Визначення доступності антидепресантів для фармакотерапії психічних розладів у постраждалих осіб (експериментальне дослідження)

The availability of drugs for international nonproprietary names "Sertraline", "Tianeptin", "Amitriptyline" using an integrated approach was studied. It is substantiated that drugs under international nonproprietary name "Sertraline" are the most accessible for medical staff and affected patients. Particularities of clinical and pharmacological, classification and legal, nomenclature and legal groups of drugs according to international nonproprietary name "Sertraline" were determined. It is noted that the use of drugs under the international nonproprietary name "Sertraline" will comply with the principles of socially oriented pharmacotherapy of mental disorders for the affected contingents of patients in a special period in Ukraine.

Interdisciplinary Pharmacoeconomic Study of Pharmacotherapy of Cupping of Drunk Forms of Alcohol Dependence: Clinical and Pharmacological, Organizational, Legal and Marketing Experiment

An interdisciplinary pharmacoeconomic study of pharmacotherapy for the relief of alcoholic dependence on the basis of experimental clinical and pharmacological, organizational, legal and marketing studies. The scheme of basic pharmacotherapy of relief of drunken forms of alcohol dependence developed by the authors for the interdisciplinary study was used. Thirteen international nonproprietary names of drugs from Ukrainian (92.3%) and foreign (7.7%) manufacturers were selected. It was established that for pharmacotherapy of support of relief of drunken forms of alcohol dependence tablets occupy 23,1% of appointments of doctors, solutions – 76,9%. The scheme of pharmacotherapy in the relief of intoxicated forms of alcohol dependence includes 38.5% of international nonproprietary names of drugs with ATC code "A" - drugs that affect the digestive system and metabolism; 30.7% with ATC code "B" - drugs that affect the blood system and hematopoiesis; 15.4% with ATC codes of classification "C" – drugs that affect the cardiovascular system and "N" – drugs that affect the nervous system. Nomenclature and legal analysis showed that 92.3% of the studied drugs belong to prescription nomenclature and legal group; the share of OTC drugs is 7.69% (international nonproprietary name Antral).

Analysis of the selection of antimicrobial drugs for community-acquired pneumonia by final year medical students

Currently bacterial community-acquired pneumonia (CAP) remains one of the important problems of providing medical care on an outpatient basis. Despite the high detection rate and modern methods of treatment this disease holds the first place among the causes of death in the category of infectious diseases. Knowledge about rational use of drugs is obtained in higher medical school and subsequently serves as a basis for further work of a practicing physician. Purpose of the study: to analyze the knowledge of final year medical students in the field of rational choice of antimicrobial agent (AMA) in the treatment of non-severe CAP in outpatient setting in patient without concomitant diseases and risk factors. Total 240 final year students of A.I. Yevdokimov Moscow State University of Medicine and Dentistry were offered in February-April, 2019 to indicate their preferred AMA for a young previously healthy patient with mild CAP. The study involved 178 women (74.17 %) and 62 men (25.83 %). The average age of the respondents was 24.8+3.3 years. There were 271 options for the appointment of AMA with 152 (56.1 %) given by the international nonproprietary name and 119 (43.9 %) by trade name. Remarkably, the AMAs which are recommended for the treatment of mild CAP on an outpatient basis, accounted only for 46.2 % in this study. Of particular concern is the fact that only about 40—50 % of AMA prescribing for CAP by medical graduates is in line with current clinical guidelines. The inappropriate choice of a drug in this particular situation not just increases the drug load, the cost of pharmacotherapy and the risk of side effects, but also directly affects the results of treatment. This situation emphasizes the need for a purposeful formation of a personal formulary of medicines for a graduate of a medical university, taking into account the basic principles of rational pharmacotherapy and the provisions of clinical guidelines relevant to the Russian Federation.

Evaluation of Prescribing Indicators in a Paediatric Population Seen in an Outpatient Consultation at the Gaspard Kamara Health Centre in 2019 (Senegal)

Introduction: Data on drug use in paediatrics are scarce in Senegal. The objective of this study was to assess the prescribing indicators in a paediatric population seen in an outpatient consultation at a Health Centre in Dakar, Senegal. Methods: A retrospective and analytical study was conducted. The study population consisted of prescriptions for children aged 0 to 14 years who were seen in ambulatory consultation between 1 June and 30 November 2019. The sample size was 600 prescriptions. The systematic survey was then conducted. Five prescription indicators recommended by the World Health Organization were calculated. The R software was used for descriptive analysis, bivariate analysis and binomial logistic regression. Results: The average number of drugs per prescription was 2.56. The proportion of drugs prescribed under the International Nonproprietary Name (INN) was 18.9%, while the proportion of drugs on the National Essential Medicines List (NEML) was 41.3%. The proportions of prescriptions with at least one antibiotic and one injectable product were 41.5% and 1.3%, respectively. Conclusions: This study showed that prescribing habits were inadequate. Thus, it would be necessary to move towards continuing training of prescribers in the wise use of medicines.

CLINICAL AND LEGAL ASPECTS OF THE APPLICATION OF LOW-MOLECULAR-WEIGHT HEPARINS IN PEDIATRICS

The acceptability and effectiveness of low-molecular-weight heparin (LMWH) use in paediatrics has been confirmed by established Russian and foreign clinical practice. However, at present, the only LMWHs that are legally allowable for children are those with the international nonproprietary name of «dalteparin sodium», since this is directly stated in it’s Package Insert Leaflet (PIL). Prescribing the rest of the LMWHs for children will, in fact, be an off-label prescription. In addition, there are currently no standards of medical care, procedures for its delivery and regulations on the organization of medical care that would allow for the possibility of assigning LMWHs to children. This situation makes it difficult to introduce into the Russian pediatric practice the choice of administration of LMWHs in children where necessary. The use of LMWH in pediatrics may become available even without making changes to PIL, but subject to the establishment of such a recommendation in the new clinical guidelines. The latter is the only legal mechanism in force allowing legal and legally secure off-label appointment.

Development of a method for the analysis of the lists of medicines and its application for the analysis of the lists of medicines in Russia, England, and Italy

Objective: the development and approbation of the method for comparative analysis of the lists of medicines in different countries and systems of healthcare.Material and methods. Based on the open-access data on the lists of medicines published on official websites of the authorized regulators, the authors selected the national lists of medicines of Russia, England, and Italy for the development and approbation of the method. It was proposed to use three parameters: the absolute number of medicines by international nonproprietary name (INN); the structure of the lists based on anatomical therapeutic chemical (ATC) classification; and the coverage of the indications based on the International Classification of Diseases, 10th edition (ICD-10). The results of the analysis provided grounds for the review of the approaches to the formation of the lists of medicines required for medical help in Russia, England, and Italy and reimbursed from the state budget.Results. The number of medicines by INN in the national lists of England and Italy exceeds the total number of drugs included in the list of vital essential and desirable (VED) in Russia. All the analyzed lists were characterized by an uneven distribution of medicines within the lists by the ATC groups. The lists of medicines in England and Italy significantly exceed the list of VED by the number of the included medicines by all ATC groups excluding groups J and H in comparison with Italy, and groups J and V in comparison with England. At the same time, the list of VED significantly exceeds the list in England by the number of covered indications from the ATC L group. During the approbation, the method showed to be effective and can be used for further comparative studies of the national lists of medicines.Conclusion. Non-uniform lists of medicines by ATC-codes show that each country has priority areas in their healthcare systems. The list of VED can be shorter by the absolute number of the included medicines in England and Italy but it can exceed them by the coverage of indications due to peculiarities of the procedure of the list formation (reimbursement of medicines by all the registered indications). The results of the study with the proposed method can serve for the optimization of the VED list and the analysis of therapeutic areas that are undercovered.

COMPLEX RESEARCH AMONG PHARMACY PRODUCTS' CONSUMERS FROM THE POSITION OF THE QUALITY MANAGEMENT SYSTEM

The Quality Management System is a universal set of tools that helps to achieve maximum efficiency of any enterprise in all aspects. In order for the Quality Management System in the pharmacy to work effectively for the consumer of pharmaceutical goods, it is necessary to periodically conduct research among the clients of the pharmacy organization. The aim of the work was a comprehensive research among consumers of pharmacy products from the standpoint of the Quality Management System. Normative documents regulating pharmaceutical activities, works of domestic and foreign scientists were adopted as the information base. The questionnaire method was used to tackle the assigned tasks. The objects of the research were the visitors of the pharmacy organizations of the Oryol region. As a result of the study, it was found that efficacy, safety and price are of decisive importance for pharmacy visitors when choosing a drug; the majority of consumers pay attention to the shelf life of a drug when purchasing it (83.0%), however, only 47.0% of respondents attach importance to storage conditions; most pharmacy clients don’t know anything about the list of vital and essential drugs, the minimum range, the international nonproprietary name of the drug; the majority of visitors to pharmacy organizations don’t distinguish between the following concepts: falsified, substandard and counterfeit medicines; some respondents found adverse reactions after taking a drug that weren’t specified in the instructions, some consumers when purchasing drugs faced their defective forms. Thus, on the basis of a comprehensive study carried out among consumers of pharmaceutical products, it can be concluded that it is necessary to develop a system of measures that increase the literacy of the population in the field of the quality of medicines.

OPTIMIZING THE QUALITY OF CUSTOMER SERVICE IN PHARMACY ORGANIZATIONS

By surveying clients of pharmacy organizations, we've analyzed quality of service. It was found that pharmaceu-tical specialists do not always inform pharmacy visitors about the regimen and doses of the drug (MP), the rules for storing it at home, and about interactions with other drugs; most buyers find it difficult to answer the question of what is the International Nonproprietary Name of a Medicinal Product (INN) and how synonyms and ana-logues differ from each other; visitors to pharmacies are not always provided with information about the availa-bility of medicinal products from different manufacturers and medicinal products with different prices; in most cas-es, if the secondary packaging is violated, the pharmacy customers are not given instructions (a copy of the in-structions) on the use of the dispensed drug. A standard operational procedure "Order of realization of medicines without a prescription" was developed on the basis of received data.

The aspects that describe the pre-clinical studies of aceclofenac, as an instrument of registration of a generic drug

The paper presents the aspects of the toxicity, specific activity, pharmacokinetics and pharmacodynamics of aceclofenac, given in various sources describing its preclinical studies. The search for information sources for the study was carried out using domestic and international databases: elibrary and PubMed using contextual queries, including terms of the international nonproprietary name, preclinical studies of pharmacokinetics, pharmacodynamics, and animal species. Aceclofenac is one of the most prescribed drugs for acute and chronic pain. It refers to non-steroidal anti-inflammatory drugs, considered as drugs of first choice in the treatment of inflammation and pain. On the pharmaceutical market of the Russian Federation, aceclofenac is presented in the form of tablets, powder for suspension preparation, cream for external use, which allows it to be prescribed for various diseases. It has shown itself to be highly effective in the symptomatic treatment of diseases of the musculoskeletal system, for the relief of acute and chronic pain. A review of preclinical studies materials cited in various literature sources and including aspects of studying the toxicity, specific activity, pharmacokinetics and pharmacodynamics of aceclofenac, in our opinion, will allow using the data obtained in our study as one of the tools for further registration of generics.