Ahmad S R, Bhutta Z A
Health Action International, Pakistan.
J Pak Med Assoc. 1990 Jun;40(6):126-30.
In an effort to understand the paediatric prescribing practices of family physicians and dispensing of medicines from pharmacies, a survey was conducted in Karachi. Another objective was to understand the factors influencing such practices. Hundred family physicians and 55 pharmacists were surveyed. Four groups of drugs namely antidiarrhoeals, appetite stimulants, multivitamins and brain tonics were identified for assessment, these being drugs widely promoted by the pharmaceutical industry. Some of these drugs are known to have deleterious effects and therapeutic benefit of most of them is dubious. It was observed that roughly 55% of all drugs prescribed by the physicians fell into the aforementioned drug categories. These drugs also constituted nearly 60% of all sales of the pharmacies surveyed. The survey indicates that the antidiarrhoeal drugs Imodium (Ioperamide) and Lomotil (diphenoxylate) are being commonly prescribed though they have hazardous side effects and are unsuitable for use in children. Thirteen percent of physicians are still prescribing the anabolic steroid Durabolin (nandrolone phenylpropionate) as an appetite stimulant long after promotion for this purpose has been dropped. The survey indicates that 95% of the physicians relied upon industry promotional material as their main source of information about drugs. The survey highlights the need to introduce the concept of rational drug use in the undergraduate and postgraduate education.
为了解家庭医生的儿科开药习惯以及药店的药品配发情况，在卡拉奇进行了一项调查。另一个目的是了解影响这些行为的因素。对100名家庭医生和55名药剂师进行了调查。确定了四组药物进行评估，即止泻药、食欲兴奋剂、多种维生素和补脑药，这些都是制药行业广泛推广的药物。其中一些药物已知有有害作用，而且大多数药物的治疗效果存疑。据观察，医生开出的所有药物中约有55%属于上述药物类别。这些药物在接受调查的药店的所有销售额中也占近60%。调查表明，止泻药易蒙停（洛哌丁胺）和复方地芬诺酯正在被普遍使用，尽管它们有有害的副作用且不适用于儿童。在已停止为此目的进行推广很久之后，仍有13%的医生将合成代谢类固醇大力补（苯丙酸诺龙）作为食欲兴奋剂开出处方。调查表明，95%的医生依赖行业宣传材料作为他们有关药物的主要信息来源。该调查强调了在本科和研究生教育中引入合理用药概念的必要性。
