Date.

Marks /10
EXPERIMENT NO. 12
Ai study fumigating agent and its marketed product.
Theory: Fumigation is a technique that
lininate pests and insects from employs various chemicals (fumigants) to
homes, buildings and processed
fumigants are harmful to humans to somegoods. A
aneration is hazardous and all The
Kninant is a chemical which, at a degree.
required temperature and pressure, can exist as a
va or gas na, When
released, penetrates objects or enclosed areasin
concentrations that are lethal to
pest organisms.
Fumigation techniques have great adaptability in pest control.
control wood-destroy1ng insects in structures and furniture They
can be used to
where
formulations are ineffective or where these materials may cause liquid
dust or

some conditions, fumigants can be

damage. Under
applied control burrowing rodents that can't
to
be reached with other types of rodenticides. Most
commonly, fumigants are used to
control insects and diseases, weed and disease control in
soils, commodity
fumigations for insects in fresh and stored food products such as fruits, grains,
vegetables, nuts and dried fruit, and ground burrowing rodent control. Limited
fumigations take place to control infestations of wood destroying insects in
structures. Fumigation may take place in a variety of locations at a customers home
orstorage facility, or it can ocur in a common carrier, such asa truck or railway car.
One important factor to consider during fumigation
is to take precautionary
measures to stay away from the home or area that is being fumigated while the area
I5 still sealed. Don't be in a
hurry to return back to your home or of business, place
but allow the area to be properly ventilated and cleaned before entering back into
ne premises. If your home or place of business is experiencing a pest infestation of

any kind and requires fumigation services

ypes and Nature of Fumigants:
Gas
Fumigation: Gas fumigation employs fumigants in their gaseous states for pest
control. gas fumigation is performed within enclosed chambers or by enclosing a
c e with a gas-proof covering. This method of fumigation, called space fumigation,
cSures toxic fumigants are not dispersed to the external environment. Methyl
oOMide is a gaseous fumigant that is used to control rodents, termites, insects,
Ematodes and weeds. Sulfuryl fluoride is a gas fumigant that is used to control
Ests in cereal grains, tree nuts and dry fruits. Gas fumigation must only be
itempted after an area is cleared of humans and animals.

73-
Social Pharmacy (F.Y. D. Pharm)
and techniques
lid
employ solic fumiga
fumins.
Solid Fumigation: Solid fumigation systems sprinkling tablets, powdaers o
fumigation is carried out by
for insect control. solid are typically easi
solid fumigants cally easier
pellets of measured quantities of fumigants. are less harmrul to the environm.
use and safer than gaseous fumigants
and men.
pests and insects
fumigant that
eliminates in a
Aluminium.phosphide is a solid
larvae, pupae and adults). It is typically used for pes
stages of development (eggs,
Calcium cyanide is a solid fumigant thha
control in flour, tea, doffer, cotton and grain.
It effectively eliminates a
reacts with water vapour to form hydrogen cyanide. Wide
range of pests.
fumigants tor mold, pests an-
Liquid Fumigation: Liquid fumigation employs liquid
which disperse large quantite
insects. Liquid fumigation is carried out by sprayers,
of liquid over a desired area. Most liquid fumigants are toxic to humans, flammahl-
and volatile. Liquid fumigation acts faster than solid fumigation. Liquid fumigation =
safest when performed outdoors or within an enclosed fumigation chamber
Examples of liquid fumigants include carbon disulfide, ethyl acetate, chloroform
carbon tetrachloride, sulfuryl fluoride, ethylene dichloride and methyl bromide.
Chemicals Used for Fumigation: Many types of chemicals are used for fumigation
Fumigants are used to control a broad spectrum of pests in many different setting
including agricultural work, home pest control and industrial applications. Fumigatio
chemicals come in both solid and gaseous forms to accommodate a of variety pe
control requirements.
Magnesium Phosphide: Magnesium phosphide is a dark grey solid that is typIcal
used a in powder or granule form. This chemical
introduced to moisture
produces phosphine gas Whe
or an acid. This
highly toxic gas is typically used to fumiga
agricultural commodities and to exterminate burrowing
pests.
Methyl Bromide: Methyl bromide is an effective
pests. It is applied in either a gaseous or solid fumigant against a wide variEy
is used. Methyl bromide is form depending on how and
most wil.
commonly used in agricultural settings To'
control in the soil or for pe
fumigating agricultural products. This
used as a residential
fumigant as recently as 2006. chemical wa> als
Sulfuryl Fluoride: Sulfuryl fluoride is a
pest control in residential pressurized liquid gas that is typically used i
Control infestations in lumbersettings. This chemical is
also
typically uSntly) n
and used (less freque
gaseous state, physical contact with automobiles. In addition to being highly c in.
and severe skin irritation. sulfuryl fluoride in its Jid state causes tox burn
liquid state causE
Some marketed Fumigants are:
1. Methyl bromide
(Meth-0-Gas® 100)
- 74
 Pharmacy(F.Y. D. Pharm)
S o c i a lP h a

Practical Manual
Chloropicrin (Chlor-0-Pic®)
2 Aluminum phosphide (Fumitoxin®)
AMagnesium phosphide (Magtoxin@)
5, Sulfuryl fluoride (Vikane®)
6. Carbon dioxide
Applicat
olication of the Fumigant: While the fumigant is
being applied, all
engaged in
engaged in or associated with this operation should wear respirators (gas persons
masks).
The only permissible exception to this rule concerns the operators working in the
open, or in some well-ventilated place, under conditions in which any gas that
escapes from the equipment is immediately diluted and dissipated. The respirators
should not be removed until the workers indoors have reached fresh air, the

fumiganthas been completely discharged, and all the valves and piping have been
losed so that no fumigant can escape from the system. During the application,
unauthorised persons should not be allowed to approach or talk to the operators

engaged in the discharge of the fumigant.

Result: Understood fumigation process.

VIVA VOCE QUESTIONS

Q1. What is fumigation?

Q2. What are the methods of fumigation?

for fumigation?
3. What are the chemicals used

technique.
chemicals used
in liquid fumigation
Write example of

is used
Why fumigation technique

75
 (F.Y. D. Pharm) Preprations
Social Pharmacy and
Marketed

Antiviral Agents
Table:

Type of Representative
Hazards Formulati
Active Chemicals*

Ingredient thuringiensis Practically

nontoxic to Granular,
Bacillus fish and wildlife. Briquette
Bacillus (Bti) humans, pets,
thuringiensis Israelensis strains o c c u r naturally
in Solution d.
Bacillus sphaericus
2362, Both
environment and are
Serotype H5a5b the
selective toxins that
|highly
only target mosquito larvae
related flies.
and that of a few
Several naturally occurring Spray, solutic
Botanicals Linalool substances are available in
in
Neem oil
Nepetacataria oil products sold for mosquito
and
(catnip) control, including neem

Oil of cedarwood linalool (from mint and citrus

Phenylethyl propionate plants). Contamination of
surfaces with these common
components of foods is not
hazardous, but inhalation of
the spray can be problematic.
Ketones Dihydro-5-pentyl-2(3H) Poses a low acute toxicity risk Granular, or
-furanone to humans and pets.
Dihydro-5-heptyl-2(3H)- toxic to fresh Slightly water
| solution
furanone
invertebrates.
Polyalkyloxy Butoxy poly propylene| Low acute
Compounds glycol (BPG) | never used as
toxicity. BPG is Solution, spr
is Solution, sp
Poly the sole active
ethanediyl) (oxy-1,2-ingredient in a
product, but is
alpha-often
isooctadecyl-omega- used with
pyrethrins,
hydroxy piperonylbutoxide,
Pyrethroids.
and
|Spinosad
Low acute toxicity for
and pets, and not humans Solutio
cause cancer likely to powder
or
other
term harm. long-|granuld
g-granular,
Highly toxic to
bees. to briquette
brique
-78
Date

EXPERIMENT NO. 13

Aim: To study ntilarval agent and its marketed products.

Theory: A larvicide (alternatively larvacide) or antilarval agent is an insecticide that is

common use
cnecifically targeted against the larval life stage of an insect. Their most
is against mosquitoes. Larvicides may be contact poisons, stomach poisons, growth
control agents.
regulators, or (increasingly) biological
regula
to water to control mosquito
Larvicides are chemicals designed to be applied directly
are used in fogging and spraying to control adult mosquitoes.
larvae. Adulticides
make adulticides
are not toxic to the mosquitoes themselves, but they
Synergists and for
effective. A variety of products available in the market for the public
more
a type of insecticide
when it comes to mosquito control. Larvicide is
professionals work by
to control mosquitoes indoors and outdoors around your home. They
used
Some formulations are
mosquito larvae before they can grow into adults.
killing when they
and some formulations work
activated when ingested by the mosquitoes,
come into contact with the larvae
divided into two chemical classes, namely, synthetic
Mosquito repellents are
and plant
N-diethyl-3-methylbenzamide), picaridin
chemicals, such as DEET (N,
and oil of citronella.
derived oils, such as oil of lemon eucalyptus
Bacillus
Bacteria are used for the control of mosquito larvae.
Biological Control: as wettable powder and granules
H 14 and Bacillus sphaericus. Available
thuringiensis human being
and toxic crystals. Safe to environment,
which contain bacteria, spores
and animals but are expensive. is
bacteria which
Bacillus thuringiensis H 14- Gram positive, spore forming
which after ingestion
mosquito larvae. Produces endotoxin
5pecifically acts against to death. It is
of contents into body cavity leading
Causes gut paralysis & leakage to
of B. thuringiensis is mixed with 10L of water
applied at 0.5 gm/sq.m 250 gm
at 1L over 50 sq.m every 2 weeks.
ake 2.5% suspension & sprayed water
toxin which is more effective in polluted
dcllus sphaericus: It also produces with 10 L
sites of Culex. 500gm of B. sphaericus
Suitable for treatment of breeding 3 weeks.
& it is sprayed at 1 L over 50 sq.m. every
Water to make 5% suspension
Others Biolarvicides:
Fungi- Coelomyces, Culicinomyces,
Romanomermis cluici vorax and R. iyengari.
Nematodes -

- 79-
Social Pharmacy (F.Y. D. Pharm)
Preprations
Marketed
and
Table: Antiviral
Agents

Hazards Formulation
Type of Active Representative
Chemicals*
Ingredient ingestion, but not Pelleted
Moderately acute toxic by
Fipronil
absorbed substantially
through the skin. |Powder.
as solutions.
Toxic to the nervous
system. Classified ,

a possible carcinogen
by US EPA. In pure granular,
form, high acute toxicity to aquatic life and Impregnated
to birds; acute toxicity is less of a
concern
in materials
dilute products.
Avermectin High toxicity in pure form, but at low Ready-to-use
acute
Toxic solution
concentrations it has low acute toxicity.
| to the nenvous system and to the developing
fetus at very low doses. Not absorbed
| through the skin to any great extent. Highly
toxic tofish and aquaticinvertebrates.
N-Methyl Carbaryl High acute toxicity to humans at low| Aerosol,
carbamates Propoxur concentrations. Toxic to the nervous system, granular,
especially for children. Highly toxic to solution,
aquatic life.
Impregnated
materials
Neonicotinoids Acetamiprid Moderate acute toxicity to humans and
Dinotefuran, absorbed through the skin to some
Granular,
Imidacloprid, Toxic to the nervous extent. solution,
system. Imidacloprid | aerosol,
Thiamethoxam has been shown to reduce sperm counts in
laboratory animals with long-term Impregnated
Acetamiprid has a ranking of hazardexposure. materials
it poses a low
acute toxicity risk to
tier two,
and is only moderately toxic to humans
Organo bees.
|Chlorpyrifos High acute
toxicity to
phosphates DDVP humans at low Aerosol,
low Aerosol,
concentrations. Toxic to the nervous
system, |solution
especially for children. Highly toxic
aquatic life. to granular,
togranular,
Impregnated
materials

80-
 Practical Manual
iarketed Products: Bactivec, Bacticide,
Marketed

VectoLex CG. Aquabac, Teknar, Vectobac, LarvX, and

Chamical Control: Methoprene is an
insect growth
rTupts the growth cycle of insect larvae,
interrupts requlator agent that
hevond the
beyond the pupa stage. Ihey are usually preventing them from development
applied to larger bodies of water in the form
time-release tormulations that can last from one to five months.
of this
larvicide does not pose an unreasonable health risks to humans or other Usewildlife and
ill not leach into the ground water supply.
t
Methoprene is moderately toxic to
come fish, shrimp, lobster, and crayfish, and
some
highly toxic to some fish and freshwater
invertebrates; it bioaccumulates in fish tissues.
Marketed Products: MetaLarv and Altosid are products containing
S-methoprene as the active ingredient.
Temephos, marketed as Abate and ProVect, is an organophosphate which
prevents mosquito larvae from developing resistance to bacterial larvicides. Due to
the small amount needed and the fast rate that temephos breaks down in water, this
type of larvicide does not pose an unreasonable health risk to humans, but at large
doses it can cause nausea or dizziness. Similarly, there is not a large risk to terrestrial
species, but there is a toxic concern for non-targeted aquatic species. Therefore,
temephos should be limited only to sites where less hazardous larvicides are
ineffective and with intenvals between applications
Marketed Products: Abate and ProVect
water at specific frequencies
Acoustic Control: Sound energy transmitted into
internal tissues
cause larvae air bladders to instantly rupture, severely damaging
further maturity
Causing death or latent effects prohibiting number of
Control: The most important step in reducing the
Environmental
involvement & multisectoral
depends on Community
mosquitoes
Osquitoes (Success
coordination) filling and leveling,
reduction) like
Elimination of breeding places (source
drainage of breeding places.
Proper disposal of wastes.
Cleanliness in and around the houses
irrigation
Observing 'dry day'- intermittent byelaws should
be
be enacted
enacted and
laws and
Legislative Measures: Suitable of water by communities, various
storage/utilization factories.
m
pl
emented for requlating
conditions at
construction sites,
mosquitogenic
agencies and
nCies and avoidance of are studied.
its marketed products
E and
Antilarval agent

-81
 Na
Social Pharmacy
(F.Y. D. PHe

Figure: Coronavirus

Fever

Cough

-Sore throat

Difficulty breathing

Figure: Symptoms of Corona Virus

-84
 prepare
Aim: To prepare chart/video or slides eflyer on
coreading, precautions treatment etc. Coronavirus about virus, way
vay of
of
Theorv: Corona viruses are a large
animals or humans. In humans, several
family of viruses which may cause illness in
factions ranging from the common cold to coronaviruses are known
to cause
ir
more severe
respiratory
Cast Respiratory Syndrome (MERS) and Severe diseases such as Middle
Acute Respiratory
The most recently discovered
coronavirus causes
Syndrome (SARS).
coronavirus disease (COVID-19).
coVID-19 is the infectious disease caused by the most
virus. This new virus and recently discovered corona
disease were unknown before the
outbreak began in
Wuhan, China, in December 2019
Symptoms of COVID-19
The most common symptoms of COVID-19 are fever, tiredness, and dry cough. Some
patients may have aches and pains, nasal congestion, runny nose, sore throat or
diarrhea. These symptoms are usually mild and
begin gradually. Some people
become infected but don't develop any symptoms and don't feel unwell. Most
people (about 80%6) recover from the disease without needing special treatment
Around 1 out of every 6 people who gets COVID-19 becomes seriously ill and
develops difficulty breathing. Older people, and those with underlying medical
problems like high blood pressure, heart problems or diabetes, are more likely to
develop serious illness. People with fever, cough and difficulty breathing should seek
medical attention.
Coronavirus Spread
Person-to-Person Transmission
from person to
CXperts believe the virus that causes COVID-19 spreads mainly
person. There are several ways this can happen
common transmission. When an infected
Droplets or aerosols: This is the most
called aerosols carry the
tiny particles
PErSon coughs, sneezes, or talks, droplets or

nose or mouth. Anyone who is within 6 feet of that

us into the air from their
person can breathe it into their lungs.
that the virus can live in the air for up to
transmission: Research shows
Alrborne has it breathes
out and you
get into your lungs if someone who
Ours. It can
divided on how often the virus spreads through the
are
reathe that air in. Experts
airborne route and how much it contributes to the pandemic.

-85
 Practical Manua
Pharm)
Social Pharmacy (F.Y. D.

Use sanitizer Room sanitization

Washing hands with
soap/handwash

cORONAVIRUS
COVID-19

Wear mask
Sanitization of mobile

Don't do shakehand
Maintain proper distance
between two Download 'Setu AppP
person while in your mobile
talking
Figure: Protection Measure
from Covid-19
86
 Pharmacy(FY. D. Pharm)

Practical Manual
ansmission: A less
Surface transmi
common
method is when you touch
n e
someone who
who has the virus has surfaces that
or door knob that's
coughed or sneezed
on. You may touch a
may touch
countertop
contaminated and then touch
es The virus can live on surtaces like your nose, mouth,
plastic and stainless steel for 2 to 3
days.
To stop it, clean and disinfect all counters, knobs, and
family touch several times a day.
other surfaces you and your
Cecal-oral: Studies also suggest that virus particles can be found in
But infected
neople's poop. experts aren't sure whether the infection can
spread through
contact with an intected person's stool. If that person uses the bathroom and
doesn't wash their hands, they could infect things and people that they touch.
Protection from Covid
There are COVID-19 vaccines available, and you are encouraged to be vaccinated when
it becomes available to you. You should still try-to limit your contact with other people.
COC guidelines suggest:
.Work from home if you can.
Avoid travel when possible. This is especially important if you or someone you live
with is older or has a health condition that raises the chances of serious COVID-19
illness.
in
Visit with family and friends by phone and computer instead of person.
I f you must go out, stand at least 6 feet away from people.
vaccinated.
Wear a face mask when you go out ifyou are not
Wash your hands often.
bedroom away from others in your home.
f you're sick, stay in a separate
items, online if possible.
shopping, especially for groceries drugstore
or
Do your
outside your home. Cats should stay
K your pets away from people and animals
Neep
indoors as much as possible. touch them,
hands afterward and after you
lean up pet waste properly. Wash your
their food, or their toys. can't have
limit contact with your pet. If you
"you have COVID-19 symptoms, around them,
wear a face
mask when you're
care of your animals,
Eone else take interact with them.
and wash hands before and after you
your
Quarantine or Isolate sick need to self-quarantine,
or stay
To stop coronavirus, people who are
away, youu
n e spread of not show symptoms
right
Because you may
away from those
those who are well.
c o m e into
contact with
someone

sho
should also self-o know that you've
Seit-quarantine if you

who ohas COVID-19.

Who
- 87-
 larmacy (F.T D. Pharm)
tactical Man-
Table: Vaccines Available in Market for Corona
Vaccine Brand How Many
Name
Company Who Can Get
this Vaccine Shots You
When are you
Will Need Fully
ModernaMRNA- Moderna People 12 years The time
Vaccinate
2 weeks after
1273 and older between 2
your second sho
shots should
be 4 weeks
(28 days)
Tozinameran Pfizer BioN People 18 years The time 2 weeks after
tech and older between2 your second sho-
shots should
be 3 weeks
(21 days)
JNU-78436735 Johnson & People 18 years 1 shot
Johnson's 2 weeks after
and older
Covid-19 your shot
AstraZeneca's People 18 years The time 2 weeks after
and older
between 2 your Second shom
shots should
be 4 weeks
Covishield Serum Institute (28 days)
of India People 18 years The time
time
and older 2 weeks after
between 2 your Second sho
shots should
be 4 weeks
Covaxin (28 days)
Bharat Biotech
People 18 years The time
and older 2 weeks after
between 2 your Second shot
shots should
be 4 weeks
Sputnik Novavax (28 days)
People 18 years The time
and older 2 weeks after
between 2 your shot
shots should
be 4 weeks
(28 days)
88
 harmacy (F.Y. D. Pharm)
cial
Socla

Stay at home. Practical Manual

Don't have visitors.

Wash your hands often with

soap and warm
water.
Don'tsharepersonal items like dishes,
ean freauently touched surtaces utensils, and towels.
like counters,
controls. doorknobs, phones, and remote
V e tested positive for
f you've COVID-19, isolate yourself. Stay at home in
oarate fro
eparate from everyone else, if possible. Avoid
contact with other
a room that's

face mask when you have to be near other people. people and pets. Wear
tf vour symptoms get worse, call your doctor or hospital before you go in. Follow their
instructions to get medical help.
Isolate yourself until there's no chance that you could spread the virus. Your doctor can
tell you when it's safe to stop.
Medical treatments
Treatment for patients with mild/asymptomatic disease in home isolation
Patients must be in communication with a treating physician and promptly report in
case of any worsening.
Continue the medications for other co-morbid illness after consulting the treating

physician.
and cough, as
symptomatic management for fever, running
nose
Patients to follow
warranted.
Immediate Medical Attention:
o
Difficulty in breathing 94% on room air)
Dip in oxygen saturation (Sp
O2 <

Persistent pain/pressure in the chest

Mental confusion or inability to arouse
Corona virus is prepared and submitted
E Chart on

89
Social Pharmacy (F.Y. D. Pharm) Practical Manual

b Sporozoites

a Infection

Merozoites
Liver

Transmission
to mosquito Asexual
cycle
Gametocytes

Figure: Malaria Transmission

Cycle
Four stages of Malaria cycle:
(a) Infection
(b) Sporozoites
(c) Asexual cycle
(d) Transmission to mosquito
Date
dcucal Manual

EXPERIMENT NO. 15 Marks /10

Aim: T nrepare chart/video or

slides eflyer on
spreadir precautions treatment etc. Malaria. About virus,
way of
Malaria
Theory: M is a
life-threatening disease. It is typically
bite
f an infected Anopheles mosquito. Infected transmitted through the
When this
parasite. When
mosquito bites you, the mosquitoesis carry the Plasmodium
bloodstream. parasite released into your
Malaria can occur it a mosquito
intected with the Plasmodium
There are four kinds of malaria parasite bites you.
parasites that can infect humans: Plasmodium
P.ovale, P. malariae and P. falciparum. vivax,
P. falciparum causes a more severe
form of the disease and those who
contract this
form of malaria have a higher risk of death. An
infected mother can also pass the
disease to her baby at birth. This is known as
congenital malaria.
Symptoms of malaria:
Malaria symptoms usually appear 10 days to one month after the
person was
infected. Symptoms can be mild. Some people don't feel sick for
up to a year after
the mosquito bite. Parasites can live in the
body for several years without causing
symptoms.
igns of malaria are similar to flu symptoms. They include:
o Fever and sweating.
Chills that shake the whole body.
Headache and muscle aches.
o Fatigue.

Chest pain, breathing problems andcougn.

oDiarrhea, nausea and vomiting.
As malaria pr of the skin and
anemia and jaundice (yellowing
diia progresses, it can cause
whites of the
eyes).
Managerement and Treatment: possible. To treat malaria,
your
Treatment
Tor malaria should start as
soon

parasite.
as
Some parasites
are resistant
provider
Will will prescribe
pre drugs to kill the
malaria
on which
to and length of t r e a t m e n t depend
malaria
Parac drugs.
The type of medication

parasite is causing your symptoms.

- 93
Social Pharmacy (F.Y. D. Pharm)
Practical Mane

Headache
Vomiting

Fever
Nausea
Dry Cough
Figure: Symptoms of
Malaria
 Experintni Name.

Page No..

tical Manu cncial Pharmacy (F.Y.

D. Pharn

Antimalarial drugs include: Practical Manual

o Artemimisinin drugs (artemether.and
o Atovaquone (Mepron®). artesunate).
o Chloroquine.

Doxycycline (Doxy-100®, Monodox®, Oracea®).

oMefloquine.
Quinine.
Tips to prevent malaria
There is no vaccine available to prevent malaria. Talk
to your doctor if
traveling to an area where malaria is you're
common or if you live in such an area. You
may
be prescribed medications to prevent the disease. These
medications are the same as
those used to treat the disease and should be taken
before, during, and after your
trip. Talk to your doctor about long-term prevention if you live in an area where
malaria is common. Sleeping under a mosquito net may help bitten
prevent being by
an infected mosquito. Covering your skin or using bug sprays containing DEET may
also help prevent infection.

Result: Understood aboutthe disease malaria.

95
 a mahU-

(F.Y. D. Pharm)
Social Pharmacy

Chills
Long-Term Coughing up
Blood
Coughing

Fever Chest Pain

Fatigue
Figure: Sign and Symptoms of
Tuberculosis

- 98
 eial Pharmacy( Pnarmn)

Date
Practical Manual

EXPERIMENT NO. 16 Marks /10

Aim:
To Drepare chart/video or slides
eading, precautions treatment etc. etlyer on
tuberculosis about virus,
way of
aN: TuberculosiS (T8) IS a
l o Soread to other parts contagious
of your
infection that
usually attacks your lungs. It
ca
body,
the bacterium Mycobacterium tuberculosis. The
like your brain and
spine. TB is caused
germs are spread through the air
and usually infect the lungs, but can also infect other
parts the of
ie infectious, spread easily. Person usually have to body.
it does not Although TB
rontact with someone who is contagious in order to spend lot of time in
a
catch it.
Types of Tuberculosis:
There are two forms of the disease
Latent TB: Persons with latent TB infection do not feel sick and do not have any
symptoms. They are infected with M. tuberculosis, but do not have TB disease. The only
sign of TB infection is a positive reaction to the tuberculin skin test or TB blood test.
Persons with latent TB infection are not infectious and cannot spread TB infection to
others. Active TB. The germs multiply and make you sick. You can spread the disease to
others. Ninety percent of active cases in adults come from a latent TB infection.

Active TB: Active TB has a greater burden of TB bacilli than latent TB, and acts as an

infection source for contacts.

Symptoms of Tuberculosis:
not exhibit symptoms. However, they may
have a positive
People with inactive TB do
can show any of the following symptoms:
SKin reaction test. Those with TB disease
blood or
Pain in the chest, coughing up
04d
Cough (lasting longer than 2 weeks), fever, night
weakness, loss of appetite, weight loss, chills,
Purum (mucus), fatigue or

sweats.
Diagnosis and Tests: TB: the Mantoux tuberculin
skin test (TST)
for
screening tests
eare two kinds of Interferon Gamma Release Assay
(1GRA).
and the blood test, called the will
healthcare provider
For the TST, a
under
The ntoux tuberculin skin test (TST):
antoux
derivative (PPD)
in called purified protein healthcare
inje a m o u n t of a
substance back to the
the person
must go there will
After 2-3 days, has a TB infection,
Of the forearm.
he n the injection site. If the person
pro Who will look at
abe a ,
reddish lump.
99
 Pharmacy(F.Y. D. Pharm)
Social

Interferon Ga Gamma Release Assay Practical Manual

lood and send the (IGRA): For the IGRA, a healthcare
draw sample to the lab. provider will
.tests
Further test to determine if an infection is active or if
Tests on sputum and lung fluid lungs are infected include:
o X-rays
oComputed tomography(CT)scans.
Drug theraPY:

Cor initial empiric

For treatment of T8, start
patients on a 4-drug regimen: isoniazid,
rifampin, pyrazinamide, and either ethambutol or streptomycin. Once the TB isolate is
known to be fuly susceptible, ethambutol (or streptomycin, if it is used as a fourth
be discontinued.
drug) can
DOTS (directly-observed therapy, short-course) means that the patient taking the
medicine should be observed by a nominated person and the taking of the medicine
should be recorded. This ensures that the patient takes the medication regularly,
which is essential for the medicines to be effective and to prevent the bacteria from
The best way to
becoming resistant and the drug from becoming ineffective.
If following the
remember to take medicines is to get directly-observed therapy.
health care worker every day or several
DOTS regimen, the patient will meet with a
home or work, or any other
times a week. This can be at the TB clinic, your health care
Patient will take medicines at this place while the
Convenient location. the
in several ways. The
health care worker can help
Worker observes. DOTS helps This means
the medicines and complete the treatment.

patient remember to take worker will make sure that

possible. The health care
ne/she will get well as soon as also watch for side-effects
should. This person will
as they to
UE medicines are working must be checked
at different times
TB. The TB patient nurse
and answer questions about should see their doctor or
well. He/ she is cured.
"ke Sure everything is going continue until the patient
medicines. This will Minor
side-effects to TB drugs.
gularly while taking the
Very few people develop orange/red urine,
or
of TB drugs: joint pain,
efects nausea,
loss of appetite, the dosages
of
include vomiting, m e d i c i n e s or adjusting
-effects of
using simple
use

be managed dizziness (with the

skin rash, and
s h , which can deafness
include and isoniazid);
visual
the drugs. Major side-effects
with rifampicin
urugs. vomiting
(mainly
renal failure
(rifampicin).
stre
LOmycin);
jaundice,
shock, purpura,
or acute
(ethambutol),
ment
Preventing TB: while coughing or sneezing.
and mouth tested regularly.
their nose should be
o should cover patient
duents contact
with a TB
in
ple who are at risk o r

- 101
 D. Pharm) when dealino
dealing with
Social
Pharmacy (F.Y. professionals
healthcare

should be
used by
Face masks
o
from TB. instructions. It is crucial
ial to
patients suffering as per the doctors
take
medications
stopped in
between
between the prescribed
It is important to medications
are
o
understand that if the
recur.
infection c a n
course, TB tuberculosis.
disease
Understood about the
Result:

|VIVA VOOCE QUESTIONS

What is tuberculosis (TB)?

Q.1.

tuberculosis?
Q,2. What kinds of tests are used to diagnose

Q.3. What is DOTS?

Q4. What are the side-effects of TB drugs?

Q.5. Ifa person is exposed to someone with active TB disease, can he/she transmit
TB to others?

MULTIPLE CHOICE QUESTIONSS

1. How is TB diagnosed?
(a) Chest X-ray (6) Sample of sputum
(c) Skin or blood test (d) All of the above
2. For Tuberculosis, the drugs used to combat it are,
(a) streptomycin, pyrazinamide
(b) isoniazid, rifampicin
(c) both (a) and (b)
(d) none of these
3 What are the
symptoms of active TB?
(a) Weight loss
(cLoss of an
(b) Night sweats
 Practical Man
Social Pharmacy (F.Y. D.Pharm)

High temperature Severe headache Nausea Stomach pain

(Fever)

Loss of appetite
Constipation
or diarrhoea Rash

Figure: Sign and Symptoms of

Typhoid Fever

104-
 (F.Y.
.
D. Pharm) Practical Manual
Pharmacy

scial
Marks /10
EXPERIMENT NO. 17

nare char
prepare
chart/video or slides eflyer on typhoid about virus, way of spreading,
To
im:
precautions
A i m

treatment etc.

The
bacterium Salmonella
typhi (S. typhi) causes typhoid fever. The bacteria
Theory:
ethrough contaminated food, drink, or water. People infected with Salmonella
carry
the bacteria in their intestinal tract and blood. Salmonella typhi is shed
phi
(discardea from the body) in feces (stoo). You may get typhoid fever if you ingest
inod or beverages prepared by someone who shedding the bacteria and who does
is

not wash their hands properly. In less developed countries, sewage containing
local water
Salmonella typhi may contaminate supplies.
some cases, people who have previously had typhoid fever still carry Salmonella
the infection
typhi bacteria. These people are carriers of the disease. They may spread
even when they have no symptoms (the
famous case of "Typhoid Mary" in the U.S.).

Symptoms of Typhoid Fever:

The incubation period is usually 1-2 weeks, and the duration of the illness is about
3-4 weeks.
Symptoms include:
oPoorappetite
oHeadaches
Generalized aches and pains
Fever as high as 104 OF (Fahrenheit)
oLethargy
Diarrhea
abdominal pain and discomfort are

Co ngestion develops in many people, and

mmon. The fever in the third and fourth
Ihe fev becomes
occurs
constant. Improvement
week in those without complications.
DiAagnosis
adiagy
gy of Typhoid Fever
samples of blood,
Oftyphoid fever can usually be confirmed by analysing
poo
Poo
stools or pee (urine). These will be examined
under a microscope
for the

Salmorella typhi bacteria that cause the condition. The bacteria

Solmon aren't always

detects edp
etecte then
firstt time, so you may need to have a series of tests.
Typhoi
thene Sol
d feve rbacterid
Salmonella treatment: Typhoid fever is treated with
fever.
antibiotics which kill
These medications
Antibiotics are used to treat typhoid
kil the ela
llthe bacteria.
Several different types of
antibiotics are used to
acteria that cause
se the infection.
-105
 Practical Manual
D. Pharm)
Social Pharmacy (F.Y.
is ampi
treated with
ampicilin
with
In many cases, typhoid fever
treat typhoid fever. However, doctors also USe
(Bactrim®). However,
cotrimoxazole
chloramphenicol, or
cephalosporins (inchd
fluoroquinolones (including Cipro
and Levaquin®), ding
Cefepime®), and azithromycin.
Prevention:
of contracting the
disease by:
Easily lower the risk two vaccines are available to
Receiving typhoid
a fever vaccination. Currently,
o
doctor about gettime
of typhoid fever. Talk with your
help prevent the spread
vaccinated.

Avoiding food that is raw or undercooked

boiled
Drinking only bottled water or water that has been
Thoroughly washing your hands each time before eating
Avoiding raw fruits and vegetables that cannot be peeled.
Avoiding eating foods and beverages purchased from street vendors.
Result: Understood about the disease typhoid fever.

VIVA VOCE QUESTIONS

Q.1. Which antibiotics are used in the treatment of Typhoid fever?

Q,2. Which bacteria causes typhoid fever?

Q.3. How can I protect myself from typhoid fever?

Q.4. Can animals spread typhoid fever or

paratyphoid fever to people?
Q.5. How are
typhoid fever and paratyphoid fever
spread?
Q6. What are the signs and
symptoms of typhoid fever?

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 Practical Manu
Social Pharmacy (F.Y. D. Pharm
Disease
Transmitted
Table: Sexually
Disease
Agent
Group
Gonorrhea,
Bacteria Neisseria gonorrhoeae
Chlamydia trachomatis. Chlamydia,
Treponemapallidum.
Syphilis

Virus Herpes simplex virus Genital herpes

Human papillomavirus (HPV), Genital warts

Human Immunodeficiency Virus AIDS

(HIV),
Hepatitis virus Hepatitis B, C, D

Fungai Candida Albicans Genital Candiadisis

Protozoaa Trichomonasvaginalis Trichomoniasis
Arthropods Phthirus Pubis Sarcopets Scabies Pediculosis Scabies