1290410-rational (1).ppt b

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2. Intro..
WHO estimates that more than ½ of all
medicines prescribed are prescribed dispensed
or sold inappropriately and half of all patients
fail to take them correctly .
Incorrect use may take the form of overuse
underuse and misuse of prescription medicines

3. Def …
WHO: The rational use of drugs requires that
patient receive medication appropriate to their
clinical needs, in doses that meet their own
individual requirements for an adequate period
of time and at lowest cost to them and their
community.

4. CRITERIA FOR USING MEDICINE

5. IRRATIONAL USE OF DRUGS
Detonation: It is the irrational use of dosage,
regimen and duration of particular ailment.
Self medication, easy accessibility of drugs,
rampant usage medicines by the prescribers are
some of the reasons for the irrational usage of
drugs.
 There are three types of irrational use. They are:

6. TYPES OF IRRATIONAL USE
DISPENSING
DIAGNOSIS
PRESCRIPTION

7. DIAGNOSIS – IRRATIONAL USE
1.Inadequate examination of patient.
2.Incomplete communication between patient
and doctor
3.Lack of documented medical history
4.Inadequate laboratory

8. PRESCRIPTION – IRRATIONAL USE
1.Under prescribing
2.Incorrect prescribing
3.Extravagant prescribing
4.Over prescribing
5.Multiple prescribing

9. DISPENSING- IRRATIONAL USE
1.Innocent interpretation of the prescription
2.Retrieval of wrong ingredients
3.Inaccurate counting, compounding, or pouring
4.Unsanitary procedures

10. 5. Packaging:
 Poor quality packaging material
Odd package size, which may require
repackaging
Unappealing package

11. Reasons for irrational use of drugs
Lack of skills and knowledge
ack of coordinated national pharmaceutical policy
Over worked health care personnel
Unaffordable medicines
Inappropriate unethical promotion of medicines by
pharmaceutical companies

12. Some of the drugs which are irrationally used.
ASPIRIN:
Its is the most OTC drug for acute pains. Its irrational
use arises due to its overdose, which may precipitate
GI bleeding and ulceration.
•SEDATIVES AND HYPNOTIC: eg.Diazepam
These are prescribed for insomnia.
They are irrationally used due to usage of these drugs
even after completion of regimen results in drug
dependence or addiction

13. OBSTACLES IN RATIONAL Drug USE
The prescriber may obtain some financial benefits in prescribing
more drugs.
The chemist may also promote irrational drug use to enhance his
sales
Easy availability of even schedule H drugs
No proper training and continues education to the prescriber
There is a wrong notion among common man that every ill has a
pill resulting in medication even in ailments which are self limiting

14. Irrationality of drug use
Causes:
1.Polypharmacy: high number of drugs on each prescription
2.Patient compliance : low patient compliance (20-50%)
indicates poor communication between prescriber and
patient
3.Low income of patient pushes the pharmacist towards
dispensing doses for one or two days only
4.Incomplete pharmaceutical information about drugs
5.Low bioavailability medication
6.Incorrect prescribing (e.g. low efficacy drugs, or given at
unsuitable circumstances and wrongly given antibiotics)
7.Self medication: (patients do not know the mode of drug
action, length of treatment, side effects)
8.Availability of numerous medicinal alternatives

15. Measures to promote rational
drug use as per WHO
Promoting public education about medicines
Drawing up and enforcing appropriate regulation
including that of promotional activities
Providing independent information about medicines
Promoting systems of supervision, audit and feedback
in institutional settings
Reserving sufficient government expenditure to ensure
equitable availability of medicines and health personnel
Eliminating perverse financial incentives that lead to
irrational prescribing
Making continual in serving medical education a
requirement for license

16. DRUG USE INDICATORS
Prescribing Indicators:
Average number of drugs per prescription.
Percentage of drugs prescribed by generic names.
Percentage of time an antibiotic is prescribed.
Percentage of drug prescribed from an essential drug
list or formulary

17. Patient care indicator:
Average consultation time.
Average dispensing time.
Percentage of drugs actually dispensed.
Percentage of drugs adequately labelled.
Patient’s knowledge of correct dosage

18. Facility Indicators:
Availability of copy of essential drugs list or
formulary.
Availability of key drugs

19. GUIDELINES
Most important step in drug therapy is correct
diagnosis.
The second step is to assess whether the need of drug is
genuine or not.
If therapy is essential then various treatment should be
considered.
Next step is the selection of dose which is appropriate
for the patient

20. Patient should be clearly instructed regarding his
ailment, how to consume and when to.
Degree of effectiveness of the therapy should be
monitored.
If there is no effect by the therapy then it must
be diagnosis, etc and other associated accept
should be reconsidered

21. ROLE OF PHARMACIST IN RDU
Legally pharmacist is not authorised to prescribe, but
can play a major role in promoting rational drug use.

As the pharmacist involves in the selection and
procurement of drugs, so selected drug should be
accordance with the essential drug concept and cost
effectively.
Pharmacist should indulge in good inventory control
which help in regular monitoring of stocks.