Rub shoulders with Kerri Barwick MPS (centre) and other members of team PSA at CPC24[/caption]
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
Aaron, a very large man in his mid-30s, presents a wad of prescriptions to your pharmacy assistant and asks to speak to you. He recently moved near your pharmacy, needs repeats of his medicines and has asked if he can leave his prescriptions with you. You notice Aaron is taking multiple psychotropic agents:
- olanzapine 20 mg at night
- aripiprazole 10 mg once daily
- desvenlafaxine 50 mg each morning
- perindopril 10 mg/amlodipine 10 mg each morning
- metformin 500 mg twice daily.
Both antipsychotics were prescribed by the psychiatrist on the same day, and Aaron has been taking both for several months. You decide to investigate this antipsychotic prescribing practice.
Introduction
Psychotropic polypharmacy is the co-prescribing of two or more psychotropics from the same or different class (e.g. antipsychotic polypharmacy or an antidepressant with an anxiolytic).1,2
A high proportion of people prescribed antipsychotic polypharmacy are also taking high-dose antipsychotic therapy (HDAT). HDAT is increasingly used in the treatment of schizophrenia and other psychotic disorders.2,3 In the past decade, this practice has been the subject of debate due to perceived unproven efficacy and increasing adverse effects; however, in recent t
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