NATIONAL
ESSENTIAL DRUGS LIST
THIRD REVISION
1.1
General Anaesthetics and Oxygen
1.2
Local Anaesthetics
1.3
Neuromuscular Blocking Agents
1.4
Miscellaneous
2.1
Opioid Analgesics
2.2
Non-Opioid Analgesics and NSAIDS
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