisons
(Poisons Standard) includes a list of drugs that
must be labelled with a specifically worded
sedation warning, as used in label 1 and label 1a.
Specific state and territory legislation may also
have labelling requirements for medicines.
When should label 19b be used?
Label 19b is used for non-steroidal
anti-inflammatories (NSAIDs). Use of multiple
NSAIDs is associated with an increased risk
of gastrointestinal bleeding, renal failure and
adverse cardiovascular effects. Consumers
might inadvertently self-administer multiple
NSAIDs (e.g. combining prescription and
over-the-counter NSAID products, or multiple
NSAIDs prescribed for different indications).
Why is label 9 recommended for
The abrupt cessation of prolonged therapy with
certain medicines has the potential to cause
serious consequences. Abrupt withdrawal of
beta-blockers may worsen angina, or precipitate
rebound hypertension, myocardial infarction or
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