Medical Health Information

What is the "proper drug use"?

"Good use of the drug" is a goal shared by all the actors of a therapeutic drug. "Good use of the drug" refers to the patient, caregivers, the pharmaceutical industry, public authorities, the Health Insurance ... The "proper drug use" is to mitigate the adverse effects of products to treat and cure in taking informed and responsible behavior vis-à-vis consumption. "Good use of the drug" is just to eat better care.

What are the requirements of compliance with the "proper drug use"?

The drug brings significant benefits, but also risks: four out of ten suffer from adverse reactions to medication. Each year, there are nearly 130,000 hospitalizations due to adverse drug. 32% of patients over 70 years, hospitalized for emergency adverse effects related to their treatment, consume more than ten medications daily (study Cnam 2004)!

Beyond these issues of public health, the economic empowerment of drugs and their misuse burden on the community.

How can the "proper drug use"?

Any drug use must be weighed and considered by both the physician and the patient. It should not require a prescription to get busy satisfied with the surgery 90% of physician visits end with a prescription drug!

Prescribers, pharmacists, providers should clearly explain the treatment to each patient doses, frequency and timing of catch, length of treatment, precautions, compliance against - indications food or other ...

Dosage form (layout) of the drug is an important means of promoting "good use". The adaptation of the form to different categories of patients is essential: oral liquid for children and the elderly who have difficulty swallowing, packaging boxes available dose-limiting to prevent accidental or intentional poisoning ...

How not to be mistaken for medicine?

Still referring to the International Nonproprietary Name (INN). This international name set by WHO avoids consuming several times the same drug at the same time under trade names (specialties) different.

This effectively limits the overdose: eg, acetaminophen is present in many specialties against pain and fever available without a prescription. Believer in making different products, it is common to combine large doses of this drug, doses harmful to the liver and kidneys.

DCI can easily find his medicine abroad, regardless of the different trade names.

How to does one find in the numerous names of drugs?

International Nonproprietary Name (INN) allows patients and caregivers around the world to navigate despite the many trade names. DCI is the name of the active substance (molecule) contained in the medicine and internationally recognized. There are over 8000 brand names for only 1700 DCI! This is WHO has established the DCI program. The objective is to develop, for each substance used, a specific name, recognizable and pronounceable in all countries of the world.

The drugs are at odds into dissimilar groups according to the organ (heart, kidney ...) or system (respiratory system, nervous system ...) on which they act and / or their therapeutic characteristics (diuretics ...) and chemicals.

How are developed DCI?

ICDs are developed by a limited length of name used in the public domain (for generic). ICDs often incorporate "segment key" to recognize the substances of the same pharmacological group and / or chemical. Key segments are suffixes, prefixes, and syllable groups (intermediate segments).

Thus, the suffix "olol" is common, for example beta-blockers (atenolol, propranolol ...) used in cardiology.
The suffix "azepam" is common to benzodiazepines (diazepam, tetrazepam ...) used as anxiolytics or hypnotics such as (1).

What are the general guidelines for the formation of DCI?


ICDs are distinguished from each other by their sound and spelling. DCI should, if possible, show this relationship pharmacological. Those that evoke an anatomical, physiological, pathological or therapeutic avoided. To facilitate the translation and pronunciation of INN, "f" is used instead of "ph", "t" instead of "th", "e" instead of "æ" and "œ" and "i" instead of "y", the use of letters "h" and "k" is avoided.

How are drugs classified?

System Anatomical Therapeutic Chemical (ATC) is used to classify drugs according to the organ or system on which they take action and / or according to their therapeutic and chemical characteristics. This is the "Collaborate Centre for Drug Statistics

Methodology" of WHO control.
Drugs are also classified as "therapeutic families," that is to say, principles of therapeutic action.

For example, analgesics (paracetamol, ibuprofen, aspirin ...) are medicines that act against the pain everyone differently, but at the same goal of reducing pain.

The infectives are of the same family that includes antifungal (against fungi), antibiotics (bacteriostatic and / or bactericidal) and antiviral (against viruses).

For the sake of simplicity, these families have been linked to a medical specialty, eg infectious diseases to the above treatments. However, a medical specialty may appeal to another specialty drugs for a specific purpose. For example, a cardiologist may lower blood pressure due to stress with "anxiolytic" drugs under psychiatric specialty yet.

Possibly by reusing previously prescribed treatments (during a previous episode for the same reason), drawing from the family medicine cabinet or seeking advice from their pharmacist. All these cases are self-medication.

A telephone survey CSA / CECOP conducted in February 2007 for the Mutuality with 1010 major issues (February 2007) reports that 40% of the population, it is automediquer heal itself without the help of a doctor and for 30% it is only through a pharmacist, 15% is to choose self-medication for treatment.

In what circumstances automediquer?
Against a benign disease, known patient, for whom he makes a autoprescription. At best, you should consult the Vidal ® dictionary of self-medication, which provides a number of recommendations and safety advice. Even aspirin (medication classic family) is dangerous in the elderly; paracetamol too often absorbed a risk toxic to the liver and kidneys.

What is the physician's role in self-medication?
The doctor may well prescribe medications without prescription. This is a good way to indicate the correct circumstances of autonomous consumption. In the best case, it becomes co-manager of rational self-medication, guiding and responding positively to the request of the patient.

What is the role of the pharmacist?

30% of patients refer to their pharmacist before purchasing a product of self-medication. They may be more numerous because the pharmacist is a valuable advisory. It is able to play its full role and can usefully contribute to the education of the user.

We find no definition of self-medication in the Code of Public Health because it is not a treatment but a behavior, practiced by 80% in certain circumstances. It is to prescribe self-medication without medical intervention. This implies that one feels able to take care of themselves independently for minor illnesses (colds, headaches, sore throat, constipation, skin problems, hemorrhoids).

Without a clear definition, it is difficult to ensure the safety of self-medication, even if the drugs known as "non-mandatory requirement" received authorization on the market (AMM) as any medicine. This ensures their clinical efficacy, therapeutic and toxicological.

What products are self-medicating?

Drugs that are freely available without a prescription. They cover products family medication, officinale, consulting, specialty consumer and prescription drugs optional. This represents 6.1% of total drug market (figures Afipa 2007).
For example, the elderly consume preferentially self-medication: analgesics to alleviate pain phenomena present in 45-70% of them, osteoarticular pain related to aging in particular, anti-inflammatory, laxatives, sedatives and anxiolytics.

What are the legal and health issues?
Practiced at all times, self-medication, the legitimate autonomy or risky that is attributed the citizen is encouraged today by the expansion of patient associations and the delisting of a number of medications (analgesics, syrups, veinotonic). Its apparent advantages (saving medical consultation and non-reimbursement by Social Security) are qualified because of the extra cost of adverse drug necessitating hospitalization (128 000 cases per year) or resumption of treatment by a physician.

Self-medication commits the responsibility of the individual, but also of the pharmacist in providing medication without medical prescription, must remember to use the right (art. R. 5015-1 of the Code of Public Health).

What should beware when we automedique?
The usual risks associated with prescription are strengthened.
1. The risks of intolerance and drug interactions are described in the warnings contained in the Vidal ® dictionary of self-medication, or medication records. Adverse effects of drugs are twice as likely after 65 years, while two-thirds are preventable.
2. Poor adherence: it involves half the elderly.
3. Misuse of a product: 60% of subjects aged well believe bronchial inhaler use, for example, when they are only 10% successful maneuver.
4. Risk of severe intoxication: a little over 3% of hospitalizations were related to an iatrogenic (caused by an incident care) drug! According APNET (National Association pedagogical teaching therapeutic) of 109 accidents that led to hospitalization, 8 are related to self-medication: 5 painkillers (analgesics), 2 non-steroidal anti-inflammatory.

This is all the more reason to fear that the patient does not specify what the doctor is already on its own behalf. The accumulation of drugs the doctor and the patient who is very risky.

Forms of drugs because there are many different routes of drug administration: oral (by mouth) is the most used (80% of drugs), assault parenterally (by injection - injection), rectally, vaginally, transdermal, inhalation, ophthalmic and followed.

The active ingredient, that is to say the active molecule (paracetamol, insulin ...) that can be administered alone, it is added with excipients (lactose, cellulose, water, oil ...) which have no therapeutic activity but allow the formatting according to its particular route of administration.

What is the dosage?

Galenic pharmacy pharmaceutical is a discipline that can turn an active molecule into a drug administered to the patient.

The term comes from pharmaceutical Galen, physician to the Emperor Marcus Aurelius in the second century of our era. He left a large number of manuscripts containing formulations remedies he prescribed. At the end of their studies, doctors swear the Hippocratic oath and the oath of pharmacists Galen.

What is the importance of a pharmaceutical drug?

The goal of the pharmaceutical is to ensure the stability of the active ingredient, facilitate administration, optimizing its therapeutic efficacy, improve retention, reduce toxicity, facilitate proper monitoring of treatment (compliance).

Oral dosage forms (oral or = by mouth, in Latin) dominate the pharmaceutical market: the head, tablets and capsules, but capsules, granules, syrups, powders, drops ...

The tablets, pills, and potions are gone. Name (wrong) the "pill" actually applies to a tablet.

Parenteral forms (para "enteron" - the Greek this time - means not passing through the digestive tract) are essential when the active ingredient is destroyed by the digestive tract. These are injectable preparations, preparations for infusions, vaccines and recently implants, eg contraceptive implants.

Forms inhaled (breathed) are nebulizers, metered increasingly sophisticated fumigations have replaced the old ...

Forms are vaginal suppositories, capsules and rings recently contraceptives.
Forms are rectal suppositories, capsules and enemas.

Forms ophthalmic eye drops, ointments, gels ...

The transcutaneous route includes ointments, gels, emulsions, creams, and increasingly used the patch called "patch" in English stamp: e.g. nicotine patch used in smoking cessation .

The dosage is it not a marketing effect?

No. The progress made is significant dosage on the treatment plan. Thanks to them:
1) it controls the release of active principle with the sustained-release forms (LP), which means for example the patient one pill per day instead of three;
2) the regularity of treatment and therapeutic response have been improved, for example with patches and implants;
3) the patient's comfort is taken into account: for example orodispersible tablets for people with swallowing problems, insulin pens almost painless patches computerized painkillers to manage the pain itself;
4) soon active molecules will be conveyed in the form of liposomes or nanospheres directly and almost exclusively into diseased cells.

Any drug developed and marketed by a pharmaceutical company is protected by a patent property and authorization for placing on the market (AMM).

The patent provides the exclusive property of its marketing to its expiration. This patent has a limited duration of 20 years from the date of filing of the application for registration at the Institute of Intellectual Property. The term of protection of data AMM following the filing of the patent property is 10 years. When intellectual property rights have expired and AMM, we say that the invention "falls into the public domain." A specialty that has the same quantitative composition and qualitative in vigorous substances, the same pharmaceutical form, and is active for the same indications as the original, can then be developed and marketed by another laboratory. It's called generic.

Since 1996, the Public Health Code (Article L. 5121-1) defines the generic "means specialty generic another specialty, a specialty that has the same quantitative composition and qualitative in active substances, similar pharmaceutical outline, and whose bioequivalence by means of the indication medicinal item for consumption has been demonstrated by apposite bioavailability studies. "Clearly, a generic drug is a drug that contains the same molecule as the drug known as" princeps "(original) to treat the same disease.

Which guarantees the quality of the generic drug?

The generic drug also must obtain an authorization for placing on the market (AMM) which guarantees its quality, safety and efficacy. It is produced by a pharmaceutical laboratory approved by the public authorities.

The generic is recorded by the Agency for Safety of Health Products, while being exempted from pharmaco-toxico-clinical, since they have already been made to the original product called "originator". Regularly publishes the official directory specialties entitled to be called "generics".

Because of this shortened course, the generic price is expected to be lower than the original drug.

How do you recognize a generic drug?
It is recognizable by its name. This may be the International Nonproprietary Name (INN). The INN is a unique international name given by WHO. The credits can also have a proper name followed by the suffix "GS".

Warning: A generic drug is several different names. For example: the word "aspirin" is the International Nonproprietary Name (INN) of aspirin widely used. But its chemical name is "acetylsalicylic acid" and its various specialties (drugs) are sold Aspro ®.

The word drug comes from the Latin "medicamentum" meaning cure. Today, the drug is subject to a rigorous definition of "drug means any substance or composition presented as having properties for treating or preventing disease in human beings or animals and any substance or composition can be used in humans or animals or their may be administered to establish a medical diagnosis or to correcting, restoring or modify physiological functions by exerting a pharmacological, immunological or metabolic action. " This is the definition European Medicines transposed by Law n ° 2007-248 of 26 February 2007 of the Public Health Code (CSP).

What is drug consumption?

In 2008, the total consumption of drugs accounted for 34,902 million representing an increase of 3% compared to 2007 (source: Directorate of Research, Studies, Evaluation and Statistics DREES - National Health Accounts 2008).

How to obtain approval to market a drug?

To be sold, any drug manufactured industrially must be authorized for placing on the market (AMM). The pharmaceutical company submits an application to request that authorization to the European Agency for the Evaluation of Medicinal Products and / or Agency for Safety of Health Products.

The marketing authorization application is assessed by official bodies such as the scientific criteria of quality, safety and efficiency. The director sign authorizations for placing on the market, which are then published in the Official Journal. A registration number is assigned to the AMM specialty pharmaceutical (delayed on the packaging, under the heading "Drug authorized No ..."). A generic drug must also be a marketing authorization application (possibly about 10 years after the first marketing authorization of the original drug).

What is a drug?

The medicament comprises one or more active ingredients (molecules) and one or more excipients. The active ingredient is a substance (chemical or herbal) or composition (one or more) possessing curative, preventive, or administered to establish a diagnosis.

Excipients are substances which shape the drug, and have no therapeutic activity: the shaping medicine is the science pharmaceutical (or more simply, the dosage).

Excipients also affect the metabolism (or assimilation) of active ingredient in the body. They facilitate the drug by the patient, for example, giving a taste and color, taste like banana antibiotics for children.