CURRICULUM VITAE Nama : Prof. DR.dr.Herri S. Sastramihardja, SpFK (K).

1. CURRICULUM VITAE Nama : Prof. DR.dr.Herri S. Sastramihardja, SpFK (K). TTL : Cianjur,8 April 1944 Agama : Islam Pangkat : Guru Besar / IV-e Jabatan : Staff Bag. Farmakologi FK UNPAD / Farmakologi Klinik RSHS Ketua BKU Farmakologi pada program pascasarjana UNPAD dan PPCD FK UNPAD

2. 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).

3. Drugs Utilities in Medical Practice & Patient Protection Against Counterfeit Drugs Herri S.Sastramihardja Department Of Pharmacology & Therapeutics Medical School – Padjadjaran University

4. Introduction • 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 treatment

5. Introduction(continued…) • 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

6. Introduction(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)

7. SOP di YANKES formal ANAMNESA PEMERIKSAAN DIAGNOSA PENGOBATAN Dengan obat Tanpa obat EBM ? Standar diagnosa Standar terapi

8. WHAT IS EBM ? Evidence-basedmedicine is the integration of best research evidence with individual clinical expertice and patient values and expectations

9. Clinical Expertise Research Patient Evidence Preferences EBM - WHAT IT IS

10. The aim of any drugs management system : to deliverthe correctdrugsto the patient who needs that medicine • In order to achieve this goal : Drug therapy should be undertaken in accordance withprinciples of rational prescribing

11. Rational Use of Drugs(RUD) (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 onRUD)

12. Criteria ofRUD(WHO, 1987) • Correct diagnosis • Appropriate indication • Appropriate drug (s) • Approriate dosage, administration & • duration of treatment • Appropriate patient • Appropriate information • Appropriate evaluation & follow-up (Managing Drug Supply, 1997)

13. 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

14. Appropriate information • Properinformation to the patient is an • integral part of the prescribing process • Needed to ensure their correct & safe use and to improve patient compliance

15. Figure 1. The drug use Process

16. Prescription • An instruction from a prescriber to a dispenser • Information must be complete & clear

17. Give information, intructions & warning • Effect of the drug • Side effects • Instructions • Warning • Next appointment • Everything clear ?

18. Irrational use of drugs (=IRUD) • 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

19. Classification ofIRUD (Quick, 19881) • Extravagant prescribing • Over prescribing • Incorrect prescribing • Multiple prescribing • Under prescribing

20. Self 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

21. IRUD, the usage of illegal or counterfeit drugs • 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)

22. Counterfeit Drugs • Physically, difficult to differentiate between counterfeit and true drugs • The best alternative  laboratory examination • Some patient protection against counterfeit drugs: • Patient Education • Responsible information • Regulation • etc.

23. Conclusion • In order to achieve the goal of pharmacotheraphy, the drugs must be used rationally • Information must be clearly, acurate and not misleading • Patient must be criticised all information about drug

24. Thank you