Rational Use Of Drugs

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A Presentation On Rational Use Of Drugs:

A Presentation On Rational Use Of Drugs S.M. Asabur Rahman Student Id: 091122 Pharmacy Discipline, Khulna University, Bangladesh Email: asabur.rahman22@gmail.com

Rational use of antibiotics in Respiratory Tract Infection(RTI):

Rational use of antibiotics in Respiratory Tract Infection(RTI) Respiratory tract is the most common site of infection Causative Agents: 1. Virus (mostly) 2. Bacteria 3. Fungi 4. Various Parasites Pharmacy Discipline, Khulna University, Bangladesh Responsible for 10% of worldwide morbidity and mortality

Respiratory Tract Infections:

Respiratory Tract Infections Lower RTI Bronchitis Bronchiolitis Pneumonia Pharmacy Discipline, Khulna University, Bangladesh Upper RTI Rhinitis Rhinosinusitis or sinusitis Nasopharyngitis Pharyngitis Epiglottitis Laryngitis Laryngotracheitis Tracheitis

Respiratory Tract Infections:

These are Self-limiting Treated symptomatically High rate of spontaneous recovery Respiratory Tract Infections So most of the cases “NO DRUG” is needed Pharmacy Discipline, Khulna University, Bangladesh

PowerPoint Presentation:

Upper RTI Viral causes Bacterial Causes Antibiotics Use Acute otitis media Mainly caused by viruses. No antibiotics for 80% of cases. • Rhinovirus • Adenovirus • Parainfluenza virus • Coronavirus Streptococcus pneumoniae Non- typable Haemophilus influenzae Moraxella catarrhalis Amoxicillin Erythromycin estolate Azithromycin Clarithromycin Acute paranasal sinusitis Mainly caused by viruses, • Rhinovirus • Influenza virus • Coronavirus • Respiratory syncytial virus • Adenovirus • Enterovirus • Parainfluenza virus Streptococcus pneumoniae Haemophilus influenzae Staphylococcus aureus Moraxella catarrhalis Anaerobes Oral Amoxicillin Macrolides Fluoroquinolones Sore throat • Influenza virus • Adenovirus • Parainfluenzavirus • Coronavirus • Respiratory syncytial virus Streptococcus pyogenes . Haemophilus influenzae Staphylococcus aureus Chlamydia pneumonia Penicillin VK Benzathine penicillin Erythromycin estolate Azithromycin Clarithromycin Pharmacy Discipline, Khulna University, Bangladesh

PowerPoint Presentation:

Lower RTI Viral Causes Bacterial Causes Antibiotic Use Bronchitis Approximately 90% of acute bronchitis is caused by viruses, such as: •Influenza • Parainfluenza virus • Adenovirus •Rhinovirus Streptococcus pneumoniae Non- typable Haemophilus influenzae Moraxella catarrhalis Mycoplasma pneumoniae Bordetella pertussis Most guidelines do not recommend the use of antibiotics in acute bronchitis. Amoxicillin or doxycycline (in special circumstances). Pneumonia Viral pneumonia: •Influenza virus •Respiratory syncytial virus • Adenovirus •Parainfluenza virus Community-acquired pneumonia: Streptococcus pneumoniae Haemophilus influenze Moraxella catarrhali Treatment of community-acquired pneumonia is complex Pharmacy Discipline, Khulna University, Bangladesh

PowerPoint Presentation:

Injudicious Use Antibiotic Resistance Adverse effects Higher Healthcare Cost Antibiotic Resistance - A Global Problem Europe-- five drug-resistant organisms lead to the deaths of 25 000 Extra Cost EU: €1.5 billion each year USA: $20 billion annually In South Africa: antibiotic-resistant bacteria that are of major concern: Bacteria % of Infection Resistant Antibiotic Staphylococcus aureus 40% Cloxacillin Klebsiella pneumoniae 60% Broad Spectrum Pharmacy Discipline, Khulna University, Bangladesh

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Antibiotic Resistance: Antibiotic fail to respond Causes of Resistant Mechanism of Resistance Some bacteria are innately resistant Others may acquire resistance by Pharmacy Discipline, Khulna University, Bangladesh Genetic mutation, Gene transfer from one microorganism to another Inappropriate use of Antibiotics Frequent use of Antibiotics

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Result of Resistance: Fail to respond to standard treatment, Leading to prolonged illness, High treatment costs, Extended hospitalization, And possibly death, Also leading to possible outbreaks. Pharmacy Discipline, Khulna University, Bangladesh

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Solution of the Problems Avoid unnecessary prescribing Patient education Careful about omission of doses Improving patient compliance Improving effective patient-doctor communication Pharmacy Discipline, Khulna University, Bangladesh

PowerPoint Presentation:

Avoid unnecessary prescribing Prescribing errors: These are Sometimes doctors prescribe antibiotics inappropriately, Ex: For viral infections such as colds & flu. Lack of understanding of the cause of their respiratory tract infection Incorrect dosage Incorrect duration of treatment Prescribing broad-spectrum antibiotics where a narrow-spectrum antibiotics would have been effective. Pharmacy Discipline, Khulna University, Bangladesh

PowerPoint Presentation:

Methods that may be effective: • Acknowledging the patient’s symptoms and discomfort. •Promoting active management of the symptoms with non pharmacological treatment. The appropriate use of cold and flu preparations Ex: Decongestants and antipyretics. • Giving a realistic time for resolution. •The use of delayed prescriptions. How can we avoid prescription errors?? Pharmacy Discipline, Khulna University, Bangladesh

PowerPoint Presentation:

Improving Patient education Community pharmacists are indispensable as educator. They will give Medical information Advice Address misconceptions Cause of a patient’s illness Inappropriate use of antibiotics And probable warning about antibiotic resistance Pharmacy Discipline, Khulna University, Bangladesh

Omission of Doses:

Omission of Doses Why patients are missing the dose?? Doses Regimen % of Patients Three-times-a-day regimen 76.5% of patients Twice-daily regimen 34% of patients Once-daily 0% of Patients Forgetting While at school or at work Some patients also stop taking their medication. Stop treatment due to adverse effects Some are: Pharmacy Discipline, Khulna University, Bangladesh Taking additional doses at the start of treatment, to “get better quickly”. Reducing dosage frequency, e.g. from 3 times a day to 2 a day. Keeping leftover antibiotics for future use

Key points:

Key points Most respiratory tract infections are caused by viruses, in which case antibiotics are rarely indicated. In the event of bacterial infection, an antibiotic that is effective against the causative agent, or the most likely causative agent, should be selected. Wherever possible, an antibiotic with a narrow spectrum should be used. If an antibiotic has been taken in the previous three months, one that is in a different class should be selected. Pharmacy Discipline, Khulna University, Bangladesh

Key points:

Antibiotics with the shortest treatment course, and least frequent dosing intervals, are associated with the best compliance. The prevention of respiratory tract infections should be encouraged with annual vaccinations. Dosing instructions should be Simple, Concise, Easy to understand Key points Pharmacy Discipline, Khulna University, Bangladesh

Conclusion:

Conclusion Antibiotic-resistance levels are increasing globally. So antibiotics should be prescribed for “ only where it is indicated”. And Improved patients understanding of the Pharmacy Discipline, Khulna University, Bangladesh Etiology of these infections and Whenever possible, a suitable antibiotic should be selected

Any questions? Anything you would like to know that I didn’t cover? :

Any questions? Anything you would like to know that I didn’t cover? Thank You All

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