E-DRUG: Spurious drug reeks havoc in Pakistan
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Dear E-Drug Readers
It saddens me to report that more than 120 lives are lost and many thousands are seriously sick after taking a spurious medicine from Punjab Institute of Cardiology (PIC), Lahore. On returning of lab reports from overseas, after many days of unfolding melodrama played in the media and social circles, it turns out that instead of the intended active ingredient "isosorbide dinitrate" the medicine contained antimalarial "pyrimethamine". Patients presented with symptoms including low count of platelets and white cells along with marks on the body and bleeding from various parts of body - indicative of a acute overdose of pyrimethamine.
The number of dead and sick is going to go up as about 40,000 patients with heart problems might have received poor quality medicines from PIC.
The tragedy prompts a lot of questions begging for answers. How did the ingredients got switched in the factory without any QA/QC system picking it up, why the post-marketing surveillance and QC system failed in screening it while in market circulation, and why did the therapeutic oversight and adverse drug reactions monitoring fail in picking it, and a host of other similar questions. All are unanswered at the moment and in every likelihood will remain so in future as well.
See more details on this
link: http://tribune.com.pk/story/330773/pic-medicine-disaster-isotab-is-the-killer-pill/
There is an obvious need to overhaul the pharmaceutical system in its entirety. Forming a well
designed and empowered DRA would be a first step in the this direction.
Kind regards,
Ayyaz
Ayyaz Gul Kiani, RPh, MPH
Public Health Pharmacist
House # 3, Street # 7/B, Sector H,
Defence Housing Authority - Phase 2
Islamabad - Pakistan
Mobile: +92-341-8946535
Office: +92-51-9242242
Ayyaz Kiani <ayyaz_kiani@hotmail.com>
E-DRUG: Spurious drug reeks havoc in Pakistan (2)
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Dear Ayyaz,
Thank you for sharing this very important and alarming information. I am sure many of us have been following this story on the news but this is a well detailed scenario that you shared.
I believe by DRA you refer to the Drug Regulatory Authorities? I support you on that for sure, but I would also contribute that as pharmacists we also have such social responsibilities, and much can be done if we might stand up to our responsibilities as a united body; either pharmacy board created and managed by law, or even just a board registered and formed by pharmacists of Pakistan.
History has shown that pharmacists have been able to catch various important disease/ prescribing patterns while fulfilling their dispensing duties. We, pharmacists afterall are an integral part of clinical teams, though we are often overlooked for our distinguished dispensing skills which, without bearing social responsibility, is just a mere business conducted by anyone and everyone.
I think this is the time when Pakistani pharmacists should find a wake up call and stand up for the people of the country, together with government efforts for Drugs Regulatory Authority.
Just food for thought...
Best Regards,
Nadiya
Pharmacist practising in Tanzania
(also studied in Pakistan)
nadiya.navroze@gmail.com
E-DRUG: Spurious drug reeks havoc in Pakistan (3)
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[Note from Ayyaz Kiani - 'Isotab is not like those small sublingual nitrates but large enough size to take in 250mg' ]
Dear Ayyaz Kiani and E-Drug Readers
Its quite saddening that such a mistake can occur in such a reputable pharmaceutical industry. However am not convinced by the bit that the drug was adulterated by such pyrimethamine as can be found in ten tablets of fansidar, as this would add upto 250mg of pyrimethamine. This would have directly affected the weight and shape of the tablet which should have even been noted by competent QC or the patient as well.
Dr kamamia wa murichu
Practising pharmacist in Nairobi, Kenya
Chairman of the Kenya Pharmaceuticals Distributors Association (KPDA).
Email- kamamiamurichu@yahoo.com
E-DRUG: Spurious drug reeks havoc in Pakistan (4)
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Is this an issue to be taken by the Pharmacists of Pakistan alone? To me this
is a case to be studied by the Pharmacists of the world to find means not to repeat it in any part
of the globe
This type of tragedy can happen in any part of the world if the Government and the Pharmacy professionals are not vigilant in giving due respects to the modern medicines.
In the 1980s in one public hospital in Bombay in India about 20 patients
young and old died because of consuming adulterated Oral Glycerine given to the patients from the
hospital. The Lentin Commission that enquired about it unearthed the unethical incidents behind the tragedy.
How can a Pharmaceutical Manufacturer market and release a product these days without proper tests of raw materials and the finished goods? It is a pity to note that there are firms which are established only for government supply and government and government agencies/ departments
purchase medicines offered at low rates!
Dr K G Revikumar
Professor, Chief & Head
Dpt. of Pharmacy Practice, Govt Medical College, Trivandrum, India. Rtd)
Chairman, GPC Society for Pharmacy Solutions,
Rajeevam, TC 30/975-1, CKRRA 195, Kavaradi Road,
Pettah, Trivandrum, Kerala, INDIA. 695 024
Phone 0471- 2475028, Fax 0471- 2570347.
Email. kg.revikumar@gmial.com