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Belize Drug Formulary and Therapeutics Manual

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Belize Drug Formulary and Therapeutics Manual BELIZE DRUG FORMULARY AND THERAPEUTICS MANUAL NINTH EDITION 2009 - 2011 MINISTRY OF HEALTH UUntitled-1ntitled-1 1 110/16/20080/16/2008 99:52:22:52:22 AMAM BELIZE DRUG FORMULARY AND THERAPEUTICS MANUAL NINTH EDITION 2009 - 2011 Prepared by: BELIZE NATIONAL FORMULARY COMMITTEE MINISTRY OF HEALTH TEL: 501-8222325/8222365 FAX: 501-8222942/8222055 UUntitled-1ntitled-1 3 110/16/20080/16/2008 99:52:56:52:56 AMAM All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means electronic, mechanical, photocopying, recording or otherwise- without the prior written permission of Belize Ministry of Health. Published - 2008 Under the authority of The Honourable Minister of Health UUntitled-1ntitled-1 4 110/16/20080/16/2008 99:52:56:52:56 AMAM CONTENTS Belize National Formulary Committee i Acknowledgemnt ii Preface iii UUntitled-1ntitled-1 5 110/16/20080/16/2008 99:52:56:52:56 AMAM Abbreviations ACE angiotensin-converting enzyme ADR adverse drug reaction AIDS acquired immunodeficiency syndrome AV Atrioventricular BP British Pharmacopoeia BSA body surface area CNS central nervous system CSF cerebrospinal fl uid DMARD disease-modifying antirheumatic drug ECG Electrocardiogram EEG Electroencephalogram G6PD glucose 6-phosphate dehydrogenase GFR glomerular fi ltration rate HIV human immunodefi ciency virus HRT hormone replacement therapy INR international normalized ratio MDI metered dose inhaler NSAID nonsteroidal anti-infl ammatory drug spp. Species SSRI selective serotonin reuptake inhibitor USP United States Pharmacopeia UUntitled-1ntitled-1 6 110/16/20080/16/2008 99:52:56:52:56 AMAM i The Drug Formulary Committee Chairperson Mrs. Sharon Sanchez-Anderson Members Mr. Anslem Anene (Deputy Chairperson) Mrs. Samira Gongora, Mr. Eugene Echegi, Ms. Angella Ebuta, Dra. Adelita Ghazy, Dr. Fernando Cuellar Dr. Jesus Ken Mrs. Dana El-Amin (Secretary) UUntitled-1ntitled-1 7 110/16/20080/16/2008 99:52:56:52:56 AMAM ii Acknowledgements The ninth edition of the Belize National Drug Formulary was modeled off the fi rst WHO Model Formulary The Ministry of Health would like to acknowledge the contributions of the following persons towards the preparation of the ninth edition of the Belize National Formulary: • The chairperson and members of the formulary committee • Medical consultants and specialists within the Ministry of Health and Non-Government organizations in Belize • British Medical Association and the Royal Pharmaceutical Society of Great Britain for permission to use material from the British National Formulary of which they are joint copy right holders and are not responsible for the accuracy of the transpositions from the original text • PAHO/WHO • Management and staff of Matron Robert’s Polyclinic 11 for their assistance and hospitality during the preparation of the document UUntitled-1ntitled-1 8 110/16/20080/16/2008 99:52:56:52:56 AMAM iii Preface The ninth edition of the Belize National Formulary is be- ing reviewed fi ve years after the previous edition of 2002. In 2002 a review of the formulary was conducted with a consultancy by the consultant of the Barbados Drug Service, Ms. Pamela Payne. From that consultancy an essential Drugs list was developed, but there was no manual produced due to administrative diffi culties. This edition of the formulary was conducted under the directorship of the Chief Pharmacist/ Technical Advisor of the Ministry of Health Mrs. Sharon Sanchez-Anderson and her competent team of Pharmacists and Doctors(: Mr. Anslem Anene, Mrs. Samira Gongora , Mr. Eugene Echegi, Mrs. Dana El-Amin, Ms. Angella Ebuta,Dra. Adelita Ghazy, Mrs. Sharon Sanchez-Anderson along with Dr. Fernando Cuellar and Dr. Jesus Ken), all Be- lizean Nationals and past Nigerian Technical Aid Corps representatives. Pharmaceuticals have assumed an increasing important role in the management of many diseases and therefore the rational use of medication provides an effi cacious and cost effective means of treating these diseases. The design and layout of the text has been adopted from the World Health Organization model formulary to produce an updated, more user friendly and attractive quick reference guide. The formulary committee revised submissions by all specialties and eventually agreed on sixty-nine (69) product additions and twelve (12) dele- tions during a two days stake holder’s workshop held to obtain the fi nal consensus on the list of drugs to be added and deleted. The drug listed in the formulary corresponds to the health care needs of the vast majority of the popula- tion taking into consideration the prevailing economic climate. A selected list of different drug products has an important infl uence on several key fi scal administrative and quality control requirements of the pharmaceutical logistics system. UUntitled-1ntitled-1 9 110/16/20080/16/2008 99:52:57:52:57 AMAM iv With regards to drug procurement, purchasing power is greatly enhanced by the elimination of duplicate and non-essential products. On the clinical side, doctors are assured that the most effective and safe drugs ( Drug of Choice) were selected for inclusion. It must be emphasized that the adoption of the formulary is not and arbitrary administrative or economic measure, but a therapeutically oriented tool to increase the availability of essentials drugs. However, in order for a drug formulary to exert its maximum impact on the care and cost of re- quirement of the health care system, its implementation and use must be mandated by regulation. I trust, therefore, that my peer and other health care providers will strictly adhere to the drugs listed in this formulary bearing in mind that provision has been made for specially authorized drugs (SAD) in exceptional cases….. Sharon Sanchez-Anderson (Mrs.) Chief Pharmacist./Technical Advisor Ministry of Heath UUntitled-1ntitled-1 1100 110/16/20080/16/2008 99:52:57:52:57 AMAM v DRUGS ADDED TO THE 9TH EDITION OF THE FORMU- LARY MANUALDRUGS ADDED TO THE 7TH EDITION OF THE FORMULARY MANUAL UUntitled-1ntitled-1 1111 110/16/20080/16/2008 99:52:57:52:57 AMAM vi Products Recommended For Addition PRODUCT, STRENGTH Sevofl urane, Inhalation bottle Midazolam, inj, 15mg Indomethacin, suppository 100mg Paracetamol, suppository 100mg Metamizole, inj, 25,000iu,1g/2ml,500mg tab Loratadine, tab 10mg Valproic acid, 500mg Clonazepam, 2 mg Lamotrigine, tab 25 mg Amoxicillin + clavulanic acid, tab 500mg +125 mg Imipenem + cilastatin, Azithromycin, cap, 500 mg; susp 200mg/5ml Fluconazole, cap, 200mg, 150 mg, inj 2mg/ml,susp 50mg/5-ml Griseofulvin, susp, 10mg/ml Nystatin, loz 100,000 iu, cream/ointment Ketoconazole, tab, 200mg,cream,shampoo Amphotericin B, inj, 50 mg/vial Flucytocine, inj, 2.5 g Oseltamivir, cap, 75mg; susp 60 mg/5-ml Abacavir (ABC), oral solution ,100mg(as sulphate)/5ml Didanosine (ddl), powder for oral solution, 2g/bottle Ritonavir, caps,100mg lopinavir +ritonavir (LPV/r), susp, 20mg/80mg; 160ml Tinidazole, tablet,500mg Sumatriptan (imigran), tab, 50 mg Ciclosporin, cap, 25mg, inj, 50mg/ml Biperidine, tablet, 4mg Levodopa +Carbidopa, tab,250 mg +25mg Losartan (cozaar), tab,25mg; 50mg Nimodipine, cap,30mg Metoprolol, tan, 50 mg, 100mg,inj 1 mg/ml-5ml amp Streptokinase, powder for inj, 1.5 million IU/vial Simvastatin, tab, 10mg,20mg Gemfi brozil, tab. 300 mg,600mg Niacin, tab, 600mg Betamethasone, cream or ointment, 0.1% (as valer- ate) Salicylic Acid, Solution, 5% Permethrin, cream 5%; lotion 1% Ranitidine, oral solution 75mg/5ml Omeprazole, tab, 20 mg;inj 40mg Dimenhydrinate, tab, suppository 10m UUntitled-1ntitled-1 1122 110/16/20080/16/2008 99:52:57:52:57 AMAM vii Metformin, tab, 850mg Pyridostigmine, Syrup Mivacurium, inj, 2 mg/ml 5-ml amp Chloramphenicol +prednisolone acetate, solution,2.5 + 5mg/ml Neomycin/polymixin/hydrocortisone, otic drops,0.35%/10,000/1% Ciprofl oxacin, otic drops,0.2% Oxymetazoline, nasal drops, 0.5% Ritodrine, inj 10mg/ml, 5-ml amp Haloperidol, LA, liquid prep Quetiapine (seroquil), tab, 50 mg, 100 mg Ritalin (methylphenidate), tab, 10 mg,20 mg SR Beclometasone, inhal(aerosol),50 mcg/ dose(dipropionate) Montelukast, tab, 10 mg,20 mg SR Prednisolone, syrup,15mg/5ml,60ml Salmeterol, inhal(aerosol) LA Morphine, oral solution 10 mg(hydrochloride or sulphate)/5ml Morphine, tab.,10 mg (sulp), Morphine, 30mg CR (sulphate) Hydromorphone, tab.,4 mg,tab, CR 3 mg Oxycontin , tab,.CR, 20mg,IR 10mg Methadone, Powder, 1 mg/ml Penicillamine, cap., or tab 250 mg Methylthioninium chloride(methylene bl), inj., 10mg/ml in 10-ml ampoule Prazequantel, tab.,150 mg, 600 mg Clozapine, UUntitled-1ntitled-1 1133 110/16/20080/16/2008 99:52:57:52:57 AMAM vi PRODUCTS RECOMMENDED FOR DELETION Lidocaine inj, 1%; topical 2% Sabutamol inj Cimetidine 200mg/2ml inj Naphazoline + Antazoline opthalmic 0.05% +0.5% Budesonide aerosol spray inhaler, 200 mcg Chlopropamide tab, 250 mg Tolbutamide tab,500mg Valproic acid cap, 250 mg, replace with enteric coated tab UUntitled-1ntitled-1 1144 110/16/20080/16/2008 99:52:57:52:57 AMAM SECTION 1 GUIDE TO RATIONAL PRESCRIBING UUntitled-1ntitled-1 1155 110/16/20080/16/2008 99:52:57:52:57 AMAM 2 Rational Prescribing PRESCRIPTION WRITING The writing of prescriptions is a vital component of the pre- scriber’s manage ment of a patient. The written prescription is a means of direct communica tion from the doctor to the dispensing pharmacist. It is also an important legal docu- ment. Careful prescription writing reduces time spent by the pharmacist in contacting the doctor for clarifi cation, improves patient compliance, and reduces life-threaten ing errors. It is therefore impera tive that sound guidelines for prescription writing be established and followed scrupulously. Legibility is most important. Poor writing leads to many kinds of errors. The patient should be told the name of the drug and asked to commit it to memory. Many drug names are similar so care must be taken to write them clearly.
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