Drug Information Bulletin (electronic)

Volume: 4

Drug Information Centre (DIC) Indian Pharmaceutical Association, Bengal Branch Tele fax: 033 24612776, E-mail: ipabengal.dic@gmail.com Web Site: http://www.ipabengal.org Contact: 09830136291

Number: 05

Content
Bare-handed Counting of Medicines have serious health implication India's Cancer Drug Market to Grow 16% Annually For Next Five Years Drug Resistance Gets a Hearing on Capitol Hill FDA Approves New Delivery Method For Injectable Form Of Cefepime India, Brazil Accuse EU Of Confiscating Generic Indian Drugs

Annual General Meeting

of IPA, Bengal Branch 6th June 2010 at IPA, Auditorium at 6.00 pm. and may not work properly. This can have serious health implications. Why is counting medicines with bare hands a problem? Using bare hands to count and dispense medicines can lead to contamination of the product. When medicines come into prolonged contact with skin, moisture, oils, bacteria and viruses can be transferred directly to the tablets or

Bare-handed Counting of Medicines have serious health implication People everywhere expect the medicines they receive in hospitals, clinics, pharmacies and drug shops to be of good quality. But often medicines are dispensed by counting them out with bare hands. Through this practice, the medicines can become contaminated

2 capsules. This can cause the medicine not to work as well, as it should or it might even make the patient more ill. Contaminated medicine could be especially problematic for persons who are at high risk of infection, including children or adults living with HIV or AIDS. Bare hand dispensing not only contaminates the medicine that is given to the patient today, but it can also taint the remaining stock in the product container, causing problems for future patients. In addition, when dispensers count different types of tablets with their bare hands, one straight after another, the powder residue can be transferred between products and this might lead to an allergic reaction being attributed to the wrong medication. This could reduce access to effective agents or increase the unnecessary use of more expensive medicines. Medicines must be handled very carefully during the dispensing process. There are some guidelines that describe the characteristics of a good dispensing environment. They include having adequate equipment, performing regular equipment cleaning, and following good staff hygiene practices. But strict implementation of these guidelines has been a challenge in the developing world. In fact, despite a long history of informal campaigns to promote appropriate dispensing practices, the bare hand counting of medicines remains fairly common in Africa, Central Asia, South East Asia and several Latin American and Caribbean countries. This is possibly because health workers and pharmacy support staff are not provided with enough knowledge about good dispensing practices, they dont have access to the necessary equipment, and standards are only enforced in a limited way. What can we do to improve the quality of care provided? Train health workers to dispense medicines properly Ensure access to suitable dispensing equipment Enforce standards for good dispensing Raise awareness in the public

India's Cancer Drug Market to Grow 16% Annually For Next Five Years Bloomberg News reports, "India's cancer-drug market, valued at about $271 million, will grow 16 percent annually for the next five years, driven by increased demand for the latest tumor-fighting therapies, Datamonitor Group said." Datamonitor also said the Indian market for cancer drugs "may reach $559 million by 2014." Drug Resistance Gets a Hearing on Capitol Hill Drug resistance finally got its day on Capitol Hill last week when the House Energy and Commerce Health Subcommittee held a hearing on the topic. The event signaled interest in two ways: first, by the expert witnesses the panel invited, Anthony Fauci of the National Institutes of Health and Thomas Frieden of the Centers for Disease Control; and second, by the number and importance of the subcommittee members who attended.

3 Fifteen members joined the subcommittees chairman, Frank Pallone (D-N.J.), and ranking member, John Shimkus (R-Ill.), including Rep. Henry Waxman (D-Calif.), chairman of the full committee, Rep. John Dingell (D-Mich.), Waxmans predecessor as chairman, and two major supporters of legislation designed to tackle problems caused by drug resistance, Reps. Jim Matheson (DUtah) and Jan Schakowsky (D-Ill.). This is the kind of serious, high-level attention we need to meet the challenge of drug resistance, a growing crisis that is undermining the global health communitys efforts to treat malaria, HIV, tuberculosis, and a range of other diseases in both developing countries and wealthier nations. Reminding us that local often trumps global, nearly every member in attendance mentioned the large and growing number of hospital-acquired infections that are resistant to at least one common antibiotic, and many expressed concern over methicillinresistant Staphylococcus aureus (MRSA), citing infections or deaths in their home states. Most of the legislators questions dealt with the use of antibiotics in feed animals and agriculture, one key aspect of drug resistance that would benefit from substantial further research. The use of antibiotics in animals has received much of the attention paid to drug resistance because it represents a deep struggle between agriculture and health interests. But, as the panels witnesses indicated, there are other issues that are far less controversial and politically charged. Dr. Fauci testified that any strategy to address drug resistance must include proper surveillance of its spread as well as infection control, the rational use of antibiotics, and sufficient biomedical research. Dr. Frieden told the subcommittee that increasing resistance leads to greater death rates and higher health-care costs, and said we must improve and monitor the use of existing antibiotics while developing new drugs. Without action, he said, we may enter a post-antibiotic world. Thats a frightening prospect, but one that we have the ability to avoid. Next month, CGDs expert Drug Resistance Working Group will release a report, more than two years in the making, on the steps necessary to meet this global challenge. In line with Dr. Fauci and Friedens statements, the Working Group strongly emphasizes the importance of improved surveillance to understand where and how resistance is spreading. Collectively, the Groups recommendations urge coordinated international action across all infectious diseases. Its good to see that Congress seems ready to be part of that effort. ** Copied for fair use from Centre For Global Development FDA Approves New Delivery

Method For Injectable Form Of Cefepime MedPage Today reported, "The FDA has approved a new delivery method for an injectable form of the antibiotic cefepime," which is "for use in manufacturer B. Braun's Duplex IV bag drug delivery system." The "system package contains a powdered form of the drug, as well as diluent, which must

4 be combined by breaking a seal separating the two components, then shaking to mix the elements, and squeezing so the resulting solution can be administered." The antibiotic "is used to treat or prevent bacteria related to pneumonia, urinary tract infection, skin structure infection, complex intraabdominal infection, and as an empiric therapy for febrile neutropenic patients." India, Brazil Accuse EU Of Confiscating Generic Indian Drugs Bloomberg News reports, "India and Brazil complained to the World Trade Organization about European Union customs rules, saying the EU has wrongfully confiscated generic Indian medicines used to treat illnesses such as AIDS and hypertension." India also "says its pharmaceutical companies...face obstacles in the US and Europe as patent holders, fearing loss of profits, use litigation to prevent the entry of cheaper generic rivals." The EU "says 17 shipments of Indian-made generic medicines have been seized in transit at European ports on the grounds of alleged patent infringement." AFP notes that "Brazil's ambassador Roberto Azevedo claimed that the seizures 'have a highly negative systemic impact on legitimate commerce, on south-south trade and national health in the developing countries.'" Readers Column: Dear Dr. Mandal and Team, Heartiest congratulations for the successful completion of three years, its really a big task. it's very easy to start a bulletin, but tough to maintain it with quality articles and time bound publication. I salute to you and your team. Is it possible to send me all 156 ecopies at your convenience? Regards
Nitin N. Maniar
Cell-98212 94060 (Alternate email-samarpanbb@gmail.com) -Ex C.C. Member Pharmacy Council of India -Mentor Indian Pharmaceutical Association's Students Forum -Hon.Treasurer Indian Pharmaceutical Association, Maharashtra State Branch -Chairman, Governing Body Bombay College of Pharmacy -E.C.Member Indian Pharmaceutical Association, Community Pharmacy Division -Jt.Secretary The Retail & Dispensing Chemists Association, Mumbai -Hon.Gen.Secretary North East Zone Chemists Association -Trustee Sarvodaya Hospital Samarpan Blood Bank Yuvak Pratishthan Samarpan Arogya Kendra