11/12/2014

PHARMCOSOCIAL 1
Eman Sutrisna
Departement of Pharmacology and Therapy
Medical School Unsoed

LEARNING OBJECTIVE
Student able to explain :

Drug information : various and resources

Benefit and leak of every drug
information

The standard requarement have to be
fulfilled by an advertisement

How to search the drug information

Drug management in development
country

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VARIOUS OF DRUGS INFORMATION

(Resources and Form)

Non-commercial
Commercial

Non Commercial Drug Information

WRITING

VERBAL

OTHERS

Handbooks
Textbook
Therapeutic
guidelines
Drugs info
bulletin
Formulary

Pharmacist

Video cassette

Advance
learning
Symposium

Disc of Drug
Info
Info service
center

Other medical
practician

Medical
magazine

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Commercial Drug Information

WRITING

VERBAL

Handbooks
Textbook
Advertisement

Medical
Video cassette
representatives
Symposium

OTHERS

Discs of Drug
Info

Special letter of
Drugs info

BENEFIT AND LEAK

DRUGS INFORMATION RESOURCES

NON COMMERSIAL

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TEXTBOOK-HANDBOOK

The main info to learn deeply

There are :


Book of drug (to learn characteristic of

pharmacology, pharmacokinetic,
pharmacodynamic, adverse effect)
Book of therapeutic (begin to clinical problems)

Important : revise frequently (according

to drug info development)
Handbook : good if just has limited time
to read.

REFERENCE BOOKS

Some of them good for guidance.

According to expert aggrement :




Therapeutic guideline
The guidance of antibiotic use
Ect

Applied in local, national,

international

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Bulletin of Drug and Therapeutic

Periodical (un-charge)
Info about promotion of drug use and
therapeutic rationally.
Objective info



Assessment for drug benefit and safety

Recommendation to apply in clinical practice

Ex : Australian prescriber (Australia)






Drug and therapeutic bulletin (UK)

Prescrire (Franc)
Drug Information Newsletter (Singapore)
Lembaran obat dan pengobatan (Indonesia)

MEDICAL MAGAZINES

There are


General Medical Magazine

Special Medical Magazine

Lancet
BMJ, AMJ
Tubercule
American Journal Of Respiratory Diseases
Journal of Gastroenterology

Be careful : a lot of research result

apposite each other (For clinical
application need to re-research/
independent research)

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VERBAL & MULTIMEDIA

Drug information center in hospital

E-drug info : internet, e-mail, disc
Quick, practice but more expensive

BENEFIT AND LEAK

DRUGS INFORMATION RESOURCES

COMMERSIAL

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Commercial Drug Information

Pharmaceutical Industry
Simply, clear and easy to be understood.
Not objective : positive info >>
Purpose to support drug selling
By involving : symposium, article in
health magazine that support by
pharmaceutical Industry
Difficult to control and re-check of the
truth

ADVERTISEMENT

Fast to reach medical service (Hospital, doctor)

A lot of them were out of guideline (WHO,1988)










Name of active substance (international Nonproprietary Names=INN) and trade name

Form
Dosage and administration
Indication
Adverse effect (safety)
Precaution and contra-indication
Drug interaction
Referencies
Name and adress of manufacture

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PRODUCT INFO

Together with drug cover

For user info
Can be believed and under-control
by Health Department RI.
Simply, complete info, without
commersial messages.
But often be forgotten (not be given
to the patient

PRODUCT INFO

The component :



INN (generic name of active substance)

Pharmacologic info (effect, work mechanism,
pharmacokinetic)
Clinical info (indication, dosage regiment,
contra-indication, precaution, adverse effect,
drug interaction and over-dosage)
Pharmaceutical info (form, strength, storage,
expire date, drug classification, manufacture
name, vehikulum

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THE OTHER RESOURCES

IIMS
ISO
Symposium
Seminar
Research report
Medical journal

How to search the drug information

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SELECTION TO DRUG INFO

RESOURCES

Pharmacologic characteristic


Adverse effect



Textbook and handbook

American Medical Association (AMA)
Drug Evaluation
Dukes MNG (1998) Meylers Side Effect
of Drugs, 11th Edition, Elsevier, oxford

Drug ingridient


IIMS, ISO dll

SELECTION TO THERAPEUTIC INFO

RESOURCES

Drug of choice and its alternative drug

for various diseases



Current medical Diagnosis & Treatment

Current pediatric Diagnosis & Treatment

Drug use in special groups (condition)







Local therapeutic guide

Australian drug evaluation committee (1989),
medicines in pregnancy
Hand book : clinical pharmacokinetik
Ect.

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DRUG IN DEVELOPMENT COUNTRY

Regulation and Use

Why is It important to be known ?

IMPORTANT ISSUES

Despite the availability of many effective drugs on

the world market.


Many development country still do not have regular

access to the most needed essential medicines.

Medically ineffective and economically inefficient

use of pharmaceuticals by both healthcare
providers and consummers is commonly
encounter in many communities
Increasing problems of counterfeit and
substandard drugs in many parts of the
development world.
Improvements in the supply, distribution, and use
of pharmaceuticals are possible.

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DRUG SITUATION IN DEVELOPMENT COUNTRY

(DArcy, 1984)

Inadequate funds to maintain constant

supply
Prices are too high
No foreign exchange for buying drugs or
raw material
Inefficient transport and distribution
Drug deterioration in the central medical
stores or during transport
Lack of government commitment for the
health and pharmaceuticals sectors

Action Needed for improving and

Maintaining sustainable financing of Drug

Efficiency in pharmaceutical and

health sector
Securing public financing
Mobilization of other financial
resources

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The Policy Can be Implemented in

Containing pharmaceutical Price and Cost

A national policy for the use of generics

Reduction or elimination of import
duties for pharmaceutical
Price competition
Price information

Mesure to Monitor and Improve the

Overall Supply

Product selection
Drug quantification
Drug procurement
Drug storage and distribution

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The Principles of Rational Drug Use

Appropriate clinical indication and not the other

reason
Appropriate drugs with the most favourable
efficacy, safety, affordability and quality
Appropriate patient characteristic with no contra
indication and the smallest likehood of adverse
reaction
Appropriate dosage, route of administration and
duration
Appropriate information
Appropriate follow up for intended effect and
unintended side effect.

The Pattern of Irrational Drug Use

The use of wrong drug for specific

condition
The use of drug




There are not indication

Doubtful efficacy and uncertain safety status
Incorrect dosage, inadequate route of
administration
With multiple therapy when mono-therapy
could already be sufficient
Too expencive

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REFERENCIES

Santoso B. Drugs Regulation :

Organization and Control. In Boxtel C. J.
V. Santoso B. And Edwards I. R. Drug
Benefits and Risk : International
Textbook of Clincal Pharmacology. New
York : John Wiley & Sons Ltd. 2001 :
61-70
Santoso B., Suryawati S., Saleh-Danu S.
Masalah Penggunaan Obat di Institusi
Pelayanan Kesehatan dalam Farmakologi
Klinik dan Farmakoterapi. Bagian
Farmakologi Klinik FK UGM. 2003 : 1-9

THANKS9.
LETS SMILE WITH SCIENCE

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