Rational Drug Use and Pharmacist: Rational drug use refers to drug therapy, which is safe, effective, economic,

used only when required. Rational drug use requires adequate diagnosis; correct prescribing of drug or non-drug treatment, and correct dispensing of medication and patient adherence(compliance)with treatment.

Importance of rational drug use: Decisions about when to prescribe, what to prescribe, how much to prescribe and how long to prescribe are becoming increasingly complex because of ever increasing number of drugs. Poor drug information and inadequate training to under graduates lead to irrational drug use. This ultimately leads to unsafe and ineffective treatment, worsening of prolonged illness, ADR's highly expensive therapy ,length of stay increases .Some times ADR's may be fatal. SO here comes the pharmacist as a caretaker

Pharmacist Role In RDU. Pharmacist's role is very important in promoting rational drug use by providing following services to the patients as well as health care professional 1) Patient counselling 2)Drug information 3)ADR reporting and management 4) Drug therapy monitoring 5)Conducting educational workshops to the Doctors and other health care professionals 6)Preparing standard therapeutic guidelines 7) Development of formulary 8) Research on drug utilization evaluation

Patient Counseling Patient counseling is one of the major important factor in promoting rational drug use. It consists of following factors: Dose, duration and frequency Possible ADR's Management minor side effects Prevent relapse by completing the course Especially elderly patients demand to prescribe the hematonics, so advised to the patients to take nutrient food and fruits instead of taking hematonic preparations.

Drug Information Drug information forms a part in promoting RDU because lack of unbiased information leads to irrational drug use. Provide unbiased information about new drugs. Drug information is also needed because more existence of new drugs and availability of more than 60 thousands formulations in India.

ADR Reporting and Management Clinical pharmacist play a vital role in reporting and management of many ADR which is due to irrational prescribing under diagnosis, more than 4 drugs in one prescription may lead to ADR, 8-10% of hospital admissions may develop ADR's. Using a prophylaxis to other drugs to prevent future ADR's. Eg: pyridoxine should be given with ATT (antitubercular drugs) drugs to inhibit the occurrence of peripheral neuropathy. Relative efficacy and safety of alternative therapies. Eg: if patient is allergic to penicillin choose other alternatives like Amoxycillin.

Documentation of ADR's is necessary to avoid reexposures.

Drug Therapy Monitoring It improves RDU by ensuring that the patient is receiving the proper dose in a proper way. Minimizing the problems by regular monitoring Managing any drug related problems It improves the quality of life of patient Eg: physician prescribed Imax (B-Complex) but patient receiving Imox (Amoxycillin)

Conducting Education Programmes Sometimes students or junior doctors are only expected to copy the prescribing habits of their clinical teachers or senior doctors, without any explanation as to why certain treatment should be given. To be spread the principles of RDU amongst the doctors and the pharmacists.

Formulary development Formulary contains a list of drugs that should be widely used in the hospital. The prescriber and physician should know about the efficacy, safety, quality, stability, ease of storage, price, availability and the other adverse effects.

Preparing Standard Therapeutic Guidelines It is a very important tool; by preparing standard guidelines we can promote the RDU. The pharmacist including microbiologist prepare this guidelines. The treatment guidelines seems to have a positive impact towards the therapeutically effective and economic use of drugs. Guidelines are systematically developed statement that helps

clinician to decide in appropriate treatment for specific clinical conditions. Eg: in respiratory disease there are many treatment options but the standard therapy guidelines contains only few options and they are cost effective too.

Research On DUE DUE is a quality assurance/management activity for drug therapy. Its purpose is to promote rational and economical drug use and improve drug therapy outcomes or in general describes the application of quality assurance principle to drug use. E.g.: drug utilization evaluation of antibiotics.