Rational drug use

RATIONAL DRUG USE

1. RATIONAL DRUG USE By, Ved prakash panda M. Pharm(Pharmacology )

2. CONTENTS Definition Criteria for using medicine Irrational use of drugs Types of irrational use Obstacle in Rational Drug Use Measures to promote RDU Drug use indicators Guidelines Role of Pharmacist in RDU

3. DEFINITION Rational drug use can be defined as the usage of appropriate drug with proven safety & efficacy for the right patient in the appropriate dose and dosage form at proper intervals of time at low cost. 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 Appropriate indications Appropriate drug Affordable Appropriate administration, dosage and duration Appropriate patient Appropriate patient information

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 Inadequate examination of patient. Incomplete communication between patient and doctor Lack of documented medical history Inadequate laboratory

8. PRESCRIPTION – IRRATIONAL USE Under prescribing Incorrect prescribing Extravagant prescribing Over prescribing Multiple prescribing

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

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

11. The rational drug use can be promoted by practicing the concept of essential drugs, providing adequate training etc,. Reasons for irrational usage of drugs In India there are many sources for providing unbiased information and many of the prescribers rely heavily on medical representatives who are not properly trained. The drug therapy is effective only when it is diagnosed properly but in many rural area it is not possible.

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. MEASURES TO PROMOTE RDU Educational Measures Regulatory Measures Managerial Measures

15. 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.

16. Cont… 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 .

17. Cont… Facility Indicators: Availability of copy of essential drugs list or formulary. Availability of key drugs.

18. 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.

19. 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.

20. 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.