[e-drug] Regarding quality of drugs

["Andrew N. Kuznetsov" <irc@nets.kz>]

E-drug: Regarding quality of drugs
---------------------------------------------

Dear e-druggers!
Speaking about a problem of quality of drugs, Nancy and Richard have
stated  completely fair point of view. But it is a position of a
pharmacologist,  and only one side of the problem.
I should like to express opinion as the clinician. When we speak about
"quality" of a medicinal preparation, we, first of all, mean a fake,
the substance  keeping poor or exuberant amount of active components.
But in my opinion, the concept of "quality" of a drug is not limited
to it.  The drug may keep adequate amount of ingredients and be
manufactured  in complete conformity with technology requirements
etc., but remain poor-quality.
Bright example is loperamide (imodium). Well-known, that this
antidiarrhoeal  drug of opioids group invokes a paresis of intestines
with  remaining of excretion of fluid (i.e. translates a "outside"
diarrhoea  in "intrinsic"). It would seem, the medicine makes its
business - detains  a diarrhoea, that is it's "good quality". But
actually  it increases an adsorption of toxins in an intestine,
invokes a sequestration  of fluid with development of a deaquation
etc. UNICEF in the  program on struggle against diarrhoeas has
forbidden assignment  of this drug. As a result in  the instruction on
application  of the producer of a drug the line that "the drug is not
recommended for  children and pregnant women" has appeared. But
loperamide is  still the most promoted an antidiarrhoeal drug in
Kazakhstan, sold without  the prescription. Also guess, what you will
be recommended  by the druggist for a diarrhoea?
It seems to me, it is one more side of the problem of quality of
medicinal  preparations, and a quite good theme for discussion.

Sincerely yours,
Andrew N. Kuznetsov, PhD,
Independent Research Ecological, Medical & Biological Center,
Republic of Kazakhstan.
mailto:irc@nets.kz
[If you look in the e-drug archives you will find an enormous amount 
of discussion concerned with quality use of medicines, rational use 
of medicines and so on. As you say, education on these themes is an 
ongoing challenge.  However,  'fake' drugs are another major concern 
and their investigation is  important.  BS]
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