Re: Next discussion: RUM in respiratory infections

[Guest guest]

Respected Dr Vijay,

Thanks for your invitation to the topic.

Presently,I am working as asso. professor in Pharmacology at S.C.B Medical college,

Cuttack, Orissa .I am also persuing PhD course in Clinical Pharmacology simultaneously.

With the help and technical support from DSPRUD ( Delhi Societyfor promotion of

Rational use of Drug),our state has adopted the policy of Rational use of Drug.I got involved with Rational Use of Medicine concept with the support of DSPRUD & WHO( SEARO) who suppoted me for few national and international training course on on RUD

There after, I got a chance to be involved with training of Doctors and pharmacists of the state as resourse person. Also, I got a chance to prepare the standard treatment guidelines for the state,as one of the coordinators.Dept. of Pharmacology of S.C.B Medical college, is also involved with the regular revision of Essential drug list for the state.

Presently I am working with one NGO ( CDMU,Orissa) with permission from state Govt.

Trupti Swain

Orissa

From: Vijay <drvijaythawani@...>Subject: Next discussion: RUM in respiratory infectionsnetrum Date: Tuesday, July 8, 2008, 8:15 AM

Hi,

The next discussion "Rational use of medicines in respiratory infections" will run from 09 to 14 July 2008 and will be moderated by Dr Trupti Swain.

Heartiest welcome Dr Trupti Swain. Kindly take over NetRUM from today eve.

Dr Trupti is our regular moderator on NetRUM. Since many have joined our family recently I request her to introduce.

Members are reminded not to initiate discussion on the topic till moderator takes over.

Vijay

Groupie

[Guest guest]

Dear Friends,

For next few days we are going to discuss on “Rational use of medicines in Respiratory Infections”

Infection of the respiratory tract (RTI) is a substantial cause of morbidity and mortality in both young children and adults. The attack rate is about 5 episodes of ARI per year, thus averaging 238 million attacks in children. And as the socioeconomic conditions go down, the number of attacks per year, increases. Improvement of drug use by prescribers, dispensers and the general public helps to reduce morbidity and mortality due to any disease. This also, helps to contain drug expenditure. Thus we are faced by a challenge to ensure therapeutically sound and cost-effective use of drugs, in a very commonly encountered clinical condition like RTI.

The points to be touched:

· Individual experience on irrational use of medicines in RTI

· Common pathogens of Upper ( URTI) & lower respiratory tract infections ( LRTI)

· Rational approach to use of antibiotics in both URTI AND LRTI

· Role of anti viral drugs in RTI

· Role of zinc and Vit A supplementations in the prevention of RTI

· Non drug treatment for RTI

· Role of homeopathic and ayurvedic medicines in RTI

· Role of cough or cold formula in RTI

· Patient Education in managing RTI

· What should be the referral criteria?

Esteem members are requested to share their experience on any irrational use of drugs in respiratory Infections.

Dr Trupti rekha Swain

Orissa

From: Vijay <drvijaythawani@...>Subject: Next discussion: RUM in respiratory infectionsnetrum Date: Tuesday, July 8, 2008, 8:15 AM

Hi,

The next discussion "Rational use of medicines in respiratory infections" will run from 09 to 14 July 2008 and will be moderated by Dr Trupti Swain.

Heartiest welcome Dr Trupti Swain. Kindly take over NetRUM from today eve.

Dr Trupti is our regular moderator on NetRUM. Since many have joined our family recently I request her to introduce.

Members are reminded not to initiate discussion on the topic till moderator takes over.

Vijay

Groupie

[Guest guest]

Dear Dr Trupti,

I need this discussion badly because I have severe URTI and literature says no drugs needed for this type of viral infection.

-Anupama

From: Vijay <drvijaythawani@ .co. in>Subject: Next discussion: RUM in respiratory infectionsnetrumgroups (DOT) comDate: Tuesday, July 8, 2008, 8:15 AM

Hi,

The next discussion "Rational use of medicines in respiratory infections" will run from 09 to 14 July 2008 and will be moderated by Dr Trupti Swain.

Heartiest welcome Dr Trupti Swain. Kindly take over NetRUM from today eve.

Dr Trupti is our regular moderator on NetRUM. Since many have joined our family recently I request her to introduce.

Members are reminded not to initiate discussion on the topic till moderator takes over.

Vijay

Groupie

Meet people who discuss and share your passions. Join them now.

[Guest guest]

Hi,

Enlightened we will be to have you as moderator.

Compliments on your achievements in RUM.

NetRUM welcomes you.

Vijay

-- In netrum , Trupti Swain <drtruptiswain@...> wrote:

>

> Respected Dr Vijay,

>  

> Thanks for your invitation to the topic.

>  

> Presently,I am working as asso. professor in Pharmacology at S.C.B

Medical college,

> Cuttack, Orissa .I am also persuing PhD course in Clinical

Pharmacology simultaneously.   

>          With the help and technical support from DSPRUD ( Delhi

Societyfor promotion of

>  Rational use of Drug),our state has adopted the policy of

Rational use of Drug.I got involved with Rational Use of Medicine

concept with the support of DSPRUD & WHO( SEARO) who suppoted me for

few national and international training course on

on  RUD                 

>           There after, I got a chance to be involved with training

of Doctors and pharmacists of the state as resourse person. Also, I

got a chance to prepare the standard treatment guidelines for the

state,as one of the coordinators.Dept. of Pharmacology of S.C.B

Medical college, is also involved with the regular revision of

Essential drug list for the state.

>  

> Presently I am working with one NGO ( CDMU,Orissa) with permission

from state Govt.

>  

> Trupti Swain

> Orissa

>  

>  

>  

>

>

>

>

> From: Vijay <drvijaythawani@...>

> Subject: Next discussion: RUM in respiratory infections

> netrum

> Date: Tuesday, July 8, 2008, 8:15 AM

>

>

>

>

>

>

>

> Hi,

> The next discussion  " Rational use of medicines in respiratory

infections "  will run from 09 to 14 July 2008 and will be moderated

by Dr Trupti Swain.

> Heartiest welcome  Dr Trupti Swain. Kindly take over NetRUM from

today eve.

> Dr Trupti is our regular moderator on NetRUM. Since many have

joined our family recently I request her to introduce.

> Members are reminded not to initiate discussion on the topic till

moderator takes over.

> Vijay

> Groupie

>  

>

[Guest guest]

Dear Prof. Trupti,

article is attached for more information

Best Regards

Mohammad Bashaar

From: Vijay <drvijaythawani@ .co. in>Subject: Next discussion: RUM in respiratory infectionsnetrumgroups (DOT) comDate: Tuesday, July 8, 2008, 8:15 AM

Hi,

The next discussion "Rational use of medicines in respiratory infections" will run from 09 to 14 July 2008 and will be moderated by Dr Trupti Swain.

Heartiest welcome Dr Trupti Swain. Kindly take over NetRUM from today eve.

Dr Trupti is our regular moderator on NetRUM. Since many have joined our family recently I request her to introduce.

Members are reminded not to initiate discussion on the topic till moderator takes over.

Vijay

Groupie

[Guest guest]

Fellow NetruMians,

Most of the time physicians and caregivers/patients allow the hearts

to rule instead of the brain. I have just recovered from my most

proplonged respiratory tract infection (~2/52) with severe cough,

chest pain and sleep disturbance. Initially (~ 4 days) i held on to

standard teaching, viral and that i didn't need antibiotics but

following embarassment from associates i commenced erythromycin and

sparfloxacin was added by my respiratory physician colleague after 4

days. I thought i should have done some basic investigations before

commencement. i have since concluded painfully though,that we often

jettisson standard teachings for parochial considerations. Although,

the final clinical outcome didn't negate what was done in my case i

still feel the right thing has not been done. We need to spend more

energy on information, education and communication. Information is

vital, perhaps detailed prospective studies of profile of respiratory

tract infections including natural history and eatiopathogenesis with

reference to different populations and locations. Such detail

information will provide the needed materials for effective

teaching/education/training/communication.

regards,

Dr Fatai Fehintola

Ibadan, Nigeria

>

> From: Vijay <drvijaythawani@ .co. in>

> Subject: Next discussion: RUM in respiratory infections

> netrumgroups (DOT) com

> Date: Tuesday, July 8, 2008, 8:15 AM

>

>

>

>

>

> Hi,

> The next discussion  " Rational use of medicines in respiratory

infections "  will run from 09 to 14 July 2008 and will be moderated

by Dr Trupti Swain.

> Heartiest welcome  Dr Trupti Swain. Kindly take over NetRUM from

today eve.

> Dr Trupti is our regular moderator on NetRUM. Since many have

joined our family recently I request her to introduce.

> Members are reminded not to initiate discussion on the topic till

moderator takes over.

> Vijay

> Groupie

>  

>

[Guest guest]

Dear friends,

This one is really a very common and important topic to talk with.

URTI is so common, we always see around us or ourselves suffering from it many times.

And hence it is more prone for mis treatment, irrationally treated...

I have a small incidence to tell you,

One of my junior collegue (Name cannot be disclosed) was suffering from URTI. we were discussing about the right treatment. Very first question of discussion was

WHICH ANTIBIOTIC DID HE START?.......The question itself is irrational....antibiotics?

The answer was "SPARFLOXACIN"

Then there were verious urguments...about the first choice of antimicrobial..like

AMPICILLIN,

AMOX,

ERYTHROMYCIN,

ROXID,

even one person dared to talk about OFLOX..

I was very confused...Even Pharmacologists have different answers for such ailment...

very poor..

One friend-practioner when contacted by me said....now a days for prompt relief we prescribe "AZITHROMYCIN"....nothing else work better.....

HOW WILL YOU SEE ALL THIS?

I have one more thing to share

its about children RTI and WHO

http://www.who.int/fch/depts/cah/resp_infections/en/

Acute respiratory infections in children

Basic facts

About 20% of all deaths in children under 5 years are due to Acute Lower Respiratory Infections (ALRIs - pneumonia, bronchiolitis and bronchitis); 90% of these deaths are due to pneumonia. Early recognition and prompt treatment of pneumonia is life saving.

Causative organisms may be bacterial (most commonly Streptococcus pneumoniae and Haemophilus influenzae) or viral. However, it is not possible to differentiate between bacterial and viral ARIs based on clinical signs or radiology.

Low birth weight, malnourished and non-breastfed children and those living in overcrowded conditions are at higher risk of getting pneumonia. These children are also at a higher risk of death from pneumonia.

Case management of ARI in children 2 month to 5 years

Assessment, classification and treatment of ARI are summarized on the attached charts. All children presenting with cough or difficult breathing should be assessed according to these charts.

All children should also be assessed for signs of severe malnutrition - visible severe wasting and oedema of both feet. Children with any of these signs must be referred to a hospital as they are at a very high risk of death from pneumonia.

Children with danger signs should be referred to a hospital after a single dose of IM chloramphenicol. In situations where referral is not possible, twice daily injections of IM chloramphenicol should be continued for 5 days, followed by oral antibiotic therapy for another 5 days.

Children with severe pneumonia should be referred to a hospital for treatment with IM ampicillin/penicillin. In situations where referral is not possible, these children can be treated with oral amoxicillin given thrice daily for 7 days. Oral amoxicillin has recently been shown to be effective in treatment of severe pneumonia.

Children with non-severe pneumonia should be given antibiotics for 5 days. The new Emergency Health kits contain co-trimoxazole, which is a low-cost broad spectrum antimicrobial. An alternative is oral amoxicillin.

Supportive measures include increased oral fluids to prevent dehydration, continued feeding to avoid malnutrition and anti-pyretics to reduce high fever.

Case management of ARI in young infants 0-2 months

Signs of pneumonia, sepsis and meningitis are difficult to differentiate in a young infant less than 2 months of age.

Young infants with fast breathing or chest indrawing should be suspected to have serious bacterial infection. These infants should be referred to a hospital and treated with IM ampicillin/penicillin and gentamicin for 10 days. In situations where referral is not possible, oral amoxicillin or co-trimoxazole twice daily with IM gentamicin once daily should be given for 10 days.

Supportive measures include frequent breastfeeding and keeping the young infant warm.

regards,

Dr Kiran Chaudhari

Lecturer,

Govt Medical College,

Nagpur.

From: Vijay <drvijaythawani@ .co. in>Subject: Next discussion: RUM in respiratory infectionsnetrumgroups (DOT) comDate: Tuesday, July 8, 2008, 8:15 AM

Hi,

The next discussion "Rational use of medicines in respiratory infections" will run from 09 to 14 July 2008 and will be moderated by Dr Trupti Swain.

Heartiest welcome Dr Trupti Swain. Kindly take over NetRUM from today eve.

Dr Trupti is our regular moderator on NetRUM. Since many have joined our family recently I request her to introduce.

Members are reminded not to initiate discussion on the topic till moderator takes over.

Vijay

Groupie

From Chandigarh to Chennai - find friends all over India. Click here.

[Guest guest]

Dear Friends,

I hope all of you know that people like Anupama always provide intelligent twist

to the discussion.

Infection of upper respiratory tract (URTI), includes common cold,

Pharyngitis,laryngitis rhinitis, sinusitis, otitis media and externa.In about

60- 70% of cases URTI is due to viral origin, Rhinovirus, Respiratory synsytial

virus to name few. Group A streptococcus,

S. Pneumoniae, H. Influenzae are few other bacteria responsible for the disease.

       Lots of literatures highlight the misuse of antibiotics in upper

respiratory tract infection. Ideally it should be managed symptomatically with

paracetamol (500 to 1 Gram) 6-8 hrly along with cetrizine I tab bed time if

required. Bacterial infections persists longer  and needs antibiotic therapy.

Rest, Warm saline / antiseptic gargle, voice rest in case of laryngitis are few

Nondrug treatment which can be of real help.

Thanks Anupama.

Hope you are fine.

Trupti

From: Vijay <drvijaythawani@ .co. in>

Subject: Next discussion: RUM in respiratory infections

netrumgroups (DOT) com

Date: Tuesday, July 8, 2008, 8:15 AM

Hi,

The next discussion  " Rational use of medicines in respiratory infections "  will

run from 09 to 14 July 2008 and will be moderated by Dr Trupti Swain.

Heartiest welcome  Dr Trupti Swain. Kindly take over NetRUM from today eve.

Dr Trupti is our regular moderator on NetRUM. Since many have joined our family

recently I request her to introduce.

Members are reminded not to initiate discussion on the topic till moderator

takes over.

Vijay

Groupie

 

Meet people who discuss and share your passions. Join them now.