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103Preventive Healthcare
vomiting, drug craving, severe tremors, depression, increased
heart rate and blood pressure, chills, flushing, and excessive
sweating.
Role of Pharmacist in Reducing/Preventing the Menace
(Substance Abuse)
Substance abuse is a major problem in society. Pharmacists
possess the exclusive knowledge, aptitudes, and responsibilities
for assuming an essential part in reducing and preventing drug
abuse. Pharmacists, as healthcare providers, must be
enthusiastically involved in decreasing the harmful effects that
substance abuse has on people and the pharmacy profession.
He/she must be adapted to the following tasks to meet local
needs and circumstances.
A. Prevention
Pharmacists ought to be involved in drug abuse prevention by
actively performing the following duties:
1. Contributing to the development of drug abuse prevention
programs inside healthcare organizations. Broadly
program must comprise of:
a. a written drug abuse policy,
b. an employee awareness program,
c. a supervisor guidance program,
d. worker help program, and
e. drug testing.
2. Participating in community drug abuse education and
prevention programs in schools, colleges, and organi-
zations and focusing on the possible undesirable health
consequences of the misuse of permissible drugs and the
use of prohibited drugs.
3. Restricting the sale of alcohol and tobacco products by
pharmacists and in drug stores.
4. Setting up a multidisciplinary controlled-drug inventory
system, consistence with legal and administrative necessi-
ties that discourages diversion and increases responsi-
bility.
104 Social Pharmacy
5. Working with nearby government authorities in
controlling drug abuse, together with participation in state
prescription drug monitoring programs, encouraging
involvement in suitable prescription discarding programs,
conforming to controlled-drug reporting regulations, and
cooperating in investigations that entail the abuse of
controlled drugs, particularly diversion from a healthcare
organization.
6. Working with the medical laboratories to (a) distinguish
drugs of abuse by using drug and poison control infor-
mation systems, (b) set up appropriate specimen collection
methods by utilizing the knowledge of the pharmaco-
kinetics of abused drugs, and (c) opt suitable laboratory
tests to identify the suspected drugs of abuse and to
identify tampering of samples.
7. Discouraging prescribing practices that encourage drug
abuse behavior (e.g. prescribing a larger amount of
analgesics than is clinically required for management of
short-term pain).
8. Interacting with outpatient and ambulatory care providers
to prevent drug abuse.
B. Education
Pharmacists ought to be involved in drug abuse education by
performing the following actions:
1. Giving information and recommendations to support
groups appropriate to the requirements of individuals
whose lives are influenced by drug abuse.
2. Giving proposals about the proper utilization of mood-
altering drugs to healthcare providers and the general
population, including persons recovering from drug
abuse.
3. Promoting the expansion of pharmacy education on the
topic of drug abuse prevention, education, and assistance.
4. Imparting drug abuse-related education and learning to
colleague pharmacists as well as other healthcare
specialists of the healthcare society.
105Preventive Healthcare
5. Advising drug abuse therapists regarding the pharmaco-
logy of abused drugs as well as drugs utilized for
detoxification.
6. Promoting and also offering alcohol risk-reduction
education and learning.
7. Keeping up proficient competency in drug abuse preven-
tion, education, and assistance by continuing education.
8. Offering postgraduate training in addictions, pain
management, and palliative care wherever possible.
9. Researching drug abuse and dependency.
10. Educating patients regarding the proper storage, handling,
as well as disposal of drugs.
3. Assistance
Pharmacists must be involved in drug abuse assistance by
performing the following activities:
1. Assisting in the identification of patients, colleagues, and
other individuals who may be having problems related to
drug abuse, and referring them to the appropriate people
for evaluation and treatment.
2. Taking interest in multidisciplinary endeavors to support
and look after the healthcare organization’s staff and
patients who are getting better from drug dependency.
3. Supporting and encouraging the improvement of health
experts with alcoholism or other drug addictions. Major
fundamentals of an employer’s support program might
include:
a. being willing to hire or retain employees,
b. participating in monitoring and reporting require-
ments associated with recovery or disciplinary
contracts,
c. maintaining an environment supportive of recovery,
d. establishing behavioral standards and norms among
all employees that discourage the abuse of psycho-
active drugs, including alcohol,
e. participating in peer-assistance programs.
106 Social Pharmacy
4. Working together with other healthcare providers in the
advancement of the pharmacotherapeutic basics of drug
detoxification protocols.
5. Giving pharmaceutical care to patients being treated for
drug abuse and dependency.
6. Keeping up information of specialists along with other
local, state, and nationwide drug therapy and patient care-
specific practice areas—organizations, programs, and
resources readily available for preventing and treating
drug abuse.
REVISION QUESTIONS
Long Answer Questions (10 marks)
1. Explain the demographic cycle and its different stages.
2. Compare the different types of contraception methods.
3. What is a diaphragm? Discuss different types of dia-
phragms with their features.
4. Discuss chemical methods of contraception.
5. Briefly describe ‘injectable contraceptives’, and ‘subdermal
implants’.
6. Give a brief account of hormonal contraceptives.
7. Discuss the natural family planning methods.
8. What is air pollution? What are the chief impurities
present in the air?
9. What do you mean by vasectomy and tubectomy? Discuss
their role in birth control.
10. Describe the essential components of a water sewerage
system.
Short Answer Questions (5 Marks)
1. Briefly describe the modern oral pills for contraception.
2. Briefly describe the modern depot formulations for
contraception.
3. What is the role of copper in contraception? Explain
different types of copper devices.
4. Describe briefly the post-contraception methods.
107Preventive Healthcare
5. What is a mini pill?
6. Write about the sources of water.
7. What are the different sources of impurities in water?
8. Describe different water-borne diseases along with their
causative agents.
9. What do you mean by noise pollution? What are the ill
effects of noise pollution?
10. Define psychoactive substances.
11. Explain types of psychoactive substances.
12. Define drug addiction.
13. Define drug dependence.
14. What are psychoactive substances?
15. Give examples of psychedelics.
Multiple Choice Questions [answers are in bold]
1. The function of Copper-T is to:
a. Stop menstruation
b. Stop the growth of embryo
c. To expel fetus
d. Prevent fertilization
2. Emergency contraceptive pills prevent pregnancy by:
a. Preventing fertilization
b. Preventing ovulation
c. Inducing abortion
d. Harming embryo
3. When was the first census in India conducted?
a. 1871
b. 1881
c. 1891
d. 1901
4. Why was the 2021 census in India postponed?
a. Economic reasons
b. Political reasons
c. COVID-19 pandemic
d. Lack of government funds
108 Social Pharmacy
5. What is the demographic gap?
a. The difference between birth rate and death rate
b. The difference between the rich and poor
c. The difference between urban and rural populations
d. The difference between literacy rates
6. At what stage of the demographic cycle is India currently
positioned?
a. First stage (high stationary)
b. Second stage (early expanding)
c. Third stage (late expanding)
d. Fourth stage (low stationary)
7. What is the total fertility rate (TFR)?
a. The average number of children born to a woman
b. The difference between birth and death rates
c. The rate of population growth
d. The ratio of females to males in a population
8. What is the role of pharmacists in promoting family
planning?
a. Performing surgeries for family planning
b. Educating the public about family planning
c. Advocating against family planning
d. Conducting demographic surveys
9. Which birth control method prevents fertilization?
a. Contragestion
b. Contraception
c. Abortion
d. Adoption
10. How long should a diaphragm remain in place after sexual
intercourse?
a. 2 hours
b. At least 6 hours
c. 24 hours
d. Immediately removed
11. What is the purpose of spermicidal jellies, foams, and
creams in contraception?
a. Increase acidity in the vagina
b. Ensure barrier effectiveness
109Preventive Healthcare
c. Provide protection against STDs
d. Prevent toxic shock syndrome
12. Which hormonal contraceptive contains levonorgestrel
and is effective within 72 hours of coitus?
a. Oral pills
b. Non-steroidal pills
c. Steroidal pills
d. Emergency contraceptives
13. What is the primary function of i-pill as an emergency
contraceptive?
a. Induce fertility
b. Prevent implantation of the egg
c. Ensure contraceptive failure
d. Increase unintended pregnancies
14. Which of the following is a natural method of contra-
ception?
a. Vasectomy
b. Tubectomy
c. Basal body temperature (BBT) method
d. Male sterilization
15. Which method involves cutting and tying both vas
deferens to prevent sperm from entering the uterus?
a. Tubectomy
b. Cervical mucus method
c. Vasectomy or male sterilization
d. Basal body temperature (BBT) method
16. What is the role of pharmacists in improving maternal and
child health during pregnancy?
a. Conducting surgeries
b. Managing medication therapy
c. Designing immunization schedules
d. Performing prenatal yoga
17. When should breastfeeding be initiated according to the
information provided?
a. Within 24 hours of birth
b. Within half an hour of birth
110 Social Pharmacy
c. After 48 hours of birth
d. After one week of birth
18. What is a potential disadvantage of substituted milk and
bottle feeding?
a. Improves visual acuity
b. Reduces the risk of allergies
c. Causes pneumonia
d. Enhances the intelligence quotient (IQ)
19. Which type of vaccine uses messenger RNA (mRNA) to
produce an immune response?
a. Inactivated vaccine
b. Attenuated vaccine
c. mRNA vaccine
d. Toxoid vaccine
20. What is the primary purpose of immunization?
a. To cause diseases in individuals
b. To make a person immune to infectious diseases
c. To reduce the effectiveness of the immune system
d. To promote allergies in individuals
21. Under the Universal Immunization Programme (UIP),
which disease is not mentioned as being preventable
through vaccination?
a. Tuberculosis
b. Meningitis
c. Influenza
d. Hepatitis B
22. What is the purpose of the ‘Cold Chain’ in the context of
vaccines?
a. To create awareness about vaccination
b. To maintain the temperature of vaccines
c. To distribute vaccines to pharmacies
d. To improve the taste of vaccines
111Nutrition and Health
INTRODUCTION
Food and nutrition are important in maintaining good health.
Several non-communicable chronic diseases like hypertension,
coronary artery disease, diabetes mellitus, and certain types of
cancers are due to imbalanced diet and sedentary lifestyle.
Nutrition is the process of consuming, absorbing, and using
nutrients from food that are necessary for the growth,
development, and maintenance of life. Good nutrition is a
cornerstone of good health as it increases the body’s immunity
and decreases disease susceptibility.
Food
Any substance, that can be utilized to yield energy to:
i. build up new tissues,
ii. repair worn-out tissues,
iii. regulate body processes, and
iv. produce important body compounds;
is classified as food.
Nutrition
Nutrition may be defined as ‘the science of food and its
relationship to health’. It is concerned mainly with the role of
nutrients in growth, physical development, and maintenance
of the body. Nutrition is a critical part of health and develop-
ment. Better nutrition is related to improved infant, child, and
maternal health, stronger immune systems, safer pregnancy
and childbirth, lower risk of non-communicable diseases (such
as diabetes and cardiovascular disease), and longevity.
Nutrition and Health
3
112 Social Pharmacy
Undernutrition
Undernutrition includes wasting (low weight-for-height),
stunting (low height-for-age), and underweight (low weight-
for-age). It is a shortage of the total essential nutrients in the
diet due to insufficient supply of food. Undernutrition makes
children much more vulnerable to disease and death.
Malnutrition
It means bad nutrition either due to deficiency or due to excess
of one or more nutrients. Malnutrition poses a significant threat
to human health. There are multiple forms of malnutrition,
including undernutrition (wasting or stunting), inadequate
vitamins or minerals, overweight, obesity, and resulting diet-
related non-communicable diseases. The developmental,
economic, social, and medical impacts of the global burden of
malnutrition are serious and affect individuals and their
families, communities, and countries.
Diet
The word ‘diet’ often implies the use of a specific intake of
nutrition for health or weight-management reasons. Diet is the
sum of food consumed by a person or other organism. A
healthy diet helps to protect against malnutrition in all its forms,
as well as non-communicable diseases, including diabetes, heart
disease, stroke, and cancer.
Functions of Diet
An adequate diet should perform the following functions:
1. It must supply energy for the basal metabolism, muscular
work, and optimum growth of the body.
2. It must supply energy and material for the synthesis of
structural components necessary for optimum growth.
3. It must supply agents necessary to perform chemical
reactions in the above processes.
4. It must supply energy and chemicals for reproduction.
The amount of nutrients needed for the body can be
expressed in terms of Recommended Daily Allowance (RDA) or