Essential Drugs

• WHO’s goal in medicines is to help save lives and improve health by ensuring the quality, efficacy, safety and rational use of medicines, including traditional medicines, and by promoting equitable and sustainable access to essential medicines, particularly for the poor and disadvantaged. people everywhere have access to the essential medicines they need; that the medicines are safe, effective, and of good quality;and that the medicines are prescribed and used rationally.

Features of essential drugs The 3 main requisites: Essential drugs are selected with regard to 1.Public health relevance. 2.Evidence on efficacy and safety 3.Comparative cost effectiveness

• Anaesthetics (local) -Atropine sulphate/inj 0.6mg/1ml -Lignocaine HCl/inj IP 2% W/V

• Analgesics,Antipyret ics and Antiinflammatory agents -Aspirin/tab 325mg -Diclofenac sodium tab50mg,inj 25mg/ml -Paracetamol tab IP 500mg,syp 125mg/5ml

• Anti-allergics and Drugs used in anaphylaxis -Chlorpheniramine maleate/tab 4mg -Hydrocortisone sodium succinate/IP inj 100mg/ml -Pheniramine maleate/ inj 22.75mg/ml -Epinephrine hydrochloride inj 1mg/ml

• Anti Epileptic Drugs -Diazepam/inj IP 5mg/ml

Anti-infective Drugs • Antibacterials -Amoxycillin cap250mg,500mg,susp 125mg/100ml -Ciprofloxacin tab 250,500mg -Co-trimoxazole/tab IP 80mg Trimethoprim + 400mg Sulphamethoxazole -Co-trimoxazole oral suspension -Doxycycline cap/tab 100mg -Procaine Penicillin(powder for inj 0.4MU/vial)

• Antihelminthics -Mebendazole tab 100mg -Albendazole susp 10ml -Pyrantel Pamoate susp 10ml

• Antifungals -Clotrimazole 1%cream,Vaginal pessary 100mg

• Antiamoebic

-Metronidazole tab 400mg

• Anti-tuberculous Drugs -Rifampicin tab/cap 300,450,600mg.syp 100mg/5ml -Isoniazid tab 100,300mg.syp100mg/5ml -Pyrazinamide tab 500mg,1gm -Ethambutol tag 400,800mg -Streptomycin inj 0.75gm/vial -Pyridoxine tab 10mg

• Antileprosy Drugs -Dapsone tab 100mg -Rifampicin tab/cap 300,600mg -Clofazamine cap 50,100mg

• AntiProtozoal Drugs -Chloroquine phosphate tab 250mg -Sulphadoxine+pyrimethamine tab 500mg+25mg -Primaquine tab 750mg -Metronidazole inj 500mg/100ml -Metronidazole tab 400mg

• Gastointestinal Drugs Antacids and Anti Ulcer -Magnesium hydroxide+Aluminium hydroxide tab(500+250mg),Gel (625+312mg/5ml)

Antispasmodic drugs

-Dicyclomine/tab 10mg/susp 10mg/10ml

Anti-Emetic Drugs

Metoclopromide tab 10mg,inj 5mg/ml

Drugs used in diarrhoea

-ORS powder(WHO formula with citrate salt) -Furazolidone tab 100mg,

• Cardiovascular Drugs -Atenolol tab 50mg - Propanalol tab 30mg

• Drugs acting on Respiratory tract -Theophylline + Etophylline/inj 2mg.amp -Salbutamol sulphate 2mg

Diuretics

-Frusemide tab 40mg

-Hydrochlorothiazide tab 50mg

Drugs affecting blood -Iron Folic Acid Tab ferrous sulphate(100mg of elemental iron) +Folic acid 0.5mg Tab ferrous sulphate(20mg of elemental iron) +Folic Acid 0.5mg

• Dermatological Drugs Anti-Infective Silver Sulphadiazine cream 1% -Povidone iodine ointment 5% , sol 5%

• Disinfectants and Antiseptics -

Scabicides

-Benzyl Benzoate 25% Antifungal -Clotrimazole 1% cream, Vaginal pessary 100mg

• Hormones and Contraceptives -Ethinyl Estradiol +Norethisterone tab 35mcg+1mg -Ethinyl Estradiol + Levonorgestrel tab 30mcg+150mcg

-Tincture benzoin co. -Spirit -Hydrogen Peroxide sol 20%w/v -Cresol with soap sol -Gentian violet crystals/sol 1% -Cetrimide + Chlorhexidine 3% + 1.5%

• Oxytoxics and Antioxytoxics -Isoxuprine tab 10mg,inj 5mg/5ml -Methyl ergometrine maleate tab 0.125mg,inj 0.2mg/ml

• Immunological Agents -Tetanus Toxoid inj

-B.C.G vaccines(freeze dried) inj -D.P.T vaccine(absorbed) inj -D.T vaccine(absorbed) inj -Measles vaccine inj 1000 TICD 50 -Poliomyelitis vaccine oral

• Solution correcting H2O and Electrolyte balance -Dextrose inj 5%,10%

-Dextrose with Saline inj 5%+0.9% -Water for injection

• Vitamins and Minerals -Vit B1,B6,B12 TAB 10mg+3mg+15mcg -Vit A syp 100000 IU/ml -Calcium gluconate tab 500mg

• Psychotherapeutic Drugs -Diazepam tab 5mg -Alprazolam tab 0.5mg

• Ophthalmological preparations -Sulphacetamide Eye drops 20% -Tetracycline Eye ointment 1%

• E.N.T Drugs -Gentamycin Eye/Ear drops(0.3%) -Paraffin liquid

Day to day O.P cases • • • • • • • •

Acute Gastroenteritis Upper respiratory tract infection Urinary tract infection Anaemia,Nutritional deficiencies Injuries Skin infections Antenatal and Postnatal Communicable diseases(TB,Malaria,Leprosy)

Deworming

DOTS therapy for TB Category

Characteristic of a TB case

Treatment regimen Intensive phase

Continuation phase

Category I

New sputum smearpositive Seriously ill, sputum smear-negative • Seriously ill, extrapulmonary

2 ( HRZE )3

4 ( HR )3

Category II

Relapse Failure Treatment after default Others

2 ( SHRZE )3 followed by 1 (HRZE )3

5 ( HRE )3

Category III

Sputum smear-negative Not seriously ill, extrapulmonary

2 ( HRZ )3

4 ( HR ) 3

Malaria Prophylaxis and Treatment presumptive Treatment- tab chloroquine 600mg stat Radical treatment P.Vivax-Tab Chloroquine 600mg stat Tab Primaquine-0.25mg/kg body wt daily for 5days P.Falciparum-Tab.Chloroquine 600mg + tab Primaquine o.75mg/kg body wt single dose

WHO Recommendations of chemotherapy for Leprosy Rifampicin 600mg once mthly (under supervision) Dapsone 100mg daily (self administered) Clofazimine 300mg once mthly(supervised) and 50mg self administered Rifampicin 600mg once mthly for 6mths(supervised) Dapsone 100mg daily for 6mths(self administerd)

REFERENCES http://www.essentialdrugs.org/index.php Revised categorised essential drug list/PHC/MAR 2003 : http://www.mp.nic.in/health/drug http://www.who.int/medicines/en Park’s textbook of social and preventive medicine Indian Drug Review Jan-Feb 2006