community pharmacy

1. VIGNAN PHARMACY COLLEGE
(Approved by AICTE & PCI Affiliated to JNTU KAKINADA)
VADLAMUDI, GUNTUR DIST, ANDHRA PRADESH, INDIA, PIN: 522 213
Submitted By:-
MUKTHIPATI TRIVENI
16AB1T0029
Submitted to:
Satheesh S.Gottipati
B.Pharm ., MS ( USA ) ,R.Ph .,CIP( USA )
HEALTH SCREENING SERVICES

2. • Health is the level of functional and metabolic efficiency of a living organism.
• The World Health Organization (WHO) defined human health in its broader sense in its
1948 constitution as "a state of complete physical, mental, and social well- being and not
merely the absence of disease or infirmity.
• Screening is a public health services in which members of a defined population who do not
necessary perceive they are at risk of, or are already affected by disease or its
complications, are asked a question or offered a test to identify those individual who are
more likely to be helped than harmed by further tests or treatment to reduce the risk of a
disease or its complications.

3. • Certain tests are performed to diagnose the disease or the extent/stage of the disease.
These tests are done at almost every health screening centers, which are commonly
available in community centers.
• These tests are also called as Health Screening Tests e.g. Estimation of blood glucose,
blood cholesterol, blood pressure, electrocardiograph and lung function test.
• These tests may or may not prescribed by physician.
• These tests are do not have any side effects and thus people can themselves carry out
such tests to check and monitor their health status. These tests are performed at
regular intervals of time in order to keep a check upon health and the disease.

4. Types of Health Screening Tests:
Health screening tests can be categorized as:
Primary Health Screening Tests:
These tests are performed either when the physician prescribe or when a patient himself
undergo such tests after the onset of the symptoms. Such test helps in diagnosing the
disease and its stages. Primary Health Screening is also called as clinical screening or
diagnostic screening.
Secondary Health Screening Tests:-
These tests are performed after the diagnoses of the disease or its stage. These tests are
done for mitigation of disease or to check its re-occurrence. Such tests are only carried
out when the physician prescribes them.

5. Relationship between Primary and Secondary
Screening

6. Significance of Health Screening Services
The health screening services are very important and are highly significant because of the
following reasons:
Accuracy And Reliability:
These are very small tests and thus accurate and can be trusted for over a perfect diagnosis of
disease.
Easily Available:
Primary Health Care tests are easily available in the nearby community or health screening
centers. Even certain pharmacists can be perform such tests like blood pressure, blood
glucose estimation etc.

7. Cost Effective:
These tests do not involve high cost. Such tests can be afforded by most of the population
whenever they feel need of them i.e. at a point of occurrence of symptoms.
Can Be Performed Anywhere:
Today most of the tests can be performed by digital portable devices and thus can be
carried out anywhere. Even the costs of the digital devices are not too high and a common
man can easily afford for such devices.
Side Effects:
Certain secondary health screening services have their own side effects but no side effects
or adverse effects on the body were observed with primary health screening.

8. Importance of Laboratory Test Results:
To assess the therapeutic and adverse effects of the drugs.
To determine the proper drug dose and dosing interval (dosing regimen).
Assess the need of additional or alternate drug therapy.

9. LUNG FUNCTION TESTS:

10. Lung function tests also called pulmonary function tests or PFTs to evaluate how well
your lungs work.
There are certain tests called as lung function tests which are performed
• To check the capacity of lung
• To check the force by which a person can inhale and exhale
• To check the capacity of lungs to diffuse into the body fluids (blood)
• Determine the cause of breathing problems.
• Diagnose certain lung diseases, such as asthma and chronic obstructive
pulmonary disease (COPD)

11. • Evaluate a person’s lung function before surgery.
• Monitor the lung function of a person who is regularly exposed to substances such as
asbestos that can damage lungs.
In overall, it checks how efficiently the lung work.
SPIROMETRY:
• The most useful test for abnormalities in airway function is the function is the forced
expiratory volume (FEV).
• This is measured by means of lung function assessment apparatus such as a spirometer.
• In this test, the patient is required to breathe very forcefully into the mouthpiece, which is
attached to an electronic recording device called as spirogram.

12. The spirogram records the information and record the information in the form of chart and
the chart called as Spirograph.
The various parameters, which can be calculated on this test.
• Total Lung Capacity
• Forced Vital Capacity
• Forced Expiratory Volume
• Forced Expiratory Flow
• Peak Expiratory Flow
• Maximum Voluntary Ventilation
• Expiratory Reserved Volume
• Residual Volume
• Inspiratory Reserved Volume
• Slow Vital Capacity
• Functional Residual Capacity

14. Forced Vital Capacity (FVC):
This measures the amount of air you can exhale with force after you inhale as deeply as
possible.
Forced Expiration Flow 25% to 75%:
This measures the airflow half way through an exhale.
Forced Expiration Volume:
This measures the amount of air you can exhale with force in one breath. The amount of air
you can exhale may be measured at 1second (FEV1), 2second (FEV2), and 3second
(FEV3). FEV1 divide by FCV can be determined.

15. Peak Expiratory Volume:
This measures how quickly you exhale. It is usually measure at the same time as your forced
vital capacity (FVC).
Slow Vital Capacity (SVC):
This measures the amount of air you can slowly exhale after you inhale as deeply as possible.
Total Lung Capacity (TLC):
This measures the amount of air in your lungs after you inhale as deeply as possible.
Residual Volume (RV):
This measures the amount of air in your lungs after you have exhale completely. It can done
by breathing in helium (or) nitrogen gas and seeing how much is exhaled.

16. Functional Residual Capacity (FRC):
This measures the amount of air in your lungs at the end of normal exhaled breath.
Maximum Voluntary Ventilation (MVV):
This measures the greatest amount of air you breathe in and out during one minute of
time.
Expiratory Reserve Volume (ERV):
This measures the difference between amount of air in your lungs after a normal exhale
and amount of air after you exhale with force (RV).

17. Inhalation Challenging Test:
Inhalation challenge tests are done to measure the
response of your airways to substances (allergens) that
may causing asthma or wheezing. The tests also may
determine the effect of chemicals such as histamine
(or) meth choline on your airways. These tests are also
called Proactive studies.
During this testing, increased amount of an
allergen are inhaled through a nebulizer. Before and
after inhaling the substance, spirometry readings are
taken to evaluate lung function.

18. Other tests for lung function test:-
1. Sputum analysis
2. Neutrophil count
3. Ig E count
4. X- ray of lung
5. C.T scan
6. Eosinophil count
7. Erythrocyte Sedimentation Rate ( E.S.R)

19. Gas Diffusion Test:
 Gas diffusion test measure the amount of oxygen and
other gases that cross the lungs air sacs per minute.
 These tests evaluate how well gases are being
absorbed into the blood from lungs.
Gas diffusion tests include:
 Alveolar capacity of lung, which determine the
amount of oxygen and carbon dioxide.
 Carbon Monoxide Diffusing Capacity also called
Transfer factor which can measures how well the
lungs transfer a small amount of CO into the blood.

20. Excessive Stress Test:
This test is performed to check the how much
sudden and continuous stress lung has the capacity
to tolerate. For this patient is made to do a stressful
exercise continuously. After some interval of time
spirometry is done.

21. Body Plethysmography:
This is performed to measure the Total Lung Capacity
(TLC) of the patient.
 The patient is allowed to sit in a closed chamber called
as plethysmograph and allowed to breathe out in a
mouthpiece and the other end is joined to the spirogram,
which will measures the flow and interpreted.
 Body plethysmography is particularly appropriate for
patients who have air spaces within the lungs that do not
communicate with the bronchial tree.

22. EVALUATION OF BLOOD CHOLESTEROL:

23. • Cholesterol accounts almost all the sterols are in the plasma. It exists as a mixture of
un-esterified form 30-40% & esterified form 60-70 %. The proportion of two forms is
constant with in the normal individual. Various adaptation of calorimetric and
enzymatic assay can be useful for the estimation of cholesterol.
• Most diagnostic and research laboratory used the enzymatic assay method. However,
the following experiments uses the chemical (calorimetry) to determine the blood
plasma cholesterol level.
• The cholesterol test determines the patient total cholesterol (TC), low density of
lipoproteins (LDL), and high-density lipoproteins (HDL) & triglycerides.

24. 1. Some tests provides the patient only with TC level where as other provides a full
lipid profile test (TC, HDL, LDL, triglycerides etc.)
2. Some kits are a single usage test in which patient apply his blood sample on
collecting cards, which is mailed to the laboratory. The measured amount of
cholesterol is determined by color of chart, which is provided with the test.
3. Calorimetry analysis:
a) Cholesterol monitor are available and their use reflectance to convert the color
change produced rapidly on the liquid crystal display.

25. b) Chemical reaction involves ( it contains ferric perchlorate ethyl acetate and
sulphuric acid)
Cholesterol (sample) + cholesterol reagent produces lavender colored complex
Principle: This test is also called as ZAK test.
This reddish purple complex is measured by calorimetry.
Serum + Ferric chloride acetic reagent Reddish purpled color complex.