NATIONAL ESSENTIAL DRUGS LIST

THIRD REVISION

           

1:         ANAESTHETICS

1.1           General Anaesthetics and Oxygen

1.2           Local Anaesthetics

1.3           Neuromuscular Blocking Agents

1.4           Miscellaneous

2:         ANALGESICS, ANTIPYRETICS, NON-STEROIDAL ANTI-INFLAMMATORY             DRUGS AND DRUGS USED TO TREAT GOUT

2.1           Opioid Analgesics

2.2           Non-Opioid Analgesics and NSAIDS

2.3           Local Analgesics

2.4           Drugs used to treat Gout

3:         ANTI-ALLERGICS AND DRUGS USED IN ANAPHYLAXIS

4:         ANTI-EPILEPTICS

5:         ANTIINFECTIVE DRUGS

5.1                 Anthelmintics

5.2                 Antibacterials

5.3                 Antituberculosis Drugs

5.4                 Antifungal Drugs

5.5                 Antiamoebic Drugs

5.6                 Antiviral Drugs

5.7                 Antimalarial Drugs and Prophylactics

5.8                 Antileishmanial Drugs

6:         ANTIMIGRAINE DRUGS

7:         ANTIPARKINSONISM DRUGS

8:         DRUGS AFFECTING BLOOD

8.1                 Antianaemic Drugs

8.2                 Drugs Affecting Coagulation

9:         BLOOD PRODUCTS AND PLASMA SUBSTITUTES

10:       CARDIOVASCULAR DRUGS

11:       DERMATOLOGICAL DRUGS

12:       DIURETICS

13:       GASTROINTESTINAL DRUGS

14:       HORMONES, OTHER ENDOCRINE DRUGS AND CONTRACEPTIVES

15:       IMMUNOLOGICALS

15.1              Diagnostics

15.2              Sera and Immunologicals

15.3              Vaccines for Universal Immunization

15.4              Vaccines for Specific Use

15.5              Immunosuppressants

16:       MUSCLE RELAXANTS (PERIPHERALLY ACTING) AND CHOLINESTRASE            INHIBITORS

17:      OPHTHALMOLOGICAL PREPARATIONS

17.1              Antiinfective Agents

17.2              Miotics and Antiglaucoma Drugs

17.3              Mydriatics and Cycloplegics Drugs

17.4              Corticosteroids

17.5             Non-steroidal Antiallergic/Decongestants

17.6            Topical Anaesthetics

17.7            Others

18:      OXYTOCICS AND ANTIOXYTOCICS

19:      PERITONEAL DIALYSIS SOLUTION

20:      PSYCHOTHERAPEUTIC DRUGS

21:      DRUGS ACTING ON THE RESPIRATORY TRACT          

22:      SOLUTIONS CORRECTING WATER, ELECTROLYTE AND ACID BASE

           DISTURBANCES

23:      VITAMINS AND MINERALS

24:      E.N.T. PREPARATIONS

25:      ANTISEPTICS AND DIS-INFECTANTS

25.1              Antiseptics

25.2              Disinfectants

26:      DENTAL PREPARATIONS

27:      DISPENSARY ITEMS  

28:      DRUGS FOR LOCAL PURCHASE

28.1              Antidotes and other substances used in poisoning

28.2              Antileprosy Drugs

28.3      Antineoplastics, Immunosuppressives and Drugs used in palliative      care

            28.3.1        Immunosuppressive Drugs

            28.4         Diagnostic Agents

29:       DRUGS FOR SPECIALIZED CENTERS

29.1         Antiretroviral Drugs

 

PREFACE

After the second World War the development and emergence of miracle drugs like antibiotics brought a revolution in the medical care. The obvious effectiveness of these new pharmaceuticals and intensive marketing efforts combined to catalyze wide spread use of modern medicine. A rapidly growing and profitable industry, together with an enthusiastic but largely uninformed audience and an  unregulated market, resulted in excess of promotion and consumption alowgwith inflated level of expenditure. However, by 1970s it had become clear that least advantageous nations were not even meeting the basic needs of their people for essential life saving and health promoting drugs. As a result gradually a  number of countries started concentrating on the development of a basic list of reliable drugs to meet the most vital basic needs of their people. 

A World Health Organization (WHO) Committee of Experts met in 1977 to determine the number of drugs, which were actually needed to ensure a reasonable level of health care for as many people as possible. Consequently, the first Model List of Essential Drugs was finalized in the same year. This list is being updated regularly by the WHO and is intended to be used as a guideline and provide basis for member countries to identify their own priorities and make their own selection. Through 1970s and 1980s the WHO started promotion of the concept of Essential Drugs Program in order to redress this imbalance. The program aimed at reduction in the number of drugs purchased/used by the hospitals/institutions to a minimum possible level in order to make best use of limited public funds. 

Essential drugs as defined by WHO are those that satisfy the health care needs of majority of the population. They should therefore be available at all times in adequate amounts and in the appropriate dosage forms. 

The National Essential Drugs List (NEDL) of Pakistan was first prepared in 1994 in consultation with relevant experts. The list was previously reviewed in 1995 and 2000. The present list is the third revision containing 452 drugs of different pharmacological classes. 

The health sector in general and public health sector in particular is expected to seriously consider adopting this list. The provincial health departments can play a pivotal role to encourage the hospitals/institutions for making bulk purchases from within this list. We hope that this list will find more acceptance among health care professionals.

 Maj. Gen. ® Mohammad Aslam HI (M)

Director General Health

 

EXPLANATORY NOTES

Letters in parentheses following drug names indicate: (P) for Primary, (S) for Secondary and (T) for Tertiary.

1.        Classification of drugs for use at various levels of Health

        Services is as follows:

(P)           PRIMARY: For use at the Primary Health Care Level including Basic Health Units and Rural Health Centers.

(S)           SECONDARY: For use at the Secondary Health Center Level i.e; hospitals.

(T)          TERTIARY: For use at the specialized and sub-specialized levels for specific expertise diagnostic precision or special equipment required for proper use.

II.       Drugs subject to international controls under :

(1)           Single Convention on Narcotic drugs 1961:

(2)           Convention on Psychotropic Substances 1971; and

(3)           Convention on Illicit Traffic in Narcotic Drugs and Psychotropic    Substances 1988.

III.     Special considerations ;

(4)           In renal insufficiency, contraindicated or dosage adjustments    necessary;

(5)           To improve compliance;

(6)           Special pharmacokinetic properties;

(7)           Adverse effects diminish benefit/risk ratio;

(8)           Limited indications or narrow spectrum of activity;

(9)           For epidural anaesthesia;

(10)  Specific expertise, diagnostic precision, individualization of dosage or   special equipment required for proper use;

(11)  Monitoring of therapeutic concentrations in plasma can improve safety   and efficacy;

(12)  COMPLEMENTARY DRUGS: Choice to be made on the basis of cost   effectiveness.

IV.     When the strength of a drug is specified in terms of a selected salt or ester, this is mentioned in brackets; when it refers to the active moiety, the name of the salt or ester in brackets is preceded by the word ‘as’.
 

ANAESTHETICS