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

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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

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‘Criteria’ for Using Medicines

• Appropriate indication• Appropriate drug• Affordable• Appropriate administration, dosage and

duration• Appropriate patient• Appropriate patient information

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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 &

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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

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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

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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

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… 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

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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

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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.

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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

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