Rational drug use

Rational drug use

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  ABUBAKAR DANBATTA RATIONAL DRUGUSE 05/19/15
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  Outline Definition of rationaluse of medicines Rationale behind rational use of medicines Reasons of irrational use of drugs Dangers of irrational drug use Steps to be taken for rational use of drugs Conclusion 05/19/15Rational Use of Drugs
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  Definition In simplest wordsrational use means “prescribing right drug, in adequate dose for the sufficient duration & appropriate to the clinical needs of the patient at lowest cost WHO: 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 05/19/15Rational Use of Drugs
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  ‘Criteria’ for UsingMedicines • Appropriate indication • Appropriate drug • Affordable • Appropriate administration, dosage and duration • Appropriate patient • Appropriate patient information 05/19/15Rational Use of Drugs
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  Reasons for Irrationaluse of Drugs 1. Lack of information 2. Role models – Teachers or seniors 3. Lack of diagnostic facilities/Uncertainty of diagnosis – medicine for all possible causes 4. Demand from the patient 5. Patient load 6. Promotional activities of pharmaceutical industries 7. Drug promotion and exaggerated claim by companies 8. Defective drug supply system & ineffective drug regulation 05/19/15Rational Use of drugs
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  Absolutely Irrational Use 1.Injudicious use of antimicrobials: Antibiotics in Viral fever and diarrhea 2. Unnecessary combinations 3. Use of drugs not related to diagnosis 4. Incorrect route 5. Incorrect dosing – under or overdose 6. Incorrect duration – prolong or short term use 7. Unnecessary use of expensive medicines 8. Unsafe use of corticosteroids 9. Polypharmacy 05/19/15Rational Use of Drugs
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  Hazards of IrrationalUse 1. Ineffective & unsafe treatment  over-treatment of mild illness  inadequate treatment of serious illness 1. Exacerbation or prolongation of illness 2. Distress & harm to patient 3. Increase the cost of treatment 4. Increased drug resistance - misuse of anti-infective drugs 5. Increased Adverse Drug Events 6. Increased morbidity and mortality 05/19/15Rational Use of Drugs
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  Steps of rationaldrug use Step:- I Identify the patient’s problem based on symptoms & recognize the need for action Step:- II Diagnosis of the disease – define the diagnosis Step:- III List possible intervention or treatment (drug or no drug) – Identify the drug Step:- IV Start the treatment by writing an accurate & complete prescription e.g. name of drugs with dosage forms, dosage schedule & total duration of the treatment 05/19/15Rational Use of Drugs
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  … contd. Step:-V Give properinformation, instruction & warning regarding the treatment given e.g. side effects (ADR), dosage schedule & dangers/risk of stopping the therapy suddenly Step:-VI Monitor the treatment to check, if the particular treatment has solved the patient’s problem. Passive monitoring – done by the patient himself. Explain him what to do if the treatment is not effective or if too many side effect occurs Active monitoring - done by physician and he make an appointment to check the response of the treatment 05/19/15Rational Use of Drugs
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  Some Rational useIndicators Rational Use of Drugs Number of medicines prescribed per patient contact % of patients receiving antibiotics % of patients receiving injections % of prescribed medicines on EDL % of prescribed medicines being generics 05/19/15
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  Conclusions Drug use isusually the end of therapeutic consultation. Ensuring that the correct drug is given to the correct patient is a high priority for all health professionals. We all have a duty and responsibility to the public to ensure that the right drug is prescribed, dispensed and taken. Medicines although ‘public good’ are not ordinary articles of commerce Improving drug use improves the quality of care and frequently lowers cost. 05/19/15Rational Use of Drugs
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  References.. 1) Irrational drugcombinations; Need to sensitize undergraduates. Gautam, C.S. Aditya S. Ind.J. Pharmacol; Vol. 38, 3, June 06, 169-170. 2) Essential drugs and Rational Therapeutics Text book of Pharmacology S.D. Seth 1st Ed.1997, 783-791. 3) Essential drugs and Rational Therapeutics Text book of Pharmacology S.D. Seth 2nd Ed.2004, 907-916 4) Organization behaviour and community health promoting rational drug use among health professionals Uma Tekur and Isha Gupta Publication from state institute of health and family welfare; Rajasthan 2nd ed. 1998, 273-276 05/19/15Rational use of Drugs