Pharmaceuticals In Society

Question 1

Consequences of resistance:

Answer 1

• increased morbidity & mortality
• greater health care costs:
  1. More investigations are needed
  2. More exp and toxic antimicrobials are required
  3. Exp barrier nursing, isolation, procedures needed
  4. Therapy too exp for 3rd world countries

Question 2

Social factors fuelling resistance:

Answer 2

1. Poverty encourages dev of resistance through underuse of drugs
   - patients arent able to afford full course
   - substandard drugs that have less potency
   - poor compliance because less educated
2. Wealthy countries encourages resistance through overuse of drugs
   - unnecessary demands
   - demands might be met by unethical healthcare providers
   - inappropriate prescription (antibio for viral)
   - overuse of antimicrobials in livestock
3. Globalisation, labour migration & rapid travel facilitate spread of resistance strains

Question 3

Problems faced by doctors when prescribing and how they can improve:

Answer 3

1. Handling patient expectations&raquo_space; doc should explain the diagnosis and reason for not giving antibio
2. Limited consultation time
   » get help from nurses, pharmacists to assist in patient education
   » provide printed materials
3. Diagnostic uncertainty
   » telephone reviews with other more experienced docs
4. Fear of litigation
   » follow guidelines
   » good communication w patients

Question 4

Improvement methods accord. to CDC:

Answer 4

1. Get culture results from lab and reassess antibio prescription within 48 hrs
2. Document dose and duration for every antibio prescription made
3. Be aware of antibio resistance patterns in your hospital
4. Follow hand hygiene/infection control measures

Question 5

Promote appropriate prescribing thru DTC:

Answer 5

1. DTC selects cost-effective drugs
2. Develops and implements standard treatment guidelines
3. Audits drug use
4. Manages adverse drug reactions and med errors
5. Educates staff on drug use

Question 6

Effects of unethical beh of drug companies:

Answer 6

1. Integrity of drug approval process
2. Quality of research projects funded by drug companies (false reporting?)
3. Integrity of drug research sponsored by drug companies
4. Integrity of clinical practice guidelines

Question 7

Disease-mongering:

Answer 7

• a form of medicalisation whereby primary motive is to market products and services to max profits
• ordinary life processes are interpreted as med probs (menopause)
• personal/social probs redefined as med probs that can be treated w drugs
• risks conceptualised as diseases

Question 8

Malaysian National Medicines Policy:

Answer 8

1. To promote access to essential meds (drugs that satisfy healthcare needs of majority & should be available at all times in adequate amounts and dosage forms, affordable price)
2. To promote safe, effective and good quality meds
3. To promote rational use of meds

Question 9

Ways to lower drug prices:

Answer 9

1. Direct negotiation between gov and drug companies
2. Parallel import of a specific drug (available locally but priced high) from another country
3. Compulsory licensing – granting a local company the right to manufacture and sell drugs patented by another company (usually only during public health emergency)