Проблемные лекарства

Учитывая такую рекламу продуктов, которые мало или совсем не отвечают нуждам общественного здоровья, давно настало время для гораздо более жестких мер. Ясно, что почти половина противодиарейных продуктов, имеющихся сейчас на рынке, может и должна быть изъята, поскольку они содержат ненужное противомикробное средство. Если фармацевтическая промышленность не готова добровольно изъять эти продукты, в таком случае правительства и регламентирующие органы могут запретить их продажу.

Рекомендации к действию

Следует немедленно убрать с рынка лекарств противодиарейные продукты, содержащие неомицин, стрептомицин/дигидрострептомицин, хлорамфеникол, или плохо всасываемые сульфаниламидные препараты.

Источники

1. WHO, A Manual/or the Treatment of Acute Diarrhoea, Doc No WHO/CDD/SER/80.2, Geneva, 1980, p13.
2. WHO, The rational use of drugs in the management of acute diarrhoea in children, Geneva, WHO, 1990, pp31 & 33.
3. Scanlon, С., "Unsafe drugs find buyers abroad", Detroit Free Press, 20 May 1991, p4A.
4. Anon., "Antidiarrhoeals again under attack", Scrip, No 1457, 20 Oct 1989, p29.
5. Anon., "Misuse of antidiarrhoeal medicines", Lancet, 21 Oct 1989.
6. Chetley, А., A Healthy Business? World Health and the Pharmaceutical Industry, London, Zed Books, 1990, p79.
7. Lanza, O. and Kerkvliet, E., Ojo con los antidiarreicos: el abuso de antidiarreicos en America Latina, Montevideo, AIS/IOCU, 1991, pp35-40.
8. Tomson, G., Sterky, G., "Self-prescribing by way of pharmacies in three Asian developing countries", Lancet, 13 Sep 1986, pp620-1.
9. Berih, A.A., Mclntyre, L., Lynk, A.D., "Pharmacy dispensing practices for Sudanese children with diarrhoea", Public Health, Vol 103, 1989, pp455-8.
10. Yudkin, J.S., "Dispensing of inappropriate medicines for diarrhoea", Lancet, 31 Mar 1990, p803.
11. Cruz, H., Paredes, P., and Haak, H., Medicamentos Inapropiados en Diarrea: La magnitud del problema, Lima, Peru, Pan-American Health Organisation, Nov 1989.
12. Carnere, R.C., "India: ORT survey", Dialogue on Diarrhoea, No 29, June 1987, p2.
13. Phillips, M., Kumate-Rodriguez, J., and Mota-Hern?ndez, F., "Costs of treating diarrhoea in a children's hospital in Mexico City", Bulletin of the World Health Organization, 67:3, 1989, pp276.
14. Nastasi, A., Massenti, M.F., Scarlata, G., et al, "A study on oral rehydration therapy of diarrheal disease in western Sicily", European Journal of Epidemiology, Vol 3, No 2, June 1987, pp151-4.
15. Quanico, U.T., "Antidiarrhoeals in the Philippines", The Drug Monitor, Vol 2, No 6, June 1987 (117 out of 194 antidiarrhoeal products were found to contain antibiotics); see also: Tan, M.L., Dying for Drugs, Manila, Health Action Information Network, 1988, pp85-88.
16. Parish, P., Medicines: a guide for everybody, London, Penguin (6th edn, revised), 1989, p144.
17. BMA and the Royal Pharmaceutical Society of Great Britain, British National Formulary, London, BMA and The Pharmaceutical Press, No 21, March 1991, p36.
18. Reynolds, J.E.F. (ed.), Martindale: The Extra Pharmacopoeia, London, The Pharmaceutical Press, (29th edn) 1989, p105.
19. WHO, 1990, op cit, pp25-6.
20. Reynolds, J.E.F., op cit, p216.
21. WHO, 1990, op cit, pp28 & 34.
22. Ibid.
23. Reynolds, J.E.F., op cit, p106.
24. Gilman, A.G., Rail, T.W., Nies, A.S., and Taylor, P., Goodman and Gilman's The Pharmacological Basis of Therapeutics, New York, Pergamon Press, (8th edn) 1990, p1128.
25. Pratt, W.B. and Fekety, R., The Antimicrobial Drugs, Oxford, Oxford University Press, 1986, p193.
26. Pecoul, В., Varaine, F., et al, "Long-acting chloramphenicol versus intravenous ampicillin for treatment of bacterial meningitis", Lancet, Vol 338, No 8771, 5 Oct 1991, pp862-6.
27. Enenkel, S. and Stille, W., Antibiotics in the Tropics: antibacterial therapy with limited resources, Berlin, Springer-Verlag, 1988, p14.
28. Reynolds, J.E.F., op cit, p108.
29. WHO, 1990, op cit, pp43-9.
30. Gilman, A.G., op cit, p1052.
31. WHO, 1990, op cit, p48.
32. Ibid., p3.
33. Tomson, G., op cit.
34. Pratt, W.B., op cit, p144.
35. Reynolds, J.E.F., op cit, p661.
36. Gilman, A.G., op cit, p1138.
37. Pratt, W.B., op cit, p255.
38. BMA, op cit, p225.
39. Reynolds, J.E.F., op cit, p234.
40. Reynolds, J.E.F., op cit, p 1595.
41. Ibid., p288.
42. Ibid., p968. 43
43. Salam, M.A. and Bennish, M.L., "Antimicrobial therapy for Shigellosis", Reviews of Infectious Diseases, Vol 12, Suppl 4, Mar-Apr 1991, pS336.
44. Pratt, W.B., op cit, p153.
45. Gilman, A.G., op cit, p1006.
46. Ibid.
47. O'Sullivan, J., "Pills for profit or saving lives?", Catholic Herald, 14 Nov 1986.
48. Ibid.
49. Quanico, U.T., "Antidiarrhoeals in the Philippines", The Drug Monitor, Vol 2, No 6, June 1987, p10.
50. Anon., "Parke-Davis/Warner Lambert: Oral streptomycin chloramphenicol combination", MaLAM Newsletter, ]ua 1987.
51. Anon., "Antidiarrheals in the Philippines ? How safe, how effective?", The Drug Monitor, Vol VI, No 3, Mar 1991, p35.
52. Letter from MaLAM to Wyeth, July 1991. See: MaLAM Newsletter, Nov 1991.