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PHARMACOVIGILANCE
AND ITS IMPORTANCE
UNDER GUIDANCE OF –
DEEP SHIKHA
BY- SHUBHAM KUMAR SINHA
M. PHARMACY (QA)
REG- 11600914
CONTENTS
• INTRODUCTION
• OBJECTIVES
• RESPONSIBILITY
• NEED OF PHARMACOVIGILANCE
• GOVERNING BODIES
• METHOD OF PHARMACOVIGILANCE
• ADVERSE DRUG REACTIONS
• SCOPE OF PHARMACOVIGILANCE
• REFERENCE
INTRODUCTION
Pharmacovigilance (PV) also called as drug safety
Pharmakon --- in Greek -- drug
Vigilance --- in Latin -- to keep watch
The science and activities relating to the
detection, assessment, understanding and
prevention of adverse affects or any other
possible drug-related problems
:
OBJECTIVES
• To improve patient care and safety
• To improve public health and safety
• To contribute to the assessment of benefit,
harm, effectiveness and risk of medicines
• To promote education and clinical training
• To promote rational and safe use of
medicines
• Tracking any drastic effects of drugs
RESPONSIBILITIES
• Time to time collection of data, recording and
notification
• Appropriate assessments (data completeness,
seriousness)
• Expedited and periodic reporting
• Creates appropriate structures for
communication
WHY PHARMACOVIGILANCE IS
NEEDED
1. Humanitarian concern
• Animal toxicology is often not a good predictor for human effects
• Evidence of safety from clinical trials is insufficient due to some
limitations
2. Safe use of medicines
Dying from a disease is sometimes unavoidable; dying from a
medicine is unacceptable - Lepakhin V. Geneva 2005
• It has been suggested that ADRs may cause 5700 deaths
per year in UK
• ADRs were 4th-6th commonest cause of death in the US in 1994
Continue..
3. To reduce healthcare expenses - ADRs are
huge burden
4. Ensuring the public confidence
5. Ethical concern
• To know something which is harmful to
another person who does not know, and not
telling is unethical
GOVERNING BODIES
• The pharmaceutical industry
• Regulatory authorities
• WHO collaborating centre for international drug
monitoring
• CIOMS(Council for International
Organization of Medical Sciences )
METHOD OF
PHARMACOVIGILANCE
1. Individual case safety reports
2. Clinical review of case reports
3. Cohort event monitoring
4. Longitudinal electronic patient records
5. Periodic Safety Update Reports (PSUR)
6. Expedited report
7. Record linkage
Individual case safety reports
• Like Yellow card system which is used in UK in
pharmacovigilance
• By this scheme they collect information on
suspected ADRs to medicines & the scheme
allow the safety to the medicines & vaccines
that are on the market to be monitored
YELLOW CARD SCHEME
• This scheme was founded in 1964 after the
thalidomide disaster was developed & also
run by medicines and healthcare product
regulatory agency (MHRA) or the commission
of human medicines
• It also include all herbal preparation or these
ADRs can be reported by pharmacist, doctor,
nurse or even patients also
CLINICAL REVIEW OF CASE
REPORT
• The quality of report is variable through
nation to nation or international organization
collect hundreds or thousands of report each
year and this is not possible to review all
report by the available experts
• Even if each report could be reviewed,
important reporting pattern would
be missed
COHORT EVENT MONITORING
Cohort Event Monitoring (CEM) systems for
intensified follow up of selected medicinal
products
The main limitations are its restriction to small
subset of medicinal products, the relatively
small fraction of the population covered
LONGITUDINAL ELECTRONIC
PATIENT RECORDS
• It is extremely valuable but still in used
• They cover large population, provide detailed
information on both exposed and unexposed
patients
• Information is extracted directly from the
computer systems in which physicians store
patient’s data
PERIODIC SAFETY UPDATE
REPORTS (PSUR)
• Pre marketing clinical trials may not be
sufficient to reflect the product safety profile
• Therefore medically advanced countries
impose the “post marketing drug safety
monitoring period ” on new drugs
• License holders shall proactively collect post
marketing safety data, prepare PSUR and submit
them to the health authority
CONTINUE..
•According to the “regulation of medical products under
safety monitoring”, if pharmaceutical companies fail to
submit PSUR as required, then the health authority may
consider the safety of the concerned product
• The last PSUR should be submitted before the
expiration of the drug safety monitoring period
•The “summary bridging report” provides summarized
information of the PSURs
EXPEDITED REPORT
• If there has been spontaneous reporting of a
suspected ADR to a pharmaceutical company,
there are legal obligations on the company to
report serious reactions within a specified time
frame to the regulatory authority
• Based on the results of drug safety assessment,
license holders shall report to the health
authorities in an expedited manner
ADVERSE DRUG REACTIONS
• In year 1932 it was
introduced for treatment
of streptococcal
infections in a elixir or
syrup dosages form
• But, in year 1937
sulphanilamide is
withdrawal from market
because it was
responsible for death of
105 individuals
THALIDOMIDE DISASTERS
• In year 1957
thalidomide was
introduced in market
for treatment of
morning sickness &
nausea
• And in year 1961 it was
withdrawal from the
market due to massive
pressure from press and
public
Continue..
• ADVERSE Drug Events- ADE, harm caused by
the drug (ADR & overdoses) and harm from the
use of the drug (including dose reductions &
discontinuations of drug therapy)
• ADVERSE Drug Reactions- are response to the
drug which is noxious & unintended which occurs
due to doses normally used in man for the
prophylaxis, diagnosis or therapy of disease.
There is causal link between a drug & an adverse
drug reaction
Continue..
•Side effects
undesirable and unavoidable effects of drugs due to
their pharmacological property at recommended doses
Ex-dry mouth from atropine therapy
•Toxic effect
It is a pharmacological action due to over dosage or
prolonged usage.
Ex-coma with barbiturates
Scope of Pharmacovigilance
• Improve patient care and safety in relation to the use
of medicines, and all medical and paramedical
interventions
• Improve public health and safety in relation to the use
of medicines
• Contribute to the assessment of benefit, harm,
effectiveness and risk of medicines, encouraging their
safe, rational and more effective (including cost-
effective) use
• Promote understanding, education and clinical training
in pharmacovigilance and its effective communication
with the public
REFERENCE
https://www.google.co.in/search?q=cerivastatin+drug+or+dosages
https://www.linkedin.com/pulse/all-pharmacovigilance-must-read-
garima-srivastava
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC59524/
https://www.google.co.in/#q=pharmacovigilance+from+medicine.net
www.who.int/medicines/areas/quality_safety/safety_efficacy/pharmvigi/
en/
who-umc.org/Graphics/24729.pdf
www.who-umc.org/graphics/28550
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Pharmacovigilanve And Its Importance

  • 1. PHARMACOVIGILANCE AND ITS IMPORTANCE UNDER GUIDANCE OF – DEEP SHIKHA BY- SHUBHAM KUMAR SINHA M. PHARMACY (QA) REG- 11600914
  • 2. CONTENTS • INTRODUCTION • OBJECTIVES • RESPONSIBILITY • NEED OF PHARMACOVIGILANCE • GOVERNING BODIES • METHOD OF PHARMACOVIGILANCE • ADVERSE DRUG REACTIONS • SCOPE OF PHARMACOVIGILANCE • REFERENCE
  • 3. INTRODUCTION Pharmacovigilance (PV) also called as drug safety Pharmakon --- in Greek -- drug Vigilance --- in Latin -- to keep watch The science and activities relating to the detection, assessment, understanding and prevention of adverse affects or any other possible drug-related problems :
  • 4. OBJECTIVES • To improve patient care and safety • To improve public health and safety • To contribute to the assessment of benefit, harm, effectiveness and risk of medicines • To promote education and clinical training • To promote rational and safe use of medicines • Tracking any drastic effects of drugs
  • 5. RESPONSIBILITIES • Time to time collection of data, recording and notification • Appropriate assessments (data completeness, seriousness) • Expedited and periodic reporting • Creates appropriate structures for communication
  • 7. 1. Humanitarian concern • Animal toxicology is often not a good predictor for human effects • Evidence of safety from clinical trials is insufficient due to some limitations 2. Safe use of medicines Dying from a disease is sometimes unavoidable; dying from a medicine is unacceptable - Lepakhin V. Geneva 2005 • It has been suggested that ADRs may cause 5700 deaths per year in UK • ADRs were 4th-6th commonest cause of death in the US in 1994
  • 8. Continue.. 3. To reduce healthcare expenses - ADRs are huge burden 4. Ensuring the public confidence 5. Ethical concern • To know something which is harmful to another person who does not know, and not telling is unethical
  • 9. GOVERNING BODIES • The pharmaceutical industry • Regulatory authorities • WHO collaborating centre for international drug monitoring • CIOMS(Council for International Organization of Medical Sciences )
  • 10. METHOD OF PHARMACOVIGILANCE 1. Individual case safety reports 2. Clinical review of case reports 3. Cohort event monitoring 4. Longitudinal electronic patient records 5. Periodic Safety Update Reports (PSUR) 6. Expedited report 7. Record linkage
  • 11. Individual case safety reports • Like Yellow card system which is used in UK in pharmacovigilance • By this scheme they collect information on suspected ADRs to medicines & the scheme allow the safety to the medicines & vaccines that are on the market to be monitored
  • 12. YELLOW CARD SCHEME • This scheme was founded in 1964 after the thalidomide disaster was developed & also run by medicines and healthcare product regulatory agency (MHRA) or the commission of human medicines • It also include all herbal preparation or these ADRs can be reported by pharmacist, doctor, nurse or even patients also
  • 13.
  • 14. CLINICAL REVIEW OF CASE REPORT • The quality of report is variable through nation to nation or international organization collect hundreds or thousands of report each year and this is not possible to review all report by the available experts • Even if each report could be reviewed, important reporting pattern would be missed
  • 15. COHORT EVENT MONITORING Cohort Event Monitoring (CEM) systems for intensified follow up of selected medicinal products The main limitations are its restriction to small subset of medicinal products, the relatively small fraction of the population covered
  • 16. LONGITUDINAL ELECTRONIC PATIENT RECORDS • It is extremely valuable but still in used • They cover large population, provide detailed information on both exposed and unexposed patients • Information is extracted directly from the computer systems in which physicians store patient’s data
  • 17. PERIODIC SAFETY UPDATE REPORTS (PSUR) • Pre marketing clinical trials may not be sufficient to reflect the product safety profile • Therefore medically advanced countries impose the “post marketing drug safety monitoring period ” on new drugs • License holders shall proactively collect post marketing safety data, prepare PSUR and submit them to the health authority
  • 18. CONTINUE.. •According to the “regulation of medical products under safety monitoring”, if pharmaceutical companies fail to submit PSUR as required, then the health authority may consider the safety of the concerned product • The last PSUR should be submitted before the expiration of the drug safety monitoring period •The “summary bridging report” provides summarized information of the PSURs
  • 19. EXPEDITED REPORT • If there has been spontaneous reporting of a suspected ADR to a pharmaceutical company, there are legal obligations on the company to report serious reactions within a specified time frame to the regulatory authority • Based on the results of drug safety assessment, license holders shall report to the health authorities in an expedited manner
  • 20. ADVERSE DRUG REACTIONS • In year 1932 it was introduced for treatment of streptococcal infections in a elixir or syrup dosages form • But, in year 1937 sulphanilamide is withdrawal from market because it was responsible for death of 105 individuals
  • 21. THALIDOMIDE DISASTERS • In year 1957 thalidomide was introduced in market for treatment of morning sickness & nausea • And in year 1961 it was withdrawal from the market due to massive pressure from press and public
  • 22. Continue.. • ADVERSE Drug Events- ADE, harm caused by the drug (ADR & overdoses) and harm from the use of the drug (including dose reductions & discontinuations of drug therapy) • ADVERSE Drug Reactions- are response to the drug which is noxious & unintended which occurs due to doses normally used in man for the prophylaxis, diagnosis or therapy of disease. There is causal link between a drug & an adverse drug reaction
  • 23. Continue.. •Side effects undesirable and unavoidable effects of drugs due to their pharmacological property at recommended doses Ex-dry mouth from atropine therapy •Toxic effect It is a pharmacological action due to over dosage or prolonged usage. Ex-coma with barbiturates
  • 24. Scope of Pharmacovigilance • Improve patient care and safety in relation to the use of medicines, and all medical and paramedical interventions • Improve public health and safety in relation to the use of medicines • Contribute to the assessment of benefit, harm, effectiveness and risk of medicines, encouraging their safe, rational and more effective (including cost- effective) use • Promote understanding, education and clinical training in pharmacovigilance and its effective communication with the public