Essential Drugs and Herbal

RA 6675 and RA 9165 NUTRITIONAL HEALTH SERVICES PD 491: created the Nutrition Council of the Philippines Policies:

1. Nutritional Surveillance (NS): to determine victims of malnutrition
1. Anthropometric Measurement: study of measurements of human dimensions
1. 1. Age for Weight-if weight is not appropriate with the age:
1. a. Stunting: growth retardation
2. b. Wasting: connotes malnutrition
2. 2. Age for Height-if height is not appropriate with the age: Stunting
3. 3. Weight for Height
4. 4. Skin Folds Test-pinch the external oblique muscle (“bilbil”) with your palm
• Normal: 1 inch
• Overweight: > 1 inch
5. 5. Middle Upper Arm Circumference (MUAC)-used in children below 5 years old by measuring the middle upper arm with a tape measure
• Normal: 13 cms. & above
• Malnutrition: <13 cms.
2. Biochemical Method
1. Micronutrient Malnutrition-available in small amount in the body
• VADAG:
• Vitamin A Deficiency:
• Deficiency: Xeropthalmia-opacity of cornea leading to night blindness
• Infants (6-12 months) : Give 100,000 i.u.
• Pre-schoolers (12-83 months) : 200,000 i.u. Post partum : 200,000 i.u.
• Never give Vitamin A to infants less than 6 months & pregnant women because it is toxic
• Example: Infant 8 months old Patterns of treatment
• Vitamin A 100,000 i.u. 2/21/06 1st Dose: give today
• 100,000 i.u. 2/22/06 2nd Dose: give tomorrow
• 100,000 i.u. 3/08/06 3rd Dose: give after 2 weeks
• Anemia: Iron Deficiency Anemia
• Target age group: 0-59 months (less than 5 years)
• Give 3-6 mg/kbw/day
• Always give the maximum
• Example: Child weighs 8 kg
• 8 x 6=48 mg/day for the 1st 3 months then monitor
• If still anemic, continue giving but compute again 6 mg/kbw
• Goiter: Iodine Deficiency Disease (endemic in uphill)
• Target age group: 0-59 months
• Give 1 capsule (200 mg) of potassium iodate in oil once a year
• For a child < 5 years old, empty contents of capsule in a cup with warm water because he can’t tolerate it
• Adverse Effect of Iodine Deficiency Disease that must be avoided:
1. Mental retardation-intelligence quotient: idiot, moron & imbecile
2. Growth retardation- cretinism (pedia) & dwarfism (adult)
2. Macronutrient Malnutrition-available in large amount in the body (Protein Energy Malnutrition or PEM)
1. Kwashiorkor-protein deficiency
2. Marasmus-carbohydrate deficiency (energy giving food)
2. Food Production
1. Fortification-products without any nutrient are added with nutrients
• RA 8172 (Asin Law): Fidel Salt (Fortification of Iodine Deficiency Elimination)=Iodized Salt-“Patak” sa Asin” by Secretary Flavier on December 1-5, 2003 where DOH workers go to market to check if salt sold contains iodine by placing few drops of reagent: If salt color turns to blue violet→ fortified with iodine If salt color show no change→ not fortified with iodine
• RA 832 (Rice Fortification): FVR (Fortified Vitamin Rice) by Secretary Flavier under FVR, Erap Rice under Erap, Gloria Rice or “Bigas ni Gloria” under PGMA
2. Enrichment-adding more nutrients to products already with nutrients
• Canned Goods-----
• Noodles → written in their labels: enriched with vitamin ABC…Z
• Junk Foods--------- with DOH seal “Sangkap Pinoy”
3. Nutritional Education-sharing of information to mothers whose children are malnourished
• 3 Basic Food Groups:
• Go -CHO
• Grow -CHON
• Glow -Vitamins, Minerals & Fats
• Pyramid for Healthy Filipino Food Lifestyle by Food & Nutrition Research Institute (FNRI)-another agency which is supportive of Nutrition Council of the Philippines
• Eat less: Oils Fats Sugar, Salt
• Eat some: Meat, Poultry, Peanut Fatty Dairies
• Eat more: Vegetables, Fruits, Salad
• Eat most: Wheat, Corn, Bread, Potato, Rice
• Drink a lot: Water, Clear broth
4. Nutritional Rehabilitation
• PP 147: declared the National Immunization Days Plus (NIDs Plus)
• In 2003, it was held during the month of March & April
• Immunization activities was not done at the Health Center but was held at a designated area
• Rural Sanitary Inspector (RSI) will locate the venue (The Patak Center) to conduct the immunization
• The Patak Center catering to the population of 1000 was composed of the following personnel: 1 Runner, 1 Recorder, 1 Organizer, 1 Vaccinator & 1 Health Educator
• NIDs Plus Activities:
1. Immunization
2. Giving Multivitamins fortified with Vitamin A, Iron & Iodine for < 5 years old, pregnant women & post partum
• Araw ng Sangkap Pinoy (ASAP): Health Centers distribute basic commodities fortified & enriched with multivitamins which is done yearly every October
  Example: Skim milk & canned goods donated by international organizations like UNICEF, WHO, etc.
• RA 4226: Hospital Licensure Act-creation of additional unit in every department of the hospital as Malnutrition Ward to house malnourished victims to be under the supervision of a nutritionist

TREATMENT OF COMMUNICABLE & NON COMMUNICABLE DISEASES

Communicable Diseases: which the DOH has special programs (other diseases under CD subject)

1. Tuberculosis: MDT, SCC & DOTS
2. Pneumonia: CARI
3. Diarrhea: CDD
4. Leprosy: RRC (MDT)