CSA103 Pharmacy Skills in Practice : Australian Healthcare System

CSA103 Pharmacy Skills in Practice

Question

Section A: Australian healthcare system

1. Pharmacists have a responsibility to report unlawful use of the PBS. Provide 3 brief examples of fraudulent use of the PBS by patients or pharmacists. [3 marks]

2. There are many lifestyle factors that can increase our risk of developing cancer. Identify ten risk factors, that pharmacists canhelp educate patients about indicating the type of cancer that the risk factor may cause. [5 marks]

3. Australia’s health 2020 (AIHW), reported that Indigenous Australians have a higher risk of dying from a range of chronic diseases compared to non-Indigenous Australians.  

a. Select 3 of the chronic diseases from the report and identify how much higher the risk of dying from each of the chronic diseases is for Indigenous versus non-Indigenous Australians. [1 mark]  

b. You wish to counsel your Indigenous Australian patients on behavioural changes that may reduce their mortality risk. Which 3 modifiable risk factorscould reduce the risk of the patients developing all of the chronic diseases you selected? [2 marks]  

Section B: Pharmacists in the Australian healthcare system

In the ‘Assessment’ Module in MyLO, you will find a document entitled ‘Professional services in community pharmacy list.’ Read through this information, and then answer the following questions.

Do not cite/reference your responses for this section.

1. Identify oneservice that you believe is the most important service to offer in a community pharmacy. Explain why you believe it is so important and give an example of people/patient groups that would most likely benefit from the service.
[2 marks]

2. Based on the list of professional services that can be offered in community pharmacies, and the web links included in the list, identifyone service that may be important for each of the following customers and briefly explain why:

a. A 75 year old man being treated for hypothyroidism (Hashimoto’s disease) and reflux disease (on Pantoprazole) who had a heart attack last year. [2 marks]

b. A 55 year old lady who is about to begin caring for her 2 month old grandchild, 3 days per week, while her daughter returns to part-time work. [2 marks]

c. A 70 year old man with type 2 diabetes who had a heart attack 2 years ago. He is not taking some of his heart medications because he does not know why he should take them. [2 marks]

d. A 60 year old homeless lady with end stage lung cancer prescribed MS Contin (controlled release morphine) for pain relief. [2 marks]

e. A 65 year old Aboriginal and Torres Strait Islander lady who is having difficulty managing her medication due to language issues. [2 marks]

Section C: Perspectives of the patient

1. Ted comes into your community pharmacy to have his Blood Pressure (BP) monitored. He is a busy, over-weight 60 year old, lawyer with Type 2 Diabetes Mellitus. He is not married and often works late. He is usually too tired to cook when he gets home from work, so he eats a lot of frozen meals. He likes to have a few glasses of wine to relax with dinner. He tries to take his medications regularly, but he forgets them at least once a week. He does not like exercising however he enjoys golf. He used to play golf every Saturday morning but has had too much work to catch up on to be able to play recently. The reading you take for his BP is significantly elevated.

What advice would you give Ted under the ‘biopsychosocial model” of care? (Use patient-centred terminology). How is your advice different than if you were treating Ted under the “biomedical model” of care? [2 marks]

2. You are a pharmacist employed at a North Queensland hospital where you usually have a number of Aboriginal and Torres Strait Islander patients admitted to the wards you work on. Your employer, Queensland Health requires all staff to demonstrate they are culturally safe health professionals. Provide 5 brief examples of how you could demonstrate each of your different cultural safety capabilities. [5 marks]

3. You are the pharmacist counselling an 80 year old lady who has just been diagnosed with polymyalgia rheumatica. She has been prescribed a reducing dose of prednisolone 5mg and 1mg tablets to treat her condition. The doctor has prescribed prednisolone 15mg daily for 4 weeks; then reduce daily dose by 2.5mg tablets every 4 weeks to 10mg daily; then reduce daily dose by 1mg every 4 to 8 weeks to stop. Briefly explain four ways you could help the elderly lady understand how to take her prednisolone tablets correctly. [4 marks]

Section D: OTC medications

1. Indicate the Scheduleof the following medications plus their storage and advertising requirements. [12 marks]

Clotrimazole for Athlete’s Foot Cream 10mg/g, 50gm.

Dexchlorpheniramine 2mg, 30 tablets.

Folic Acid 500mcg (recommended dose 1 tablet daily), 150 tablets.

Hydrocortisone Cream 0.5%, 30gm.

Levonorgestrel 1.5mg, 1 tablet.

Low Dose Aspirin 100mg, 28 tablets.

Metoclopramide 10mg, 25 tablets.

Naloxone Nasal Spray 2.2mg/spray.

Nystatin Oral Drops, 24mL.

Pantoprazole 20mg, 7 tablets.

Paracetamol modified release 665mg, 96 caplets.

Sumatriptan 50mg, 24 tablets.

Cite/reference ALL your responses for the remaining questions.

2. Mr Jones is a 30 year-old man who comes into the pharmacy and asks to speak to the pharmacist about his painful mouth ulcers.

a. What five questions (in addition to WWHAMM)would you ask Mr Jones to determine if he needs a referral to his GP? [2.5 marks]

b. After you determined Mr Jones did not require a referral, what medication would you recommend for Mr Jones’ mouth ulcers and how should he use it? [2.5 marks]

c. Describe four lifestyle measures that you would recommend for Mr Jones to reduce his discomfort. [2 marks]

3. Mrs Williams is a 40 year old lady who comes into the pharmacy and asks for Zoltrip (Zolmitriptan 2.5mg, 2 tablets) because she is “coming down with a migraine”.    

a. What three questions (in addition to WWHAMM)would you ask to determine whether the patient has made the correct diagnosis? (Use patient-centred terminology). Briefly explain why. [3 marks]

b. What are five important points you would include in your counselling for Mrs Williams, to ensure she takes the medication safely and effectively? [5 marks]

4. Mr Shadbolt is an overweight, 50-year-old Ancient History Teacher. He likes to have a few glasses of red wine with dinner each night to relax. He has been marking exam papers the last few weeks and drinking more coffee and eating more chocolate than usual. He has recently developed indigestion. He comes into the pharmacy to ask for something that will work longer than the Mylanta tablets his wife gave him.

a. What questions would you ask Mr Shadbolt to determine if he needs a referral to his GP? (Use patient-centred terminology). Identify which disease/condition each question is designed to exclude.[4 marks]

b. You determine Mr Shadbolt does not need a referral to his GP. Explain what OTC medication (generic name) you would provide for Mr Shadbolt and why?[3 marks]

c. What lifestyle recommendations would you suggest for Mr Shadbolt? [3 marks]

5. The following patients have a common cold and they want some medications to relieve their blocked noseand mild headache. Identify an appropriate medication (generic name) and suitable dose directions to treat each symptom, for each patient. Briefly explain why you selected the two medications you chose for each patient. Please note that any recommendations that may cause harm to the patient could result in a zero mark for the subsection (ie 0/3):  

A 3-year old boy who weighs 12kg (provide a dose in milligrams). [3 marks]

A lady who is in week 10 of her pregnancy. [3 marks]

A 76 year old man with well managed hypertension. [3 marks]

6. Mr Davidson is a 75 year old man who comes into the pharmacy and requests something to relieve his lower back pain. He was playing in a Masters golf tournament on the week-end and says that his back is “playing up again”. You determine that he does not need a referral to his GP.

a. What medication would be most suitable to rapidly relieve Mr Davidson’s lower back pain? Include the generic name and a brief justification of your selection. Also include, an appropriate duration of therapy and eight relevant points of self-care advice [7 marks]

7. Mrs Branson is a 35 year old lady who comes into the pharmacy with an itchy, red and inflamed rash on her hands. She explains that the rash started a week ago. You can see some vesicles when you examine the rash. You determine that she does not need a referral to her GP.

What medication would be most suitable to rapidly relieve Mrs Branson’s rash? Include the generic name and a brief justification of your selection. Also include, an appropriate duration of therapy and four important points of self-care advice. [6 marks]

CSA103 Pharmacy Skills in Practice