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Essential drug concept and rational use of medicines


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Class for MBBS 1st year

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Essential drug concept and rational use of medicines

  1. 1. Essential Medicine List Concept and Rational Use of Medicine For MBBS 1st Year Dr. Pravin Prasad 2nd Year Resident, MD Clinical Pharmacology Maharajganj Medical Campus, T.U. 11th December, 2016 (Mangsir 26, 2073), Sunday
  2. 2. Objectives • Essential Drug Concept • Rational use of Drugs
  3. 3. Essential Medicine(Drug) Concept “Those drugs that satisfy the priority of healthcare needs of the population” - World Health Organization
  4. 4. Medicines RegisteredMedicines Public Health Relevance Efficacy and safety Cost effective Essential Medicines: Selection Essential Medicines
  5. 5. Essential Medicine Concept At all times Should be available within the context of functioning health systems In adequate amount In appropriate dosage forms
  6. 6. Essential Medicine Concept Assured Quality Should be available within the context of functioning health systems Adequate information Affordable price to individual (community)
  7. 7. Essential Medicine List: What’s included? • Drug name • Dosage forms • Dosage strength • Indications* Single vs Fixed Dose Combinations?? Main vs Complementary List
  8. 8. 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)
  9. 9. 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
  10. 10. Rational Use of Medicines
  11. 11. 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?
  12. 12. 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
  13. 13. 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
  14. 14. Why used irrationally?? • Patient load • Promotional activities of pharmaceutical industries • Drug promotion and exaggerated claim by companies • Defective drug supply system & ineffective drug regulation
  15. 15. choosing treatment options
  16. 16. 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
  17. 17. Moving towards Rational Use…
  18. 18. That will be all for today!! • Any Queries? • Next class we will be discussing about: • Adverse Drug Reaction •Thank you!