The use of insulin, considered a high-risk medication with APINCHs classification,5 Ms Barwick notes, provides justification for a Home Medicines Review (HMR). ‘There’s an advantage to going into the home to observe the patient’s diet, consider potential interactions, and educate patients on the best effects and outcomes,’ she says.
Advice around cleaning blood glucose level (BGL) monitors to ensure accuracy can also be provided. ‘Pharmacists can explain how to put test drops through and clean blood spills on the monitor, common in pregnancy due to higher blood volume,’ says Ms Barwick.
With only 50% of women diagnosed with GDM receiving tests for heart disease and type 2 diabetes post-pregnancy,6 HMRs can be beneficial at this stage of the journey, too.
‘Along with conversations around diet choices, exercise regimes and sleep, I also explain how often testing is required over the next 5–10 years, and how to monitor for signs of the development of diabetes,’ Ms Barwick advises.
Nausea and vomiting in pregnancy
The presence of iron in pregnancy multivitamins may exacerbate symptoms of nausea and vomiting in some pregnancies, according to Ms Barwick.
‘Pharmacists can recommend a trial cessation of the iron component of pregnancy vitamins, often unnecessary in pregnancy,’ she says.
In 2020, photographer Bobbi Lockyer created a Birthing on Country project to highlight and create awareness around birthing issues and outcomes in Aboriginal women. For more, see 
Suzanne Nielsen MPS[/caption]
Case scenario
Mrs Jones has come into your pharmacy with a prescription for Vagifem Low pessaries (10 microgram estradiol). You ask Mrs Jones to join you in the private counselling area so you can discuss her condition and gather further information. Mrs Jones explains that she is going through menopause and visited her GP to get something to treat her persistent vaginal dryness. She has been fortunate so far to experience very few hot flushes, however she is finding the vaginal dryness particularly bothersome as she is experiencing intense itch and irritation. Sexual intercourse with her husband is painful. She is very keen for symptomatic relief but is concerned about using hormone therapy, as her mother died of breast cancer. Her girlfriend recommended she try the natural progestogen cream that she uses.
Learning objectivesAfter successful completion of this CPD activity, pharmacists should be able to:
Competency standards (2016) addressed: 1.1, 1.4, 1.5, 2.2, 3.1, 3.5 |
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Introduction
Vaginal dryness is a common and bothersome problem experienced by a large number of women at some point in their lives.1 It occurs due to reduced vaginal secretions caused by decreasing estrogen levels.2,3 It is most commonly experienced by women going through menopause but can also be experienced by premenopausal women.
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