TREATMENT REGIMENS

When to undertake sputum smear examination

If at the end of second month of treatment the patient has a positive sputum smear (indicating poor initial phase supervision or patient compliance, slow rate of progress or MDR tuberculosis) the initial phase is prolonged for a third month. A positive smear at the end of fifth month constitutes treatment failure; patient is re-registered and starts a full course of treatment as a Category 2 patient. In new patients who were initially sputum smear negative it is important to check sputum smear at the end of second month if an error at the time of initial diagnosis was possible or non-adherence to treatment is suspected. Such patients who test sputum positive at the end of second month a full course as category 2 patient is started.

 

Gingival overgrowth has been reported as a consequence of the use of various drugs. The most commonly implicated drug is phenytoin. Certain other drugs like Dihydropyridine calcium channel blockers and cyclosporin have also been reported to exhibit this effect. In a report published by the Australian Adverse Drug Reactions Advisory Committee (ADRAC) 68% of all cases of gingival hyperplasia are attributed to five drugs, viz. Nifedipine(25), Amlodipine(22), Felodipine (14), Phenytoin (13) and cyclosporin (9).

Although it is an unusual side effect, prescribers should be aware of the possibility of gingival overgrowth associated with the long term use of these drugs. It is usually reversible after the offending drug has been withdrawn. Meticulous oral hygiene in the form of plaque control and reduction in dosage may minimise or even prevent the emergence of the effect.

 

( Excerpt from Kenya National Drug Policy )

Promotion and advertising of drug to health professionals must be ethical, factual, educational, balanced in approach and designed to impart non-exaggerated information to prescribers.

Promotional material must be in good taste and not in any way offensive to any segment of society. Major warnings with regard to the dangers of using the advertised product must be included in the advertisement so that they are noticed and clearly understood. The Pharmacy and Poisons Act has a strict provision for misleading and exaggerated claims in any advertisement.

A drug product must not be advertised or launched before registration is complete and the advertisement has been approved.

Promotion and advertising of drugs to the general public must be limited to drugs legally available without prescriptions and should help people make rational decisions on rational use of Drugs.

Advertising must not be addressed directly or indirectly to children and it should not encourage unnecessary or excessive use of medicinal drugs.
Free sample of products registered for sale in Kenya may be provided only in moderate quantity to the prescribers only on request and should not be sold.

 

Drug Panorama encourages reporting of all suspected adverse reactions to drugs or medicinal substances The reporting of such reactions will lead to a better understanding of drug reactions in the Indian context and allow us to identify and deal with these in an efficient manner. The following are especially of interest: Suspected reactions to new drug; drug interactions, reactions to herbal products, drugs which in your experience lead to increased morbidity and mortality