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Summary Global Health and Pharmacotherapy
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This is a very extensive summary that belongs to the course Global Health and Pharmacotherapy. The summary is written in English.
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Global Health and PharmacotherapyAims
- Knowledge of
* Factors that influence the health of individuals and populations worldwide
* Basic concepts of pharmacotherapy, pharmacoepidemiology and pharmacovigilance and
drug regulatory affairs
- Conversant with
* Different treatment guidelines
* With role and relevance of pharmacy-epidemiology
- Insight into
* How patients experience taking medication
Three diseases
- Hypertension
- Rheumatoid arthritis and pain
- Acute infectious disease
(COVID-19)
The approach of these diseases
When we look at these disease there will be looked at the global health (epidemiology). In which
areas of the world is the disease seen frequently. There is also looked at the patient, the
symptoms, what do patients experience with the disease. There is looked at the
Pharmacotherapy (how to treat the disease), Clinical trials, how to take the medication
(guidelines), side effects. etc.
Lectures
- Introduction global health and pharmacothearpy, including COVID-19 pandemic
- Pharmacotherapy
* Hypertension
* Rheumatoid Arthritis and pain
* Infectious diseases
- Pharmacoeconomics
- Pharmacoepidemiology
- Pharmacovigilance (side effects)
- Drug Regulatory Affairs
Tutorials
- Patient cases to practice pharmacotherapy and understand the content of lectures (madatory
to be completed)
* Hypertension
* Rheumatoids Arthritis and pain
* Infectious diseases including a COVID 19 case
- E-learning program: www.pscribe.nl How does this course fit into the pharmacy
curriculum? Pharmaceutical Chemistry,
Technology Biology
Physiology
Mathematics
Pathophysiology
How does this course fit into the pharmacy Immunology Drug Design
curriculum? Genetics Medicinal Chemistry
All these subjects come together in Pharmacotherapy Pharmacology Epidemiology
So there will be a basic knowledge of all these Toxicology Psychology
subjects. Pharmacokineti Human Behaviour
cs/dynamics Pharmaceutical Ethics/Law
Analysis
Pagina 1 van 69
,Global Health
Overview
Aim: to gain knowledge of global health
Leading questions:
- What is global health?
- What are currently the biggest threats/challenges for global health
What is Global Health?
Global
Health issues that concern many countries.
Health
Health is a state of complete physical, mental and social well-being and not merely the absence
of disease or infirmity.
Global Health
Global health is an are for study, research and practice that places a priority on improving health
and achieving equity (equal rights for health) in health for all people worldwide. Global health
emphasizes transnational health issues, determinants and solutions; involves many disciplines
within and beyond the health sciences and promotes interdisciplinary collaboration; and is a
synthesis of population based prevention with individual-level clinical care.
What are currently the biggest threats/challenges for global health?
COVID-19 Pandemic - a global health challenge
How it started
- 31-12-2019: WHO informed of cases of pneumonia of unknown microbial etiology associated
with Wugan City, China The SARS-CoV-2 Virion and Its Proteins.
- Novel coronavirus detected and identified
- 30-01-2020: WHO declared public health emergency
- 11-03-2020: Pandemic
Severe acute respiratory syndrome coronavirus 2 (SARS-Coc-2)
causing corona virus disease 19 (COVID-19)
It is a RNA virus of the group of the SARS viruses.
The SARS-CoV-2 Virion and it Proteins.
This is from the family of the corona viruses.
COVID-19
- Respiratory infection
- Symptoms ranging from mild common cold-like illness to severe viral
JM Parks, JC Smith. N Engl J Med 2020. DOI: 10.1056/NEJMcibr2007042
pneumonia with potentially fatal acute respiratory distress syndrome
- Characteristics symptoms:
* Fever
* Cough
* Dyspnoea
- Complication of severe disease:
* Multi-organ failure
* Septic shock
* Blood clots
Pagina 2 van 69
, How to determine the risk to die from a COVID-19 infection?
How risky is it? Who will die from the disease?
Different figure
- The case fatality rate (CFR) is the number of confirmed deaths divided by the number of
confirmed cases.
- Crude mortality rate: dividing the number of death from the disease by the total population.
- Infection fatality rate (IFR) is the number of deaths from a disease divided by the total number
of cases.
IFR gives the best view of how to determine the risk to die from a disease (COVID-19 infection)
The case fatality rate is the number of confirmed deaths
The case fatality
divided by the ratenumber
is the of confirmed cases.
number of confirmed deaths
divided by the number of
The number of confirmed cases is not reliable because not
confirmed cases.
all cases are confirmed so there is an overestimation of the
risk of COVID-19.
The number of actual cases is higher than the number of
confirmed cases
Estimation of the infection fatality rate (IFR)
https://ourworldindata.org/mortality-risk-covid#the-current-case-fatality-rate-of-covid-19
- Around 1%??
- 1.04%
- 1.3%
Prevention and treatment options
- No drug currently proven to be effective in
treating COVID-19
- No vaccine currently available
There are a few drugs which will important and
these will be informed in more detail later on.
Difference between Traditional Vaccine Development and
Development Using a Pandemic Paradigm.
Difference between Traditional Vaccine
Development and Development Using a Pandemic
Paradigm
This is the normal procedure of how a vaccine is
developed and how much times it costs before it gets
on the market.
There has to be sure that the vaccine or drugs is safe.
Pagina 3 van 69
et al. N Engl J Med 2020;382:1969-1973.
, COVID-19 and global health
- Possible impact long term
* Changes in supply chain for pharmaceutical and equipment
* More investments in infectious disease prevention and treatment
* Investments in preparedness to respond to emergencies
* Increase in inequities: poor and disadvantaged affected much more by the crisis and its
consequences
* Attention for the other global health problems?
Air pollution and climate change
Problem: Microscopic pollutants enter respiratory and circulatory systems and image the lungs,
heart and brain causing/contributing to disease such as cancer, stroke, heart and lung disease.
Consequence: 7 million people die prematurely every year
Fragile and vulnerable settings
22% of the global population without access to basic care because of drought, famine, conflict,
and population displacement.
Weak primary health care
Global influenza pandemic
Dengue
Mosquito-borne disease, especially during rainy seasons of countries such as Bangladesh and
India causes flu-like symptoms.
390 million infections a year, about 40% of the world is at risk of dengue fever up to 20% of those
with severe dengue die.
HIV/AIDS
Around 37 million worldwide live with HIV 22 million are on treatment about 1 million die every
year.
Ebola and other high-threat pathogens
In 2018, the Democratic Republic of the Congo saw two separate Ebola outbreaks, both which
spread to cities of more than 1 million people.
Vaccine hesitancy
1.5 million deaths/year could be avoided.
Antimicrobial resistance
This is under threat with COVID-19 there is a reduction in antimicrobial resistance.
Pagina 4 van 69
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