5 - Improving public health

• Population based care

• Reducing health disparities and inequalities in CAPE

• Designing prevention, intervention, and educational strategies for individuals and communities…

3 roles of pharmacist in public health (acc. to AACP)

• Antimicrobial stewardship and infection control

• Substance abuse prevention, education, and treatment

• Prevention of controlled substances diversion

• Managing drug product shortages

• Immunization and tobacco cessation

• Emergency preparedness and response

6 roles of pharmacist in public health (acc. to ASHP)

• Promoting population health.

• Promoting medication safety efforts in their institutions and communities

• Engaging in opioid stewardship efforts, including prevention, intervention, and treatment

activities pharmacists can engage in to promote public health (3)

public health

• It is one of the efforts organized by society to protect, promote, and restore the peoples’ health

• It is a combination of sciences, skills, and beliefs that is directed to the maintenance and improvement of the health of all the people through collective social actions.

• health promotion

• prevention

• rehabilitation

3 core activities of public health

health promotion

a key element in public health and is applicable in the community, clinics or hospitals, and in all other service settings.

• Directing action to risk factors or causes of illness or death

• Initiating action against health hazards

• Involving public participation in defining problems, deciding on action

• Advocating relevant environment, health, social policy

• Encouraging health professionals’ participation in health education and health policy

5 elements of health promotion

PREVENTION

refers to the goal of medicine that are to promote, to preserve, and to restore health when it is impaired, and to minimize suffering and distress

• Primary

• Secondary

• Tertiary

3 levels of prevention

primary preventions

• prevention that refers to those activities that are undertaken to prevent the disease and injury from occurring

• works with both the individual and the community

• directed at the host, to increase resistance to the agent

• Search and destroy mosquito breeding sites

• Self-protection measures

• Seek early consultation

• Support fogging for impending outbreaks

• Sustain hydration

5S of dengue

secondary preventions

• prevention that refers to the early diagnosis and management to prevent complications from a disease

• includes steps to isolate cases and treat or immunize contacts to prevent further epidemic outbreaks

tertiary preventions

prevention that involves activities directed at the host but also at the environment in order to promote rehabilitation, restoration, and maintenance of maximum function after the disease and its complication have stabilized.

rehabilitation

• process of restoring a person’s social identity by repossession of his/her normal roles and functions in society

• involves the restoration and maintenance of a patient’s physical, psychological, social, emotional, and vocational abilities

• Interventions are directed towards the consequences of disease and injury

providing high quality rehab services

• Providing measures and services to deliver the care plan

• ▪ Conducting a full assessment of people with disabilities and suitable support systems

• Establishing a care plan

• Providing measures and services to deliver the care plan

Nutrition

science of food, the nutrients and other substances therein. Their action, interaction and balance in relation to health and disease

Reproductive Health

health in the matter relating to the reproductive system and to its functions and process.

• biologic

• chemical

• social

• physical

basic approach to environmental control is first to identify _____, _____, _____, and _____ factors that represent hazards to health or well-being and to modify the environment in a manner that protects people from harmful exposure

• Water sanitation

• Ensure water is safe for drinking. Regular inspection

• waste disposal (MRF)

3 principal components of environmental health

health education

• defined as a combination of learning experiences designed to facilitate voluntary actions conducive to health

• essential part of health promotion

smoking

• practice of inhaling smoke from burning plant material

• It travels down your airways, into your lungs and through your bloodstream to your brain and other organs

• social activity and a part of people’s routine

• Relaxed and calm

• Buzzed and energized

• More able to focus on tasks

smoking might you feel (3)

• 2021

• DOH Quitline

• 1558

In _____, the ______ nationwide toll- free hotline ____ was launched.

smoking cessation initiative

• This program aims to provide support for smokers in order to improve their ability to become and stay nicotine-free

• general objective of the program is to generate awareness of and promote the early prevention

• heart disease

• fertility problems

• pregnancy complications

• poor oral hygiene

• integumentary system problems

5 possible effects of smoking

atherosclerosis

• buildup of plaque in the blood vessels

• This buildup limits blood flow and can lead to dangerous blockages

Secondhand smoke exposure

occurs when people breathe in smoke breathed out by people who smoke or from burning tobacco products

nicotine patch

• this intervention works by releasing nicotine throughout the day which is absorbed through your skin

• The released nicotine binds to nicotine receptors in the body, reducing nicotine craving and withdrawal symptoms

nicotine gum

• this intervention works by releaseing nicotine into the system, helping to reduce nicotine withdrawal symptoms and cravings

• provides a lower level of nicotine to the blood than cigarettes, allowing smokers to gradually reduce their need to smoke

bupropion

• this drug intervention is highly effective in treating depressive disorders

• norepinephrine-dopamine reuptake inhibitor (NDRI)

• can be used as a smoking cessation aid

• it doesn’t affect the user’s libido and doesn’t cause any weight gain

norepinephrine-dopamine reuptake inhibitor (NDRI)

type of drug that boosts levels of the neurotransmitters norepinephrine, also known as noradrenaline and dopamine

Smoking cessation

critical step towards achieving better health and well-being

physical symptoms

these type of symptoms are collectively known as smoker’s flu

psychological symptoms

these type of symptoms affects the brain in numerous ways with the nicotine directly activating neurotransmitters to release dopamine and other chemicals

antibiotics

are medicines that fight infections caused by bacteria in humans and animals by either killing bacteria or making it difficult for bacteria to grow and multiply

• orally

• topically

• injection

• IV

4 ways antibiotics can be taken

penicillins

this type of antibiotics blocks cross linking via competitive inhibition of the transpeptidase enzyme

vancomycin

this type of antibiotics disrupts peptidoglycan cross-linkage

beta-lactamase inhibitors

this type of antibiotics blocks cross-linking

cephalosporins

this type of antibiotic inhibits bacterial cell wall synthesis via competitive inhibition of the transpeptidase enzyme

aminoglycosides

this type of antibiotic does irreversible binding to 30S

tetracyclines

this type of antibiotic blocks tRNA

macrolides

this type of antibiotic reversibly binds to 50S

lincosamide

this type of antibiotic inhibits peptidyl transferase by interfering with aminoacyl-tRNA complex

rifampin

this type of antibiotic inhibits RNA transcription by inhibiting RNA polymerase

metronidazole

this type of antibiotic works by producing metabolic byproducts that disrupt DNA

inhibits cell synthesis

• penicillin

• vancomycin

• carbapenems

MOA of this class of antibiotics?

inhibits cell wall synthesis

• beta-lactamase inhibitors

• aztreonam

• cephalosporins

MOA of this class of antibiotics?

protein synthesis inhibition

• aminoglycosides

• tetracyclines

• macrolides

• chloramphenicol

• lincosamide

• linezolid

MOA of this class of antibiotics?

DNA synthesis inhibition

• rifampin

• metronidazole

• isoniazid

MOA of this class of antibiotics?

anbiotic misuse

broad term that refers to improper use of antibiotics

antibiotic overuse

• another term for antibiotic misuse (specific)

• excessive or unnecessary use of antibiotics

• one of the most common ways for antibiotic misuse to happens

antibiotic / antimicrobial resistance (AMR)

• public health development threat

• global concern

• one of the most prominent and important risk of antibiotic misuses and overuse

• puts modern medicine at risk

National Antimicrobial Stewardship (AMS) Program

• integral component of the Philippine Action Plan to Combat Antimicrobial Resistance (AMR)

• gives structure and direction to healthcare facilities to adopt a proactive multidisciplinary approach to promote rational antimicrobial use

National Antibiotic Guidelines Committee (NAGCOM)

National Antibiotic Guidelines 2017 were formulated by the ______, which comprised experts in infectious diseases, epidemiology, pharmacology, and public health program management.

National Antibiotic Guidelines 2017

These guidelines cover treatment recommendations for various infectious diseases, considering evidence based practices and local context

NAG app

• mobile application that aims to increase the rational use of the National Antibiotic Guidelines in a bid to combat antibiotic resistance

• The app aims to provide an accessible, cost-effective, and easily updated form of the NAG to healthcare workers

National Antibiotic Guidelines (NAG) 2018

The guidelines in the NAG app reflect the _____ by the Department of Health

PSMID

for now, access to the NAG app is limited to ____ members and research respondents

ReproductiveHealth (RH)

state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity, in all matters relating to the reproductive system and to its functions and processes.

RA10354 (An Act Providing for a National Policy on Responsible Parenthood and Reproductive Health) (RPRH Act of 2012)

RA that defined reproductive health and the national safe motherhood program

National Safe Motherhood Program

This program contributes to the national goal of improving women’s health and well-being by:

• collaborating with Local Government Units in establishing sustainable, cost-effective approach of delivering health services that ensure access of disadvantaged women

• Establishing core knowledge base and support system

• component A - local delivery of maternal-newborn service package

• component B - national capacity to sustain maternal-newborn services

2 program components of National Safe Motherhood Program

• LGU

• development partners

2 partner institutions of the national safe motherhood program

AO 2008-0029

this AO is the implementing health reforms to rapidly reduce maternal and neonatal mortality

AO 2015-0020

this AO is the guidelines in the administration of life saving drugs during maternal care emergencies by nurses and midwives in birthing centers

AO 2016-0035

this AO is the guidelines on provision of quality antenatal care in all birthing centers and health facilities providing maternity care services

AO 2018-0003

this AO is the national policy on the prevention of illegal and unsafe abortion and management of post-abortion complications

National Family Planning

The objectives of this program are:

• To increase modern Contraceptive Prevalence Rate (mCPR) among all women from 24.9% in 2017 to 30% by 2022

• reduce the unmet need for modern family planning from 10.8% in 2017 to 8% by 2022

Components A, B, C, D

5 components of the national family planning program

A

this program component of the national family planning is: Provision of free FP Commodities that are medically safe, legal, non-abortifacient, effective and culturally acceptable to all in need of the FP service

B

this program component of the national family planning is: Demand Generation through Community-based Management Information System

C

this program component of the national family planning is: Family Planning in Hospitals and other Health Facilities

D

this program component of the national family planning is: : Financial Security in FP

• Adolescent Health Education and Practical Training (ADEPT)

• Foundational Course (including Healthy Young Ones)

• Healthy Young Ones (HYO) Training

• Adolescent Job Aid (AJA) Training

4 types of service in HIV, AIDS and STI, prevention and control program

AO 2017-0019

this AO is the Policies and Guidelines in the Conduct of Human Immunodeficiency Virus (HIV) Testing Services (HTS) in Health Facilities

AO 2018-0024

this AO is the Revised Policies and Guidelines on the Use of Antiretroviral Therapy (ART) among People living with Human immunodeficiency virus (HIV) and HIV-exposed infants

AO 2019-0001

this AO is the Guidelines on the Implementation of Rapid HIV Diagnostic Algorithm

AO 2019-0016

this AO is the Policies and Guidelines on the Prevention of Mother to Child Transmission (PMTCT) of Human Immunodeficiency Virus (HIV)

AO 2022-0010

this AO is the guidelines Guidelines on Human Immunodeficiency Virus (TB-HIV) Services Integration for Universal Health Care (UHC)

abstinence

The most reliable way to avoid STD infection

Birth control (contraceptives) pills

A daily pill that contains hormones to change the way the body works and prevent pregnancy

condom

highly effective in reducing STD transmission

vaccines

safe, effective, and recommended ways to prevent hepatitis B and HPV

• 11 or 12

• 9

• 26

HPV vaccination is recommended for preteens ages ___ or ___ (or can start at age ___ ). Vaccination is not recommended for everyone older than age ___ years.

Mutual monogamy

means that you agree to be sexually active with only one person, who has agreed to be sexually active only with you

STDs

infections spread from person to person during sex (vaginal, oral, or anal) or close sexual contact

Antibiotics (single-dose)

Indicated for the three bacterial (chlamydia, gonorrhoea and syphilis) and one parasitic STIs (trichomoniasis)

Antivirals

Indicated for herpes and HIV that can modulate the course of the disease, though they cannot cure the disease

RA 10354

RA that has the potential to contribute to the improvement of public health outcomes, socioeconomic development, and the wellbeing of individuals and families in the Philippines