CONNECTED FACE-TO-FACE LEARNING SYSTEM

BACHELOR IN PHARMACY

PEDRO LUCAS CABRAL BARROSO

SUPERVISED INTERNSHIP REPORT IN

STRATEGIC PROGRAMS IN HEALTH

Tucuruí/PA
2022
 Pedro Lucas Cabral Barroso

SUPERVISED INTERNSHIP REPORT IN

STRATEGIC PROGRAMS IN HEALTH

Internship Report, presented to the Bachelor Course

in Pharmacy, from the North Paraná University -
UNOPAR, as part of the necessary requirements for
obtaining a grade in the Internship subject
Supervised in Strategic Health Programs.

Distance Tutor: Jessica Vertuan Rufino

Tutor Presencial:Rafael
Professores: Flavia Soares Lassie

Tucuruí/PA
2022
 SUMÁRIO

1 PRESENTATION
2 INTRODUCTION.......................................................................................................4
3 ACTIVITIES.........................................................................................................5
4 VALIDATION TERM OF THE REPORT.......................................................11
5 FINAL CONSIDERATIONS
REFERÊNCIAS...........................................................................................................13
 3

1. PRESENTATION

The following report of the Supervised Internship of the course of

Pharmacy at the University of Northern Paraná, in the Internship course
supervised in Strategic Health Programs aims to associate the
role of the pharmacist in the Strategic Programs of the Ministry of Health in
Unified Health System (SUS) with the application of theoretical-scientific knowledge
acquired in the classroom with the experience of situations in the internship practice.
The University of Northern Paraná - UNOPAR, through the hub of
Tucuruí/PA (1051620), from the Pharmacy course, organized the internship.
supervised internship discipline in strategic health programs.
the college is located at Av. Raimundo Veridiano Cardoso 422B, Tucuruí - PA.
Together with the City Hall of Tucuruí - Municipal Health Secretariat (agency
internship grantor), located at Rua Raimundo Ribeiro de Souza, SN, in this
city, in the state of Pará.
O Estágio Supervisionado em Programas Estratégicos aconteceu
in basic health units, which operate with strategic programs of the SUS.
Observing the pharmacist's performance with actions for prevention, control and
treatment of endemic diseases with epidemiological significance, which
affect populations more exposed to diseases with few financial conditions,
in which they are notified as diseases and conditions subject to compulsory notification.

During the Strategic Health Programs internship, I observed the

Pharmaceutical Action in the Strategic Programs of the Ministry of Health
Unified Health System (SUS): Leprosy Control Programs, Program
Tuberculosis Control, HIPERDIA, Sexually Transmitted Diseases Program
Transmissible (STDs) HIV/AIDS and in the treatment of Mental Health.
The Supervised Internship in Strategic Health Programs
It took place from 05/17/22 to 05/26/2022, lasting for 10 days, with a load
total schedule of 80 hours, taking place from 12:00 PM to 6:00 PM. Held at
health units of Tucuruí: Basic Health Unit (UBS) of Matinha (Brenda
Couto), Health Surveillance, Testing and Counseling Center (CTA).
 4

2. INTRODUCTION

The following report of Supervised Internship aimed to

associating the role of the pharmacist in the Strategic Programs of the Unified Health System
Health (SUS) with the application of the theoretical and scientific knowledge acquired in
classroom with the experience of situations in the internship practice.
What are strategic programs? The Strategic Programs of
The Ministry of Health has programs that address endemic diseases of profile
epidemiology, which impacts and poses a great risk to health levels of
population. The Pharmacist is an integral part of the multiprofessional team with
doctors, physiotherapists, nurses, among others. The pharmacist participates and acts
in the strategic programs of the SUS, being of great importance for treatment
and the dispensing of medications. Works with preventive actions for promotion
to health, guidance regarding medication treatment, acts with actions
to prevent outbreaks, focusing your attention on the diseases that affect health
of the population.

The report is organized into three activities, the first activity

will address the pharmaceutical activity in the Strategic Health Programs of
Ministry of Health in the Unified Health System (SUS) in basic units of
health in the city of Tucuruí.
The first activity will describe the pharmacist's performance in
strategic programs in the health units of the UBS of Brenda Couto is
focused on leprosy control programs, Leprosy Control Program
Tuberculosis and the HIPERDIA Program. The Testing and Counseling Center
(CTA) that works with diagnosis, treatment, and follow-up in the program
of Sexually Transmitted Diseases STD/HIV/AIDS. The Specialized Center and
the Psychosocial Care Center (CAPS) that works with the dispensing and
guidelines for the treatment of neurological and psychiatric diseases and Vigilance
Sanitary inspection of pharmaceutical products.
The other two activities will address two case studies, The
The first case study will be about the role of the pharmacist in the program of
Leprosy Control. The second case study will be about the performance of
pharmacist in the Malaria Control Program.
 5

3. ACTIVITIES
3.1. Field Activities

In the internship, we observed the activities carried out by the

pharmacist in health units, acting in prevention, control and
treatment of endemic diseases. The pharmacist promotes actions in education in
health for communities exposed to diseases and endemic profile conditions with
epidemiological importance. Promotes actions aimed at ensuring access
equitable pharmaceutical products acting in prevention, diagnosis,
treatment or control of these diseases, which impact the health of the population.
In the Basic Health Units (UBS), the field activities of
pharmacists in strategic programs are focused on ensuring access
equitable access to medications and pharmaceutical supplies, as well as diagnosis,
treatment, control and prevention of these diseases.
These diseases are reported as notifiable diseases and conditions.
mandatory and received by the pharmacist in health units to be
forwarded to Epidemiological Surveillance. The treatment of diseases of
strategic programs follow the protocols established by the Ministry of Health,
which aims to guide healthcare professionals in the treatment of endemic diseases
of epidemiological profile.
The Strategic Programs for the control of Leprosy and
Tuberculosis is treated at the Basic Health Unit (BHU) of Brenda Couto,
the actions of the pharmacist are related to the management of the pharmacy, as well as the dispensing

from the medication to the nurse who passes it on to the patient with all the instructions

the treatment. The Brenda Couto UBS provides follow-up services for
people with Hypertension and Diabetes through the HIPERDIA program.
The diagnosis, treatment, and follow-up of diseases
Sexually Transmitted Diseases (STD) of the Prevention and Control Program
DST/HIV/AIDS screenings are conducted at the Testing and Counseling Center - CTA. The
patient undergoes a consultation and screening conducted by a team of
multiprofessionals, being referred to the pharmacy to receive the medication by
Farmacêutico que dispensa e orienta sobre o uso da medicação.
The Specialized Center and the CAPS are health units that
they work with neurological and psychiatric diseases. The Specialized Center
 6

works more with neurological diseases and works with psychiatric patients. The
The pharmacist is an integral part of the multi-professional health team, which promotes
the information for the effective treatment of patients with neurological problems and
psychiatric.
Another activity of the pharmacist is to carry out the inspection of
pharmacies and drugstores, from the distributors of medicines and supplies
pharmaceuticals, manufacturers, carriers, and pharmaceutical products,
in addition to registration and bidding that are carried out at the Sanitary Surveillance.

3.2. Case Study 1

For the Strategic Health Programs, the medications have

its centralized acquisition by the Ministry of Health is transferred to the
States. The state secretariats are responsible for doing the
storage and distribution to the municipalities.
They constitute strategic health programs: Control of the
Tuberculose; Controle da Hanseníase; Controle do Tabagismo; Endemias Focais;
Influenza; Prevenção de Deficiências Nutricionais; Sangue e Hemoderivados; Saúde
of the Child.
Among these programs, we will pay attention to the control of
Leprosy, which is an infectious, transmissible, and chronic disease, that
still persists as a public health problem in Brazil. Its etiological agent is the
Mycobacterium leprae, a bacillus that primarily affects the peripheral nerves,
eyes and skin.
Preliminary data from 2019 shows that Brazil diagnosed
23,612 new cases of leprosy, of which 1,319 (5.6%) are in individuals under 15 years old.

You are the Municipal Pharmacist, and on the same day you receive three
notifications of Leprosy. When faced with this situation, it is observed that the
the municipality does not have a leprosy control program.

a) What is your guidance for the professionals at the Basic Health Unit with
regarding Leprosy?
 7

The pharmacist is an integral part of the team of professionals of

health area, its role is important for prevention actions, diagnosis,
treatment and control of Leprosy. It is the pharmacist's responsibility to carry out the
educational guidance on diseases, as well as the correct and rational use of
medication and important advice not to abandon treatment.
The Pharmacist plays a fundamental role in health education.
within the basic health units that aim for the well-being of the population. From
in accordance with Resolution CFF No. 308, of May 2, 1997, which provides for the
Pharmaceutical Assistance in pharmacies and drugstores, talks about the responsibilities of
pharmaceutical, responsible for promoting the education of health professionals and
patients, actively participate in public health education programs,
promoting the rational use of medications, acting as a source of information about
medications to other health professionals. (Resolution CFF No. 308, of May 2
from 1997)

b) Describe the steps necessary for the implementation of the program

of leprosy control in the municipality?

Leprosy is an ancient disease and it continues to this day

being a public health problem. The Leprosy Control Program
follows the guidelines of the Ministry of Health of the National Control Program
leprosy, in Ordinance No. 3,125, of October 7, 2010, approves the Guidelines for
Surveillance, Attention, and Control of Leprosy, provides for the National Program
of Leprosy Control of the Ministry of Health that develops a set
of actions aimed at guiding the practice of service at all levels and in
different complexities, following the principles of the SUS, as a way of
strengthening the actions of epidemiological surveillance of leprosy for the
health promotion based on health education and comprehensive care for
carriers of this disease. (BRAZIL, 2010)
In light of this, for the implementation of the Control Program
Leprosy in the municipality requires following the guidelines of the Ministry of
Health of the National Leprosy Control Program. It was the responsibility of the Ministry of

Health protocols for treatment, planning and programming, financing and

centralized procurement, and distribution of medicines to the states. They are of
 8

responsibility of the States, the storage of medications, the distribution

to the regions and municipalities, and the programming. The Municipality has the

responsibility to store, schedule, dispense, and distribute the units of

municipal health.

c) What are the results published in the Epidemiological Bulletin of Hansen's disease of

year 2019?

Brazil diagnosed 23,612 new cases of leprosy.

preliminary results of the Hansen's Disease Epidemiological Bulletin in the year 2019, with 1,319

new cases in minors under 15 years old showing a percentage of 5.6%. The Mato
Grosso has the highest number of new cases in its general population with 3,731.
cases of the disease. Maranhão, Pará, and Pernambuco continue with more than two thousand

cases each one. (BRAZIL, 2020)

The Epidemiological Bulletin of Leprosy shows about 240 of
new cases in minors under 15 diagnosed in the state of Maranhão,
occupying the first position in the number of new disease cases, followed by
there are Pará and Pernambuco. The states that diagnosed less than 100 cases
New cases of leprosy were in the states of Acre, Roraima, and Rio Grande do Sul.
BRAZIL, 2020

3.3. Case Study 2

Malaria is an acute infectious febrile disease caused by

protozoa transmitted by the infected female Anopheles mosquito.
Everyone can contract malaria. Individuals who have had several
malaria episodes can reach a state of partial immunity, presenting
few or even no symptoms. However, a sterilizing immunity, which
It provides total clinical protection, which has not been observed to date. If it is not treated

adequately, the individual can be a source of infection for months or years,

according to the parasitic species.
You are the Pharmacist and you are also the Manager of the Surveillance in

Health, from the municipality of Anajás, in Pará, which in 2019 achieved one of the largest

malaria notifications from the state.

 9

a) Create a health education booklet to be used in the municipality.

Below are the information contained in the model of the booklet.

Health education aimed at guiding the population about Malaria:

Tabela:Modelo de Cartilha para conscientização da população sobre a Malária

Malaria: what do you need to know?

Hello, everyone. In this booklet, you will learn about Malaria,
Introduction will teach you how to prevent illness and to seek treatment.
Let's go then? Happy reading!
Malaria is a disease caused by a protozoan called
What is the
Plasmodium. There are four types of protozoa from the genus Plasmodium:
Malaria?
Plasmodium vivax, P. falciparum, P. malariae and P. ovale.
Main symptoms: Fever, headache, body pain, chills,
intense heats.
Symptoms
Other symptoms: Vomiting, diarrhea, abdominal pain, loss of appetite,
dizziness and feeling of tiredness.
The disease is transmitted by the bite of the female Anopheles mosquito.
also known as muriçoca, carapanã, Suvela, Bicudo, and prego.
Transmission
That bites a person infected with malaria, sucks the blood and
When you are going to eat again, pass it on to someone else.
The diagnosis is performed using the thick blood drop method.
This method is simple and effective; however, there are other tests available.
advanced.
It is provided free of charge by SUS in all units of
health. The medications used for treatment: Artemisinins,
Chloroquine plus Primaquine. (Dosage according to guidance
Medical treatment). The follow-up is carried out through the Slide examination.
of Cure Verification (LVC), this exam aims to verify
the effectiveness of the treatment is recorded in the Monitoring Card
of the Patient.
Individual preventions: use of mosquito nets; protective clothing
legs and arms; screens on doors and windows; use of repellents.
Collective prevention: indoor spraying; use of
mosquito nets; drainage; small sanitation works for
Prevention
elimination of vector breeding sites; landfill; cleaning of the banks of
breeding grounds; modification of water flow; vegetation control
aquatic; improvement of housing and working conditions; use
rationale of the land.
It is important to diagnose at the onset of the disease and start the
quick treatment.
The treatment cannot stop as there may be a recurrence of the disease.
Guidance
and pose the risk of new transmission;
If you feel the symptoms, seek the nearest health unit.
from your house or city.
 10

Source: Table prepared by the author.

b) What type of strategic action, besides the Handbook, you could develop in
municipality to reduce malaria cases?

One of the ways to promote strategic actions to reduce the

malaria cases and the promotion of lectures and educational campaigns, encouraging the
population on the care that should be taken for the prevention of the disease, with

information and guidance on individual and collective prevention methods, such as

diagnose and treat, about the symptoms of the disease.

c) How is the follow-up of patients who have been notified done?

Malaria?

The patient when diagnosed with malaria is notified,

followed up, guided on how to take the medications. The treatment for
malaria is provided free of charge at all health units. The treatment is
carried out according to age, weight, considering factors such as pregnancy, child,
child and the type of malaria present. In the most severe cases of the disease, the patient is

immediately, if the symptoms do not disappear the patient should continue to take
medications to prevent recurrence of the disease and worsen the case.
Through the Patient Monitoring Card, it is possible
monitor the evolution and effectiveness of the treatment. It contains all the data of the

paciente como: nome completo, idade, data de nascimento, endereço, telefone, a

pharmacotherapy, the start of treatment, control of Verification Sheet Curve
(LVC), health unit, municipality, clinical history, laboratory diagnosis and the
recommendations that must be followed.
The LVC is a microscopic examination performed during and after the

treatment that controls the results by checking the reduction of parasitemia.

When the patient continues with a positive LCV result, they should undergo a
new investigation and assess whether there was no new exposure to the parasite or
recurrence of the disease, in this case, a supervised treatment should be adopted.
 11

4. REPORT VALIDATION TERM

 12

5. FINAL CONSIDERATIONS

The pharmacist plays a fundamental role in promoting

population health, acting on prevention, treatment, and guidance actions
about the way to take the medication, in the control of endemic diseases of
epidemiological importance through educational health actions promoting the
rational use of medication.
In the past, the Pharmacist was limited to staying behind a
counter with dispensing and in medication guidance, today the action comes
crescendo and being valued over the years. The pharmacy sector has been growing
over the years, the activities performed by the pharmacist have been
valued for being the professional with more in-depth knowledge
two drugs. Therefore, it is of great importance for the follow-up of
pharmacotherapy of the patient, as it may intervene in a possible interaction, reaction
medication or treatment efficacy.
Through the supervised internship in Strategic Programs in
It was possible to understand the reality in the health units, as well as
understanding the challenges faced by health professionals. The internship consisted of
of great importance for professional growth, which served to unify
the knowledge acquired from the theoretical-scientific material at college with the
practice of pharmaceutical action.
 13

REFERENCES

ARMANI, Fernanda. Microbiologia. Londrina: Editora e Distribuidora Educacional

S.A., 2016. 184 p.

BRAZIL. Federal Council of Pharmacy. Resolution No. 308, of May 2, 1997.

It provides for Pharmaceutical Assistance in pharmacies and drugstores. Brasília/DF,
[1997]. Available at:[Link]
June 30, 2021.

BRAZIL. Ministry of Health. Office of the Minister. Ordinance No. 3,125, of 7 of

October 2010. Approves the Guidelines for Surveillance, Care, and Control of
Leprosy. Brasília/DF, 2010. Available at:
[Link]
Accessed on: July 30, 2021.

BRAZIL. Ministry of Health. Health Surveillance Secretariat. Bulletin

Epidemiological of Leprosy 2021. Department of Conditions Diseases
Chronicles and Sexually Transmitted Infections - DCCI. - Brasília: Ministry of
Health, 2021. 56 p. Available at: [Link] Accessed on: 30
from July 2021.

BRAZIL. Ministry of Health. Health Surveillance Secretariat. Department of

Epidemiological Surveillance. Malaria control actions: manual for professionals
of health in primary care. - Brasília: Ministry of Health Publishing House, 2006. 52 p.
Available at:
[Link]
Accessed on: June 30, 2021.

LASSIE, Flávia Soares. Farmácia e profissão. Londrina: Editora e Distribuidora

Educational S.A., 2020. 184 p.

Oliveira, Dreisson Aguilera. Farmacologia. Londrina: Editora e Distribuidora

Educational S.A., 2020.

PINTO, Simone Nunes. Comprehensive training in health. Londrina: Publisher and

Educational Distributor S.A., 2016. 200 p.

PINTO, Simone Nunes. Collective health. – Londrina: Publisher and Distributor

Educational S.A., 2016. 200 p.

SANTOS, João Paulo Manfré dos; SANTOS, Flávia Soares Lassie. Assistance
Pharmaceutical. Londrina: Educational Publisher and Distributor S.A., 2020. 176p.