“Rational use of medicines” means prescribing the right medicines, in an adequate dose for a sufficient duration and appropriate to the clinical needs of the patient at the lowest cost.

1. FACULTY OF PHARMACEUTICAL SCIENCE
PHARMACOTHERAPEUTICS ER20-24T
Chapter 1: Pharmacotherapeutics
Topic 2. Rational use of medicines
Presented by- Ms. ALKA
Assistant Professor
FACULTY OF PHARMACEUTICAL SCIENCE
RAMA UNIVERSITY UTTAR PRADESH
KANPUR, INDIA
2023-2024
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Rational Use of Medicines
“Rational use of medicines” means prescribing the right medicines, in an adequate dose
for a sufficient duration and appropriate to the clinical needs of the patient at the lowest
cost.
Or
“Correct medicine for the correct individual at the correct time for correct diseases”.
According to WHO: The rational use of drugs requires the patient to receive medication
appropriate to their clinical needs, in doses that meet their own individual requirements for
an adequate period and at the lowest cost to them and their community.

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 Objectives of the RUM
Rational use of
medicines
Appropriate
frequency of drug
administration
Appropriate Doses
of drug Appropriate
Dosage form
Appropriate route
of administration
Appropriate
information for the
patients
Appropriate
duration of therapy
Appropriate
follow-up
Appropriate
indication for the
patient

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 Important initiatives will be implemented to raise knowledge about the
Rational use of medicines.
1.National Essential Medicines List (NEML): Develop and regularly update a NEML that
includes a limited number of essential, cost-effective, and evidence-based medicines. This
helps guide healthcare professionals in prescribing and dispensing medications appropriately.
2.Clinical Guidelines and Protocols: Develop evidence-based clinical guidelines and
treatment protocols for common medical conditions. These guidelines should provide clear
recommendations on appropriate medication use, dosages, and treatment durations.
3.Medication Formularies: Establish medication formularies at healthcare institutions, which
list approved medications and their intended uses. This can help healthcare providers make
informed choices when prescribing medications

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4. Medication Review and Audit: Implement regular medication reviews and audits to assess
the appropriateness of prescriptions, identify potential drug interactions, and reduce
polypharmacy (use of multiple medications).
5. Healthcare Provider Education: Provide ongoing education and training to healthcare
professionals about rational prescribing practices, the latest clinical guidelines, and evidence-
based medicine.
6. Public Awareness Campaigns: Educate the general public about the proper use of
medications, the importance of following prescriptions, and the potential risks of self-
medication.
7. Promotion of Generic Medicines: Encourage the use of generic medicines by healthcare
professionals and patients, emphasizing their quality, safety, and cost-effectiveness.

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8. Regulation and Quality Control: Strengthen regulatory frameworks for pharmaceuticals,
ensuring that medications meet quality standards and are safe and effective. Enforce
regulations to combat counterfeit and substandard drugs.
9. Antibiotic Stewardship: Implement strategies to combat antimicrobial resistance,
including promoting appropriate antibiotic use and discouraging the unnecessary use of
antibiotics for viral infections.
10. Pharmacovigilance Programs: Develop and maintain pharmacovigilance programs to
monitor and report adverse drug reactions, enabling swift action to address safety concerns.
11. Research and Development: Invest in research to identify innovative, effective, and safe
treatment options, especially for conditions with limited therapeutic options.

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 Factors responsible for the RUM
1. Arises during manufacturing procedures
2. Arise due to individual
3. Environmental effects
 How to improve the RUM
1. Educational promotion
2. Regulatory and management promotion
3. By proper compounding and dispensing
4. Establishment of a multidisciplinary national body

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 Rational prescribing
Rational prescribing is not just the choice of a correct drug for a disease, or the mere
matching of drugs with diseases, but also the appropriateness of the whole therapeutic set-up
along with follow-up of the outcome.
 The criteria to evaluate rational prescribing are:
a) Right indication: the reason to prescribe the medicine is based on sound medical
considerations.
b) Right drug in efficacy, tolerability, safety, and suitability for the patient.
c) Right dose, route, and duration according to specific features of the patient.
d) Right patient: no contraindications exist; drug acceptable to the patient; the likelihood of
adverse effect is minimal and less than the expected benefit.

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e) Proper dispensing with appropriate information/instruction to the patient.
f) Proper monitoring of patient’s adherence to medication, as well as of anticipated beneficial
and untoward effects of the medication.
 Irrationalities in prescribing: It is helpful to know the commonly encountered
irrationalities in prescribing so that a conscious effort is made to avoid them.
 Use of drug when none is needed, e.g., antibiotics for viral fevers and nonspecific diarrhoea.
 Compulsive co-prescription of vitamins/tonics.
 Use of drugs not related to the diagnosis, e.g., chloroquine/ciprofloxacin for any fever,
proton pump inhibitors for any abdominal symptom.
 Selection of the wrong drug, e.g., tetracycline/ ciprofloxacin for pharyngitis, β blocker as
antihypertensive for asthmatic patients.

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 Prescribing ineffective/doubtful efficacy drugs, e.g., serratiopeptidase for injuries/
swellings, antioxidants, cough mixtures, memory enhancers, etc.
 Incorrect route of administration: injection when the drug can be given orally. Incorrect
dose: either underdosing or overdosing; especially occurs in children. Incorrect duration
of treatment, e.g., prolonged postsurgical use of antibiotics or stoppage of antibiotics as
soon as relief is obtained, such as in tuberculosis. Unnecessary use of drug combinations,
e.g., ciprofloxacin + tinidazole for diarrhoea, ampicillin + cloxacillin for staphylococcal
infection, ibuprofen + paracetamol as analgesic.
 Unnecessary use of expensive medicines when cheaper drugs are equally effective, the
craze for the latest drugs, e.g., routine use of newer antibiotics.

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