scholarly journals Evaluation of knowledge on Fixed Dose Combinations, Concept of P Drugs and Essential Medicines List among Interns and Residents

2021 ◽  
Vol 09 (03) ◽  
Author(s):  
Dr D.N. Nivedha ◽  
Keyword(s):  
Essential Medicines ◽  
Fixed Dose ◽  
Essential Medicines List ◽  
Interns And Residents

scholarly journals Insufficient Stability of Clavulanic Acid in Widely Used Child-Appropriate Formulations

Antibiotics ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 225
Author(s):  
Ines Mack ◽  
Mike Sharland ◽  
Janneke M. Brussee ◽  
Sophia Rehm ◽  
Katharina Rentsch ◽  
...  
Keyword(s):  
Ambient Temperature ◽  
Clavulanic Acid ◽  
Storage Conditions ◽  
Essential Medicines ◽  
Active Components ◽  
Middle Income ◽  
Ambient Temperatures ◽  
Essential Medicines List ◽  
Dispersible Tablets ◽  
The Stability

Amoxicillin-clavulanic acid (AMC) belongs to the WHO Essential Medicines List for children, but for optimal antimicrobial effectiveness, reconstituted dry powder suspensions need to be stored in a refrigerated environment. Many patients in low- and middle-income countries who are sold AMC suspensions would be expected not to keep to the specified storage conditions. We aimed to assess the stability of both ingredients in liquid formulations and dispersible tablets, combined with nationally representative data on access to appropriate storage. Degradation of amoxicillin (AMX) and clavulanic-acid (CLA) was measured in suspensions and dispersible tablets commercially available in Switzerland at different ambient temperatures (8 °C vs. 28 °C over 7 days, and 23 °C vs. 28 °C over 24 h, respectively). Data on access to refrigeration and electricity were assessed from the USAID-funded Demographic and Health Survey program. In suspensions, CLA degraded to a maximum of 12.9% (95% CI −55.7%, +29.9%) at 8°C and 72.3% (95% CI −82.8%, −61.8%) at a 28 °C ambient temperature during an observation period of 7 days. Dispersible tablets were observed during 24 h and CLA degraded to 15.4% (95% CI −51.9%, +21.2%) at 23 °C and 21.7% (−28.2%, −15.1%) at a 28 °C ambient temperature. There is relevant degradation of CLA in suspensions during a 7-day course. To overcome the stability challenges for all active components, durable child-appropriate formulations are needed. Until then, prescribers of AMC suspensions or pharmacists who sell the drug need to create awareness for the importance of proper storage conditions regarding effectiveness of both antibiotics and this recommendation should be reflected in the WHO Essential Medicines List for children.

A STUDY AIMED TO INCREASE THE KNOWLEDGE ABOUT THE FIXED DOSE COMBINATIONS (FDC'S) AND IRRATIONAL FDC'S AVIALABLE IN INDIA.

2021 ◽  
pp. 45-46
Author(s):  
Tauseef Nazir Vaidha ◽  
Sabahat Farooq ◽  
Samina Farhat
Keyword(s):  
Drug Therapy ◽  
Essential Medicine ◽  
Essential Medicines ◽  
Fixed Dose ◽  
Concomitant Drug ◽  
Essential Medicine List ◽  
Single Dosage

Fixed dose combinations(FDC's) is a combination of 2 or more than 2 drugs in a single dosage formulations, it should not be confused with concomitant drug therapy which refers to taking 2 or more than 2 drugs separately. Fixed dose combinations may be rational or irrational. In India there are more FDC's than single drugs and majority of those FDC's are irrational. Many of these irrational FDC's are widely prescribed. The WHO essential medicine list incorporates only 23 FDC's while as the National list of essential medicines(NLEM) of 2011 has only 12 FDC's.

Reproductive Risk Information Missing from Assessment of Drugs in the WHO's Essential Medicines List

2018 ◽  
Vol 80 ◽  
pp. 164
Author(s):  
Janine Polifka ◽  
Hamid Ferdosi ◽  
Isabella Boroje ◽  
Steven H. Lamm
Keyword(s):  
Risk Information ◽  
Essential Medicines ◽  
Reproductive Risk ◽  
Essential Medicines List

scholarly journals High global consumption of potentially inappropriate fixed dose combination antibiotics: Analysis of data from 75 countries

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0241899
Author(s):  
Barbara Bortone ◽  
Charlotte Jackson ◽  
Yingfen Hsia ◽  
Julia Bielicki ◽  
Nicola Magrini ◽  
...  
Keyword(s):  
The United States ◽  
Antibiotic Consumption ◽  
Essential Medicines ◽  
World Health ◽  
Fixed Dose ◽  
Middle Income ◽  
Us Fda ◽  
Analysis System ◽  
Health Organization ◽  
Data Analysis System

Antibiotic fixed dose combinations (FDCs) can have clinical advantages such as improving effectiveness and adherence to therapy. However, high use of potentially inappropriate FDCs has been reported, with implications for antimicrobial resistance (AMR) and toxicity. We used a pharmaceutical database, IQVIA-Multinational Integrated Data Analysis System (IQVIA-MIDAS®), to estimate sales of antibiotic FDCs from 75 countries in 2015. Antibiotic consumption was estimated using standard units (SU), defined by IQVIA as a single tablet, capsule, ampoule, vial or 5ml oral suspension. For each FDC antibiotic, the approval status was assessed by either registration with the United States Food and Drug Administration (US FDA) or inclusion on the World Health Organization (WHO) Essential Medicines List (EML). A total of 119 antibiotic FDCs were identified, contributing 16.7 x 109 SU, equalling 22% of total antibiotic consumption in 2015. The most sold antibiotic FDCs were amoxicillin-clavulanic acid followed by trimethoprim/sulfamethoxazole and ampicillin/cloxacillin. The category with the highest consumption volume was aminopenicillin/β-lactamase inhibitor +/- other agents. The majority of antibiotic FDCs (92%; 110/119) were not approved by the US FDA. Of these, the most sold were ampicillin/cloxacillin, cefixime/ofloxacin and metronidazole/spiramycin. More than 80% (98/119) of FDC antibiotics were not compatible with the 2017 WHO EML. The countries with the highest numbers of FDC antibiotics were India (80/119), China (25/119) and Vietnam (19/119). There is high consumption of FDC antibiotics globally, particularly in middle-income countries. The majority of FDC antibiotic were not approved by either US FDA or WHO EML. International initiatives such as clear guidance from the WHO EML on which FDCs are not appropriate may help to regulate the manufacturing and sales of these antibiotics.

scholarly journals Combining retrosynthesis and mixed-integer optimization for minimizing the chemical inventory needed to realize a WHO essential medicines list

2020 ◽  
Vol 5 (2) ◽  
pp. 367-376
Author(s):  
Hanyu Gao ◽  
Connor W. Coley ◽  
Thomas J. Struble ◽  
Linyan Li ◽  
Yujie Qian ◽  
...  
Keyword(s):  
Essential Medicines ◽  
Mixed Integer ◽  
Integer Optimization ◽  
Mixed Integer Optimization ◽  
Essential Medicines List ◽  
Multiple Products ◽  
On Demand

Retrosynthetic pathways suggestions are optimized to minimize the number of unique chemicals required to synthesize multiple products as would be useful for on-demand manufacturing.

scholarly journals Access to WHO Essential Medicines for Childhood Cancer Care in Trinidad and Tobago: A Health System Analysis of Barriers and Enablers

2020 ◽  
pp. 67-79 ◽  
Author(s):  
Brandon Tang ◽  
Curt Bodkyn ◽  
Sumit Gupta ◽  
Avram Denburg
Keyword(s):  
Trinidad And Tobago ◽  
Childhood Cancer ◽  
Cancer Care ◽  
System Analysis ◽  
Essential Medicines ◽  
Middle Income ◽  
Essential Medicines List ◽  
Mixed Methods Case Study ◽  
Relevant Evidence ◽  
Context Specific

PURPOSE Improving access to essential medicines is necessary to reduce global mortality resulting from childhood cancer. However, there is a lack of context-specific data in many low- to middle-income countries on the determinants of access to essential childhood cancer medicines. We conducted a mixed-methods case study of the barriers to and enablers of access to WHO essential medicines for childhood cancer care in Trinidad and Tobago, in response to domestic calls for policy attention and reform. METHODS We interviewed stakeholders (N = 9) across the pharmaceutical supply system using a novel analytic framework and qualitative interview guide. Interviews were recorded, transcribed, and analyzed with constant comparative methods to capture emergent themes. Quantitatively, we examined alignment of the national essential medicines list with the 2017 WHO Essential Medicines List for Children (EMLc). National buyer prices for EMLc cancer medicines were compared with median international prices, with calculation of median price ratios to assess procurement efficiency. RESULTS Principal barriers identified included a lack of data-driven procurement, low supplier incentive to engage in tenders, reactive rather than proactive processes in response to stockouts, and siloed information systems. Recurring themes of regionalization, standardization, and proactivity emerged as priorities for policy reform. Quantitative analysis of the national essential medicines list and median price ratios for procured medicines aligned with findings reported qualitatively. CONCLUSION Our study contributes to global efforts to improve childhood cancer care by identifying policy-relevant evidence on access to essential childhood cancer medicines and providing a model for future studies in other jurisdictions.

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