research rational use of controlled drugs in istanbul

1. Research Rational Use of Controlled Drugs
In Umraniye District of Istanbul
Isa Badur, MPharm, (Ph.D)
Department of Clinical Pharmacy, Istanbul
Medipol University, Istanbul, Turkey

2. •Controlled drugs prescriptions in
(population= 4,7% of Istanbul)
• Umraniye (1008- 564) district of
• Istanbul (32 659*3,1%- 15 406*3,7%) were
evaluated retrospectively from the aspect
of
• consume,
• prescribing
• and distributions by pharmacy
• Pharmaco-epidemiologically and to develop the rational
use of drug was aimed by detecting the irrational use of
these drugs.

3. In Umraniye-last 3 months of 2014- prescriptions
(P) randomly selected from all (205) pharmacies
• 474 out of the 2682 (in 2008
was 2367)psychotropic-
green prescriptions (GP)
• 418 out of 1685 (in 2008 was
540) narcotic- red
prescription (RP)
• 60 RP more detailed investigated from the
aspect of
• drug-drug interaction,
• overdose,
• psychiatry consultation frequency,
• birth months
• and demographic data

4. Female 40-44
pearson’s rho=0,322;
male 45-49 pearsons
rho 0,323
Both female and male sig.
correlation 20-24
(Pearson’s rho=0.359;
male = 0.358)
+12
Eczaneler her
yerde korele

5. GP
Con*; p<0,00; Female more
than male patients
Xa*; p<0,00; Female
more than male
patients
Ak*;p<0,00; Male more
than female patients

6. •FdFp 21.9 mg/box >
FdMp 20.8 mg/box>
MdFp 19.2 mg/box>
MdMp 17 mg/box.

7. n Minimum Maximum Mean
Standard
deviation
Age 48 7 19 11,69 3,026
Gender 48
%71
Male
0,459
Onset of drug (Age) 48 5 17 9,10 3,005
Drug usage duration
(Year)
48 2 5 2,58 1,048
Overdose (60mg) 31
0 (there is
not)
1 (there
is) 0,45 0,506
Drug interaction 48
0 (there is
not)
1 (there
is)
0,35 0,483
Interaction and
overdose (together)
31 0 (none) 2 (both) 0,97 0,706
Number of psychiatric
examinations (2014-
2015)
46 ? 23 6,61 4,942
Percent of psychiatric
examinations (2014-
2015)
45 ? %100 %59 29,383
44% of males were born
June- July-August
(rho=0,302; p=0,042)

8. Red prescriptions
• Almost all of the red
prescriptions of the 3 months
were methylphenidate which
can be accepted as irrational
drug use.
• We could say that both female
and male doctors were more
generous in prescribing
methylphenidate to female
patients.
• There was + correlation
between the number of
psychiatric examinations
and the interaction
(rho=0,44;p=0,00).
• Patient gender; there was no
significant relationship between the
drug (Spearman’s rho=0,030;
p=0,53).
• This can be considered as an irrational
drug use, because ADHD, an indication
for methylphenidate, is more common
in male patients

9. Methylphenidate
• The ADHD guide in the UK, which
is almost the same guidelines in
Europe and America, suggests
parental education programs and
behavioral strategies (*).
• However, in severe ADHD,
medication is recommended along
with "psychosocial suggestions"
only for patients over 6 years of age
(*). The maximum dose of
methylphenidate is 60 mg per day (*).
• The drug should be periodically
discontinued and stopped after puberty
(*).
• Methylphenidate is known to be used
especially in children (*).
• The FDA also has a number of safety
precautions to be aware of in this regard
(*).
• To reduce the overuse of methylphenidate,
psychotherapeutic approaches are
needed before drug treatment.