essential drug concept and rational use of medicines
TRANSCRIPT
Essential Medicine List Concept and Rational
Use of MedicineFor MBBS 1st Year Dr. Pravin Prasad
2nd Year Resident, MD Clinical PharmacologyMaharajganj Medical Campus, T.U.
11th December, 2016 (Mangsir 26, 2073), Sunday
Objectives
• Essential Drug Concept
• Rational use of Drugs
Essential Medicine(Drug) Concept
“Those drugs that satisfy the priority of healthcare needs of the population”
- World Health Organization
Med
icin
es
Regi
ster
ed M
edic
ines
Public Health Relevance
Efficacy and safetyCost effective
Essential Medicines: Selection
Essential Medicines
Essential Medicine Concept
At all times
Should be available within the context of functioning health systems
In adequate amount
In appropriate dosage forms
Essential Medicine Concept
Assured Quality
Should be available within the context of functioning health systems
Adequate information
Affordable price to individual (community)
Essential Medicine List: What’s included?
• Drug name• Dosage forms• Dosage strength• Indications*
Single vs Fixed Dose Combinations??
Main vs Complementary List
Essential Medicine List
• First Model List of Essential Drugs by WHO in 1977 AD
• Current Edition – 19th Edition, April 2015 (Amended August 2015)
• Separate List for Paediatric Population – 5th Edition (2015)
Nepal’s Essential Medicine List
• National List of Essential Medicines
• Current Edition: 2011, 4th
• No separate list for paediatric population
• Modified for different level of health facilities
• 368 medicines
Rational Use of Medicines
Rational Use of Medicines
• The rational use of drugs requires that patients receive medications appropriate to their clinical needs, in doses that meet their own individual requirements for an adequate period of time, and at the lowest cost to them and their community.
WHO conference of experts Nairobi 1985
So, what would you understand by Irrational use of Medicines?
Why Rational Use is Important?Irrational Use has various harms.
Ineffective & unsafe treatment
Increased morbidity (Adverse Drug Events, prolonged illness) and mortality
Distress, harm and cost burden to patient and community as a whole
Increased drug resistance
Why used irrationally??
• Lack of information
• Role models – Teachers or seniors
• Lack of diagnostic facilities/Uncertainty of diagnosis –
medicine for all possible causes
• Demand from the patient
Why used irrationally??
• Patient load
• Promotional activities of pharmaceutical industries
• Drug promotion and exaggerated claim by companies
• Defective drug supply system & ineffective drug regulation
choosing treatment options
Irrational Use: Few examples• Injudicious use of
antimicrobials• Unnecessary combinations• Use of drugs not related to
diagnosis• Incorrect route• Incorrect dosing – under or
overdose
• Incorrect duration – prolong or short term use
• Unnecessary use of expensive medicines
• Unsafe use of corticosteroids
• Polypharmacy
Moving towards Rational Use…
That will be all for today!!
• Any Queries?
• Next class we will be discussing about:
• Adverse Drug Reaction
•Thank you!