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ABUBAKAR DANBATTA
RATIONAL DRUG USE
04/15/23
Outline
Definition of rational use of medicinesRationale behind rational use of medicinesReasons of irrational use of drugsDangers of irrational drug useSteps to be taken for rational use of drugsConclusion
04/15/23Rational Use of Drugs
Definition
In simplest words rational 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
04/15/23Rational Use of Drugs
‘Criteria’ for Using Medicines
• Appropriate indication• Appropriate drug• Affordable• Appropriate administration, dosage and
duration• Appropriate patient• Appropriate patient information
04/15/23Rational Use of Drugs
Reasons for Irrational use of Drugs
1.Lack of information2.Role models – Teachers or seniors3.Lack of diagnostic facilities/Uncertainty
of diagnosis – medicine for all possible causes
4.Demand from the patient5.Patient load6.Promotional activities of pharmaceutical
industries7.Drug promotion and exaggerated claim
by companies8.Defective drug supply system &
ineffective drug regulation 04/15/23Rational Use of drugs
Absolutely Irrational Use1. Injudicious use of antimicrobials:
Antibiotics in Viral fever and diarrhea2. Unnecessary combinations3. Use of drugs not related to diagnosis4. Incorrect route5. Incorrect dosing – under or overdose6. Incorrect duration – prolong or short
term use7. Unnecessary use of expensive
medicines8. Unsafe use of corticosteroids9. Polypharmacy
04/15/23Rational Use of Drugs
Hazards of Irrational Use1. Ineffective & unsafe treatment
over-treatment of mild illness inadequate treatment of serious
illness2. Exacerbation or prolongation of illness3. Distress & harm to patient4. Increase the cost of treatment5. Increased drug resistance - misuse of
anti-infective drugs 6. Increased Adverse Drug Events7. Increased morbidity and mortality
04/15/23Rational Use of Drugs
Steps of rational drug useStep:- I
Identify the patient’s problem based on symptoms & recognize the need for action
Step:- IIDiagnosis of the disease – define the diagnosis
Step:- IIIList possible intervention or treatment (drug or no
drug) – Identify the drugStep:- 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
04/15/23Rational Use of Drugs
… contd.Step:-V
Give proper information, instruction & warning regarding the treatment given e.g. side effects (ADR), dosage schedule & dangers/risk of stopping the therapy suddenly
Step:-VIMonitor 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
04/15/23Rational Use of Drugs
Some Rational use Indicators
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
04/15/23
ConclusionsDrug use is usually 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.
04/15/23Rational Use of Drugs
References..1) Irrational drug combinations; 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
04/15/23Rational use of Drugs