Transcript Drugs Utilities in Medical Practice & Patient Protection

CURRICULUM VITAE
Nama
TTL
Agama
Pangkat
Jabatan
: Prof. DR.dr.Herri S. Sastramihardja, SpFK (K).
: Cianjur,8 April 1944
: Islam
: Guru Besar / IV-e
:  Staff Bag. Farmakologi FK UNPAD /
Farmakologi Klinik RSHS
 Ketua BKU Farmakologi pada program pascasarjana
UNPAD dan PPCD FK UNPAD
Pengalaman bekerja, antara lain :
• Ketua Komite Farmasi dan Terapi RSHS (1994-2005).
• Anggota Komite Medik RSHS (1996-2005).
• Staf Pengajar / Dosen di beberapa Perguruan Tinggi :
- FK UNPAD (sejak 1972)
- Pascasarjana UNPAD (sejak 1996)
- Program Pascasarjana Combined Degree (PPCD) FK
UNPAD (sejak 2002)
- Luar biasa FK UNJANI (sejak 1995).
- Luar biasa FK UNILA (sejak 2002)
- Pascasarjana ITB (Program S2 Farmasi RS) (sejak 1997)
- Dosen tetap FK UNISBA (Sejak 2004)
• Ka. Bag. Farmakologi FK UNPAD/Farmakologi Klinik RSHS (1998-2005).
• Anggota Senat UNPAD (sejak 1999).
Drugs Utilities in Medical
Practice & Patient Protection
Against Counterfeit Drugs
Herri S.Sastramihardja
Department Of Pharmacology & Therapeutics
Medical School – Padjadjaran University
Introduction
 Drug:
Any subtance or product which is to
prevent, relieve or cure a pathological
state or to explore or influence
physiological or pathological mechanism
for the benefit of the patient
 Prevention & treatment of many diseases
or disorder are close-related with medical
treatment
Introduction
(continued…)
 Source of medical treatment
 Health care facilities
 PHC
 Hospital
 Private Doctors
 Self medication (=SM)
 The principal of medication therapy
were : to inhibit or cure the disease or disorder
Introduction (continued…)
 Praktik kedokteran:
Rangkaian kegiatan yang dilakukan oleh dr &
drg terhadap pasien dalam melaksanakan
upaya kesehatan
 Dokter dalam melaksanakan praktik
kedokteran harus dilakukan sesuai
dengan standar pelayanan, standar
profesi dan standar operasional prosedur
(=SOP)
SOP di YANKES formal
ANAMNESA
PEMERIKSAAN
DIAGNOSA
PENGOBATAN
Tanpa
obat
Dengan
obat
EBM ?
Standar diagnosa
Standar terapi
WHAT IS EBM ?
Evidence-based medicine is
the integration of best
research evidence with
individual clinical expertice
and patient values and
expectations
EBM - WHAT IT IS
Clinical
Expertise
Research
Evidence
Patient
Preferences
 The aim of any drugs management
system :
to deliver the correct drugs to the patient who
needs that medicine
 In order to achieve this goal :
Drug therapy should be undertaken in accordance
with principles of rational prescribing
Rational Use of Drugs (RUD)
(WHO, 1985)
Occurs when patients receive medication :

Appropriate to their clinical needs in doses that
meet their own individual requirements

For an adequate period of time

At the lowest cost to them & their community
(conference of experts on RUD)
Criteria of RUD (WHO, 1987)
 Correct diagnosis
 Appropriate indication
 Appropriate drug (s)
 Approriate dosage, administration &

duration of treatment
 Appropriate patient
 Appropriate information
 Appropriate evaluation & follow-up
(Managing Drug Supply, 1997)
 Appropriate indication
 The reason to prescribe is based on
medical reasons
 Pharmacotherapy is proven to be the
best alternatif for treatment
 Appropriate drug (s)
Considering efficacy, safety, suitability
for patient, and cost
 Appropriate information
• Proper information to the patient is an
integral part of the prescribing process
• Needed to ensure their correct & safe
use and to improve patient compliance
Figure 1. The drug use Process
Prescription
 An instruction from a prescriber to
a dispenser
 Information must be complete &
clear
Give information,
intructions & warning
 Effect of the drug
 Side effects
 Instructions
 Warning
 Next appointment
 Everything clear ?
Irrational use of drugs (=IRUD)
 Occurs in all countries
 Examples of IRUD :
• No drug needed
• Wrong drugs
• Ineffective drugs & drugs with doubtful
efficacy
• Unsafe drugs
• Underuse of available effective drugs
• Incorrect use of drugs
Classification of IRUD
(Quick, 19881)
 Extravagant prescribing
 Over prescribing
 Incorrect prescribing
 Multiple prescribing
 Under prescribing
Self medication
 SM is the treatment of health problems
without medical supervision.
 by using:
 Non-prescriptions drugs (commonly)
 Traditional drugs (TD +)
 Prescriptions drugs:
 Pharmacies freely supply drugs to
informal shops & small groceries
 Re-use of copies of prescription
 RUD only partly improve the use of drugs
 SM is the most common form of choice &
people often rely on informal drug
distribution channel (including the
possibility of buying medicines through
internet)
IRUD,  the usage of illegal
or counterfeit drugs
Counterfeit Drugs
 Physically, difficult to differentiate
between counterfeit and true drugs
 The best alternative  laboratory
examination
 Some patient protection against
counterfeit drugs:




Patient Education
Responsible information
Regulation
etc.
Conclusion
 In order to achieve the goal of
pharmacotheraphy, the drugs must be
used rationally
 Information must be clearly, acurate and
not misleading
 Patient must be criticised all information
about drug
Thank you