Availability of essential drugs in Pakistan

Abstract

The anaesthetists are probably the only specialists in healthcare facilities in this country. The drug might the practice of medicine who administer drugs well have to be used only a few times in the life time of (almost always intravenously) and observe its effects a professional anaesthetist, but its presence in his on different physiological or pathological phenomena armamentarium will ensure that no patient will ever in a patient. The art of administering anaesthesia is die just because of its non-availability. really an induction of an unnatural state to facilitate Almost all textbooks of anaesthesia advocate surgical procedures and in itself involves many ephedrine as the drug of choice to counter the systemic changes in the body of the recipient. Hence, postspinal hypotension. Yet only select centres induction of general anaesthesia as well as spinal manage to procure this important vasoconstrictor; analgesia is usually associated with hypotension and the drug is not available in the open market. Similarly intubation and is usually followed by tachycardia and phenylephrine, another peripheral vasoconstrictor, is hypertension, especially in susceptible patients. The not ava i l abl e anywhe r e. Nor adr ena l ineadverse effects observed during anaesthesia are not (norepinephrine in USA), a very useful ionotropic only limited to the drug actions, but the surgical drug introduced only a few years back, is at risk of patients may either have deranged physiology due to being discontinued due to its restricted use in the surgical disease itself or the patient might have intensive care centres and emergency medical care, concurrent systemic ailments like diabetes mellitus, and thus has a low business profile for the marketing hypertension, cardiac insufficiency or hormone 3-4 company . disturbances etc. Although all efforts are usually made to optimise the patients' general condition before Adequate analgesia is the hallmark of the anaesthetic operative procedure, it is sometimes not possible to technique; rather it constitutes an important bring the abnormalities in physical parameters back to component of the anaesthetic triad, namely sleep, normal even with the most sincere discourse by the pain relief and relaxation. Pain relief is essential to treating physicians. The anaesthetist depends upon counter the effects of the sympathetic stimulation ready availability of a variety of therapeutic agents to associated with unrelieved pain during and after the facilitate as smooth a sailing as possible, and to surgery. Unfortunately in this country, all what is counteract the foreseeable side effects of the drugs available to us for intraoperative and postoperative used as well as systemic dysfunction. pain relief is NSAID's or second line narcotic analgesics, e.g., diclofenac, nalbuphine, tramadol and The readers of this journal are quite familiar with an ketorolac. Morphine and even pethidine are not acute and potentially life threatening condition marketed openly and are tightly controlled by the precipitated by many anaesthetic agents malignant health authorities, for fear of illegal use. These drugs hyperpyrexia. Only the luckiest patients will manage are sometimes made available to military hospitals, to survive. The factors favouring survival are the but civil hospitals are exempt from this favour. Same anticipation, the early recognition of the onset of the is the case with fentanyl. Fentanyl is one of the most condition and aggressive symptomatic treatment. potent analgesic drugs (80 times as compared to The specific drug indicated in this condition, morphine), which remained available round the globe 1-2 dantrolene , is not available even in the advanced