Rational Drug Use

Presentation
Plan
 Definition of rational use of medicine
 Criteria of using medicine
 Steps to be taken for rational use of drugs
 Types of irrational use
 Reasons behind rational / irrational drug use
 Hazards ( dangers) of irrational drug use
 Roles of pharmacist in RDU / Methods for
development of RDU
 Definition of rational use of
medicine

• The concept of rational drug use is old, as evidenced by the

statement made by the Alexanderian physician Herophilus
300 B.C that “Drugs are nothing in themselves but are of
good if employed with reason and prudence”.
• The rational use of Medicines (RUM) is defined as such by
the World Health Organization in 1985 “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.”
 Criteria of using medicine
 Adjusting medication hours.
 Regular time intervals( antibiotic).
 According to the meal times.
 He should use the drug in the right way , at the right time
intervals,in the right dose , and for the specified period of time.
 He should’nt stop taking the drug on his own when he feels well .
 If he doesn’t benefit from the medication,he should inform his
doctor.
 He should think that he might forget the drug, and make reminder
arrangement .
 He should’nt forget that the medicine that is good for his neighbor
may harm him.
 Steps to be taken for
rational use of drugs
• As a pharmacist you needs principles to support your choice of a drug
and its regular use. Therefore the world health organization (WHO)
recommends certain procedures for rational drug use/ prescription.
• The procedure for Rational Drug prescription comprises 6 steps which
are:
• Step 1: Determining the patient’s problem; this step is very crucial to
enable the physician to point out your problem through diagnosis and so
on.
• Step 2: Determining the objective of the treatment: you need to know
the objective of the treatment before you can take any other steps.
• Step 3: Verification of the suitability of the P-treatment for the specific
patient; the World Health Organization (WHO) recommends the use or a
[Personal] Drug List. The concept of P-medication includes the active
agent, the form of medication, the dosage scheme and the duration of
the medication treatment. These medicines must be included in the
Model List of Essential Medicines and in the National Drug Directory;
They must also be approved by EOF (National Organisation for Medicines)
 Steps to be taken for rational use of drugs

• Step 4: Onset of treatment; this step has to do with the first

appearance of the signs or symptoms of an illness.
• Step 5: Information, instructions and precautions: this step is
very important as its provides patient on the information
needed, the instructions which is the guidelines and the
precautions needed while taking the drug. Several factors are
taken into consideration such as the age, gender, environmental
factors and so on.
• Step 6: Monitoring (and termination) of treatment: this is the
last step and is also very important a way of knowing whether
the treatment is working while also protecting patient from
adverse drug effects. Termination is the final stage of counseling
and marks the close of the relationship.
 Types of Irrational Use
• Diagnosis / Follow upThe diagnosis stage involves identifying and
defining the problem(s) which require intervention. This initial stage can
set up a cycle of inappropriate medicine usage if the wrong problem is
diagnosed by the clinician for the intervention. If in the case of wrong
intervention is outlined the patient will get wrong medicines which
further interrupts the cycle and it leads to irrationality.
• Dispensing:The dispensing is the stage in which the patients receive
their medications and often dispensing is carried out by the pharmacist
and the technicians. According to the WHO, some necessary actions
should be taken by the dispenser to minimize the irrationality by cross -
checking the prescription, review the legal requirements, safety and
appropriateness.
• Prescription:Irrational prescribing refers to prescribing that fails
to conform to good standards of treatment .
 Resons behind
irrational drug use
•  Worldwide more than 50% of all medicines are
prescribed, dispensed, or sold inappropriately,
while 50% of patients fail to take them correctly.
Moreover, about one-third of the world’s
population lacks access to essential medicines. 
• Causes of irrational use include lack of
knowledge, skills or independent information,
unrestricted availability of medicines, overwork
of health personnel, inappropriate promotion of
medicines and profit motives from selling
medicines. Prescribing, dispensing and patient
utilization should be regularly reviewed to
address irrational drug use.
 Hazards of
irrational drug use
• Irrational use of drugs may lead to:
 -Increased treatment costs
 -Decreased adherence of patients
 -Drug resistance
 e.g.:  Antibiotic resistance
 -Unsafe and Ineffective treatment
  e.g.: misuse, overdose, underdose
 -Harm to patient
 e.g.: toxicity, ADRs (Adverse Drug Reactions), drug–drug
interactions, noncompliance
 -Exacerbation of illness and increased mortality
 e.g.: Irrational use of SABAs(short-acting β2-agonists) increase
exacerbations, hospitalizations, mortality, and healthcare costs. 
 Roles of
pharmacist in
RDU
• In recent decades, the pharmacist’s role in
therapy has expanded. Many factors have an
influence on prescribing and have expanded
the pharmacist’s role from a passive
dispenser to an active participant in the
therapeutic decision-making team.
• The clinical pharmacist’s activities can be
summarized as following: consulting,
selection of drugs, drug information,
formulation and preparation, drug use
research, pharmacokinetics/ therapeutic drug
monitoring, clinical trials, pharmacoeconomy,
dispensing & administration, teaching &
training. The aims of these activities are to
maximize the clinical effect of medicines, to
minimize the risk of treatment- induced
adverse events and to minimize the
expenditures for pharmacological treatments
for the national health systems and for the
patients .
 Methods for
development of
RDU

• Many global organizations are pointers to the

increasing recognition being accorded to the
importance of rational drug use in healthcare
practice and also have their own essential drug
lists. Many of the mechanisms required for the
rational use of drugs are already in place. A
structured mechanism for additions or
modifications to this list is available and
functional. The systems for procurement and
supply of drugs ensure that shortages
generally do not occur and available for
common diseases.
• No amount of teaching, training or
sermonising can replace the need for ideal
prescribing behaviour by 'seniors' at all levels:
the senior intern, the senior medical officer,
the senior resident, the senior specialist.
 CONCLUSION

• Rational use of drug is so important

• https://youtu.be/M4VE7aOz6lQ
topic , and pharmacists have
enormous responsibilty for this
issue. We believe that people's
awareness on this issue will
increase and we, new pharmacists,
will have a great impact on this.
Do you have any questions?
References
• https://apps.who.int/iris/bitstream/handle/10665/67438/W
HO_EDM_2002.3.pdf
• https://d-nb.info/1111773378/34
• https://www.academia.edu/23562342/
• Rational_drug_use_awareness_of_the_nurses_in_the_Turkis
h_Republic_of_Northern_
Cyprus_Near_East_University_Hospital
• https://terrailac.com.tr/Akilci-ilac-Kullanimi-i20
• https://www.imop.gr/en/urotools-prescription-principles
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC274045/
• http://www.fip.org/files/fip/Patient%20Safety/PatientSafetyAd
vidShah.pdf
• https://www.ncbi.nlm.nih.gov/pmc/articles/ PMC3862784/
References
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5419375/
• https://journals.sagepub.com/doi/full/10.1177/20503121211025146
• https://journals.sagepub.com/doi/full/10.1177/20503121211025146
• https://www.sciencedirect.com/science/article/abs/pii/S159086581630
4704
• https://www.sciencedirect.com/science/article/abs/pii/S221326001830
0067
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6422419/
• https://erj.ersjournals.com/content/55/4/1901872?ctkey=shareline
• https://www.sciencedirect.com/science/article/pii/S092966462200219
4
• https://www.titck.gov.tr/faaliyetalanlari/ilac/akilci-ilac-kullanimi
• https://terrailac.com.tr/Akilci-ilac-Kullanimi-i20
 Lecture : Orientation to Pharmacy ( Pharmacy Department)
Professor :Zubeyir Elmazoglu

Prepared By:
Presenter :Fatima Attahiru Haliru
Slide – Maker : Verda Zeyrek
İrem Atasayar
Hatice Arık
Fatima Umar Hatice Arık
Büşra Saliha Tomakin
Huri Nida Çınaroğlu
İrem Uysal
Zeynep Gül Tüzel
Zehra Tepe
Elif Nur Sarıcan
İrem Nur Çırtan
Rohey Badjie