CURRICULUM VITAE

NamaNama : Prof. DR.dr.Herri S. Sastramihardja, SpFK : Prof. DR.dr.Herri S. Sastramihardja, SpFK (K).(K).TTL TTL : Cianjur,8 April 1944: Cianjur,8 April 1944AgamaAgama : Islam: IslamPangkatPangkat : Guru Besar / IV-e: Guru Besar / IV-eJabatan Jabatan : : Staff Bag. Farmakologi FK UNPAD / Staff Bag. Farmakologi FK UNPAD /

Farmakologi Klinik RSHS Farmakologi Klinik RSHS Ketua BKU Farmakologi pada program Ketua BKU Farmakologi pada program

pascasarjana pascasarjana UNPAD dan PPCD FK UNPAD dan PPCD FK UNPADUNPAD

Pengalaman bekerja, antara lain :

• Ketua Komite Farmasi dan Terapi RSHS (1994-2005). • Anggota Komite Medik RSHS (1996-2005).• Staf Pengajar / Dosen di beberapa Perguruan Tinggi : - FK UNPAD (sejak 1972) - Pascasarjana UNPAD (sejak 1996) - Program Pascasarjana Combined Degree (PPCD) FK

UNPAD (sejak 2002) - Luar biasa FK UNJANI (sejak 1995). - Luar biasa FK UNILA (sejak 2002) - Pascasarjana ITB (Program S2 Farmasi RS) (sejak

1997) - Dosen tetap FK UNISBA (Sejak 2004)• Ka. Bag. Farmakologi FK UNPAD/Farmakologi Klinik RSHS

(1998-2005).• Anggota Senat UNPAD (sejak 1999).

Drugs Utilities in Medical Drugs Utilities in Medical Practice & Patient Practice & Patient Protection Against Protection Against Counterfeit DrugsCounterfeit Drugs

Herri Herri S.SastramihardjaS.Sastramihardja

Department Of Pharmacology & Department Of Pharmacology & TherapeuticsTherapeutics

Medical School – Padjadjaran Medical School – Padjadjaran UniversityUniversity

IntroductionIntroduction Drug: Any subtance or product which is to

prevent, relieve or cure a pathological state or to explore or influence physiological or pathological mechanism for the benefit of the patient

Prevention & treatment of many diseases or disorder are close-related with medical treatmentmedical treatment

Source of medical treatment Health care facilities

PHC Hospital Private Doctors

Self medication (=SM)

The principal of medication therapy were : to inhibit or cure the disease or disorder

IntroductionIntroduction (continued…)(continued…)

IntroductionIntroduction (continued…)(continued…)

Praktik kedokteran:Rangkaian kegiatan yang dilakukan oleh dr & drg terhadap pasien dalam melaksanakan upaya kesehatan

Dokter dalam melaksanakan praktik kedokteran harus dilakukan sesuai dengan standar pelayanan, standar profesi dan standar operasional prosedur (=SOP)

SOPSOP di di YANKESYANKES formal formalANAMNESAANAMNESA

PENGOBATANPENGOBATAN

PEMERIKSAANPEMERIKSAAN

Dengan Dengan obatobat

TanpaTanpa obatobat

Standar diagnosaStandar diagnosa Standar terapiStandar terapi

EBM ?EBM ?

DIAGNOSADIAGNOSA

WHAT IS EBM ?WHAT IS EBM ?

Evidence-basedEvidence-based medicinemedicine is the is the integration of best research integration of best research

evidence with individual clinical evidence with individual clinical expertice and patient values and expertice and patient values and

expectationsexpectations

EBM - WHAT IT ISEBM - WHAT IT IS

ClinicalExpertise

Research Evidence

Patient Preferences

The aim of any drugs management system :

to deliver the correctthe correct drugsdrugs to the patient who needs that medicine

In order to achieve this goal :Drug therapy should be undertaken in

accordance with principles of rational principles of rational prescribingprescribing

Rational Use of DrugsRational Use of Drugs (RUD)(RUD)

(WHO, 1985)(WHO, 1985)

Occurs when patients receive medication :

Appropriate to their clinical needs in doses that meet their own individual requirements

For an adequate period of time

At the lowest cost to them & their community

(conference of experts on RUD)

Criteria ofCriteria of RUDRUD (WHO, 1987)(WHO, 1987)

Correct diagnosisCorrect diagnosis

Appropriate indicationAppropriate indication

Appropriate Appropriate drugdrug (s) (s)

Approriate dosage, administration & Approriate dosage, administration & duration of treatmentduration of treatment

Appropriate patientAppropriate patient

Appropriate Appropriate informationinformation

Appropriate evaluation & follow-upAppropriate evaluation & follow-up

(Managing Drug Supply, 1997)

Appropriate indication The reason to prescribe is based on medical reasons

Pharmacotherapy is proven to be the best alternatif for treatment

Appropriate drug (s)Considering efficacy, safety, suitability for patient, and cost

Appropriate information• Proper information to the patient

is an integral part of the prescribing

process

• Needed to ensure their correct & safe use and to improve patient compliance

Figure 1. The drug use Figure 1. The drug use ProcessProcess

Prescription Prescription

An instruction from a prescriber to a dispenser

Information must be complete & clear

Give information, Give information, intructions & warningintructions & warning

Effect of the drug

Side effects

Instructions

Warning

Next appointment

Everything clear ?

Irrational use of drugsIrrational use of drugs (= (=IRUDIRUD))

Occurs in all countries

Examples of IRUD :

• No drug needed• Wrong drugs• Ineffective drugs & drugs with doubtful efficacy• Unsafe drugs• Underuse of available effective drugs• Incorrect use of drugs

Classification ofClassification of IRUDIRUD

(Quick, 19881)(Quick, 19881) Extravagant prescribing Over prescribing Incorrect prescribing Multiple prescribing Under prescribing

Self medicationSelf medication SM is the treatment of health

problems without medical supervision.

by using: Non-prescriptions drugs (commonly) Traditional drugs (TD +) Prescriptions drugs:

Pharmacies freely supply drugs to informal shops & small groceries

Re-use of copies of prescription

RUD only partly improve the use of drugs

SM is the most common form of choice & people often rely on informal drug distribution channel (including the possibility of buying medicines through internet)

RUD only partly improve the use of drugs

SM is the most common form of choice & people often rely on informal drug distribution channel (including the possibility of buying medicines through internet)

IRUD, IRUD, the usage of the usage of illegal illegal or counterfeit drugsor counterfeit drugs

Counterfeit DrugsCounterfeit Drugs PhysicallyPhysically, difficult to differentiate

between counterfeit and true drugs

The best alternative laboratorylaboratory examination

Some patient protection against counterfeit drugs: Patient Education Responsible information Regulation etc.

Conclusion Conclusion In order to achieve the goal of In order to achieve the goal of

pharmacotheraphy, the drugs must pharmacotheraphy, the drugs must be used rationally be used rationally

Information must be clearly, acurate Information must be clearly, acurate and not misleadingand not misleading

Patient must be criticised all Patient must be criticised all information about drug information about drug

Thank youThank you