CURRICULUM VITAE Nama : Prof. DR.dr.Herri S. Sastramihardja, SpFK (K). TTL : Cianjur,8 April 1944 Agama : Islam Pangkat : Guru Besar / IV-e Jabatan :  Staff Bag. Farmakologi FK UNPAD / Farmakologi Klinik RSHS  Ketua BKU Farmakologi pada program pascasarjana UNPAD dan PPCD FK UNPAD

Pengalaman bekerja, antara lain : Ketua Komite Farmasi dan Terapi RSHS (1994-2005). Anggota Komite Medik RSHS (1996-2005). Staf Pengajar / Dosen di beberapa Perguruan Tinggi : - FK UNPAD (sejak 1972) - Pascasarjana UNPAD (sejak 1996) - Program Pascasarjana Combined Degree (PPCD) FK UNPAD (sejak 2002) - Luar biasa FK UNJANI (sejak 1995). - Luar biasa FK UNILA (sejak 2002) - Pascasarjana ITB (Program S2 Farmasi RS) (sejak 1997) - Dosen tetap FK UNISBA (Sejak 2004) Ka. Bag. Farmakologi FK UNPAD/Farmakologi Klinik RSHS (1998-2005). Anggota Senat UNPAD (sejak 1999).

Herri S.Sastramihardja Drugs Utilities in Medical Practice & Patient Protection Against Counterfeit Drugs Herri S.Sastramihardja Department Of Pharmacology & Therapeutics Medical School – Padjadjaran University

Introduction Drug: Any subtance or product which is to prevent, relieve or cure a pathological state or to explore or influence physiological or pathological mechanism for the benefit of the patient Prevention & treatment of many diseases or disorder are close-related with medical treatment

Introduction (continued…) Source of medical treatment Health care facilities PHC Hospital Private Doctors Self medication (=SM) The principal of medication therapy were : to inhibit or cure the disease or disorder

Introduction (continued…) Praktik kedokteran: Rangkaian kegiatan yang dilakukan oleh dr & drg terhadap pasien dalam melaksanakan upaya kesehatan Dokter dalam melaksanakan praktik kedokteran harus dilakukan sesuai dengan standar pelayanan, standar profesi dan standar operasional prosedur (=SOP)

SOP di YANKES formal Standar diagnosa ANAMNESA PEMERIKSAAN DIAGNOSA PENGOBATAN Dengan obat Tanpa obat EBM ? Standar diagnosa Standar terapi

WHAT IS EBM ? Evidence-based medicine is the integration of best research evidence with individual clinical expertice and patient values and expectations

EBM - WHAT IT IS Clinical Expertise Research Patient Evidence Preferences

system : The aim of any drugs management to deliver the correct drugs to the patient who needs that medicine In order to achieve this goal : Drug therapy should be undertaken in accordance with principles of rational prescribing

Rational Use of Drugs (RUD) (WHO, 1985) Occurs when patients receive medication : Appropriate to their clinical needs in doses that meet their own individual requirements For an adequate period of time At the lowest cost to them & their community (conference of experts on RUD)

Criteria of RUD (WHO, 1987) Correct diagnosis Appropriate indication Appropriate drug (s) Approriate dosage, administration & duration of treatment Appropriate patient Appropriate information Appropriate evaluation & follow-up (Managing Drug Supply, 1997)

Appropriate indication The reason to prescribe is based on medical reasons Pharmacotherapy is proven to be the best alternatif for treatment Appropriate drug (s) Considering efficacy, safety, suitability for patient, and cost

Appropriate information Proper information to the patient is an integral part of the prescribing process Needed to ensure their correct & safe use and to improve patient compliance

Figure 1. The drug use Process

Prescription An instruction from a prescriber to a dispenser Information must be complete & clear

Give information, intructions & warning Effect of the drug Side effects Instructions Warning Next appointment Everything clear ?

Irrational use of drugs (=IRUD) Occurs in all countries Examples of IRUD : No drug needed Wrong drugs Ineffective drugs & drugs with doubtful efficacy Unsafe drugs Underuse of available effective drugs Incorrect use of drugs

Classification of IRUD (Quick, 19881) Extravagant prescribing Over prescribing Incorrect prescribing Multiple prescribing Under prescribing

Self medication SM is the treatment of health problems without medical supervision. by using: Non-prescriptions drugs (commonly) Traditional drugs (TD +) Prescriptions drugs: Pharmacies freely supply drugs to informal shops & small groceries Re-use of copies of prescription

IRUD,  the usage of illegal RUD only partly improve the use of drugs SM is the most common form of choice & people often rely on informal drug distribution channel (including the possibility of buying medicines through internet) RUD only partly improve the use of drugs SM is the most common form of choice & people often rely on informal drug distribution channel (including the possibility of buying medicines through internet) IRUD,  the usage of illegal or counterfeit drugs

Counterfeit Drugs Physically, difficult to differentiate between counterfeit and true drugs The best alternative  laboratory examination Some patient protection against counterfeit drugs: Patient Education Responsible information Regulation etc.

Conclusion In order to achieve the goal of pharmacotheraphy, the drugs must be used rationally Information must be clearly, acurate and not misleading Patient must be criticised all information about drug

Thank you