Availability of medicines

Public-private-NGO (non-governmental organization) mix approaches are being pursued to ensure timely availability of medicine supplies of assured... 

Box 4). Causes of irrational use include lack of knowledge, skills or independent information, unrestricted availability of medicines, overwork of health personnel, inappropriate promotion of medicines and profit motives from selling medicines. 

Sufficient government expenditure to ensure availability of medicines and staff... 

III.b.1.12. Sufficient government expenditure to ensure availability of medicines and staff Lack of essential medicines leads to the use of non-essential medicines, and lack of appropriately trained personnel leads to irrational prescribing by untrained personnel. Furthermore, without sufficient competent personnel and finances, it is impossible to carry out any of the core components of a national programme to promote rational use of medicines. Poor clinical outcome, needless suffering and economic waste are sufficient reasons for large government investment. 

In the Preface to the First Edition we emphasised some key factors that led us to produce another text book in the general area of pharmacology and phar-macotlierapy. For those who make decisions on the general availability of medicines, as well as those who provide treatment for individual patients, the essential need to be aware of and to balance the benefits and risks of medicines is paramount. Errors in these judgements will prove costly both financially and in terms of additional morbidity and mortality. 

The availability of medicinal chemistry resources can decide which approach to take in the absence of chemistry, a specific enzyme inhibitor that does not distinguish between host and parasite has little value. If chemistry is available, however, identifying a specific enzyme inhibitor can lead to the discovery of parasite-selective compounds. Random screens that search for novel structures are based on the premise that discovery of a specific inhibitor is an extremely rare event, and so the nutrient-dependent viability format is more desirable for HTS. 

At the same time, meeting sustained availability of medicinal plants for various purposes is one of the challenging tasks. The present chapter deals with various traditional and ongoing management and conservation practices with respect to the medicinal plants and their long-term sustainability. 

The analysis of this problem introduces, on the one hand, the obligation of the pharmacist to promote the optimum treatment for the patient, and on the other hand, the obligation of the administration to establish explicit criteria for access to or availability of medicines being researched for severe illnesses or those which are life-threatening without satisfactory alternative treatments (such as policies on orphan medicines, magistral formulation of nonregistered active ingredients, etc.). 

The availability of medicinal Botox is not likely to contribute to a terrorist attack as the vials contain dilute toxin approximately 0.3% of the lethal inhalational dose estimate and 0.005% of the lethal oral dose estimate. Yet if available right before being diluted, it would certainly be an attractive object. Obviously, the toxin is needed for producing a toxoid and an antiserum. 

Increase the availability of medicines specifically adapted and licensed for use in children. 

The availability of medicines in ocular dosage forms is low due to the efficient barrier function of the cornea, lachrymation, tear turn over and drainage. Formulations should take into account these constraints. The vehicle and excipients selected should improve the permeation of the active substances in the eye or the residence in the conjunctival sac and consequently the therapeutic effects, but also minimise irritation. Tolerance of the preparation is of utmost importance. 

Pharmacists will, in their work, reflect on all processes for which they are responsible, with the purpose of improving quality and availability of medicines and hence to minimise any risk of harm to patients. Quality risk management (QRM) offers a structure and tools for a systematic approach to these efforts. The process usually consists of the phases risk assessment (Sect. 21.3.1) (with sub processes risk identification, risk analysis and risk evaluation) and risk control... 

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