PORTFOLIO - WEEKLY ACTIVITIES
This ‘Portfolio- Weekly Activities’ is a resource for you while undertaking Weekly
Community Pharmacy Placements in third year.
Ensure you have read about, and understand, your responsibilities during these
placements. Before you commence, please read “Weekly Placements: Information
Sheet”’ on the Supplementary Materials page.
These activities will assist you in focussing on relevant areas of pharmacy practice for
your on-campus tutorials. These activities are a guide, you may add to these as guided
by your preceptor/supervising pharmacist. This portfolio is to assist you in creating an
ongoing record of your activities, observations, experiences and reflections about the
practice of pharmacy, during your programme of clinical and experiential placements.
You are to fill–in these pages and add other pages as required. For each visit, in
addition, you are to write a brief (one – two paragraphs) reflective note on your
visit for that week. You will recall that reflection is more than a list of ‘what was
done,’ as it is a thoughtful process that will encourage you to integrate your
experiences during the year.
Please note - the portfolios may be audited at any time, so ensure you are up-to-date
with your activities, reflections and interviews. The portfolio, including the reflective note
for each week, is to be handed in at the end of the semester. Keep all your portfolio
documents during the year as these will form part of your assessment in Year
Three and Year Four.
Take the portfolio to each tutorial, as you will need to be able to discuss your
experiences from the weekly community pharmacy placement.
Additional topics/activities may be loaded onto the website during the year.
Look at your timetable for the semester/year and list the tutorial topics. Think about these
upcoming topics as you prepare for your weekly pharmacy placement.
Semester One Topics:
(List)
Semester Two Topics:
(List)
1|P age
J. Tutorials - Mental Health
ACTIVITIES
1. Observe an interaction between pharmacist and patient/customer about ‘sleep’ .
(This may be a prescription for a benzodiazepine for insomnia, or someone
seeking advice about an over the counter product, or general advice about how
to improve sleep…).
2.
Describe the discussion.
The patient brought a script for diazepam (valium) and the pharmacist asked questions
regarding his sleeping patterns, work and social life as the patient had never taken it
before.
3.
What are the key points in taking a relevant history?
If on any other anxiolytic or hypnotics
Sleeping patterns
How long does it take to sleep.
Check medical history if any chances of abuse or using it for more than 4 weeks
4.
What are important counselling points when dispensing a benzodiazepine?
May cause drowsiness so don’t drive or use any heavy machinery
Take it on a when required basis.
For short term use only; max 4 weeks otherwise tolerance develops
Avoid alcohol and other meds that may cause drowsiness.
5.
Are there any relevant OTC products?
Some antihistamines example Dozile, restavit
Valerian
6.
What is the level of evidence for their use?
In the pharmacy it has been given out quite a lot indicating the customers are satisfied
with its therapeutic effect.
7.
Are there circumstances when they be could be recommended?
They recommended for short term use only. Also for patients that are not on any other
sedating medication.
2|P age
8.
When should they NOT be recommended for use?
When the patient is on anti-cholinergic medicines, tri-cycline antidepressants, antipsychotics or MAOI’s.
9.
What is ‘good sleep hygiene’?
Sleep hygiene involves having a set of habits that helps us have a good sleep at night.
10.
What advice would you give to a customer about ways to improve sleep habits?
Use for bed for sleep only, sleep in dark quiet room, avoid caffeine or any such thing at
night that causes wakefulness, go to bed at same time each night, avoid heavy meals
just before bed.
11.
Depression is common in the community, and may be difficult to discuss in the
pharmacy.
What opportunities for counselling about depression and antidepressant
medications would you want to have in your pharmacy? How would you facilitate
this clinical service?
Foremost, the customers need to feel comfortable and attended every time they enter
the pharmacy, this will allow them to open up about their life and hence build a rapport.
This can be achieved by having enough staff with a friendly attitude.
Also by having special private rooms to discuss any serious matters
Have a staff mental health educator or their details to refer the patients if necessary
12.
Observe the pharmacist dispense an antidepressant medication and, with
permission, observe the counselling. What are the important counselling points when
dispensing an antidepressant medication?
The pharmacist spoke to the patient about her social life and how she is as her
husband passed away 1 month ago. After empathising, he gave her the
medication and explained to her that
-it takes 4-6 weeks to have full effect
-best taken in the morning
-not to stop taking if she feels better one day
Then the pharmacist told her of some non-pharmacological method to help when
she is not feeling well
13.
If possible, seek permission to interview the patient about their experience of
medications.
3|P age
14.
Preparations of St John’s Wort are commonly sold in pharmacies.
List examples of the products:
They included in many brands, but I could not find it in healthy care.
Some example: blackmores, natures own, imprega, cenovis, thompsons etc
15.
What is the evidence for benefit for this St John’s Wort preparations?
Why is this not a scheduled medication?
The evidence is showed to be slightly better than placebo when treating patients with
mild depression. However, its not as effective when used for severe depression. It is a
herbal product hence not a prescription medicine.
16.
What are the important drug interactions with St John’s Wort?
It is a major CYP inducer. Interacts with many drugs example cyclosporine, warfarin,
triptans, clopidogrels, anti-depressants, antiarrythmics etc
17.
What advice would you give to a customer who seeks to purchase St
John’s Wort?
It interacts with many drugs so need to be careful.
Generally its well tolerated but may cause GI problems, anxiety, dizziness, dry mouth
Also, should not be used for long term.
18. What are the medications in the pharmacy that may be prescribed for
patients with a diagnosis of schizophrenia?
Chloropromazine, droperidol, haloperidol, pericyazine, trifluperazine, flupenthixol. Ie
these are conventional antipsychotics
19.
List important counselling points when dispensing these medications.
Can cause drowsiness, may increase effects of alcohol cannabis etc.
Take the medicines regularly.
20.
If you have the opportunity, interview a patient who has a mental health
condition. Make notes about the interview (do not record any identifying
information)
4|P age
K. Tutorials - Neurology
21.
A customer approaches you for advice regarding a product to treat a
headache. What do you need to know about the clinical situation before, as a
pharmacist, you can give advice?
Severity, location, duration
Other symptoms
If used any medicines or on any medication
Blood pressure management if hypertensive
22.
List the questions you would ask to establish what may be an appropriate
product/ or referral.
Can you describe the headache?
How long have you had it for?
Are you on any medication?
Do you know what caused it?
Has it happened before?
23.
List the S3 products in the pharmacy that may be used to treat a
headache, or to prevent or treat a migraine. When should these products be
used?
Agent
aspirin
paracetamol
NSAID’s
Anagraine
Nausetil
Nurofen plus
24.
Place in Therapy
1st line
1st line
1st line
2nd line
2nd line
2nd line
What are the differences between headache and migraine?
Headaches are usually bilateral, and rarely severe. Hardly ever experience nausea or
vomiting
Migraine: often bilateral, pain is severe and limits activity. Usually experience nausea or
vomiting
5|P age
25.
What advice could you give regarding prevention of migraine?
Rest or sleep in a dark room
Relax and reduce caffeine intake
26.
What information or resources in the pharmacy may support your counselling?
Headache and migraine on PSA
AMH and TG’s have a list of counselling points
27.
If possible, interview a patient who has a neurological condition (migraine,
Parkinson’s Disease, epilepsy, other…). Find out about the impact of this condition
on their health. What have been the medication-related issues for this patient? (do not
record any identifying information)
No chance
28.
If a customer seeks advice about assistance in remembering to take
medications, or if there is concern about confusion regarding medications, what
options can you suggest?
Blister packing and alarm on his phone to remind when to take the medicine.
Place a notification on fridge or wallet to remind when to take medicine.
29.
What questions would you ask?
Questions about side effects, therapeutic efficacy or any problems associated with it or
while taking the medicines. These could effect the compliance.
30.
What pharmacy resources or services may be appropriate?
The pharmacy I did my placement in offered free messaging services to remind them
about the next repeat due.
Pharmacy also provided blister packing services for the patients.
31.
List what you could do to assist the patient and carer.
Explain the importance of the medications.
Inform about the services to help them take their medication.
Have a carer informed to remind them about the next medication.
6|P age
L . Tutorials - Eye and Ear
32.
Observe the way your pharmacist dispenses an eye or ear drop.
How is the product labelled?
Flagged on the bottle (never on the box)
Comment on this, are there any potential problems?
Inconvenience in reading it.
The instructions can get ripped easily.
33.
Which dispensing package do you have? And are there any differences
among the computer systems and printers, when it comes to dispensing and
labelling eye drops?
LOTS dispensing system is used. And the size is consistent through every
medication, so flagging is needed.
34.
Design a label for dispensing eye drops, how could this label be
produced?
On one side it says the name of patient, the drug name and instructions.
On the other side it says the expiry date cost and script number
35.
Which resources are available in the pharmacy to assist with giving advice
about technique for administering eye drops and ointment, ear drops.
eMIMs, AMH and TG’s. furthermore the pharmacist downloaded a video from youtube
on how to administer eyedrops.
36.
Listen to your preceptor counsel some patients on the use of eye drops.
What were the eye drops for? Do patients seem to have difficulty with correct
techniques?
Xalatan for glaucoma. The patient was using it for the first time and so he
explained its storage, side effects and proper administration. Also, he printed out
a CMI for the patient
37.
Counsel one patient on the use of their eye or ear drops (with supervision
by a pharmacist).
List the questions you asked as well as the main counselling points you gave.
(do not record any identifying information)
7|P age
-what symptoms he experienced. How long he had it for? Any other medication
he is using? Family history?
-counselling: place finger under lower eyelid and pull it down gently to create a
small gap and instil with the other hand. Then close the eyes and block the tear duct for
3 minutes. Also have a 15 minute gap between next eye drop administration.
38. Pick 12 different eye or ear drops or ointments off the shelf and from the fridge
(include OTC preps as well as prescription drops) and list the ingredients and
indications.
NAME
INGREDIENTS
INDICATION
Xalacom
Timolol and latanoprost
glaucoma
Lumigan
bimatoprost
glaucoma
Xalatan
latanoprost
glaucoma
alphagon
brimonidine
glaucoma
Tenopt
timolol
glaucoma
Chlorsig
Chloramphenicol
Bacterial conjunctivitis
FML
Fluorometholone
Eyezep
Azelastine
Allergy and inflammation
condition
Allergic conjunctivis
Refresh plus
Carmellose
Dry eyes
Minims
Pilocarpine
Open angle glaucoma
Azopt
Brinzolomide
glaucoma
Visine allergy
Naphzoline+pheniramine
Mild allergic conjunctivis
8|P age
39.
Discuss with your preceptor how to differentiate between bacterial, allergic and
viral conjunctivitis and how to treat each type.
Bacterial
Viral
CAUSES?
Bacterial infections VIRAL INFECTION
Discharge?
(describe)
Yellowy pus
Associated
with?
Gritty feeling but no Painful, red eyes
pain
TREATMENT? Chlorsig
Watery clear discharge
Refer to Dr need
antiviral
Allergic
ALLERGIES
Watery eyes with No
pus
Irritation, itchy with
no pain or pus
antihistamine
40.
If possible, interview a patient who has been treated for glaucoma for a
long time, (these patients are usually using more than one agent for treatment and
are often elderly). In particular try to focus on the history of diagnosis, history of
treatment, the impact of this condition on lifestyle.
Make notes on the interview. Do not record any identifying information.
A patient in his 50’s had been receiving treatment for 7 months. The condition is well
managed but he was scared for what will happen in near future. He was on timolol for
now but expects to be on more medication later on.
9|P age
M . Tutorials - Musculoskeletal
41.
There are many different types of NSAID preparations on the market. Make a list
of all the different dosage forms and their schedule, and describe when they might be
useful.
Preparation
Example: S2 Gel (Voltaren, Diclac)
Potential Use

Patient has injured one area playing
sport e.g. elbow
Caution required in treating this patient
with systemic therapy
NSAID tablets available in s2 or s3. Eg
Pain, headache, fever
voltaren, nurofen, advil
Nurofen back patch
Back pain
nurofen liquid
Mostly for children, fever, headache
10 | P a g e
42.
Observe dispensing of a NSAID. Review the patient’s medication history for
any relevant clinical issues. Before supplying a NSAID, what are important clinical
conditions and medications that should be considered in the patient’s history?
Medications: if on Blood pressure, antiarrythmic or some other cardiovascular
medicines.
Who is it for? What is it being used for? How long did you experience this symptom for?
Any allergies? Other medications or medical condition? WWHAMM
43.
If possible interview a patient about their arthritis. Ask the patient about their
arthritis (i.e. is it osteoarthritis or rheumatoid arthritis). Find out about the impact on
the mobility and lifestyle. Make notes on the interview. Do not record any identifying
information
Elderly man. Struggled to walk quickly. Had a lot of pain getting up while seated. Was
on paracetamol osteo and also taking glucosamine
44.
Are there any products/devices in your pharmacy that might assist an arthritic
patient with their daily activities?
Are there any other places that you could refer such a patient?
Walking sticks
Exercise regimens and examples in pamphlets for anyone interested
45.
If possible, interview a patient who has gout. (Hint: someone taking allopurinol
who may be collecting a repeat prescription). Make notes after the interview below. Do
not record any identifying information
No oppurtunity
N. Tutorials – Oncology
46.
Pharmacists have an important role to play in helping people to reduce risk
factors which may contribute to development of common cancers including: skin, lung
and gastrointestinal cancers. List products available in the pharmacy which you could
recommend to assist people to prevent the following cancers (note these may include
non-drug and drug strategies):
11 | P a g e
a) melanoma, squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) of
the skin
Sunscreens
Sunglasses and hats
b) lung cancer
Information about risk of smoking
Patches and replacement therapy
c) colon cancer
prep kits for colon scopy
47.
Mouthwashes which contain alcohol can sting, cause irritation and discomfort to
patients receiving chemotherapy affecting the oral mucosal lining. Look at the
mouthwashes available in your pharmacy. List mouthwashes which do not contain
alcohol. Of these, list three products which you could recommend to a patient who
comes into your pharmacy requesting a mouthwash to help relieve symptoms of a sore
mouth and mouth ulcers. Include the dose and any special instructions for use in your
answer.
Product
Dose
Instructions
1 teaspoon
Rinse and gargle for 30 seconds
Brotene dry mouth oral care
Dentel alcohol free
mouthwash
½ cup
Rinse and gargle for 30 seconds
Colgate alcohol mouthwash
½ cup
Rinse and gargle for 30 seconds
12 | P a g e
It is estimated that more than 50% of patients with a malignant illness are using
or taking some form of alternative/complementary therapy. There is evidence to
suggest that many patients choose not to discuss taking alternative or complementary
therapies with their doctors. Look around your pharmacy, identify at least five
treatments which might be used by people with cancer as alternate/complementary
therapies. For each product, list how it is used or taken, the dose range which might be
being taken, and any concerns and/or interactions which may be associated with your
patients using these products.
48.
Product
Acai berries
Vitamin E
Resveratrol
Co-enzyme Q10
Evening primrose
oil
Garlic
How Used
Dose
Interactions
2-3 scoops of
powder daily
1 cap 2 times a
day
1 daily with food
-
Hardly any
500IU in each
capsule
200 mg
Warfarin
1 daily with food
150 mg
1-3 daily with food
1000mg
1-2 three times a
day with food
30mg bulbs
Warfarin and
Nsaids
Warfarin and BP
medication
Anticoagulants,
NSAIDs
Anticoagulants
and NSAIDs
Side
Effects/toxicity
Has caffeine so
has its SE
Nausea, vomitting,
diarrheoa etc
Nothing serious
Cardiac SE, GI
problems
GI and headaches
Bad odour,
nausea,Vom, Dia
49.
If possible, interview a patient who has been affected by cancer (includes all
types of cancer including skin cancers) or carer who looks after someone receiving
treatment for cancer. Make notes of the interview. Do not record any identifying
information.
13 | P a g e
50.
Infections may be a complication of the treatment of some malignancies.
Depending on the type and severity of the infection, home-based intravenous treatment
may be continued out of hospital. Does you pharmacy have any resources or services
to support these patients and their carers?
Nothing much is provided
If this were the situation for one of your regular patients, how could you assist the
patient?
Refer to the hospital
O. Tutorials - Dermatology
51. List FIVE topical products that may be recommended by a pharmacist- and list the
condition, with signs and symptoms that would be treated appropriately with this topical
product
product (generic name of drug and concentration)
Condition(signs and symptoms)
Dermaid
-----------------------------------------canestan
-------------------------------------Dermeze ointment
-----------------------------------------SOOV itch
-----------------------------------------Voltaren
-----------------------------------------Hydrosole
------------------------------------------
inflammation, bites, eczema
-----------------------------antifungal
-----------------------------dryskin
-----------------------------itchy skin
-----------------------------muscle pains
-----------------------------anti-fungal and antiinflammatory
------------------------------
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14 | P a g e