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UNIVERSIDAD DE ZAMBOANGA

School of Allied Medicine (SAM)


College of Pharmacy

ASSIGNMENT IN CLINICAL PHARMACY


LABORATORY
FINAL
TTH: 03:30-04:30 PM

SUBMIITED BY:

JASHER DAVE. ACABAL

Student

SUBMITTED TO:

DR. SAPIA N. AÑANA

Clinical Pharmacy Instructor


SLEEP DISORDER

Etiology

 Sleep problem can cause by various physical (ulcers), medical


(asthma), psychiatric (depression) and anxiety disorder), or
environmental (alcohol) factors. It is true that about half of the people
over the age of 65 have some type of sleep disorder.

Definition

 A sleep disorder is any condition that involves difficulty experienced


when sleeping. Such disorder involve daytime fatigue causing severe
distress and impairments to work.

Classification

1. Insomnia- difficulty falling asleep/staying asleep


2. Narcolepsy- uncontrollable random sleep attacks
3. Sleep Apnea- temporary cessation of breathing while sleeping usually
involving loud snoring
4. Night Terrors- vivid and frightening experiences during sleep
5. Sleep Paralysis- phenomenon where a person, either falling asleep or
awakening, temporarily experiences an inability to move

Signs and Symptoms

Night Time

1. Apneic episodes
2. Frequent awakenings
3. Noticeable snoring
4. Wandering
5. Falls
6. Talking while asleep
7. Frequent leg movement during sleep or when lying in bed awake

Day Time

1. Agitation, hostility, combativeness


2. Excessive daytime sleeping and/or napping
3. Falls
4. Reduce cognitive function: problems in concentration, attention, and
memory
5. Loss of physical function
6. Falling asleep early in the evening
7. Reduced participants in activities
8. Complaints by roommate caregiver

Risk Factors

Health Risk Factors

 Obesity
 High blood pressure
 Pain condition

Psychological Risk Factors

 Stress
 Anxiety
 Depression

Triggers

1. Lack of exercise imbalance diet, alcohol consumption, substance


abuse.

Laboratory Test and Diagnostic Procedure

Common Laboratory Test

1. Hemoglobin and Hematocrit


2. Arterial Blood Gases
3. Thyroid Function Tests
4. Drug and Alcohol Toxicology Screening

Common Diagnostic Test

1. Overnight Oximetry- simplest and generally, earliest sleep studies


that may be conducted
2. Polysomnography (PSG)- this is largely regarded as the gold
standard for the diagnosis of sleep disorders.
3. Titration Study- commonly done during the same night as diagnostic
PSG to save waiting time, minimize cost to the patient, and treat sleep
apnea as soon as possible
4. Multiple Sleep Latency Testing (MSLT)- is also known as “nap
study”. It is similar in setup to the polysomnography described above.
5. Actigraphy- is the measurement with the use of a small, wristwatch-
sized device. This device monitors movement and can be used tp
assess sleep-wake-cycles, or circardian rhythms, over an extended
period of time.
6. Sleep Diary- sleep log, sometimes useful for assessing circardian
rhythm disorders or insomnia.
7. Home study- most individuals recognize that they sleep far better at
home than they might in a sleep center.

Treatments

Drugs

Major Classes

 Benzodiazepine hypnotics
 Non-benzodiazepines hypnotics
 Melatonin receptor agonist

1. Antidepressants (Trazadone)
2. Benzodiazepines (Triazolam)
3. Doxepine (Silenor)
4. Ramelton

Non-Drugs

1. Relaxation training
2. Stimulus control
3. Cognitive Behavioral Therapy (CBT)

Prevention

1. Try to go to sleep at the time each night and get up at the same time
each morning
2. Try not to take naps during the day because naps may make you
less sleepy at night
3. Avoid caffeine, nicotine, and alcohol late in the day.
4. Get regular exercise
EATING DISORDER

Etiology

 Eating disturbances may include inadequate or excessive food intake


which can ultimately damage an individual’s well-being. The most
common forms of eating disorders include anorexia nervosa, bulimia
nervosa, and binge eating disorder and affect both females and males.

Definition

 Describe illnesses that are characterized by irregular eating habits and


severe distress or concern about body weight or shape.

Classification

Anorexia Nervosa

1. dangerously underweight
2. a relentless pursuit of thinness
3. distorted perception of the body image and intense fear of
gaining weight

Types

Binge Eating/Purging Type- regular engages in binge-eating


and/or purges food later through self-induced vomiting, laxatives or
other medication

Restricting Type- regularly engages in binge-eating and/or


purges food later through self-induced vomiting, laxatives or other
medication.

Bulimia Nervosa

1. May be of normal weight or slightly overweight


2. Recurrent episodes of bingeing and compensatory behaviors in
order to prevent weight gain
3. Worried about weight and usually feels lack of control over such
episodes

Types

Purging Type- purges through self-induced vomiting, laxatives or


other medication
Non-Purging Type- tries to lose weight through fasting or
excessive exercising.

Binge Eating Disorder

1. Frequently loses his/her control on eating


2. Consuming very large amounts of food but without behaviors to
prevent weight gain

Signs and Symptoms

1. Eat large amounts of food in a short period


2. Not able to control overeating
3. Eats food very fast each time
4. Keeps eating even when full
5. East event though not hungry
6. Eats alone
7. Feels guilty, disgusted, ashamed, or depressed after eating so much

Risk Factors

Family

 History of dieting/eating disorders


 History of depression/anxiety/alcohol dependence
 History of obesity

Individual

 Female gender
 Genetics
 Premature birth
 Low self-esteem
 Perfectionism
 Previous depression/anxiety
 Previous obesity
 Early puberty
 Diabetes
 Crohn’s disease

Possible Triggers and Maintaining Factors

 Puberty
 Socio-cultural pressures
 Family factors
 Pressure to achieve
 Behavioral peers
 Comments about weight

Laboratory Test and Diagnostic Procedure

1. Blood test
2. X-ray
3. Other test for heart and kidneys
4. BMI calculation
5. Physical assessment
6. Skinfold measurements
7. Body fat measurements
8. Diagnostic tests for metabolic and endocrine disorders

Treatment

Drugs

1. Antidepressants -SSRI (citalopram, sertraline)


2. Antiepileptic (topiramate, lamortrigine, zonisamide)
3. Appetite suppressants (sibrutamine)

Non-Drug

1. Yoga
2. Acupuncture
3. Relaxation Therapy
4. Biofeedback
5. Building Lifestyle habits to help reach your goal

Prevention

1. Learned how to live a healthy lifestyle through nutritious eating and


physical activity
2. Understanding the self-worth is not purely defined by physical
appearance
3. Challenging society’s misleading messages about beauty
4. Developing realistic expectations of self and body image
5. Accepting one’s physical characteristics
STD
(Sexually Transmitted Diseases)

Etiology
 The STD’s are group of communicable disease that are predominately transmitted
by sexual contact and caused by a wide range of bacteria, virus, fungi, protozoa and
ectoprasites. Bacterial STD’s includes: Gonorrhea, Genital Clamydia infection,
syphilis, chancroid.
Definition
 A sexually transmitted disease (STD) is an illness that has a significant probability of
transmission between humans by means of human sexual behaviors, including
vaginal intercourse, oral sex, and anal sex

Causes
1. Bacteria
2. Virus
3. Fungi
4. Protozoa
5. Parasites

Risk Factors
1. Incorrect number of partners
2. Inconsistent condom use
3. Breaks in skin
4. Severity of your partner’s infection
5. Sexual contact with infected partner
6. Transmission during pregnancy
7. Adolescence and young adult
8. Compromised immune system
9. HIV positive
10. Men having sex with men without protection

Signs and Symptoms

MEN WOMEN
 Groin pain  Milky discharge
 Burning during urination  Burning during urination
 Milky discharge  Lower abdominal /back pains
 Irritation around opening of  Nausea and Fever
penis  Painful intercourse between
 Testicular pain/swelling periods
 Sore throat  Sore throat/anal itch
 Anal itching

Types
Common STD’s in WOMEN
Common STD’s MEN

Laboratory Test and Diagnostic Procedure

Common Laboratory Test

1. HIV 4th Generation Assay


2. HbSAG (Hepatitis B)
3. HCV (Hepatitis C)
4. VDRL (Syphilis)
5. HSV I & II. IgG/IgM (Herpes)
6. Chlmydia IgG/IgM
7. Urine for Gonnococcal infection
Treatment

Drugs

Diseases Treated Drug of Choice


AIDS NRTI’s, NNRT’s, PIs, and enfuvirtide
Chlamydia Doxycycline, Azithromycin, or Erythromycin
Gonorrhea Ceftriaxone or Fluoroquinolone
Genital Herpes Acyclovir, Valacyclovir, or Famciclovir
HPV Imiquimod, Podofilox, or other therapies
Syphilis Penicillin, Doxycycline, or Tetracycline
Vaginosis: Bacterial Metronidazole, Clindamycin
Vaginosis: Yeast Vaginal candidiasis products

Non-Drugs

1. Used Test Kit for Monitoring your Status


2. Regular exercises

Prevention

1. Practice Abstinence
2. Have Fewer Partners
3. Talk With Your Partner
4. Use Condoms
5. Get Vaccinated
6. Get Tested
CONTRACEPTIVES

Definition

 “CONTRACEPTION”- against conception or avoiding unwanted


pregnancy

Overview

 According to figures from the population reference Bureau, there are 8300
million humans on the planet. There are 42 births and 17 deaths every 10
seconds, a net gain of 25 extra people somewhere on the globe every 10
seconds.

 According to UN figures, out of about 180 million conceptions each year,


at least 75 million are unwanted. This results in about 50 million abortion

 Around 600, 000 women die each year (one woman/min)-killed by


pregnancies. 200, 000 would not die if adequate services/contraception
make available to them

Methods

Choosing Contraceptive Method

1. Individual general health


2. Frequency of sexual relationship
3. Consideration for adolescence women
4. Number of partners
5. Consideration for women who have recently given birth
6. Consideration for women near menopause

Classification

Birth control is the use of various device, drugs, agents, sexual practices, or
surgical procedures to prevent contraception or pregnancy

Types of Contraceptives

1. Natural Methods- traditional birth control does not involve any type of
device or medication
 Abstinence-celibacy or sexual abstinence means avoiding
sexual intercourse
 Withdrawal- also known as “coitus interruptus”, this s when the
man removes the penis from the vagina.

2. Devices- barriers devices prevent the sperm from meeting the egg.
They may be combined with spermicide, which kills the sperm.

 Male Condom- stopping sperm from entering the vagina.


 Female Condom- made of polyurethane. It has flexible ring
each end. One fixes behind the pubic bone to hold the condom
in place, while the other ring stays outside the vagina.
 Sponge- inserted into vagina using the applicator
 The diaphragm-is a rubber, dome-shaped device that is
inserted into the vagina and place over the cervix.
 Cervical Cap- is a thimble-shaped, latex rubber barrier device
that fits over the cervix and blocks sperm from entering the
uterus.
 Injection- also known as “the shot” is progestin-only, long
acting, reversible, and birth-control drug.

3. Pharmaceutical Types/Hormonal Methods

 Intrauterine Device (IUD) - or coil is a small, flexible T-shaped


device that is placed in the uterus by a physician.

Types:
1. A copper IUD- last up 10 years
2. Hormonal IUD- contains progestin

 Contraceptive Pill- combined pill taken daily. It contains 2


hormones, estrogen and progestin.
 Contraceptive Patch- applied to the skin
 Vaginal ring- is a flexible, plastic ring that releases a low dose
of progestin and estrogen over 3 weeks.
 Implants- is a rod with a core of progestin, which is releases
slowly
4. Permanent Contraception/Sterilization Methods- sterilization is a
permanent method of sterilization

In females
1. Tubal Ligation- the surgeon will cut, block, or burn the
fallopian tubes, or a combination of these methods, to
seal them and prevent future fertilization
2. Tubal Implant- a coil is placed in the female’s fallopian
tubes

In Males

1. Vasectomy- this is surgery to make a man sterile

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