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
Mr Walker, aged 59 and weighing 100 kg, is found at home acting erratically. His clothing is drenched, the shower is running and his medicines are scattered everywhere. His Glasgow Coma Scale (GCS) score is fluctuating between 5 and 14 and he is agitated. The ambulance transports him to hospital.
Initial observations are: temperature 37.8°C, blood pressure (BP) 106/64 mmHg, heart rate 105 bpm, respiratory rate 16 breaths/minute, oxygen saturation 98%. Initial labs show white cell count 25×109/L, creatinine 160 micromol/L (baseline 60). Urgent blood cultures have been sent, and 2 L of 0.9% sodium chloride has been administered intravenously. His BP is now 98/67 mmHg. A central line is inserted and noradrenaline infusion commenced.
Learning ObjectivesAfter reading this article, pharmacists should be able to:
Competency |
THIS IS A CPD ARTICLE. YOU NEED TO BE A PSA MEMBER AND LOGGED IN TO READ MORE.
