RATIONALE OF ESSENTIAL DRUGS
Following are some briefs from “The Rational Use of Medicine, VHAI, New Delhi, 1988”. The inserts within the parenthesis are from the editor. 1. What are rational drugs? They are those drugs which are accepted worldwide and included in standard textbooks of medicine and pharmacology, and medical journals. There is no controversy about their efficacy and safety. 2. Essential drugs must be:
- a. effective
- b. safe
- c. meet the medical need
- d. offer value for money
They should be vital for the health needs of the people in a country, region, or institution. 3. Priority drugs are those required for 4. Medicines with generic names are:
- cheaper
- used in medical and pharmacology books and medical journals
- safe way to prescribe
- scientific way to prescribe
It is a bad practice to prescribe drugs by brand names. Drug companies charge hiked prices for their aggressive promotional and marketing techniques. Their standards are widely variable for reliable standardization. 5. India has 8000 pharmaceutical companies producing over 60,000 formulations (brand names). Many such formulations are combinations of different drugs. (Won’t you try to avoid poly-pharmacy?) 6. Irrational drugsIrrational drugs are those which have not been proven to be effective and safe. A combination of 2 or more drugs may become irrational because:
- a. increased cost
- b. increased chances of drug interaction
- c. cause revision of drug pricing
- d. controlling quality and drug is difficult
- e. monitoring of drug reactions becomes difficult
- f. information about different ingredients is either not given or not specific.
7. Hazardous drugs are those with many side effects. Since safer alternatives are available, they should not be are banned in Nepal but sold illegally. Help the people by not prescribing them). 8. Do not use anabolic steroids.They are dangerous. Instead, use nutritious food and a balanced diet. 9. Injectable contraceptives should not be used in family planning programs because they:
- – are long-acting and difficult to treat when there is a side reaction
- – cause menstrual disturbances
- – aggravate anemia
- – cause headache, weight gain, dizziness, and abdominal discomfort (probably habit-forming too)
- – increase the risk of cancer
10. Misuse of antibiotics causes:growth and spread of resistant organisms bone marrow damage (breakdown of the immune system) 11. Useless drugs are those whose usefulness has not been proven.They:
- – are a waste of money
- – create a false sense of security may actually be harmful or delay the healing process
Some of the useless drugs are:
- 1. so-called anti-inflammatory enzymes
- 2. digestive enzymes
- 3. lactobacillus preparations
- 4. combination of cough sedatives and expectorants
- 5. topical anticoagulants
- 6. brain or nerve tonics
- 7. brain vasodilators
- 8. placenta preparations
- 9. tonics and vitamin concentrates
12. Medicines in pregnancy could be dangerous for foetus and mother. Take extra caution while prescribing for pregnant women. 13. Avoid routine use or misuse of steroids. *Please also read:
- 1. Melrose, D., Bitter Pills,OXFAM, Bangladesh ed.,UBING, Dhaka, 1985
- 2. The use of essential drugs. Tech.Rep. Sr. 722, WHO, Geneva,1985 Indian reprint (Rs. 10/-) available from VHAI
- 3. Hoechst a cause of illness? The pharma Business in the thirdworld. BUKO PHARMA, KAMPAGNE, Bielefeld, FRG, 1987.
- 4. Banned and banable drugs, Health action Sr. 2, VHAI, New Delhi, 1986
- 5. Tiranti, D. J., Essential drugs. The Bangladesh example Four yearson. New internationalist Publu.,Oxford, 1986.A rational drug policy. AIDAN &VHAI, New Delhi, 1986.
*From: Family Health No. 29, 1988.
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