Home CPD Cystic fibrosis

Cystic fibrosis

CPD

February 2, 2021

CPD credits

Accreditation Number : CAP2102CDMPB

Group 1 : 1.75 CPD credits

Group 2 : 3.5 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 1 CPD (or 1.50 CPD credits) upon successful completion of relevant assessment activities.

Introduction

Cystic fibrosis (CF) is an autosomal recessive disorder affecting the cystic fibrosis transmembrane conductance regulator (CFTR) gene.¹ Patients with CF have a mutated gene, resulting in defective CFTR proteins causing thick mucus in multiple body systems.² CF mainly affects the lungs and the digestive systems in the body.² At present there is no cure for CF, so the aims of treatment are to delay disease progression with lifelong pharmacological and non-pharmacological interventions.³ CF pharmacists are involved in medicines optimisation, antimicrobial stewardship and medication counselling to improve treatment adherence.

Learning objectives

After successful completion of this CPD activity, pharmacists should be able to:

Define cystic fibrosis
Describe the pathophysiology of cystic fibrosis
Discuss the management of patients with cystic fibrosis
Identify the role of the pharmacist in managing a patient with cystic fibrosis.

Competency standards (2016) addressed: 1.1, 1.3, 1.4, 2.1, 2.3, 2.4, 3.2

Extended learning activity

After additional reading and research from recommended resources, pharmacists should be able to:

Identify drug-drug interactions and modify treatment regimens when managing people with cystic fibrosis
Assess the pharmacokinetic and pharmacodynamic properties of drugs used in cystic fibrosis when formulating treatment options
Discuss the drug treatment used for managing cystic fibrosis, including the management of adverse drug reactions.

Competency standards (2016) addressed: 1.1, 1.3, 1.4, 1.5, 2.2, 2.4, 3.1, 5.3

Already read the CPD in the journal? Scroll to the bottom to SUBMIT ANSWERS. Submit answers for the EXTENDED

THIS IS A CPD ARTICLE. YOU NEED TO BE A PSA MEMBER AND LOGGED IN TO READ MORE.

CPD LOGIN

Click here to become a member

	Australian data	Rural and remote residents
People taking a prescribed medicine every day	> 9 million	2.61 million
People taking two or more prescribed medicines in a week	8 million	2.32 million
People taking over-the-counter medicines daily	> 2 million	0.58 million
People taking a complementary medicine daily	> 7 million	2.03 million

Instead of saying . . .	Perhaps try . . .
Do you have any questions?	What questions do you have? (An example to prompt might be: Have you ever been worried about side effects or drug interactions?)
Take four times each day on an empty stomach	Taking a capsule four times a day on an empty stomach can be hard to organise. Can you explain for me how you will fit this into your daily meal routine for the next 5 days?
Do you take any other medicines?	This tablet can cause problems with some medicines, particularly antidepressants and diabetes medicines. What other medicines do you use?
Have you used this medicine before?	How effective has this medicine been for you in the past? OR If you had to give this medicine a score out of 10, what would it be?
Take this tablet every morning	When would you usually take your medicine?
Assumption . . .	Safer practice: Assume little to no knowledge with questions like . . .
Assuming patients know their medicines well	Why do you use that medicine? How do you take it? What time of day? Is it every day or just when you need it? How do you remember to take it regularly?
Assuming adverse effects are known to the patient	Have you ever experienced muscle soreness? What was the pain like (for muscle issues with statins)?
Directing what should happen when specific issues are identified	You’ve taken that PPI for X amount of time, but haven’t had any reflux symptoms for Y amount of time. As long-term use of PPIs can lead potentially to vitamin B12 deficiency and an increased risk of fractures from falls, would you be open to reducing the PPI dose, making it ‘when required’ or ceasing it altogether with an antacid or H2 antagonist on hand if needed?
What other medicines and natural supplements do you take (of which the GP may be unaware)?	Have I forgotten to ask about other medicines you might use? What others – vitamin supplements, puffers, creams, etc – do you use? What do you use for pain, say, for a headache or sore muscles? How often do you use these products? Have you bought anything else from the pharmacy lately?

Types 1, 2 or 3	Silicone foam dressing	Moderate exudate Longer wear time (2–7 days depending on exudate levels)	A silicone wound contact layer May need a secondary cover dressing appropriate to amount of exudate Mesh maintains moisture balance and is useful in minimising damage on removal
Types 1, 2 or 3	Silicone mesh	Dry or exudative wound
Types 1 or 2	Skin glue	To approximate wound edges	For experienced practitioners
Types 2, 3	Hydrogel	To create a moist environment	For necrotic, sloughy or painful wounds Non-adherent; needs secondary dressing e.g. foam
Type 3	Foam, mesh or hydrogel	Choose based on wound characteristics	No need to protect flap

Non-approved substances (i.e. those not approved by a government regulatory health authority for human therapeutic use)	Stimulants Narcotics Cannabinoids Glucocorticoids Beta-blockers	Beta-blockers (may be prohibited in competition only or at all times)
Anabolic substances
Peptide hormones, growth factors and related substances
Beta-2 agonists (exceptions are given for inhaled beta-2 agonists within maximum doses)
Hormone and metabolic modulators
Diuretics/masking agents

Rural and remote Australia statistics

Medicine misadventure

Indigenous Australians

Invisible work

Health professional access

Burden of disease

Workforce

Suboptimal medicine use and harm

The way forward

‘Fingers crossed’ for Easter

Advice for pharmacists

Pharmacist vaccinations

Supporting pharmacists during COVID-19

Making medicines more accessible

More pharmacists honoured

Asthma medicines advice

Prevention and other recommendations

TAREN GILL MPS

Accessibility issues

EVA QUEK MPS

Impact on patients

Counselling advice

Efficacy of treatment

Collaborating with allied health professionals

Pharmacists critical to rollout

A lack of knowledge

Pharmacist intervention

Flying blind

Words matter

A patient’s perspective

Body language is important

ILWOO PARK MPS

Bridging the gap

Instead of saying . . .

Perhaps try . . .

Assumption . . .

Safer practice: Assume little to no knowledge with questions like . . .

Case scenario

Learning objectives

Already read the CPD in the journal? Scroll to the bottom to SUBMIT ANSWERS.

Introduction

How is a skin tear identified and classified?

What causes skin tears?

What are the risk factors?

How should a skin tear be managed?

What dressings are recommended?

When is referral required?

How can skin tears be prevented?

Role of the pharmacist

Resources

Conclusion

Case scenario continued

Key points

Case scenario

Learning objectives

Already read the CPD in the journal? Scroll to the bottom to SUBMIT ANSWERS.

Introduction

Incidence and risks of drug misuse in sport

Reasons for drug misuse

World Anti-Doping Agency Prohibited List

Prohibited substances used by athletes

Androgens

Beta agonists and beta-blockers

Diuretics

Growth hormone and growth factors

Stimulants

Oxygen transport enhancers

Recreational drugs

Dietary supplements

Therapeutic Use Exemptions

The role of the pharmacist

Resources

Conclusion

Case scenario continued

Key points

Case scenario

Learning objectives

Already read the CPD in the journal? Scroll to the bottom to SUBMIT ANSWERS.

Introduction

Classification

Considerations for residents in aged care facilities⁸: