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Clinical pharmacology
Clinical pharmacology
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Introduction to clinical pharmacology (RUD)

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rational use of drugs by WHO recommendation

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Introduction to clinical pharmacology (RUD)

  1. 1. Clinical pharmacology - the science that studies the characteristics, effects, properties, reactions and uses of drugs—especially their therapeutic effect in humans—including toxicology, safety, pharmacodynamics and pharmacokinetics. 2/9/2015 By Dr. Mirbek Nyshanbaev
  2. 2. Pharmacotherapy (drug therapy, medication treatment ) is the application of drugs in the prevention treatment or diagnosis of diseases and their use in the purposeful alteration of normal function. 2/9/2015 By Dr. Mirbek Nyshanbaev
  3. 3. The studying of all aspects of drug influence on human body 2/9/2015 By Dr. Mirbek Nyshanbaev
  4. 4. Tasks of clinical pharmacology • The study of clinical pharmacokinetics • The study of clinical pharmacodynamics • The study of drug interactions • The study of adverse and toxic effects of drugs • Monitoring of efficacy and safety of drug treatment • Formulating of good recommendations to drug therapy for rational drug use 2/9/2015 By Dr. Mirbek Nyshanbaev
  5. 5. General principles of drug therapy • Safety – providing the benefit exceeding than risk • Rationality – optimal ratio of benefit/risk • Minimizing – use of minimal numbers of drugs and minimally effective duration of drug therapy, excluding of polypharmacy • Monitoring of efficacy and safety of drug therapy • Individualizing – accounting of pharmacologic properties of drugs depending on patients individual peculiarities and clinical characteristics of disease2/9/2015 By Dr. Mirbek Nyshanbaev
  6. 6. Rational use of drugs 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 2/9/2015 By Dr. Mirbek Nyshanbaev
  7. 7. • Rational use of drugs should ensure: • correct drug • appropriate indication • appropriate drug considering efficacy, safety, suitability for the patient, and cost • appropriate dosage, administration, duration • no contraindications • correct dispensing, including appropriate information for patients • patient adherence to treatment 2/9/2015 By Dr. Mirbek Nyshanbaev
  8. 8. IMPACT OF IRRATIONAL PRESCRIBING • Delay in cure • More adverse effects • Prolonged hospitalization • Emergence of antimicrobial resistance • Loss of patient’s confidence in the doctor • Loss to the patient/community • Lowering of health standards 2/9/2015 By Dr. Mirbek Nyshanbaev
  9. 9. Prescription: Types of Irrational Drug Use • Under-prescribing • Incorrect prescribing • Extravagant prescribing • Over-prescribing • Multiple prescribing 2/9/2015 By Dr. Mirbek Nyshanbaev
  10. 10. HOW TO CHOOSE A DRUG ? • Ask the following sequence of questions before writing the prescription • Is the drug therapy Indicated ?!! • Which drug? • Which class---which group----which particular drug • Which route? • Which formulation? • What dosage regimen? 2/9/2015 By Dr. Mirbek Nyshanbaev
  11. 11. Good prescribing (rational drug use) is to give: • Right drug in the right dose • In the right formulation • At the right frequency • For the right duration 2/9/2015 By Dr. Mirbek Nyshanbaev
  12. 12. P-Drug Concept 2/9/2015 By Dr. Mirbek Nyshanbaev
  13. 13. • WHO has produced a Guide for Good Prescribing - a problem-based method • Developed by Groningen University in collaboration with 15 WHO offices and professionals from 30 countries • Widely translated and available on the WHO medicines website 2/9/2015 By Dr. Mirbek Nyshanbaev
  14. 14. P-Drug Concept (Personal drugs) • P-drugs are the drugs you have chosen to prescribe regularly, • With whom you have become familiar. • They are your drugs of choice for given indications • Choosing and using only 50-60 drugs only among 1000s 2/9/2015 By Dr. Mirbek Nyshanbaev
  15. 15. ADVANTAGES OF USING P DRUGS • More convenient • More confidence • Can be able to master easily • Drug effects predictable • Less chances of unexpected adverse effects and drug interactions • Less complications 2/9/2015 By Dr. Mirbek Nyshanbaev
  16. 16. ADVANTAGES OF USING P DRUGS • Possibility of adopting to rational drug use • Less burden on the physicians • Health care delivery is easy • Health care management is simple • Less health care costs 2/9/2015 By Dr. Mirbek Nyshanbaev
  17. 17. A P-drug is a drug that is ready for action! 2/9/2015 By Dr. Mirbek Nyshanbaev
  18. 18. • Step i : Define the diagnosis • Step ii : Specify the therapeutic objective • Step iii : Make an inventory of effective groups of drugs • Step iv : Choose an effective group according to criteria: efficacy, safety, suitability and cost • Step v : Choose a P-drug • Step vi : Give information, instruction and warning about drug (effects of the drug, side effects, instruction and warning) • Step vii: Monitor and stop the treatment 2/9/2015 By Dr. Mirbek Nyshanbaev
  19. 19. • Efficacy is based on pharmacodynamics and pharmacokinetics • Safety – the risk of side effects and overdosage of drugs • Suitability: The comorbidities, drug interactions, easy to handle, physiologic conditions • Cost of drug 2/9/2015 By Dr. Mirbek Nyshanbaev
  20. 20. Most of the illness respond to simple, inexpensive drugs Physician should avoid :  Use of expensive drugs. Use of drugs in nonspecific conditions (e.g., use of vitamins).  Use of not required forms (e.g. injection in place of capsules, syrup in place of tablets) 2/9/2015 By Dr. Mirbek Nyshanbaev
  21. 21. 2/9/2015 By Dr. Mirbek Nyshanbaev

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