SYSTEMIC DRUG THERAPY

SYSTEMIC DRUG THERAPY

There are many different types of systemic medication therapy: those that treat the entire body as a whole, or those that target specific bodily systems, such as the cardiovascular, gastrointestinal, or nervous systems. Additionally, the treatment of mental health issues is systemic.

The nervous system Before medications like tacrine (which showed limited promise for enhancing cognition) was developed, treatment for Alzheimer's disease—the most common form of dementia—was purely supportive. Research shows that older people who are routinely stimulated with memory exercises retain information better than those who are not, proving that the continuous use of cognitive abilities prevents memory loss in the elderly.

" shaking palsy," as described by the English surgeon James Parkinson in 1817, is a persistent neurological illness that results in a gradual loss of motor function. Levodopa and other medications help reduce tremors, muscle rigidity, and postural instability, but no treatment has been found to stop the disease's progression. One of the several ergotamines and nonsteroidal anti-inflammatory drug formulations is effective in treating migraines, which are thought to be caused in part by aberrant neurophysiological reactions (NSAIDs). In the treatment of severe migraines, sumatriptan has dramatically better, with fewer side effects, than ergotamine or dihydroergotamine.

Mental disorders For anxiety and depression, recent developments in medication have proven significant. Although long-term use of benzodiazepines can lead to mild dependence, they have been the primary treatment for anxiety disorders since the 1960s. No matter how much alcohol you

consume, you won't experience any withdrawal symptoms when taking a drug like buspirone

(azapirone). As a result, there are also newer and safer treatments for panic disorder and OCD.

In the last few decades, significant progress has been made in the treatment and prevention of

depression. Anxiolytics such as Prozac and other SSRIs are as effective as older antidepressants

but come with fewer unpleasant side effects. Overdosing is less of a risk with these drugs,

which is important to keep in mind for patients with severe depression.

SYSTEMIC DRUG THERAPY

SYSTEMIC DRUG THERAPY

There are many different types of systemic medication therapy: those that treat the entire body

as a whole, or those that target specific bodily systems, such as the cardiovascular,

gastrointestinal, or nervous systems. Additionally, the treatment of mental health issues is

systemic.

The respiratory system

Acute bronchitis cough medications are the most commonly prescribed for respiratory

treatment. Only bacterial infections can be treated with antibiotics. Expectorants and

humidification (steam therapy) are the most common treatments for colds and flus because

they help loosen or liquefy thick mucus and soothe the inflamed mucous lining. Despite the fact

that they are frequently recommended, no clinical evidence supports the effectiveness of these

treatments. The natural defensive mechanism of coughing, which is to clear the airway of fluids

and foreign substances, is also subverted by cough suppressants, which are designed to prevent

unneeded coughing. This non-opioid cough suppressant, dextromethorphan, is readily

accessible over the counter and is nearly as effective as codeine. Antihistamines and

decongestants may be helpful if nasal congestion and postnasal discharge are present.

Asthma is a condition in which the airways become obstructed, resulting in wheezing episodes.

Using bronchodilators to treat a mild to moderate asthma episode is beneficial. Corticosteroids

or other anti-inflammatory medications like cromolyn sodium or necromil sodium must be used

for long periods of time to control recurrent attacks.

Chronic cough and shortness of breath are the first symptoms of chronic obstructive pulmonary

disease (COPD), which usually appears in old age. Some benefit can still be gained by quitting

smoking, utilizing bronchodilators, and taking antibiotics early when a superimposed infection

appears, even when the majority of the harm has already been done. When a patient's

condition is grave, supplemental oxygen therapy may be necessary.

The gastrointestinal system

Diarrhea and constipation are routinely treated with medications, which either decrease or

increase lower gastrointestinal activity. To help with constipation, there are many different

types of laxatives that can be taken in the form of stimulants (such as cascara sagrada), bulk-

forming agents (like psyllium seed) or even lubricants (like mineral oil) that can be taken in the

form of laxatives. If the cause of the diarrhea is a bacterial infection, such as traveler's diarrhea,

antibiotics must be used, or an antiparasitic medication must be used if a parasite is to blame.

Narcotics (codeine, paregoric) and nonnarcotic analogues (loperamide hydrochloride) are used

to treat diarrhea, as well as bismuth subsalicylate, a nonnarcotic analogue (Pepto-Bismol).

Antibiotics and bismuth are commonly used to treat chronic gastritis and recurrent peptic

ulcers caused by Helicobacter pylori infection. The H2-receptor antagonists (e.g., cimetidine)

and medicines that build a barrier to protect the stomach from the acid are used to treat ulcers

that are not caused by H. pylori (e.g., sucralfate). In addition to providing symptomatic relief,

anti-acids can be employed.

Vomiting and nausea are natural defense mechanisms that should not be ignored until the

underlying reason has been identified. They may be the result of mental illness or be brought

on by problems with the digestive or central nervous systems, drugs, or underlying health

issues (pregnancy or diabetic acidosis). The phenothiazines (e.g., Compazine) are among the

most commonly used antiemetics, although new medications are being researched to assist

reduce the vomiting associated with cancer chemotherapy.

SYSTEMIC DRUG THERAPY

SYSTEMIC DRUG THERAPY

There are many different types of systemic medication therapy: those that treat the entire body as a

whole, or those that target specific bodily systems, such as the cardiovascular, gastrointestinal, or

nervous systems. Additionally, the treatment of mental health issues is systemic.

The cardiovascular system

In the most prevalent form of arteriosclerosis, known as hardening of the arteries, cholesterol deposits

form plaques in large and medium-sized arteries, narrowing the lumen and reducing blood flow. When

the coronary arteries (which supply blood to the heart muscle) become obstructed, this narrowing

reduces the artery's capacity to deliver oxygen-rich blood to tissues. Depending on the extent of injury, a

heart attack might occur, which leads in the loss of heart muscle. Lowering blood cholesterol,

particularly the low-density lipoprotein (LDL) component, can halt or even reverse the progression of

atherosclerosis. Exercise, a low-cholesterol diet, and a healthy weight can all help lower cholesterol

levels. High-density lipoprotein (HDL) cholesterol is advantageous in that it aids in the removal of

dangerous cholesterol from the artery wall. Some medicines can enhance HDL cholesterol levels in the

blood, but avoiding smoking and increasing exercise are the most effective ways to raise the amount of

HDL cholesterol.

Angina can be caused by coronary artery narrowing, which reduces blood flow to the heart (angina

pectoris). A variety of medications, including nitroglycerin and beta blockers, can be used to treat this

disease.

Cardiotonic drugs have long been used to treat congestive heart failure (CHF). A positive inotropic

impact (affecting the force with which muscles contract) on the heart was first observed using digitalis, a

foxglove plant derivative. There are two ways to administer digoxin, the most frequent type of this drug.

Too much digitalis is poisonous and can cause cardiac arrhythmias, thus it has a narrow therapeutic

range. A patient's serum potassium levels are closely monitored since toxicity is exacerbated when the

patient's serum potassium levels are lower than normal.

In addition to decreasing the burden on the heart, drugs that dilate arterial smooth muscle and lower

peripheral resistance (vasodilators) help cure heart failure. Treatment for heart failure includes the use

of ACE inhibitors, vasodilators that suppress the angiotensin converting enzyme. Hypertensive patients

can also benefit from taking these medications.

Essential hypertension, or primary hypertension, is the most common kind of hypertension.

Approximately 5% of all hypertensive patients have secondary hypertension, which is high blood

pressure that is caused by a known underlying medical condition (e.g., kidney disease). While weight

loss, exercise, and a reduction in sodium intake are usually the first steps in treating hypertension, a

wide range of medications are available to help lower blood pressure, whether the systolic or diastolic

reading is too high. Traditionally, a single, well-tolerated medication, such as a diuretic, was the first

step in a stepped-care approach. If it doesn't work, a second drug is added and the combination is

tinkered with until the most successful regimen is discovered with the fewest adverse effects. In some

cases, a third medicine may be required for treatment.

SURGICAL THERAPY

SURGICAL THERAPY

 Major categories of surgery

1. Treating wounds

Wound heal in three ways:

1) primary intention (wound edges are brought together, as in a clean surgical wound),

2) secondary intention (the wound is left open and heals by epithelization), or

3) third intention, or delayed closing, whether they were caused by an accident or a surgical

scalpel (the wound is identified as potentially infected, is left open until contamination is

minimized, and is then closed).

The optimum procedure depends on a number of factors, including the presence of severe bacterial

contamination, the ability to identify and remove all necrotic material and foreign bodies, and the ability

to control bleeding. Clean wound edges and close opposing without putting too much strain on the

tissue are essential for normal healing to occur. The wound necessitates an adequate blood flow. The

blood supply will be compromised if the tissue is too tight and the margins can't be closed without

putting pressure on them. The edges can be pulled together more easily if the subcutaneous tissue is

removed by cutting under the skin. Skin grafts or flaps are utilized to close the wound if direct

approximation is still not achievable.

After the wound has been thoroughly cleaned, a local anesthetic, such as lidocaine, is used and left in

place for one to two hours before the incision is sealed shut. Local anesthetic injections might be

followed by additional washing of the wound, especially if foreign material is present. Scrubbing

aggressively is essential to remove the many small pieces of debris that are embedded in the skin if the

injury was caused by a fall on gravel or asphalt. Drenching the affected area in high-pressure saline

solution will eliminate most foreign material and limit the risk of further infection. As tetanus is a

disease caused by infection with Clostridium tetani, wounds that have been contaminated must be given

proper immunizations.

Sutures are the most often used method of wound closure, but staples and sticky tissue tape may be

more suited in some cases. To seal skin wounds, silk sutures were initially used, however nylon is more

durable and less likely to trigger tissue reaction than silk. As a general rule, sutures should be as small in

diameter as possible while still ensuring that the wound edges are kept as close together as possible.

Catgut (produced from sheep intestines) or a synthetic material like polyglycolic acid are used to imitate

the deeper layers of tissue beneath the skin in order to reduce tissue response. In order to speed up

healing or prevent fluid from accumulating, the goal is to fill in any empty spaces. Open suction drains

are used to prevent the accumulation of liquid, but drains are a source of contamination and only

seldom used. Staples allow for a quicker skin closure, although they lack the precision of sutures. Tape is

a great tool if the edges can be pulled together effortlessly and tension-free. However, tape can come

loose or be removed by the patient and is less effective if there is substantial wound edema even

though it is comfortable, quick to apply and avoids the markings produced by sutures.

Depending on the location, the desired cosmetic outcome, the blood flow to the area, and the degree of

reactivity around the sutures, sutures are normally removed after 3 to 14 days. In order to avoid visible

scarring, sutures in the facial area are normally removed within three to five days of placement. Tape is

commonly used to support the wound for the time it takes to heal. If there is a lot of tension on the

wound, sutures in the trunk or leg will be removed in 7 to 10 days or even longer. The horizontal neck

incision for thyroidectomy minimizes scarring and tension by placing an incision parallel to normal skin

lines.

Dressings keep the site clean and allow drainage to be absorbed more easily. During the first 24 hours

after surgery, a surgical wound is most vulnerable to surface contamination, hence an occlusive dressing

of gauze and tape is used. Transparent semipermeable membranes allow the wound to be viewed

without the dressing being removed, thereby protecting the wound from contamination. Compression

aids healing in the same way that skin grafts do.

When a wound heals, a scar forms; the goal is to have a scar that is strong but not overly visible.

Regardless of how meticulously the incision was closed, some people develop a keloid, a dense

overgrowth of scar tissue. Irritation and migration are followed by migration and proliferation, and

finally scar formation and closure. During the first 24 hours, platelets form a clog by attaching to the

collagen revealed by blood artery injury. The platelets and fibrin combine to create a clot, and the white

blood cells enter to remove any foreign material that may have gotten into the wound. In order to

increase the amount of blood flowing to the injured region, the vessels in the area widen, which speeds

up the healing process. Fibroblasts and macrophages invade the wound during the migratory phase to

begin healing. A scab is formed when epithelial cells migrate across a blood clot and connect with

nearby capillaries to produce new blood vessels. new epithelial cells cover and connect to build new

blood vessels in the proliferative phase. Fibroblasts release collagen to promote healing strength. Late in

the healing process, the scar is remodeled, blood vessels expand, and the epithelium on the surface of

the wound heals.

Wound healing can be affected by a variety of conditions, including diabetes mellitus and drugs. If the

blood glucose level is too high, wound healing may be impaired and the wound may be more susceptible

to infection in patients with well-controlled diabetes. Wound healing can be delayed by kidney or liver

failure, malnutrition, and poor circulation caused by arteriosclerosis. Steroids, anticancer treatments,

and other medications might interfere with the body's natural healing process.

2. Surgical extirpation

In the treatment of cancer or other damaged or contaminated organs, the term "extirpation" refers to

the removal or eradication of an organ or tissue to its whole. All malignant tissue must be removed,

which usually entails removing both the visible tumor and any nearby tissue that may contain tiny tumor

expansions. A complete cure is guaranteed unless the cancer spreads through the lymphatic system,

which is the primary method of cancer dissemination. Therefore, it is common practice to remove

nearby lymph nodes at the same time that the tumor is surgically removed. The results of a node biopsy

will reveal whether or not the cancer has spread to other parts of the body (spread). Using this

information, doctors can determine if more treatment is necessary, such as radiation therapy or

chemotherapy. Palliative surgery, which offers pain relief but does not remove the tumor entirely, may

be an option if removing the tumor completely is not possible. In the early stages of breast cancer,

radical surgery may not be the best option. No more benefit has been proven in early breast cancer than

a lumpectomy (removal of tumor only) followed by radiation treatment to the area, but the patient's

psychological anguish is typically enhanced by this procedure. In recent years, however, advancements

in breast reconstruction techniques have reduced the severity of the trauma associated with a

mastectomy.

3. Reconstructive surgery

To replace tissue that has been severely damaged or removed during surgery or trauma, reconstructive

surgery is often required. If the wound cannot be closed properly, a skin graft may be required. Split-

thickness skin grafts are employed when a substantial region of skin needs to be replaced. In spite of the

fact that this type of graft has a higher survival rate and a faster healing rate than other grafts, their

appearance is visually unappealing. For tiny defects, such as those on the face or hands, a full-thickness

skin graft (epidermis and dermis) is performed, and skin from the ear or neck is most commonly

employed. A skin flap is necessary for exposing bone, nerve, or tendon. Both a local flap and a free flap

can be utilized to cover the defect, depending on how much tissue is available in the location where the

wound is located. Using nearby tissue (skin and subcutaneous tissue) rotated to cover a scar from skin

cancer removal is an example of a local flap. When the required amount of tissue isn't accessible locally,

like in a lower-leg injury caused by a car bumper, a free flap is employed. There are a variety of flaps that

can be employed depending on the amount of tissue needed and the blood supply available. A sufficient

blood supply is required to feed both the split flap and the wound edge.

Additional tissue can be generated using tissue expanders, which can be utilized to conceal a deformity.

Reservoirs are implanted under the skin of a neighbouring area using inflatable plastics. To stretch the

overlaying skin and cover the defect, saltwater is injected into the reservoir for several weeks.

Medical issues that can necessitate reconstructive surgery include but are not limited to: Implanting

prosthetic devices, such as artificial heart valves, pacemakers, joints and blood arteries, or bones, can be

necessary in some cases.

Replace sick tissue with a prosthetic device. Because they are created of a substance that does not

provoke rejection, they often perform better than donated tissue. Early in the 16th century, the first

attempts at creating artificial limbs were made. An aortic aneurysm graft, developed by American

surgeon Michael DeBakey and his colleagues in 1954, was one of the earliest prosthetic devices used in

cardiovascular medicine to replace dilated vessels that risk rupture and death. Later, grafts consisting of

identical materials were used to replace damaged arteries in the body. Metal joints and heart valves are

two further examples of prosthetic devices (e.g., hip, knee, or shoulder).

4. Transplantation surgery

The discovery of immunosuppressive cyclosporine in the early 1970s dramatically enhanced the success

of organ transplantation. It has since been created a variety of immunosuppressive medications such as

prednisone, macrolide lactone, and antibodies that have been shown to be effective in the treatment of

autoimmune diseases (e.g., muromonab-CD3 and basiliximab).

Transplant surgeries involving the kidney are among the most common. Living relatives frequently

donate their kidneys in order to increase the chances of a transplant recipient's long-term survival.

Identical twins have the best chance of surviving. There is also the utilization of cadaver transplants.

Ninety percent or more of grafts survive one year. Approximately 50 percent of grafts fail after 8 to 11

years, although some can endure for decades. However, the chances of a successful transplantation

decline rapidly with time, thus kidneys removed from living donors must be implanted within 24 hours

at the latest. They can be kept for up to 72 hours.

Success rates with this operation are steadily rising, and it can be performed for up to six hours. To

reduce the chance of rejection, blood and tissue types are closely matched. The donor and donated

organs should be the same size as the receiver and the recipient's organ, and the time between the

declaration of death and the procurement of the organ should be as short as feasible.

End-stage liver disease can be treated by a liver transplant in some patients. The mortality rate following

surgery ranges from 10% to 20%, depending on the patient's age and health. All survivors need long-

term immunosuppressive treatment.

SKIN SURGICAL TECHNIQUES

SKIN SURGICAL TECHNIQUES

1. Laser surgery

At short distances, a laser beam can generate significant heat by emitting a very intense

monochromatic, nondivergent beam of light. Laser photocoagulation (also known as laser

welding) is used to stop bleeding in the gastrointestinal tract after a peptic ulcer. It is also used

to repair a surgically detached retina. Lasers can be used to cure pigmented tumors, erase

tattoos, or coagulate a hemangioma since they are absorbed by pigmented lesions (a benign but

disfiguring tumor of blood vessels). To treat superficial bladder cancer, laser surgery can also be

paired with transurethral ultrasound-guided laser-induced prostatectomy (TULIP). The

treatment of glaucoma and cervix and vulva diseases, including cancer in situ and genital warts,

are more recent applications.

2. Cryosurgery

Cryosurgery is a technique in which tissue is vaporized under extremely low temperatures.

Liquid nitrogen can be used to treat warts, precancerous skin lesions (actinic keratoses), and tiny

cancerous lesions on the skin. Extraction of central nervous system abnormalities (including

difficult to reach brain tumors) and treatment of some heart conduction problems are other

possible uses.

3. Stereotactic surgery

For deep lesions in the brain that cannot be reached otherwise, stereotactic surgery is a

valuable neurosurgical technique that allows the use of cold (as in cryosurgery), heat, or

chemicals to find and treat them. One of the advantages of this technique is that it keeps the

head immobile in a "halo frame," which aids in the precise location of the lesion or area that

needs treatment.

High-intensity radiation is also focused using stereotactic techniques on specific parts of the

brain in order to treat tumors or eliminate arteriovenous malformations. With the patient under

local anesthetic, a single burr hole in the skull is all that is needed to guide fine-needle aspiration

biopsies of brain lesions with this approach. Additionally, stereotactic fine-needle biopsy can be

utilized to examine breast lesions that are not palpable but are found by mammography.

4. Minimally invasive surgery

New technology that uses a small incision to insert a rigid or flexible endoscope to enable

internal video imaging is replacing traditional open surgical techniques. Treatments such as

endoscopic procedures (endoscopy) are frequently used to treat the nasal sinus, intervertebral

discs, fallopian tubes (including the uterus), shoulders, and knee joints. Even while endosurgery

has several advantages over conventional surgery, it can be more expensive and have a greater

rate of complications.

5. Trauma surgery

One of the most common reasons of lost life expectancy is trauma. Surgeons are now able to

save more lives than ever before thanks to the rapid advancement of medical technology and

instrumentation. Adult respiratory distress syndrome, multiorgan failure, kidney failure, sepsis,

and other life-threatening conditions can now be treated in the intensive care unit thanks to a

variety of life-supporting monitoring and technology.

Radiation therapy and other nonsurgical treatment options

1. Radiation therapy

electromagnetic waves (e.g., X-rays) or particles, such as electrons, neutrons, or protons, are

examples of ionizing radiation. Free radicals and oxidants are formed when cells come into

contact with tissue, resulting in cell death. Radiation may typically retain organ structure and

function while causing less harm than surgery when done correctly. Depending on the tumor's

radiosensitivity and the surrounding healthy tissues, a specific kind of radiation is applied. By

depositing their energy at a higher depth with high-energy sources such as linear accelerators,

these treatments not only cure deep-seated tumors but save the skin as well. Alternatively,

numerous beams of radiation can be directed at the deep tumor, providing a lesser dosage to

the rest of the body. Some skin malignancies can be treated with low-intensity electron beam

radiation.

2. Hyperthermia

More sensitive than healthy tissue to temperatures about 43 degrees Celsius (109.4 degrees

Fahrenheit). Tumor centers, where blood supply is low and radiation is ineffective, are more

sensitive to heat than the rest of the tumor. Microwaves or ultrasound can be used to heat a

tumor. Hyperthermia, a kind of nonionizing radiation treatment, may improve the effects of

radiation and chemotherapy.

3. Photodynamic therapy

Photodynamic treatment is another non-ionizing radiation therapeutic method (PDT). To use

this method, a light-absorbing chemical is injected into the body, and only the cancer cells retain

it. Laser beams of the proper wavelengths are used to destroy the cells. Tumors of the bronchi,

bladder, skin, and peritoneal cavity can be treated using PDT.

4. Extracorporeal shock wave lithotripsy

"Extracorporeal shock wave lithotripsy" refers to the use of shock waves to disintegrate stones

in the urinary system, most commonly the kidney or upper ureter (ESWL). The urethra and

bladder are the final destinations for the resulting stone pieces or dust particles.

The patient is given a general, regional, or even local anesthesia before the shock wave is

administered to the flank above the kidney. Stones of this size don't need to be submerged in

water; shock waves are instead conveyed through the skin by use of a water-filled rubber bulb.

Endoscopes are used to remove stones that are too big to be handled this way.

PSYCHOTHERAPY

PSYCHOTHERAPY

Pharmacotherapy:

With the introduction of new and more effective pharmaceuticals for a wide range of mental

diseases, the use of drugs to treat mental problems has increased substantially. Antipsychotics,

antianxiety medicines, and antidepressants are all psychotropics, and they may be subdivided

into three categories:

1. Antipsychotic agents:

Patients with mental illness were able to return to society thanks to antipsychotics like

chlorpromazine. Schizophrenia, a severe mental illness marked by delusions, hallucinations,

and occasionally aberrant behavior, is the major reason for the use of antipsychotics. In

paranoid schizophrenia, hallucinations are commonly accompanied by delusions that

revolve around a particular topic. A patient's metabolism of the medicine or the intensity

and character of the adverse effects may determine which drug is most beneficial.

2. Antianxiety agents:

Anxiolytics, often known as mild tranquillizers, help patients who are otherwise unable to

cope with the environmental or personal variables that cause their symptoms to worsen.

These medications include barbiturates, benzodiazepines, nonbenzodiazepine-

nonbarbiturates, and hypnotics, as well as other related classes. Since they've been around

for the longest, the barbiturates phenobarbital, amobarbital, pentobarbital, and

secobarbital are the most common. They're sedatives or used to treat seizures

(phenobarbital).

Anti-anxiety medications such as benzodiazepines have taken over the market.

Chlordiazepoxide (Librium) was the first to be discovered in 1959. Following the discovery of

chlordiazepoxide, a wide range of benzodiazepines were synthesized, each with a unique

set of characteristics. Some are primarily used to treat insomnia with hypnotics (sleep aids).

Prior to the introduction of benzodiazepines, there were only barbiturates and

meprobamate to treat anxiety. Barbiturates and meprobamate have been supplanted in the

treatment of anxiety by benzodiazepines, which have less negative side effects and a lower

potential for addiction. Treatment of alcohol withdrawal and relaxation of muscular spasms

as well as preparation for anesthesia are all possible benefits of these drugs. However, drug

dependence can be a concern, especially in those who have previously been dependent on

alcohol or other psychoactive substances. Examples of nonbenzodiazepine and

nonbarbiturate drugs include meprobamate. Benzodiazepines, on the other hand, are more

effective and safer.

Some additional anxiolytics include buspirone, which has a minimal potential for misuse and

is safer than other anxiolytics in the long-term treatment of chronic conditions such as

generalized anxiety disorder. In addition, they do not cause drowsiness, making them safe

for patients to use while driving or using machinery.

These include chloral hydrate, antidepressant sedation, and sedating antihistamines such as

diphenhydramine (Benadryl) and hydroxyzine, which are all hypnotic drugs (Atarax). In

comparison to benzodiazepines, they have a greater morning hangover impact and other

side effects that make them less popular. Many anti-anxiety and hypnotic medications may

be used for both purposes, making the difference between the two difficult. Antianxiety

benzodiazepines, particularly in the elderly, can induce sleep in many people with low

dosages of hypnotic benzodiazepines.

3. Antidepressant drugs

Affective disorders include depression, which is a prevalent mental illness (also called mood

disorders). Depression can be adequately treated with a variety of medications. Based on

side effects or safety, one is chosen over another. Tricyclics, selective serotonin reuptake

inhibitors (SSRIs), monoamine oxidase inhibitors (MAOIs), and other heterocyclic

antidepressants are the primary groups of antidepressants (e.g., trazodone, bupropion). For

example, the SSRIs such as fluoxetine and paroxetine have no sedative effect or

anticholinergic action, related weight gain or heart toxicity. However, they can provoke

uneasiness in certain people.

Tricyclic antidepressants, which include tertiary amines and secondary amines, are the

oldest and most researched class. In addition to their sedative properties, tricyclics can

cause cardiac problems and have a range of anticholinergic side effects that some people,

particularly the elderly, have trouble tolerating. To put it another way: The inhibition of

parasympathetic nervous system impulses results in anticholinergic side effects as dry

mouth and diarrhea. Drug interactions with MAOIs can be hazardous. For tyramine, which

may cause hypertension and severe headaches, this is especially true Tyramine can be

contained in a wide variety of foods, thus patients who take it must follow a strict diet.

Mood swings are a hallmark of bipolar illness, which can range from exuberant exhilaration

and gregariousness to deep sadness. To get the best results from lithium, the most

commonly prescribed mood stabilizer, it is necessary to have frequent blood concentrations

monitored. Anticonvulsants, such as carbamazepine and lamotrigine, may be recommended

if the patient has mania or depression while taking lithium.

4. Psychotherapy

Psychological counselling can be used to modify unwanted or possibly hazardous behavior

in a behavioral treatment, or behavioral modification. Most treatment focuses on modifying

unhealthy behaviors including smoking cessation, weight loss, alcohol control, or better

stress management.

5. Behavioral therapy

Changes in behavior can be achieved by behavioral therapy, also known as behavioral

modification, which employs psychological counselling. Changing bad behaviors, such as

quitting smoking, dieting to decrease weight, abstaining from alcohol, or managing stress

more efficiently, is the primary focus of treatment.

6. Group therapy

In group therapy, a skilled therapist—a psychiatrist, psychologist, social worker, or member

of the clergy—works with a group of patients or family. Each member of the group benefits

from the group's interactions. Behavioral modification can be used in groups to improve

eating habits, resulting in weight loss. A variety of support groups are provided to help

those coping with cancer, alcoholism, abuse, death, and other life-altering events.

7. Family and systemic therapy

Following World War II, general systems theories began to appear in the biological and

social sciences. As a result, people began to see themselves as interconnected parts of

broader social systems. The focus of systemic treatment in psychotherapy is not on the

genesis of issues, but on the dynamics of connections that impact problems. Instead of

focusing just on the behavior or internal dynamics of individuals, the therapist's purpose is

to transform the dynamics of the relationships. For example, if a child is exhibiting tantrum-

like behavior, the family's developmental stage, communication quality, and the clarity and

flexibility of family roles would be taken into consideration.

One or more family members, such as teenage disciplinary issues, marital strife, drug

misuse, or relational difficulties in families that come from remarriage might benefit from

family counselling.

PREVENTIVE MEDICINE

PREVENTIVE MEDICINE

The goal of preventive medicine is to decrease or eliminate a patient's exposure to risk factors

in an effort to keep disease away. Vaccination of children is an example of primary prevention,

which aims to prevent disease from occurring in the first place. It is possible to prevent or cure

diseases through secondary prevention, which involves spotting early signs of illness before

they manifest into symptoms. Pap smears and mammograms are two examples of routine

screenings. The goal of tertiary prevention is to slow or halt the spread of an existing disease.

To put it plainly, primary prevention is a more cost-effective approach to illness management.

There are a number of leading causes of death around the world that include:

 cardiovascular disease,

 cancers,

 cerebrovascular illness,

 accidents, and

 chronic obstructive pulmonary disease.

 Cigarette smoking is a leading cause of preventable death because of the increased risk

of cardiovascular illness (e.g., heart attack), cancer, stroke, and chronic lung diseases

like emphysema and chronic bronchitis.

Disease prevention suggestions and guidelines have been issued by a variety of organizations

around the world. According to a Canadian Task Force on Periodic Health Examination, the US

Preventive Services Task Force was established to evaluate the efficiency of various screening

tests, vaccinations and preventive regiments based on a careful review of the scientific

literature in the US. Clinical Preventive Services Guide presents the panel's recommendations

for a wide range of disorders.

Preventing infectious diseases is best done through vaccinations. Diphtheria, tetanus, and

pertussis, also known as whooping cough (DTP), polio (OPV), measles, mumps, and rubella

(MMR), Haemophilus influenzae type b (HbCV), and hepatitis B, are all common childhood

vaccines that are routinely administered to children and babies (HBV). Infants and children

under the age of 2 should be vaccinated against influenza every year; adults over 65, those with

chronic cardiopulmonary disease, and those in long-term care facilities should also receive the

vaccine each year. Pneumococcal pneumonia can be prevented using a vaccine that contains 23

of the most frequent strains of Streptococcus pneumoniae.

A major infectious illness problem is acquired immunodeficiency syndrome (AIDS), caused by

the human immunodeficiency virus (HIV). Obstacles in the way of a vaccine's development

remain high. Preventive strategies include abstaining from sexual contact, using condoms, and

avoiding sharing needles among intravenous drug users.

A heart attack can be prevented by reducing or eliminating risk factors such as a sedentary or

inactive lifestyle, being overweight or obese, smoking, high blood pressure, raised serum

cholesterol, and binge drinking. Risk factors for cardiovascular disease include a higher LDL (low

density lipoprotein) level, as well as a decrease in HDL (high density lipoprotein). Changing

one's diet to one that is lower in total cholesterol and higher in LDL can lower these levels,

while quitting smoking and getting more exercise can improve HDL levels. If none of those

options work, there are a number of cholesterol-lowering medications to choose from.

Hypertension, cigarette smoking, and type 2 diabetes mellitus are all substantial risk factors for

stroke. Up to 20 percent of stroke victims experience a TIA, which includes symptoms such as

momentary visual loss in one eye, unilateral numbness, slurred speech, and localized weakness

in one arm or leg. TIAs usually occur before a stroke. Until a stroke occurs, attacks continue no

more than 24 hours and dissipate without causing permanent damage.

Avoiding cigarette smoke is the most effective way to reduce one's chance of developing

cancer. Nonsmokers are increasingly becoming aware of the dangers of exposure to continue

smoking, which causes 30 percent of all cancer deaths. Sunscreens and protective clothing can

be used as primary skin cancer prevention measures. As a secondary preventive measure for

cancers other than cancer of the uterus, uterus, and ovaries, secondary measures include

mammography (clinical breast examinations), breast self-examinations (BSEs), and Pap tests

(cervical cancer/ovarian cancer) and sigmoidoscopy (digital rectal examinations) for colorectal

cancer.

Osteoporosis is more common in men and women over the age of 70, and it can lead to

fractures, low back discomfort, and a shortening of stature. A common symptom of oestrogen

insufficiency in postmenopausal women is osteoporosis. Estrogen replacement medication and

increased calcium intake are the most effective ways to maintain bone mass after menopause.

Tobacco and excessive alcohol use should be avoided, and physical activity should be increased

as a primary preventive measure.

A major cause of accidental fatality in the United States is alcohol misuse. Other factors include

not wearing seatbelts or motorcycle helmets, lack of sleep, and having guns in the house. Take

appropriate precautions and learn about the dangers of alcohol and guns to help limit the

number of accidental deaths caused by these two substances.

MUSIC THERAPY

MUSIC THERAPY

A therapeutic field in which music is employed for nonmusical purposes. Musical activities such

as songwriting and improvisation are used by therapists to achieve goals in mobility, cognition,

language and emotional health.

Music therapy is an allied health profession that provides health treatments that aren't often

supplied by doctors or nurses or other medical professionals. Music is a strong and familiar

medium that may be used across the lifetime, from neonatal intensive care units through

elderly homes and hospices. Music therapy can also be used in psychiatric hospitals, prisons,

and drug treatment facilities.

Historical evolution

The oldest musical instrument ever discovered is a bone flute that dates back 42,000 years. For

these and other reasons, music therapy is assumed to have been around for a long time. Music

therapy has been explored and recorded mostly from a Western perspective, though. As a

result, there is a strong Western bias in the therapeutic use of music. Music as Medicine: The

History of Music Therapy was edited by British academic Peregrine Horden. There has been a

distinction made between "first world" music therapy (found in nations such as the United

States and the United Kingdom) and "traditional" or "indigenous" music therapy (found in

countries such as Africa, Asia, and Latin America). There are many instances of indigenous

healing rituals that incorporate music and dance. Music and dancing are often referred to as

the same thing in various African languages.

Understanding the dominant idea of healing and sickness is often crucial to understanding the

use of music as treatment. After a shift in thinking from a belief in divine retribution (disease as

punishment from the gods) to a focus on the physical causes of illness (such as an imbalance of

four bodily fluids), ancient Greek physicians began to believe that music could help restore both

body and soul to a state of harmony. One of the most widely cited philosophers in favor of

music is Plato, who has written extensively on the subject of music.

Music was studied for its physiological effects in the 1800s as the scientific approach became

more refined. In 1789, a paper titled "Music Physically Considered" was the first to be published

on the subject of music therapy (author unknown). Edwin Augustus Atlee and Samuel Mathews

both produced dissertations on the topic in 1804 and 1806, respectively. Atlee and Mathews

trained under Benjamin Rush, an American physician who advocated for the use of music in the

treatment of patients. Blackwell's Island Asylum in New York was the first facility to conduct

music therapy studies on patients in the 19th century.

Post-WWII, the discipline of music therapy saw a spike in activity. To help troops suffering from

post-traumatic stress disorder, American veteran's hospitals recruited musicians (PTSD). As a

result, a college-level curriculum was developed for a professional music therapy practice.

The National Association for Music Therapy (NAMT) was established in 1950, after many

unsuccessful efforts to form a professional organization in the United States. There was a

second organization founded in 1971, the American Association for Music Therapy, with a

distinct approach to practice. The American Music Therapy Association was formed in 1998

with the merger of the two organizations.

In addition, the World Federation of Music Therapy and the European Music Therapy

Confederation were also established in 1985 and 1990, respectively, as organizations dedicated

to music therapy. It was their job to put on conferences and oversee educational activities, as

well as research projects and advocacy efforts. Undergraduate and graduate programme in

music therapy may be found all around the globe. Typically, the clinical phase required more

than 1,000 hours of training.

Clinical Practice

When it comes to music therapy, a wide range of instruments and musical styles are used.

Listening and singing familiar music might be used as an example of intervention. Music is

selected based on the patient's interests and demands. Rhythmically driven music, for example,

may be utilized to enhance gross or fine motor movement if a music therapist is dealing with a

patient who has a movement issue. Sedative music may be used by a music therapist to help a

patient prepare for surgery, childbirth, chemotherapy, or the end-of-life care. Reducing one's

response to everyday stresses may also be achieved via the use of these strategies.

For young children who have not yet learned to speak, music therapy may be a useful

treatment option for autism. To the autistic child, music is a world apart from spoken language

or ambient noises. When children are captivated by music, it may be utilized to help them

develop communication and social skills. Music therapists may help patients with dementia by

bridging the gap between their deteriorating mental abilities and their love of music. A person's

favorite music from their formative years is stored in their brain for as long as they want, even

if the condition has progressed significantly. When a person is feeling worried or agitated or has

to do everyday tasks like washing or dressing, music therapy may help them recall happy

experiences and bring comfort, inspiration, and relaxation.

Music therapists, like other therapists, operate within the framework of a therapeutic

interaction. ' In order to provide the best possible care to patients of any age or ability level,

music therapists are educated in psychology, biology, and neuroscience.

In music therapy, there are several approaches:

Music therapy may be practiced in a variety of ways. Nordoff-Robbins music therapy, for

example, is an improvisational method to treatment that also incorporates the writing of music.

When Paul Nordoff and Clive Robbins were working with children with developmental

problems, they came up with the idea of using music to help them (e.g., intellectual, sensory, or

motor disability). Patients of all ages may benefit from this treatment method, which is widely

used across the globe.

An autistic youngster, for example, may spontaneously vocalize, and these vocalizations might

serve as the foundation for improvised music. When a youngster has the sensation of "being

heard," it captivates them. It is possible for a music therapist to adjust and develop the music

improvisation after attention has been gained in order to encourage the kid to express

themselves vocally or musically in certain ways. An infant's nonverbal communication with his

or her careers is mirrored in the musical background. Taking turns, repeating the other's

output, and building on those products are all essential to the development of speech,

language, and cognition throughout this stage of development.

Neurologic music therapy is a specialization that music therapists might choose to pursue

(NMT). As a neurorehabilitation specialist, you'll learn how to apply scientifically proven

methods to your practice (the recovery of neurologic function). There are a number of

strategies that may be utilized in this approach to help improve cognitive, sensorimotor, and

speech abilities, including auditory perception training and patterned sensory augmentation. A

variety of health care professionals, including physical, occupational, and speech therapists as

well as doctors and nurses, may get training in neurology music therapy at institutions all

around the globe.

Originally developed by Helen Lindquist Bonny, a music therapist in the United States, guided

imagery and music (GIM) is a music-based psychotherapy approach that tries to integrate the

many components of well-being. Patients are guided into an even deeper level of relaxation by

the therapist in sessions. During this time, the patient is encouraged to share his or her

innermost thoughts, emotions, and recollections while listening to specially chosen music.

The use of music therapy in the neonatal critical care unit is also possible (NICU). Premature

newborns benefit greatly from NICU music therapy, a highly specialized field of practice.

Premature newborns may benefit from the systematic use of music therapy in the NICU, such

as improved eating, according to studies. Hospitalization stays may be minimized and costs

slashed by this method.

LOCAL DRUG THERAPY

LOCAL DRUG THERAPY

A general anesthetic is not necessary for many surgical procedures because to the use of local

anesthetics, which provide numbness and reduce pain. The patient won't have to spend the

night in the hospital unless something goes wrong. Anesthetizing particular peripheral nerves or

larger nerve trunks can also be accomplished with local anesthetics. There are a variety of uses

for nerve blocks that include pain management, but they are most commonly used to

anaesthetize the hands or feet during surgeries on the upper extremities. A local injection of

anesthetic into the subarachnoid or epidural region of the lumbar (lower back) section of the

spinal canal provides pain relief during childbirth or pelvic surgery while avoiding the

complications associated with a general anesthetic injection. On the skin, in the eyes' cornea

and conjunctiva, in the mucous membranes of your nose or mouth or throat or urethra are all

places where topical anesthesia can be applied.

A significant portion of local medication therapy is devoted to the treatment of dermatologic

problems, whether that means prescribing a medicine to promote hair growth or alleviate an

itchy, burning rash. Eczema, poison ivy allergies, and seborrheic dermatitis can all be treated

with a variety of corticosteroid formulations. UV rays can cause skin cancer, so it's important to

wear a sunblock to keep your skin safe from them. Cleansers, keratolytic agents to encourage

peeling, and topical antibiotics are all used to treat and prevent acne. Many different types of

wet dressings, gels, creams, and ointments are used by doctors to treat intensely inflammatory,

crusting wounds and to protect and hydrate dry, cracked skin. Topical medicines like silver

sulfadiazine help burns heal more quickly and with less scarring when used correctly. Nystatin

or an imidazole medication is effective in treating Candida infections of the mouth mucous

lining (i.e., thrush) or the vagina. Podophyllin, a crude resin, has been the conventional therapy

for genital warts. Interferon-, however, was developed in the late 20th century and is effective

in the majority of patients when injected directly into the lesion or subcutaneously below the

lesion.

Mydriatics (drugs that dilate the pupil) like atropine are commonly used in ophthalmology to

aid in refraction and internal inspection of the eye, as well as to treat glaucoma and other eye

conditions.

CHEMOTHERAPY

Chemical agents are used to treat sickness in order to kill off the underlying organism without

causing harm to the patient. Antibiotics used to treat bacteria, viruses, fungus, or parasites are

included in this definition. There are a number of uses for the term "chemotherapy," but the

most prevalent is to describe the treatment of cancer with chemicals. Because most

medications have a small therapeutic zone beyond which they destroy normal cells as well as

cancer cells, the goal of the therapy is to kill tumor cells while leaving healthy cells intact.

When it comes to cancer treatment, anticancer medications are only moderately selective for

cancer cells, making it difficult for doctors to choose a drug that would destroy the most cancer

cells, while causing the fewest unpleasant and undesirable side effects. The goal of therapy is to

achieve a risk-benefit ratio that favors the treatment's morbidity above its possible advantages.

Many patients would refuse additional therapy if a treatment causes them to be unpleasant

and has only a little possibility of extending their lives. Patients may choose to continue with

severe treatment if they believe it will help them live longer.

Chemotherapy's effectiveness is dependent on the drug's concentration being at the tumor site

for an extended period of time to kill the tumor cells. In the early stages of the disease, when

the tumor is tiny and isolated, there is the best chance for a cure. Getting rid of a huge and

dispersed tumor becomes more difficult the larger and more widespread it is. Oral,

intravenous, intra-abdominal, intrathecal (into the spinal cords subarachnoid region), or intra-

arterial (into the tumor's artery) administration can all be options depending on the tumor's

stage.

The greatest limiting aspect in chemotherapy is the suppression of bone marrow function,

which reduces blood cell formation. A longer interval between chemotherapy treatments is

sometimes necessary to prevent full bone marrow suppression since chemotherapy works best

when administered at the highest safe dose. Platelet transfusions and white blood cell

transfusions are common supportive therapies used when bone marrow suppression occurs (to

prevent bleeding caused by decreased platelet production) (to control infection).

Chemotherapy used in conjunction with surgery or radiation to treat cancer is called adjuvant

chemotherapy. As a result of the frequent occurrence of distant micrometastases, this is an

absolute necessity. Cancer recurrence rates are reduced by adjuvant chemotherapy in various

tumors, particularly ovarian cancer, osteogenic sarcoma and colorectal cancer. Tamoxifen, an

antiestrogen medication, has shown promise in the treatment of some women with early-stage

breast cancer.

Pharmacy: What is it?

Pharmacy: What is it?

The word "PHARMAKON," which refers to a medication or medicine, is the foundation of

the pharmacy profession.

Typically, it is a place where pharmaceuticals or medicines are sold.

Art and science of pharmacy are used to create pharmaceuticals that are used to treat

and prevent disease by using a variety of natural and synthetic substances.

In academic and professional settings, pharmacy is defined as the branch of science

concerned with the preparation, dosing, administration, and effects (including safety) of

pharmaceuticals (or medicinal drugs or simply drugs). Pharmacy is the synthesis of

chemistry and the health sciences in the broadest sense.

The origin of the pharmacy profession:

Pharmacology was evolving in the mediaeval Persian and European empires.

Historians claim that the Arabic civilizations were among the first to create a list of

medications and dosage forms (pills, syrups, extracts), as well as to establish the

pharmacist as a licenced healthcare practitioner.

There are influences from the Greek and Arabic cultures in this pharmacy (apothecary).

Professional guilds aided in the education of chemists and pharmacists, leading to the

establishment of formal institutions and organisations.

What is a pharmacist's job?

Often referred to as a DRUGGIST or CHEMIST.

An expert in the safe and efficient use of medicines, a pharmacist is a medical

professional.

What are the requirements for a pharmacist to get a job?

Acknowledgement of:

manufacture of drugs

checks for quality control,

discovering the products of deterioration

Proper storage of medications

preparation of the dosage form,

route of administration,

Drug-drug interactions and the effects of medications on diet.

Functions performed by a pharmacist:

Compounding and dispensing the patients' drugs was standard routine.

A pharmacist in the developed world:

a "happy to help person" with proper training.

Filling prescriptions.

provides patients with specialized guidance on the use of drugs.

In Pakistan, you can take courses such as:

Diploma in Pharmacy

Bachelor of Pharmacy

Master of Pharmacy

Master of Science in Pharmacy

Master of Technology in Pharmacy

Doctor of Pharmacy

Doctor of Philosophy in Pharmacy

Combining two degrees, such as a B.Pharm and an MBA or an M.Pharm and an MBA.

CAREER IN PHARMACEUTICALS

For the Public Sector

Pharmaceutical industries

Drugs Inspector

Analyst for the Federal Government

Hospital Pharmacist

Military forces

In the private sector, however,

Pharmaceutical companies, both global and regional

Production units

R&D Units

Quality Assurance

Laboratories (QC)

Clinical Trials

Biotechnology

Pharmaceutical Marketing

Pharmacovigilance

DEO such as medical writing, coding, etc.

Academicians

Clinician and hospital pharmacist

Pharmacy majors and minors:

The course will cover a wide range of topics, both major and minor.

Here are the main subjects (or modules) that we cover:

Human Physiology and Anatomy (Human Biology including Patho-physiology)

Pharmaceutical Chemistry (including Physical Chemistry, Inorganic Chemistry, Organic

Chemistry, Analytical Chemistry and Medicinal Chemistry)

Pharmaceutics (deals with formulation, drug delivery, drug stability, dosage forms, patient

acceptance etc.)

Pharmacology (study of effects of drugs on human body and biological systems – mixture

of biology, physiology and chemistry; will cover both basic, advanced and clinical

pharmacology)

Pharmacognosy (study of medicinal drugs derived from plants; deals with botany, plant

science and phyto-chemistry)

Biochemistry (study of biological reactions within living organisms)

Microbiology (study of micro-organisms like bacteria, virus, protozoa etc.)

Pharmaceutical Technology and Engineering (deals with basic concepts of Chemical

Engineering – e.g. Fluid Dynamics, Process Chemistry and Industrial Processes)

Minor modules or subjects

The following are some of the minor modules or subjects that will be covered:

Hospital Pharmacy

Clinical Pharmacy

Immunology

Marketing and business administration

Electronics and computer science (or Applications)

technological drawing

advanced mathematics

Statistics

Pharmaceutical biotechnology

Computational Chemistry

Note: This is not a complete list of minor and elective courses.)

Pharmacy departments

Pharmacognosy

Pharmaceutical chemistry

Pharmaceutical Analysis

Pharmacology

Pharmaceutics

Pharmacy Practice

Biopharmaceutics

DEPARTMENT OF PHARMACY PRACTICE IN HOSPITAL

DEPARTMENT OF PHARMACY PRACTICE IN HOSPITAL

DEFINITION:

“The practice of pharmacy within the hospital under the supervision of a professional

the pharmacist is known as hospital pharmacy”

WHAT THE HOSPITAL PHARMACY DOES?

 Predicting demand

 Identifying trustworthy vendors

 Preparation of sterile or non-sterile preparations

 maintenance of Manufacturing records

 Quality control of purchased or manufactured products

 Distribution of medicaments in the wards

 Dispensing of medicaments to out-patients

 Implement the pharmacy and therapeutic committee's recommendations

 Provide patient counselling

 Maintain communication between medical, nursing, and the patient.

 Center for medication utilization studies.

AIMS OF HOSPITAL PHARMACISTS' WORK:

1. To improve the quality and efficiency of hospital pharmacy services.

2. To ensure that the prescribed drug is available at a reasonable cost and at the right

time.

3. To organize the pharmacy's policies and put them into action.

4. To perform functions of management of material, purchase, storage of essential

items.

5. To keep track of everything that is received or given out.

6. Advise the patient and anyone associated in their care about the proper use of

medications, as well as any risks, side effects, toxicity, or other negative effects.

7. In order to act as a resource for drug usage data

8. Large and small volume parenterals, which are crucial to patient care, must be

manufactured.

9. To be a member of the pharmacy and therapeutics committee and to help carry out

their recommendations.

10. To plan and participate in educational and research initiatives.

11. To educate the patient's care team about the numerous facets of drug action,

administration, and usage, including: 11.

12. Participate in public health activities to help the general public's health.

13. Involvement with other hospital departments, cooperation, and coordination

INFRASTRUCTURE

 Ground floor or first-floor location.

 Sufficient space to accommodate patients' sitting needs.

 Outpatients' waiting room with Posters on health and cleanliness should be provided, as

should reading material.

 Adequate room for routine production of bulk medicines (stock solutions, bulk powders

and ointments etc.) is required.

 a chief executive officer's office

 Labeling and packaging of drugs area.

 Cold storage area

 Inquiry wing

 Pharmacy store room

 The Library

 Radio Isotope Dispensing and Storage area

FLOW OF MATERIALS

 Requisition or an indent Medications and other supplies are needed for this.

 Keep track of stuff you've received.

 Distributes medication to in- and out-patients via the outside pharmacy and nursing

station, respectively.

FINANCES

1. The patient's bills are the primary source of payment.

2. Either the patient or a third party pays for the services he or she receives.

3. Research work

4. Endowment money that have been put to use

5. Investing in other ways

6. Payment of general operating expenses by way of gifts or other sources

ROLES AND RESPONSIBILITIES OF HOSPITAL PHARMACIST INDOOR PHARMACISTS

a) Central dispensing area:

1. To ensure that all medications are correctly maintained and delivered.

2. To ensure that the doses prepared are accurate.

3. Keep accurate records.

4. Preparation of bills

5. Coordinate the patient's entire pharmaceutical needs 6.

7. Maintain a high level of professionalism and expertise 8. Maintain open lines of

communication with all pharmacy staff members.

b) Patient care areas

1. To keep in touch with the nurses

2. Taking a closer look at how drugs are administered.

3. Assist the junior pharmacist and direct patients to the appropriate areas:

4. Identifying the medications that were taken into the hospital

5. obtaining a history of the patient's medication

6. Encourage patients to make their own medicinal product choices

7. Follow-up on a patient's complete drug regimen

8. Taking care of patients' mental health issues

9. Assisting in the treatment of cardiac and respiratory emergencies

c) General duties:

1. First, make certain that all medications are handled correctly.

2. Participate in cardiac and pulmonary emergencies

3. to provide training and instruction for pharmacists.

RESPONSIBILITIES OF AN OUTPATIENT PHARMACIST

This is where the bulk of the products are sold.

a) Central dispensing area:

1. To make certain that all medications are correctly maintained and administered.

2. To ensure that the doses prepared are accurate.

3. Keep accurate records.

4. Preparation of invoices

5. Maintains a clean and orderly pharmacy.

b) Patient care areas

1. The pharmaceutical regions should be inspected on a regular basis.

2. Recognize the medications that have been delivered into the hospital.

3. The tracking of medications

4. Offer guidance to the patients.

c) General responsibilities:

1. First, make certain that all medications are handled correctly.

2. Participate in cardio-pulmonary emergencies

3. The next phase is to provide training and instruction for pharmacists.

4. Coordinate outside service's overall pharmacological needs.

HEALTH CARE SERVICES MANAGEMENT

HEALTH CARE SERVICES MANAGEMENT

Most countries aim to structure their health services in such a way that people, families, and

communities get the most out of recent knowledge and technology available for health

promotion, maintenance, and repair. As part of this process, governments and other agencies

face a number of challenges, among them:

 A lack of reliable information can lead to misplaced planning; therefore, they must

gather as much information as possible on the scope and urgency of their demands.

 Second, the resources available to meet these needs must be assessed; developing

countries may require outside assistance to enhance their own resources.

 Following their assessments, governments need to set realistic goals and draw up plans

based on their findings.

 Final point: the programme must include an evaluation procedure; the absence of

precise data and reliable information can lead to confusion, waste and inefficiency.

The most noticeable, but not necessarily the most significant from a national point of view,

characteristic of health services is the curative function; that is, caring for individuals who are

already ill. There are many more types of health care, including those that focus on specific

populations (like children or pregnant women) and those that focus on specific requirements

(like nutrition or immunization), as well as those that focus on both individuals and

communities (like health education).

LEVELS OF MEDICAL CARE

There are a variety of medical practices in the realm of healing. Most of them can be pictured

as standing on top of one another in a pyramidal structure, with each tier denoting a higher

level of specialization and technical sophistication while serving an ever-shrinking number of

patients. For diagnosis or treatment, only those patients who necessitate more attention

should be referred to the second or third tiers, where the cost per service increases. Patients'

first encounter with the healthcare system occurs at the primary care level, sometimes known

as "first contact care."

An essential aspect of any country's health care system is primary care, which makes up the

largest and most vital portion of it. Primary health care should be "based on practical,

scientifically sound and socially acceptable methods and technology made universally

accessible to individuals and families in the community through their full participation and at a

cost that the community and country can afford to maintain at every stage of their

development," according to the Alma-Ata declaration. Patients' first point of contact with a

healthcare provider in developed regions is typically a physician with medical training; in

developing countries, the first point of contact is more frequently handled by non-physicians.

At the primary level, the vast majority of patients can be successfully treated. Referral services

(secondary health care or consultants) are used for those who are unable to get primary health

care (primary health care) on their own. Secondary health care typically necessitates the use of

hospital technologies. However, the radiology and laboratory services offered by hospitals are

increasingly available to the family doctor directly, strengthening and expanding his service to

patients. Health care facilities such as teaching hospitals and units dedicated to the treatment

of specific populations, such as women, children, and people with mental illnesses, provide the

third level of care by utilizing specialized services. When it comes to health care in developing

countries, it's important to keep in mind that the cost of treatment varies dramatically between

levels, with the basic health-care level typically costing only a small fraction of the cost of

treatment at the third level.

All patients should have access to all levels of health care, which can be referred to as universal

health care. Medical care can be obtained in the private sector by those who are well-off,

whether they live in wealthy industrialized countries or in impoverished developing countries.

In most countries, the vast majority of people rely on government-provided health care, even if

they may contribute very little or nothing at all in poorer countries.

FAMILY MEDICAL CARE

FAMILY MEDICAL CARE

Pregnant women, mothers, and their young children are often given extra attention in many

countries. Health care for all three of these groups should be provided in an integrated manner,

with prenatal care, childbirth, postpartum care, and infant care all being considered integral

components. A service that is sensitive to the requirements of young children should be

followed by a school health service. State-funded health care systems, such as those in the

United Kingdom and other European countries, have made family clinics commonplace. For

low-income families in developed countries like the United States, the state subsidizes health

care facilities, although private doctors and clinics are preferred by other groups.

A variety of services are offered at prenatal clinics. One must take special care of a woman in

her final weeks of pregnancy in case she becomes ill or is otherwise at risk of complications that

could demand a premature birth. Diabetes and high blood pressure are just two examples of

potential dangers that can be discovered and taken precautions against. Pregnant women in

underdeveloped nations are particularly vulnerable to a wide range of illnesses, including

infections like malaria. To ensure the health of a child, additional precautions must be taken in

the area where the child lives. Pregnant women are generally open to receiving basic health

information since they are concerned about their own health and the health of their unborn

children. There are several advantages to attending a prenatal clinic, including the opportunity

to learn how to care for oneself and one's unborn child. Pregnant women who frequently visit

their physician immediately will have their records on hand for delivery-day staff, which is

critical for those who have been identified as high-risk. Prenatal, natal, and postnatal care, as

well as newborn care, should all be handled by the same clinical unit.

Most pregnancies can be successfully delivered in basic settings without an extensively trained

personnel or advanced technical facilities, provided that these can be accessed in emergencies.

Delivery in a woman's home supervised by an experienced midwife or her family doctor was

common practice prior to the advent of modern medicine in many developed countries. Most

women, particularly those living in cities by the middle of the twentieth century, wanted to give

birth to their children in a hospital, whether it was a normal hospital or an especially specialized

one for pregnant women. Traditionally, in many developing countries, birth attendants oversee

the delivery. The majority are untrained women who have developed their skills via

collaboration with others and personal experience. Many of them are members of the

neighborhood where they live and work, and their skills are greatly valued by the people

around them. Many underdeveloped countries place a great focus on the training of birth

attendants. Natural childbirth is becoming more popular in Western industrialized countries,

including the option of giving birth in a hospital without anesthetic as well as at home.

A mother's return to normalcy is monitored by postnatal care services. In most cases, they are

provided by members of the same unit that delivered the goods. The decision to breastfeed or

bottle feed the child, as well as the baby's overall well-being, must be carefully considered.

Premature babies and those born after a tough or complicated labour, as well as newborns

(recently born babies) with some physical anomaly, all have much better survival odds now

than they did in the past. This can be attributed to advancements in technology, such as the

ability to detect birth abnormalities, and to the expansion of the field of neonatology as a

whole. One of the most important components of family health care is the child welfare clinic,

which provides newborns with medical attention. Initially, a comprehensive assessment of the

child's physical and mental health is necessary to discover whether or not the child has any

abnormalities. Perinatal exams can determine whether the child is developing normally. For

example, vaccinations and dietary supplements can be used to protect the youngster from

major risks. The early detection and treatment of any underlying illness, such as a chest

infection or skin disorder, is possible. During this time, the mother and child are always

together, and special emphasis is placed on preparing the mother to take care of the infant.

Child guidance is part of the health care given to children in developed countries. This involves

the collaboration of a child psychiatrist, an educational psychologist, and a schoolteacher to

provide psychiatric assistance to children who have been socially maladjusted.

HEALTH-CARE COSTS

 HEALTH-CARE COSTS

Providing health care comes at a high cost to the national economy, and that cost has been rising rapidly in countries like the United States, Germany, and Sweden; in Britain, the rise has been slower. Both industrialized and developing countries have expressed serious concern about this development. A large part of this fear stems from the absence of consistent data to support the idea that more health care spending will result in better health. Countries in the developing world are pushing to replace the health-care system that developed under European colonialism with one that is more affordable and more suited to their needs.

For both private and public health-care delivery systems, rising costs have prompted a review of policies and a search for more cost-effective ways to accomplish their objectives. Despite the money spent, health services aren't always used efficiently by those who need them, and the results might vary greatly from community to community, despite the expenditures. There was a 24% drop in deaths in Britain's most wealthier areas between 1951 and 1971 compared to a 16% drop in the most impoverished areas of society. More than only the quality of medical care affects one's ability to stay healthy. Well-being encompasses all of the above, in addition to adequate living and working conditions and enough access to social services.

IN THE DEVELOPING NATIONS:

Culturally, socially and economically, developing countries differ greatly from developed countries, but they all have a low average income per person and huge percentages of their populations living below the poverty line. The majority of their inhabitants reside in rural areas, despite the fact that most have a small elite class that lives mostly in the city. During the mid- and late-20th century, pockets of slums appeared in urban areas in emerging and some developed countries due to an increase in rural peoples and immigrants. In the 21st century, improved, cheaper construction methods allowed for the production of inexpensive homes in highly crowded areas like New York City and cities in India, reducing some of the city's housing woes. Some cities are simply too congested to keep public health under check, though. Thousands of urban and rural poor die each year from avoidable and curable diseases, generally linked to inadequate hygiene and sanitation, contaminated water supplies, malnutrition, vitamin deficiency, and chronic preventable infections, due to a lack of even the simplest steps. In the 1980s, life expectancy at birth for men and women in Africa was roughly one-third lower than in Europe, and infant mortality in Africa was about eight times higher than in Europe. These and other deprivations are reflected in the findings. As a result, emerging countries place a great focus on expanding primary health care.

Lacking adequate resources, developing countries have often been unable to establish or implement the plans necessary to offer basic services at the village or urban poor level. They are. Health care systems that work in one country may not work in another, and this is becoming increasingly apparent. Research has shown that a country's unique circumstances, people, culture, philosophy, and economic and natural resources all have a role in providing high-quality health care.

More and more developing countries are promoting services that use less highly qualified primary health care workers who may be deployed more broadly in order to cover the widest possible range of people. Undernutrition, infection, gastrointestinal illnesses, and respiratory symptoms are some of the most pressing medical issues in the developing world, all of which may be traced back to factors like poverty, ignorance, and poor hygiene. It's not difficult to recognize and treat them in most cases. Preventive measures, on the other hand, are usually easy and inexpensive. There is no need for specialized training in most circumstances; the phrase "primary health worker" encompasses all nonprofessional members of the healthcare team.

IN DEVELOPED NATIONS:

Health care providers in the industrialized world face a distinct set of challenges than those in developing countries. While many diseases that once ravaged the Third World have been eliminated or are easily curable, many others remain unaffected. Environmental and public health threats have been reduced or eliminated. A wide range of social services, varied in quality, have been made available. Public monies are available to help pay for medical expenses, and private insurance policies are also an option. In spite of this, governments have a finite amount of money to spend on health care, and the rising expense of modern medicine means that many people will be unable to afford effective treatment. The growing need for more money for health education and prevention initiatives targeted at the poor raises the overall cost of modern medical care.

What is PHARMACOTHERAPY |

PHARMACOTHERAPY

Basic characteristics

·         How drugs are absorbed into the body and distributed?

Pharmacokinetics is the study of how pharmaceuticals travel through the body, including absorption, distribution, tissue localization, biotransformation, and excretion. Pharmacodynamics refers to the study of how medications work and the impact they have on the body. Absorption and distribution in the body are prerequisites for a drug's effectiveness. Intestinal absorption of drugs taken orally can vary widely, with some taking longer to be absorbed than others. It is possible to decrease the rate of absorption of even the most rapidly absorbed medications such that they can remain effective for up to 12 hours or more. Intravenous or intramuscular administration of drugs circumvents absorption issues, however, accurate dosage calculations are still essential.

The same medicine can have various effects on different people. Drug metabolism and excretion may be slower in the elderly due to decreased renal and liver function. As a result of these and other reasons, elderly patients typically require lesser doses of medication.

The existence of the disease, nutrition, heredity, and the presence of other medicines in the system can all influence a person's response to medication. In addition, just as everyone's tolerance for pain differs, so does the body's reaction to the medication. In certain cases, bigger doses are required, while in other cases persons who are extremely sensitive to medications experience negative effects at lower amounts than others.

As intestine motility and gastric acidity decline with age, infants and children may absorb nutrients at different rates than adults. Premature newborns, who have less fat tissue and a higher proportion of water in their bodies, may have a distinct pattern of drug distribution. During childhood, metabolic rates, which influence pharmacokinetics, are substantially higher. Children's medication dosages are typically based on their weight (in milligrams per kilograms) or their surface area (in square centimeters) (milligrams per square meter). Children of the same age can have a broad range of sizes, which makes it difficult to determine how much a medicine should be given depending on the child's age. For children, drug dosages may be considerably different from those for adults because they are not miniature adults.

Taking several drugs, some of which may be incompatible with others, makes the elderly particularly vulnerable to the side effects of pharmaceuticals, and this makes them more likely to have drug interactions that are harmful to their health. Gastric acid production and arteriosclerosis restrict the arteries, reducing blood flow to the digestive tract and other organs, as we get older. It is a good example of the principle that should guide all drug therapy—drugs should be administered in the lowest effective dose, especially because adverse effects rise with concentration—in prescription medication to the elderly. Elderly people often have poorer tolerance for small side effects, which younger people may not even notice, due to illness or frailty.

Repeated dosages of medication ensure that the amount delivered and the amount excreted or metabolized are equivalent. Because of individual differences, it may be difficult to identify the correct dosage for some medications. If the therapeutic window (i.e., the concentration above which the medicine is hazardous and below which it is useless) is relatively limited, assessing the plasma level of the drug may be informative. It is common practice to keep an eye on the blood levels of drugs like phenytoin, digitalis, and lithium, which are used to treat bipolar disorder and treat seizures, in order to assure their safety.

INDICATIONS FOR USE

In order to alleviate symptoms, treat infection, lower the risk of future sickness, and destroy targeted cells, such as in the chemotherapeutic treatment of cancer, medications are used. There may be no need for a medicine at all in some cases. As vital as deciding which drug to take, it is also crucial to recognize that there is no effective medication out there. In situations where more than one drug is beneficial, doctors choose the one that is most effective and least harmful to patients. A new medicine may promise better results, but it may also be more expensive and unpredictable.

In addition to the organs and systems to which it is explicitly addressed, every medication has many functions. Patients may also have idiosyncratic effects (abnormal reactions unique to that individual) and allergic reactions to some treatments, which are further indications of the need to pick drugs carefully and avoid their use altogether when simpler procedures can be implemented instead. Consider the widespread notion that antibiotics such as penicillin may treat viral infections, which simply isn't true. Antibiotics should only be used when absolutely necessary, as new antiviral medications are now being developed. There is a growing number of drug-resistant organisms that need to be countered by cautious use of these substances.

The risk of drug interactions, which can reduce a drug's effectiveness, rises when it is taken in excess. It is possible that a drug's presence in the stomach or intestines will affect the absorption of another. Tetracycline's absorption is decreased by antacids, which generate insoluble complexes. The interfering effects of one medicine on another are of increasing consequence. If a drug inhibits the metabolism of another drug, it permits the drug to accumulate in the body, increasing the risk of toxicity in the absence of a reduction in the dosage. Many medicines that require microsomal enzymes in the liver to be digested are increased in quantities after taking Cimetidine, a medication used to treat peptic ulcers. If the other medicine is warfarin, this inhibition can be dangerous. If the dosage is not lowered, bleeding may occur. A wide range of other medications are also impacted, including antihypertensives (like calcium channel blockers), antiarrhythmics (like quinidine), and anticonvulsants (like phenytoin) (e.g., phenytoin). The excretion of one drug may be reduced by the excretion of another. Penicillin's elimination is decreased when probenecid is given with it, which raises the blood level of the antibiotic as a result. The combination between quinidine and digoxin, a medication used to treat heart failure, can impede the drug's clearance, elevating the concentration to potentially lethal levels. Toxic effects can also be caused by the combination of two medications, despite the fact that either one on its own would be beneficial.

When a patient is being treated by more than one doctor, it is possible that one of those doctors is unaware of the medications that the other has given. It is not uncommon for a doctor to give medication to alleviate a side effect of another medication. It's better to stop taking the first medication than to start taking another one that has unknown negative effects. Most often, a recently started medication is suspected as the cause of a new symptom before any other possibilities are explored. Patients should notify their doctors of any new medications they are taking and speak with their pharmacists about the possibility of nonprescription medications interfering with any prescription medications they are currently taking. Patients who have a personal physician who checks all of their medications, prescription and over-the-counter, should do so.

The Food and Drug Administration (FDA) oversees the safety and efficacy of prescription pharmaceuticals in the United States (FDA). New pharmaceuticals are approved, indications are identified, formal labelling is put in place, and adverse responses are monitored. Methods of manufacture are also approved. Submission and approval by the FDA are required before INDs can be tested in humans. Clinical studies must be completed before an NDA can be filed and a medication can become available for sale. Normally, this takes years, but if the drug helps people with life-threatening illnesses when existing treatments don't, it may be approved faster. An unapproved medicine can be prescribed to a single patient with the authorization of a physician. A patient may be given emergency usage or compassionate use if there is no alternative treatment option available and the patient's life is in danger. If a life-threatening emergency warrants it, the FDA may also approve the acquisition of medications from foreign nations that are not currently available in the United States. Participating in a clinical trial is another way to get your hands on an experimental medicine. An "open study," in which the investigator is not "blinded" and knows which subjects and controls are being studied, increases the probability that the patient will be given a placebo instead of a medicine that works. Food, over-the-counter medications, and cosmetics are all subject to "truth in advertising" regulations by the Federal Trade Commission (FTC).

Other countries and governmental bodies have similar drug regulation agencies. Like the FDA in the United States, the Chinese government has its own regulatory agency for pharmaceuticals, medical devices, and cosmetics. Medicines are approved by the European Medicines Agency, which also oversees the scientific evaluation of medicines and keeps tabs on the safety and efficacy of those sold within the European Union's member countries.

As a result of the limited patient population, it is not economically feasible for pharmaceutical companies to go through the lengthy and expensive regulatory and marketing processes required for treatments for rare diseases. The Orphan Drug Act of 1983, enacted in the United States to encourage the development of treatments for uncommon diseases, makes these medications available to the public.

The term "controlled substance" refers to drugs that can lead to addiction and abuse. Their production, prescription, and dispensing are all subject to DEA regulation in the United States. Based on their misuse potential and physical and psychological dependence, controlled substances are classified into five schedules. There is no recognized medical purpose for any of the medications included in Schedule I, which includes heroin and other narcotics with a high potential for misuse. Narcotics like opium and cocaine as well as stimulants like amphetamines fall under the category of Schedule II substances because of the great potential for abuse and dependence they carry. Barbiturates, sedatives, and preparations containing only a small amount of codeine are all included in Schedule III, as is a small number of stimulants and depressants. Some sedatives, antianxiety medications, and nonnarcotic analgesics are included in Schedule IV because of their low abuse and dependence potential. Even more so than schedule IV substances, Schedule V pharmaceuticals have a lesser potential for abuse. A prescription is not required for some medications, such as cough syrups and antidiarrheal medications having a little quantity of codeine in them. Any restricted substance prescribed by a physician must have a DEA registration number on file. It is not possible to replenish a patient's supply of schedule II medicines without a fresh prescription in several states, where special triplicate prescription forms are necessary. Countries and international territories like the European Union, where the European Drug Enforcement Agency (EDA) is in charge of combating illegal drug usage and trafficking.