For proper use of medication rational drug use (RDU) is raised. Requirements of rational drug use and it's different steps and roles of pharmacists are described here.

1. Rational Drug use
By,
Manisha Sahariah
Dept. of Pharmaceutical Sciences,
Dibrugarh university

2. CONTENTS
• Definition of rational drug use
• Factors that raised the RDU
• Benefits of rational drug use
• Irrational use of medicines
• Factors affecting the irrational use of drug
• Requirements of rational drug use:
• Role of pharmacists in RDU
• Steps of rational drug use
• Promotion of rational drug use
• References

3. DEFINITION OF RDU:
• The World Health Organization (WHO) defines as, “The rational use
of drugs requires that patients receive medications appropriate to
their clinical needs, in doses that meet own individual requirements
for an adequate period of time, and at the lowest cost to them and
their community”.
The definition states,
• Correct drug dispensing and informing the patient about the
prescribed drug
• Indication should be appropriate
• Efficacy, suitability, safety and cost of the medicine should be
adequate for the patient
• Quality and quantity of the dosage must be sufficient to last the
treatment duration
• Appropriate patient

4. FACTORS THAT RAISED THE RDU:
– Increasing drug explosion
– For the prevention of development of resistance
Effort
– Increasing health awareness
– As cost of the treatment is increasing day by day
– Lastly ,Consumer protection act (CPA)

5. BENEFITS OF RATIONAL DRUG USE:
• In case of several common diseases like
hypertension, CHF, diabetic nephropathy using
the appropriate drug significant development
is achieved.
• If use proper medication the medicines
become investments.

6. IRRATIONAL USE OF MEDICINES:
It mainly includes the under use, misuse or overuse of
medicines which may be prescribed or non prescribed.
The results includes,
• Polypharmacy i.e. use of more than one medicines
• Under use may lead ineffective treatment and
prolongation of illness
• Unsafe treatment if self medicated
• Overuse of antibiotic leads to antimicrobial resistance
• Wrong medication may cause some adverse reaction of
drugs and results in distress and harm to patient
• Due to inappropriate use of medication resulting in
negative health outcomes increase the cost of
treatment and may reduce the patient confidence.

7. FACTORS AFFECTING THE IRRATIONAL USE OF DRUG:
• Lack of the prescriber knowledge, patient information, uncertain diagnostic
contributes the irrational use of drug
• Prescriber obtaining information from the companies rather than clinical
guidelines may lead to use of inappropriate use of drug
• lack of training and supervision for prescribers
• In regulation and monitoring of medicine use inappropriate measure and
infrastructure i.e. ineffective drug regulation
• Due to high cost of medicines people left the full course of medicines
• Poor diagnosis and treatment due to lack of time of prescriber to each patient.
Inadequate communication between doctor and patient and due to poor
examination of patients leads inproper use of medicines
• Defective drug supply system
• Incorrect prescribing which include multiple prescribing, over or under prescribing
or . extravagant prescribing
• During dispensing the possible reasons for irrational use of drug are prescription
interpretation, use of wrong ingredient, poor quality packaging or during pouring
and compounding etc.

8. REQUIREMENTS OF RATIONAL DRUG USE:
• Appropriate diagnosis which includes private
examination, sufficient time with patient,
adequate knowledge and explaination to the
patients to be made .
• A correct medication to be prescribed
• Correct dispensing to be made in a dispensary
with trained dispenser. Etc

9. ROLE OF PHARMACISTS IN RDU:
• An important link between the patient and the health care
professionals is the pharmacists. They have an important role in
reducing the potential medication error. Theier role in different
stages of medication are as follows,
• 7.1. In prescribing:
• If not sure about the drug it should be clarified and verified
• Establishment of protocol and order set is possible and monitoring
of all medication profiles is important
• Open communication with the physicians and informing the
physicians about dangerous abbreviation should be maintained
• Average number of drug per encounter, percentage of drugs
encountered from an antibiotic or from essential drugs are
measured.

10. • In dispensing:
• For the separation of drugs with similar name
reorganization of drug storage and shelves is
done
• To facilitate the safety and efficiency of drug
redesign the work flow
• Before dispensing communicate clearly with the
nurses and use of computerized clinical
information to be made
• With the high risk medication pharmacist should
be more vigilant like establishment of double
check system.

11. • In administering:
• The use of electronic medication administration
records(MARs) should be facilitated and supported
• To ensure that the drug orders are interpreted correctly
the MAR should be compared and checked daily
• Point of care dispensing cabinets should be used
• In monitoring:
• Laboratory results and blood level monitoring should
be followed up
• To detect the potential spot daily review of the drug
profiles should be performed.
• Effective communication with the nurses should be
established. Etc.

12. STEPS OF RATIONAL DRUG USE:
Step-1:
• Identification and recognization of the patients problems.
Step-2:
• Determination of the object of the treatment.
Step-3:
• List possible intervention or treatment which may be drug or non-drug treatment.
Step-4:
• Using the accurate and complete prescription the starting of the treatment.
Step-5:
• Proper information, instruction and precaution are to be given which includes side
effects, ADR, dosage schedule and danger/ risk of stopping the therapy suddenly
Step-6:
• Monitoring and termination of the treatment. The monitoring process may be:
Passive monitoring: where the patient himself is asked to monitor if there is any
adverse effects.
Active monitoring: physicians directly monitor the patient by calling him into the
chamber for checking.

13. REFERENCES
• “Essential drugs and rational therapeutics textbook of
pharmacology” ; S.D. Seth, 2nd edition 2004, page no:
907-916
• NCCMERP ( National Coordinating Council for
Medication Error Reporting and Prevention), 2009
“About Medication Error”
• (http://www.nccmerp.org/aboutMedErrors.html)
• (Time: 10.51pm, 25th Oct)
• “Irrational drug combinations; Need to sensitize
undergraduates” ; Gautam, C.S. aditya S. Ind. J.
Pharmacol; Vol. 38, 3 June 2006, page no: 169-170.