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PHARMCOSOCIAL 1

Wahyu dwi k
Departement of Pharmacology and Therapy
Medical School Unsoed

LEARNING TOPICS

Drug Information Resources


Drug regulation : organization and
control
Drug Use in Health Service Center

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

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

Medical
magazine

Other medical
practician

Commercial Drug Information


WRITING

VERBAL

Handbooks
Textbook
Advertisement

Medical
Video cassette
representatives

Special letter of
Drugs info

Symposium

OTHERS

Discs of Drug
Info

BENEFIT AND LEAK


DRUGS INFORMATION RESOURCES

NON COMMERSIAL

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 aggrimment :

Therapeutic guideline
The guidance of antibiotic use
Ect

Applied in local, national,


international

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


Lancet
BMJ, AMJ
Special Medical Magazine
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)

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

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

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

THE OTHER RESOURCES

IIMS
ISO
Symposium
Seminar
Research report
Medical journal

How to search the drug information

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.

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.

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

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

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

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

THANKS.
LETS SMILE WITH SCIENCE

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