Summary Global Health and
Pharmacotherapy
Lectures of 2021 – Year 1 Bachelor of Pharmacy – By Kim Scholten
Lecture 1 – Global Health – a first introduction (Katja Taxis)
What is global health?
Global health issues are issues that concern many countries, have transnational
determinants, and require transnational solutions. The problems are not local but spread
over many countries.
- Health is a state of complete physical, mental and social well-being and not merely
the absence of disease or infirmity. This may not be able to achieve for everyone
world-wide.
- Important aspects are improving health, equity in health worldwide, transnational
health issues, interdisciplinary collaboration, prevention, and care.
Biggest threats of global health
COVID-19 pandemic à not many details! Now that it the virus is severe acute respiratory
syndrome coronavirus 2 (SARS-CoV-2) causing coronavirus disease 19 (COVID-19). It is a
respiratory infection which can cause mild to severe symptoms like fever, cough, but also
multi-organ failure and septic shock.
- Crude mortality rate = number of deaths from the disease divided by the total
population
- Case fatality rate (CFR) = number of confirmed deaths divided by the number of
confirmed cases
- Infection fatality rate (IFR) = number of deaths from a disease divided by the total
number of cases
o By an increase in age, the IFR also increased.
When there is a pandemic, the vaccine development goes much faster than normal,
different stages already begin before the last stage has ended.
- Recombinant virus vaccines are Astra-Zeneca & Janssen
- RNA vaccines are Moderna & Pfizer
Pandemics like COVID-19 can have many impacts on long time, like changes in supply chains
and more investments in prevention, treatment and preparedness to respond to
emergencies.
Other threats for global health are air pollution and climate change, fragile and vulnerable
settings, weak primary health care, Global influenza pandemic, Dengue (mosquito),
HIV/AIDS, Ebola and other high-threat pathogens, vaccine hesitancy, antimicrobial resistance
and noncommunicable disease (diabetes, cancer and heart disease).
Goals for global health
SDG = Sustainable Development Goals for health and wellbeing > to end poverty, protect the
planet and ensure that all people enjoy peace and prosperity.
, Lecture 2 – Pharmacotherapy (Katja Taxis)
What is a medicine?
A lot of drugs are based on plant extracts like morphine. Drugs are small or large organic
molecules, often proteins. The route of administration depends on the drug characteristics.
What happens when you take a medicine?
ADME = Absorption, Distribution, Metabolism, Excretion.
This is pharmacokinetics, what happens when you
swallow a drug? Metabolism is important (f.e.
paracetamol can be metabolized into the working drug or
in a toxic metabolite which can lead to liver damage).
- Pharmacodynamics is the effect of drugs and their
mechanisms of action.
- Metoprolol is a ß1 antagonist which leads to
decreased cardiac output and decreased renin
release.
Effects of a drug can be desirable (the therapeutic effect) or undesirable (side effects, toxic
effects or allergic reactions). The individual response to a drug depends on age, gender,
pharmacogenetics, organ function, co-morbidities and co-medication. Drug interactions may
occur when the patients take more than one prescribed drug, use over-the-counter drugs or
have unusual diets and this may lead to failure of therapy or toxicity.
How do we know that a medicine is effective?
Clinical trials with multiple phases test the effectiveness and safety of drugs. Only in phase III
there are human clinical tests. It is determined by randomized trials, double blind or
placebo.
- Evidence based medicine determine the treatment guidelines that pharmacists and
GPs use in daily practice.
With good prescribing you have a balance in the patients wishes, the costs of the drug, the
effects and the harms.
Lecture 3 – Hypertension (Katja Taxis)
What is hypertension?
Hypertension is a high blood pressure. The blood pressure is the force the circulating blood
has against the arteries, it is writing as 120/80 mmHg where 120 is the systolic number and
80 the diastolic number. The blood pressure is regulated by the cardiac output, peripheral
resistance of the vessels (lower in older people) and myriad mechanisms (these can be
influenced to treat hypertension).
- Myriad mechanisms are the nervous system, water and salt intake and excretion by
the kidneys, RAS system, peptides produced in the heart.
Hypertension can be divided into three grades, where Grade 3 hypertension is the most
severe (don’t remember exact blood pressures).
What are symptoms of hypertension?
Many people experience no symptoms, or they are unspecific like headache, shortness of
breath and nosebleeds. Only when the hypertension is really severe, they can experience
more symptoms.
Causes of hypertension are lifestyle (high sodium intake, weight gain, excess alcohol use),
medications (NSAIDs), genetics (often polygenic) or secondary to other diseases.
Pharmacotherapy
Lectures of 2021 – Year 1 Bachelor of Pharmacy – By Kim Scholten
Lecture 1 – Global Health – a first introduction (Katja Taxis)
What is global health?
Global health issues are issues that concern many countries, have transnational
determinants, and require transnational solutions. The problems are not local but spread
over many countries.
- Health is a state of complete physical, mental and social well-being and not merely
the absence of disease or infirmity. This may not be able to achieve for everyone
world-wide.
- Important aspects are improving health, equity in health worldwide, transnational
health issues, interdisciplinary collaboration, prevention, and care.
Biggest threats of global health
COVID-19 pandemic à not many details! Now that it the virus is severe acute respiratory
syndrome coronavirus 2 (SARS-CoV-2) causing coronavirus disease 19 (COVID-19). It is a
respiratory infection which can cause mild to severe symptoms like fever, cough, but also
multi-organ failure and septic shock.
- Crude mortality rate = number of deaths from the disease divided by the total
population
- Case fatality rate (CFR) = number of confirmed deaths divided by the number of
confirmed cases
- Infection fatality rate (IFR) = number of deaths from a disease divided by the total
number of cases
o By an increase in age, the IFR also increased.
When there is a pandemic, the vaccine development goes much faster than normal,
different stages already begin before the last stage has ended.
- Recombinant virus vaccines are Astra-Zeneca & Janssen
- RNA vaccines are Moderna & Pfizer
Pandemics like COVID-19 can have many impacts on long time, like changes in supply chains
and more investments in prevention, treatment and preparedness to respond to
emergencies.
Other threats for global health are air pollution and climate change, fragile and vulnerable
settings, weak primary health care, Global influenza pandemic, Dengue (mosquito),
HIV/AIDS, Ebola and other high-threat pathogens, vaccine hesitancy, antimicrobial resistance
and noncommunicable disease (diabetes, cancer and heart disease).
Goals for global health
SDG = Sustainable Development Goals for health and wellbeing > to end poverty, protect the
planet and ensure that all people enjoy peace and prosperity.
, Lecture 2 – Pharmacotherapy (Katja Taxis)
What is a medicine?
A lot of drugs are based on plant extracts like morphine. Drugs are small or large organic
molecules, often proteins. The route of administration depends on the drug characteristics.
What happens when you take a medicine?
ADME = Absorption, Distribution, Metabolism, Excretion.
This is pharmacokinetics, what happens when you
swallow a drug? Metabolism is important (f.e.
paracetamol can be metabolized into the working drug or
in a toxic metabolite which can lead to liver damage).
- Pharmacodynamics is the effect of drugs and their
mechanisms of action.
- Metoprolol is a ß1 antagonist which leads to
decreased cardiac output and decreased renin
release.
Effects of a drug can be desirable (the therapeutic effect) or undesirable (side effects, toxic
effects or allergic reactions). The individual response to a drug depends on age, gender,
pharmacogenetics, organ function, co-morbidities and co-medication. Drug interactions may
occur when the patients take more than one prescribed drug, use over-the-counter drugs or
have unusual diets and this may lead to failure of therapy or toxicity.
How do we know that a medicine is effective?
Clinical trials with multiple phases test the effectiveness and safety of drugs. Only in phase III
there are human clinical tests. It is determined by randomized trials, double blind or
placebo.
- Evidence based medicine determine the treatment guidelines that pharmacists and
GPs use in daily practice.
With good prescribing you have a balance in the patients wishes, the costs of the drug, the
effects and the harms.
Lecture 3 – Hypertension (Katja Taxis)
What is hypertension?
Hypertension is a high blood pressure. The blood pressure is the force the circulating blood
has against the arteries, it is writing as 120/80 mmHg where 120 is the systolic number and
80 the diastolic number. The blood pressure is regulated by the cardiac output, peripheral
resistance of the vessels (lower in older people) and myriad mechanisms (these can be
influenced to treat hypertension).
- Myriad mechanisms are the nervous system, water and salt intake and excretion by
the kidneys, RAS system, peptides produced in the heart.
Hypertension can be divided into three grades, where Grade 3 hypertension is the most
severe (don’t remember exact blood pressures).
What are symptoms of hypertension?
Many people experience no symptoms, or they are unspecific like headache, shortness of
breath and nosebleeds. Only when the hypertension is really severe, they can experience
more symptoms.
Causes of hypertension are lifestyle (high sodium intake, weight gain, excess alcohol use),
medications (NSAIDs), genetics (often polygenic) or secondary to other diseases.
