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Drug profiles > Public Health > Flashcards

Public Health Flashcards

1
Q

Health definition

A

Persons capacity to function in relation to age and need while having feelings such as enjoyment from everyday life

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2
Q

determinants of health

A

range of factors that combine together to affect or influence the health of individuals
conditions in which people are born, grow, live, work and age

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3
Q

causes of ill-health

A 
cancers 
communicable diseases (can be spread)
mental disorders 
liver disorders 
CV disease 
congenital malformation (birth defects)
respiratory disease 
dental caries 
disability 
HIV/AIDS
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4
Q

Health inequalities

A

systematic differences in health status between different socio-economic groups

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5
Q

health literacy

A

people having the skills (language, literacy and numeracy), knowledge, understanding and confidence to access, understand, evaluate, use and navigate health and social care information and services

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6
Q

two types of health behaviour models

A
  1. explanatory theory/ social cognition models

2. change theory

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7
Q

public health

A

the health of a population as a whole, especially as the subject of government regulation and support

understanding causes of ill-health, seeking to explain and or predict health-related behaviour, helping clients, groups or communities redirect their own activities towards health and wellbeing

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8
Q

health education

A

combination of learning experiences to help individuals and communities improve their health by increasing their knowledge or influencing their attitudes

part of health promotion

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9
Q

what is explanatory theory

A

used to explore reasons behind a particular health behaviour by focusing on the individual

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10
Q

examples of explanatory theories

A 
health belief model 
theory of reasoned action/planned behaviour 
transtheoretical (stages of change) model 
social cognitive (learning) theory
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11
Q

What is change theory

A

Theory to guide change following explanation of change needed to improve health

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12
Q

health belief model (HBM)

A

desire to avoid negative health consequences

used to try and predict health behaviours

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13
Q

examples of health belief models

A

condoms, seat belts, medical compliance, health screening

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14
Q

6 concepts protective/health promoting actions depend on in the Health Belief Model

A
  1. perceived susceptibility
  2. perceived severity
  3. perceived benefits
  4. perceived barriers
  5. cues to action
  6. self-efficacy
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15
Q

what is perceived susceptibility

A

belief of chances of getting a condition

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16
Q

what is perceived severity

A

belief of how serious condition and consequences

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17
Q

what is perceived benefits

A

belief in the efficacy of the advised action to reduce risk or seriousness of impact

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18
Q

what is perceived barriers

A

belief in the tangible and psychological costs of the advised behaviour

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19
Q

what are cues to action

A

strategies to activate ‘readiness’

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20
Q

what is self-efficacy

A

confidence in ones ability to take action

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21
Q

3 challenges in applying the HBM

A
  1. avoiding blame (HBM stresses personal responsibility)
  2. solutions often more complex or caused by factors over which individuals have less personal control
  3. challenge of providing meaningful cues to action
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22
Q

theories of reasoned action and planned behaviour

A

centres on individuals attitudes and beliefs

seeks to explain behaviours under voluntary control

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23
Q

Stages of change (transtheoretical) model

A

identifies 5 stages of change in behaviour representing ‘levels of readiness’

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24
Q

5 stages of stages of change model

A
  1. pre-contemplation
  2. contemplation
  3. preparation
  4. action
  5. maintenance
    - potentially relapse as 6th stage
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25
Q

social cognitive theory (SCT)

A

takes into account determinants of health and individual behaviours

links personal factors, behaviour and environmental influences

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26
Q

diffusion of innovations

A

identifies factors that influence how quickly an idea or behaviour is adopted

highlights uncertainties associated with new behaviours

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27
Q

according to diffusion of innovations, what 4 factors does the adoption of a new idea depend on

A
  1. characteristics of the innovation
  2. communication channels
  3. time
  4. social system
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28
Q

behavioural change wheel

A

developed from 19 frameworks of behaviour change and consists of 3 layers

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29
Q

3 layers of behaviour change wheel

A
  1. 6 source of behaviour (2 in each domain)
  2. domains of: opportunity, capability and motivation
  3. 9 intervention functions
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30
Q

6 sources of behaviour in behaviour change wheel

A 
Capability domain
1. physical 
2. psychological 
Opportunity domain 
3. social 
4. physical 
Motivation domain
5. reflective 
6. automatic
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31
Q

what is the purpose of screening

A

to reduce risk of certain groups in the population by identifying those more susceptible to diseases, reducing associated risks of complications

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32
Q

what is screening

A

process of identifying healthy people who may be at increased risk of disease or condition, enabling earlier treatment and better informed decisions

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33
Q

11 UK national population screening programmes

A 
abdominal aortic aneurysm (AAA)
bowel cancer screening (BCSP)
breast screening (BSP)
cervical screening (CPS)
diabetic eye screening (DES)
fetal anomaly screening (FASP)
infectious diseases in pregnancy screening (IDPS)
newborn and infant physical examination (NIPE)
newborn blood spot (NBS)
newborn hearing screening (NHSP)
sickle cell and thalassaemia (SCT)
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34
Q

screening parameters

A
  • eligible group (decided by risk and benefit; balancing both with affordability)
  • test (sieve or screen)
  • sorting for positives (
  • intervention for cases
  • avoidable outcomes
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35
Q

false positive

A

wrongly reported as having the condition

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36
Q

false negative

A

wrongly reported as not having the condition

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37
Q

harm caused by false negative/positive

A

unnecessary treatment
physical and emotional stress
cost to NHS
deter people from trusting results in future

38
Q

what is obesity

A

accumulation of body fat when energy intake from eating is greater than energy expended over time

39
Q

BMI

A

kg/(m^2)

healthy = 18.5 - 24.9
overweight = BMI >25
obesity = BMI >30
40
Q

risk factors of obesity/ excess weight

A 
CV disease 
T2D
hypertension 
cancer 
MSK pain and impair mobility from stress on joints and spine 
poorer mental health and wellbeing
41
Q

approach to tackling obesity

A

whole system approach

  • diet
  • physical activity
  • sitting less
  • alcohol consumption
42
Q

UK advice on diet

A
  • 5 (80g servings) fruit and veg per day
  • no more than 35% of food energy should be from fat
  • maximum salt intake = 6g/day
  • at least one 140g portion of oily fish per week
  • dietary fibre 30g/day

choose smaller portions

43
Q

health issues from alcohol harm

A 
heart disease 
stroke 
high blood pressure
liver cirrhosis/ cancer 
reduced fertility 
depression and anxiety 
breast cancer 
cancer of mouth, throat, oesophagus or larynx 
pancreatitis 
harm to unborn babies
44
Q

7 priorities for action to improve national health

A
  1. tackle obesity, particularly among children
  2. reduce smoking and stop children starting
  3. reduce harmful drinking and alcohol related hospital admissions
  4. ensure every child has best start in life
  5. reduce risk of dementia, incidence and prevalence in 65-75y/o
  6. tackle growth in antimicrobial resistance
  7. achieving a year-on-year decline in the incidence of Tb
45
Q

UK guidance for alcohol consumption

A

14 units spread over 3 days or more

46
Q

1 unit of alcohol equivalent to…

A

half a pint of beer
half a small glass of wine
one single shot of spirit

47
Q

low risk of drinking behaviour

A

both men and women not drinking regularly more than 14 units per week spread over 3 or more days

48
Q

increasing risk of drinking behaviour

A

men - regularly drinking 15-49 units/week

women - regularly drinking 15-34 units/week

49
Q

higher risk of drinking behaviour

A

men - regularly more than 8 units/day or 50+ units/week

women - regularly more than 6 units/day or 35+ units/week

50
Q

binge drinking - risk of drinking behaviour

A

men - more than 8 units on heaviest drinking day in previous week

women - more than 6 units on heaviest drinking day in previous week

51
Q

brief alcohol interventions

A

short, time-limited interaction/ conversation (no more than 5 mins)

guided nature of conversation, delivered in a motivational style, distinguishes it from basic information giving

52
Q

addressing smoking (3 A’s)

A

ASK - all patients if they smoke
ADVISE - the best way to stop (for them)
ACT - by offering referral to local stop smoking services

53
Q

4 quitting methods for smoking

A
  1. local stop smoking services offer best chance of success
  2. using a prescribed medicine
  3. using OTC nicotine replacement (patches, gum or e-cig)
  4. using will power alone - least effective method
54
Q

Nicotine Replacement Therapy products (NRT) formulations

A
  • transdermal patch
  • gum (chewed slowly)
  • inhalation cartridges
  • sublingual tablets/ lozenge
  • nasal spray/ mouth spray
55
Q

prescription only smoking cessation therapy

A

bupropion

varenicline

56
Q

benefits of smoking cessation

A

slows decline in lung function

gives extra years of life

57
Q

duration of potential withdrawal symptoms

A 
less than 4 weeks:
- irritability/ aggression 
- depression 
- restlessness 
less than 2 weeks:
- poor concentration
more than 10 weeks:
- increased appetite 
less than 48 hours:
- light-headedness 
less than 1 week:
- night-time awakeness 
urges to smoke:
years
58
Q

advise for smoking cessation pregnancy and breastfeeding

A

try to stop without NRT but can be used as far less risk to baby than continuing to smoke
for breastfeeding: if using NRT = should use intermittently (not patches)

59
Q

factors that can lead to relapse

A 
low self-efficacy 
negative emotions and poor coping 
high craving 
expectation of reinforcement 
low motivation 
interpersonal issues
60
Q

3 interventions to promote smoking cessation

A
  1. clinical interventions
  2. motivational support (friend/family support)
  3. public health (workplace/government interventions etc)
61
Q

normal waist circumference

A

men - less than 94cm

women - less than 80cm

62
Q

high and very high risk waist circumference

A

high:
men - 94-102
women - 80-88

very high:
men - over 102
women - over 88

63
Q

advice for low waist circumference and overweight

A

general advice on healthy weight and lifestyle

64
Q

advice for low waist circumference and obesity I or high waist circumference and overweight

A

diet and physical activity

65
Q

advice for high waist circumference and obesity I or very high waist circumference and overweight

A

diet and physical activity; consider drugs

66
Q

advice for very high waist circumference and obesity I

A

diet and physical activity
consider drugs
consider surgery

67
Q

activity recommendations for adults

A
  • at least 30 minutes
  • moderate or greater physical activity
  • 5 or more days a week
  • either in one session or several sessions lasting 10 minutes or more
68
Q

activity recommendation for children

A

at least 60 minutes of moderate or greater intensity physical activity

69
Q

dietary advice for losing weight in adults

A
  • 600kcal/day deficit
  • reduce calories by lowering the fat content
  • in combination with expert support and intensive follow-up
70
Q

dietary advice for losing weight in children

A

dietary approach alone not recommended

should be part of multicomponent intervention

71
Q

pharmacological interventions for weight loss (2)

A

should only be recommended after lifestyle changes have been made and evaluated

orlistat - lipase inhibitor
liraglutide - glucagon-like peptide-1 receptor agonist

not recommended for children 12 and under

72
Q

Orlistat - mechanism of action

A

reduces absorption of dietary fat by inhibition of GI lipases which stops breakdown of triglycerides to absorbable free fatty acids and monoglycerides

73
Q

BMI that is orlistat used

A

BMI 30 or more
OR
BMI 28 or more PLUS other risk factors (T2D, HTN etc)

74
Q

administration of orlistat

A

120mg up to 3 times a day

taken immediately before, during or up to 1 hour after a meal

if meal contains no fat - skip dose

review at 12 weeks

75
Q

additional meds when taking orlistat

A

use additional contraceptive to prevent failure of oral contraception from severe diarrhoea

orlistat may impair absorption of vit A,D,E and K - consider multivitamins taken at least 2 hours after orlistat, or at bedtime

76
Q

conditions for buying orlistat OTC

A
  • over 18 years
  • BMI 28 or above
  • have a mildly hypocaloric, lower fat diet
  • treatment should not exceed 6 months
  • dose = 60mg TDS
  • capsule should be taken with water
77
Q

orlistat contraindications

A
  • hypersensitivity to orlistat
  • taking ciclosporin or warfarin (and other anticoagulants)
  • chronic malabsorption syndrome
  • cholestasis
  • pregnant/ breastfeeding
  • signs of eating disorder
78
Q

what is an opioid

A

natural derivative of opium or synthetic substance with agonist, partial agonist or mixed agonist and antagonist activity at opioid receptors

79
Q

what is an opioid antagonist

A

drug that blocks the activity of a drug with agonist activity

80
Q

what is an opiate

A

a natural derivative or semi-synthetic constituent of opium

81
Q

what is dependence

A

strong desire or sense of compulsion to take the substance

difficulty in controlling use

82
Q

goal of maintenance therapy

A

harm reduction and stabilisation of lifestyle

83
Q

goal of detoxification

A

to come off opioids altogether

84
Q

what is needle exchange service

A

safe disposal of needles

encourages testing for BBV and other diseases spread through needles

85
Q

what is the antidote for opioid overdose

A

naloxone (POM) = opioid antagonist

86
Q

definition of pain

A

unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage

87
Q

influences on pain perception

A 
co-morbidities 
- psychological 
- substance misuse
- previous trauma 
lifestyle factors
- exercise
- smoking 
- alcohol intake 
- stress
social isolation 
- elderly 
- disabled patients
88
Q

Qs in pain assessment

A

intensity, location, quality, duration, aggravating/relieving factors, associated symptoms, impact on activities of daily living, patients pain beliefs, cause of the pain, expectations, acceptable pain levels, coping mechanisms, emotional response and spiritual beliefs

89
Q

descriptions of neuropathic pain

A 
shooting
tingling 
numbness 
like an electric shock 
burning
90
Q

descriptions of somatic pain

A

achy
throbbing
dull
well localised

91
Q

descriptions of visceral pain

A

cramping
pressure
distention
deep

Drug profiles (6 decks)

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