Home' Australian Pharmacist : Australian Pharmacist June 2014 Contents Australian Pharmacist June 2014 I ©Pharmaceutical Society of Australia Ltd.
CONTINUING PROFESSIONAL DEVELOPMENT
Brian (55 years) is a regular customer at your pharmacy, and he would
like to discuss a sensitive matter with you today. You speak with Brian in
your private consultation room and discover that he is concerned about
his unusually sad mood, which seems to be with him most of the time.
You take the time to investigate his concern further.
You ask Brian some questions
to investigate the cause of his
Onset of symptoms
• When did you first notice these
• Have you experienced these symptoms
in the past?
Brian has noticed changes in his mood
over the past six months. He has only just
built up the confidence to come to the
pharmacy to confide in you about this
matter. He is particularly concerned, as in
the past he has been an extremely happy,
motivated and relaxed person, and he
feels that his recent mood changes have
started to affect his home life and work
relationships. He has never felt this way
before, and feels that the symptoms are
‘getting worse’ by the day.
• Can you further describe the
symptoms you are experiencing?
• Are you experiencing any other
symptoms at present?
Upon further questioning you discover
that Brian has been experiencing
extreme sadness daily. He has trouble
sleeping and as a result, he is often tired,
irritable and agitated during the day.
Brian also explains that he has very low
energy levels, which is why he started
taking a multivitamin last month to boost
However, he has not noticed any
difference and is starting to lose hope
that he will ever feel ‘normal’ again.
Brian’s wife (Molly), has expressed her
concerns at Brian’s changing mood, and
identified that Brian has lost motivation
in daily tasks and hobbies (such as
playing the guitar). Brian also mentions
that he has a reduced appetite and
he wonders if this is connected to his
• Are you taking any medicines at the
moment (including over-the-counter
and herbal medicines)?
• Do you have any medical conditions?
Brian is currently taking metformin 500 mg
twice daily. He was diagnosed with type
2 diabetes approximately 12 months ago,
and has been taking the metformin ever
since. Additionally, in the past six months
Brian has commenced insulin therapy
with Lantus 12 units before his evening
meal. Brian occasionally takes Panamax for
A bad case of
BY SARAH GRAY, MPS
Melbourne-based Sarah Gray (formerly Curulli)
is Clinical Education Pharmacist at the Hydration
After reading this article, pharmacists should be
• Discuss the increased risk of depression
associated with diabetes
• Identify potential causes and risk factors for
depression associated with diabetes
• Counsel customers on appropriate ways to
manage depression associated with diabetes.
Competency standards (2010) addressed: 4.2, 6.1, 7.1 .
Accreditation number: CAP140606D
Pharmacists routinely use investigative questioning
in their pharmacy practice. Medication mystery
scenarios are commonly occurring situations
where detailed questioning uncovers a complex
case requiring a substantial intervention. These
articles demonstrate how a pharmacist can adopt
a systematic problem-solving approach to improve
patient outcomes. For educational purposes,
questions and answers are presented collectively,
while in practice, questions would be asked and
headaches, and is still taking Blackmores
sustained release multi once daily. He is
not taking any other over-the-counter or
complementary medicines at present.
Brian has been suffering from an
extremely sad mood and reduced energy
levels for the past six months. There are
several potential causes of Brian’s current
symptoms discussed below.
Symptoms of grief can occur after a
significant life event, such as the death
of a spouse, relationship failure, personal
injury or loss of employment.
who experience grief can suffer from
a wide range of symptoms, including
extreme sadness, insomnia, anxiety,
irritability and anger.
1,2 Grief is considered
a normal response to stressful life events
and usually resolves with time.
not typically associated with suicidal
thoughts or feelings of worthlessness.
Upon further questioning you discover
that Brian has not experienced a
significant or stressful life event. In
addition, Brian informs you that he has
experienced feelings of worthlessness,
especially when he cannot seem to ‘drag
himself out of this state, like a normal
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