Home CPD Chronic kidney disease and quality use of medicines

Chronic kidney disease and quality use of medicines

CPD

Associate Professor Ronald L Castelino and Dr Wubshet Tesfaye

April 11, 2024

CPD credits

Accreditation Number : CAP2405CDMRC

Group 1 : 0.75 CPD credits

Group 2 : 1.5 CPD credits

This activity has been accredited for 0.75 hours of Group 1 CPD (or 0.75 CPD credits) suitable for inclusion in an individual pharmacist's CPD plan, which can be converted to 0.75 hours of Group 2 CPD (or 1.5 CPD credits) upon successful completion of relevant assessment activities.

Case scenario

Mrs Johnson, 72, visits your pharmacy seeking over-the-counter relief for her lower back pain. She shares that her GP has advised her to avoid certain analgesics due to her reduced kidney function, though she could not recall the specifics. You review her My Health Record, and assess her medical history. Mrs Johnson weighs 56 kg and has a blood pressure reading of 137/90 mmHg from your measurement in the pharmacy. Her recent My Health Record shows an eGFR of 52 mL/min/1.73 m² and serum creatinine of 95 micromoL/L. Her current medications include apixaban (5 mg twice daily), fenofibrate (145 mg daily), sotalol (80 mg twice daily), metformin (1 g twice daily), rosuvastatin (5 mg daily), valproate (200 mg twice daily), thiamine (100 mg daily), candesartan (8 mg daily) and insulin glargine (18 units at bedtime).

Learning objectives

After reading this article, pharmacists should be able to:

Discuss the methods used to estimate renal function to guide adjustment of doses in chronic kidney disease
List commonly prescribed medicines that may require dose reduction or cessation in people with chronic kidney disease
Discuss risk factors for developing chronic kidney disease
Describe strategies to optimise quality use of medicines in patients with chronic kidney disease.

Competency (2016) Standards addressed: 1.1, 1.4, 1.5, 2.2, 3.1, 3.2, 3.3, 3.5

Accreditation number: CAP2405CDMRC

Accreditation expiry: 30/04/2027

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ACT³	No comparable criteria
NSW⁴	· pharmacist gives the person an opportunity to seek advice as to the use of the substance · quantity, or for a purpose must accord with the recognised therapeutic standard of what is appropriate in the circumstances
NT⁵	· pharmacist must not intentionally supply to a person in a manner reckless to their circumstance
QLD⁶	· pharmacist reasonably believes the patient has a therapeutic need
SA	No comparable criteria
TAS⁷	· pharmacist forms the opinion use in the treatment of the patient is justified on consideration of the condition, disease or symptoms of the person
VIC⁸	· for treatment of a patient under pharmacist’s care · pharmacist has taken all reasonable steps to ensure a therapeutic need exists
WA⁹	No comparable criteria

ACT³	No comparable criteria
NSW⁴	· pharmacist gives the person an opportunity to seek advice as to the use of the substance · quantity, or for a purpose must accord with the recognised therapeutic standard of what is appropriate in the circumstances
NT⁵	· pharmacist must not intentionally supply to a person in a manner reckless to their circumstance
QLD⁶	· pharmacist reasonably believes the patient has a therapeutic need
SA	No comparable criteria
TAS⁷	· pharmacist forms the opinion use in the treatment of the patient is justified on consideration of the condition, disease or symptoms of the person
VIC⁸	· for treatment of a patient under pharmacist’s care · pharmacist has taken all reasonable steps to ensure a therapeutic need exists
WA⁹	No comparable criteria

ACT³	No comparable criteria
NSW⁴	· pharmacist gives the person an opportunity to seek advice as to the use of the substance · quantity, or for a purpose must accord with the recognised therapeutic standard of what is appropriate in the circumstances
NT⁵	· pharmacist must not intentionally supply to a person in a manner reckless to their circumstance
QLD⁶	· pharmacist reasonably believes the patient has a therapeutic need
SA	No comparable criteria
TAS⁷	· pharmacist forms the opinion use in the treatment of the patient is justified on consideration of the condition, disease or symptoms of the person
VIC⁸	· for treatment of a patient under pharmacist’s care · pharmacist has taken all reasonable steps to ensure a therapeutic need exists
WA⁹	No comparable criteria

ACT³	No comparable criteria
NSW⁴	· pharmacist gives the person an opportunity to seek advice as to the use of the substance · quantity, or for a purpose must accord with the recognised therapeutic standard of what is appropriate in the circumstances
NT⁵	· pharmacist must not intentionally supply to a person in a manner reckless to their circumstance
QLD⁶	· pharmacist reasonably believes the patient has a therapeutic need
SA	No comparable criteria
TAS⁷	· pharmacist forms the opinion use in the treatment of the patient is justified on consideration of the condition, disease or symptoms of the person
VIC⁸	· for treatment of a patient under pharmacist’s care · pharmacist has taken all reasonable steps to ensure a therapeutic need exists
WA⁹	No comparable criteria

1. PBS co‑payment will drop

2. Transition to the new MMR credential must be completed

3. Continued freeze on PBS concessional co‑payment

4. Optional allowable discount phase out continues

5. New PSA standards for CPD accreditation launch

Is advance provision of S3s legal?

But don’t we need to assess a patient’s therapeutic need?

So when is advanced supply of S3 OK?

What other things do I need to consider?

So what about the Rikodeine?

Table 1 – Legal requirements for pharmacists when prescribing Schedule 3 medicines

References

What motivated you to seek election as the next PSA National President?

What do you hope to achieve as PSA President?

Why do you feel this is such a pivotal moment for PSA and the profession?

What are the major challenges pharmacists are facing right now?

How do you see the profession evolving in 5 years?

How have your background and previous experiences shaped your views of the profession?

Case scenario

Learning objectives

Introduction

Aetiology and pathophysiology

Clinical features

Diagnosis, differential diagnosis and prognosis

Management and treatment

Knowledge to practice

Conclusion

Case scenario continued

Key points

References

Our authors

Our reviewer

Conflict of interest declaration

1. PBS co‑payment will drop

2. Transition to the new MMR credential must be completed

3. Continued freeze on PBS concessional co‑payment

4. Optional allowable discount phase out continues

5. New PSA standards for CPD accreditation launch

Is advance provision of S3s legal?

But don’t we need to assess a patient’s therapeutic need?

So when is advanced supply of S3 OK?

What other things do I need to consider?

So what about the Rikodeine?

Table 1 – Legal requirements for pharmacists when prescribing Schedule 3 medicines

References

What motivated you to seek election as the next PSA National President?

What do you hope to achieve as PSA President?

Why do you feel this is such a pivotal moment for PSA and the profession?

What are the major challenges pharmacists are facing right now?

How do you see the profession evolving in 5 years?

How have your background and previous experiences shaped your views of the profession?

Case scenario

Learning objectives

Introduction

Aetiology and pathophysiology

Clinical features

Diagnosis, differential diagnosis and prognosis

Management and treatment

Knowledge to practice

Conclusion

Case scenario continued

Key points

References

Our authors

Our reviewer

Conflict of interest declaration

1. PBS co‑payment will drop

2. Transition to the new MMR credential must be completed

3. Continued freeze on PBS concessional co‑payment

4. Optional allowable discount phase out continues

5. New PSA standards for CPD accreditation launch

Is advance provision of S3s legal?

But don’t we need to assess a patient’s therapeutic need?

So when is advanced supply of S3 OK?

What other things do I need to consider?

So what about the Rikodeine?

Table 1 – Legal requirements for pharmacists when prescribing Schedule 3 medicines

References

What motivated you to seek election as the next PSA National President?

What do you hope to achieve as PSA President?