Pharmacy Education in Bangladesh

Pharmacy Education The education and training of pharmacists should be based on their attainment of educational objectives that correspond to the professional tasks relevant to the country concerned and to their roles, functions and responsibilities in health teams. The learning experiences, and the methods of evaluating the knowledge, skill and attitudes involved in satisfactory practice performance, must be relevant to the components of professional competence. The design and management of the curriculum should apply the curricular principles of continuity sequence and integration so that students may a progressively master the necessary professional skills at the expected levels of performance, by their repeated performance at increasingly complex levels. To maintain the relevance of undergraduate education to changing patterns of practice, curricula should be kept under regular review by academic pharmacists, together with pharmacists from all aspects of practice and other concerned parties, such as health administrators and specialists in curriculum management and evaluation. In common with most health professional education pharmacy education programmes while often indicating the relevance of topics to practice need to do more towards helping students achieve competence in the application of knowledge in practice; this would involve the linking of knowledge's, skill and attitudes in professional problem solving. Course in pharmacy law, ethics and practices make a vital contribution to the role of pharmacists in the rational use of drugs and in the prevention and management of drug abuse. Traditionally, pharmaceutical courses have been divided into four subject areas namely pharmaceutics, pharmaceutical chemistry, pharmacognosy and pharmacology and schools of pharmacy have been organized accordingly. However, the academic foundation for pharmacy practices demands and integrated approach to the teaching of those four traditional subjects. This can be encouraged by designing the course to include the three elements of pharmaceutical science described below. This would mean the integration of substantial parts of the teaching in each of the three subject areas with corresponding parts in the others. By doing so, schools of pharmacy would enable students to a ppreciate more readily the relevance of the pharmaceutical sciences to the practice of pharmacy. Chemical and Physical Properties of Drugs The structure and properties of chemical substances of natural and synthetic origin used in medicine, their relevant stereo? chemistry and biological activities relevant physico ?chemical aspects, including chemical kinetics and thermodynamics; quality control by physical,, chemical and biological techniques. Pharmaceutical Aspects of Medicines Physical and physicochemical properties of substances used in medicine and their application in the formulation and production of medicinal products; the influence of formulation on the biological availability of substances; the evaluation of products and pharmaceutical processes with particular reference to uniformity, quality and stability of products; the principals of sterilisation and of aseptic procedures; immunological products microbiological aspects of the contamination and preservation of pharmaceutical products; radio ?pharmaceutical surgical dressings; the dispensing and storage of medicines. The Action and Uses of Drugs and Medicines Human and mammalian physiology and biochemistry as a basis for the understanding of the pharmacology of drugs. It should include experimental pharmacology and biological methods of measurement of activity; chemical, physical, biochemical and biological aspects of the action of drugs in man and animals; plant biology in relation to natural sources of drugs and medicines and in relation to pesticides; microbiology in relation to immunology, disease and chemotherapy; the presentation, use and adverse reactions of drugs and medicines, including some opportunities to observe and study the clinical effects of drugs on diseases an understanding of the principals of disease processes; medical terminology; sources of information on drugs and medicines. The emphasis placed on the topics included in these three elements of the degree course will vary with educational needs, objectives, resources, and developments in health care, but the three elements should receive approximately the same emphasis. However, the growing importance of the pharmacists role in promoting the rational use of drugs by patients and in advising other health processionals must be reflected in the teaching of pathology and therapeutics related to both community and hospital pharmacy. A fourth element in the pharmacy course should deal with national legislation related to pharmacy, and introduce the subject of international control mechanisms. A specialised part of the course should be devoted to professional ethics, which should at the same time permeate the entire course. While the entire course should be seen to be relevant to practices there should be two units or modules devoted to the rational use of drugs and the prevention of misuse and abuse, and to the application of pharmaceutical sciences to aspects of practice. Additionally pharmacy students should be made aware of their countries general health policies and strategies, particularly for the control of their principal public health problems such as malaria leprosy tuberculosis and AIDS and for the care of mothers and children, including family planning. In relation to all aspects of the pharmacy programs there should be a module dealing with the general principles of the rational use of drugs. This should be introduced early in the undergraduate programs and should be designed to introduce early in the undergraduate program and should be designed to introduce students to the basic competencies ? the clusters of knowledge, attitudes and skills for performing the pharmacist's several role related to the rational use of drugs, including advising physicians and patients, monitoring of prescribing reporting of adverse drug reactions, advising on drug interactions in relation to individual patients and within national schemes and the training of other health professionals. These basic competencies should be gradually expanded and strengthened throughout the remainder of the course. Independent reviews of pharmacy in recent years, including the Nuffield Foundation inquiry into pharmacy in the United Kingdom (2) have highlighted the advisory role of the pharmacist vis?avis health professionals and patients. Many schools have introduced course on interpersonal and communication skills. All schools need to introduce modules dealing with the principles of communication written and oral and providing for learning and evaluation methods by which students may acquire and develop these skills An understanding of national pharmaceutical legislation and of its underlying philosophy will continue to be an important objective of pharmacy programs. In the context of international control, all students should learn the concept of and appreciate the reasons for international control mechanisms. More important, however, undergraduate education must at all times inculcate high standards of professional conduct. This will ensure that pharmacists can supplement the minimum legal requirements by standards of conducts which ensure that the greatest possible help and protection is given to the public in relation to the supply and use of drugs. A satisfactory standard of pharmaceutical education which is a prerequisite for a satisfactory pharmaceutical service to satisfy legitimate public needs, depends upon a sufficiency of suitably qualified academic staff, and an adequate provision of equipment, text books and other learning materials. Government strategies should provide for, and give priority to, these resources, as they are the foundation of the pharmacist's contribution to the cost?effective use of quality medicines. The pharmacy council, pharmacy board, or the registration authority, should be involved in establishing acceptable minimum standards for the structure, facilities and curricula of schools of pharmacy. Pharmacy Education in Bangladesh The education in Pharmacy was first introduced in the country in 1964 with the establishment of the Department of Pharmacy in the University of Dhaka. Recently the Department has been expanded to a Faculty comprising of three new Departments. For about 25 years the Dhaka University had been the only institution offering Pharmacy courses until establishment of a "Pharmacy Section" in Jahangirnagar University. The Section was expanded to a full?fledged Department within a few years of its establishment. Until now, there are four public universities and five private universities offering the undergraduate courses in Pharmacy. The public universities are Dhaka University, Jahangirnagar University, Rajshahai University and Khulna University. Among the private universities, University of Science & Technology, Chittagong and Asia Pacific University have conferred the degree of Bachelor of Pharmacy to a few batches of their students. The other private universities have started academic activities within last couple of years. Pharmacy Education in Public Universities ( Accreditation ) Sl. Name Location Estd of Pharmacy Department Approved No of Seats 1. University of Dhaka Dhaka 1964 70/Yr go 2. Jahangirnagar University Savar 1985 55/Yr go 3. University of Khulna Khulna 37/Yr go 4. University of Rajshahi Rajshahi 1993 45/Yr go Pharmacy Education in Private Universities ( Provisional Accreditation ) Sl. Name Location Estd of Pharmacy Department Approved No of Seats 1. University of Science and Technology, Chittagong Chittagong 1994 50/semester go 2. The University of Asia Pacific Dhaka 1996 50/semester go 3. Gono Biswabiddyalay Savar 1998 50/semester go 4. Stamford University Dhaka 2003 50/semester go 5. Manarat University Dhaka 2003 50/semester go 6. State University of Bangladesh Dhaka 2003 50/semester go 7. East-West University Dhaka 2003 50/semester go 8. Northern University Dhaka 2003 50/semester go 9. Southeast University Dhaka 2003 50/semester go 10. University of Development Alternative Dhaka 2002 50/semester go 11. Primeasia University Dhaka 2003 50/semester go 12. Northsouth University Dhaka 2005 50/semester go 13. Bangladesh University Dhaka 50/semester go 14. Atish Dipankar University of Science and Technology (ADUST) Dhaka 50/semester go 15. Dhaka International University Dhaka 2006 50/semester go 16. BGC Trust University of Bangladesh Chittagong 2006 50/semester go 17. International Islamic University, Chittagong Chittagong 2006 50/semester go 18. Southern University Bangladesh Chittagong 2006 50/semester go Universities that have got primary approval Sl. Name Location Estd of Pharmacy Department Approved No of Seats 1. Daffodil International University Dhaka 25/semester 2. Noakhali Science and Technology University Noakhali 50/Yr 3 World University of Bangladesh Dhaka 50/semester

Gene responsible for heart attack will assist in diagnosis

Gene responsible for heart attack will assist in diagnosis An extended family living in the American mid-west state of lowa has helped scientists to find the first gene that unequivocally causes heart attacks in late middle age. The family has an extensive history of heart attacks with the risk highest at about the age of 60. A heart attack becomes almost inevitable in members of the family who have inherited a defect in gene known to be involved in the formation of blood vessels. Eric Topol Cleveland Clinic Foundation on Ohi said that although the genetic defect has only been found in this family, its discovery could lead to a better understanding of heart attacks in the general population. "This stands out because of its potential impact. It's a great first step towards understanding the basis of coronary artery disease at its genetic studies that once you get the first gene it starts to unlock whole story". Doctors eventually traced 26 closed family members with heart problems. The researcher took blood samples for DNA analysis in the hope of finding a common genetic link to the discover. The study found that a region of chromosome 15 - one of the 23 pairs of chromosomes in the human genome - contained a linkage "hotspot" that was known from previous studies to include a gene called MEF2A.

Low Aspirin does little for heart diseas to patients of diabetes Dr. Michele Sacco, from the Consorzio Mario Negri in Italy, and other members of the Primary Prevention Project (PPP) collaborative Group note that low dose aspirin reduces the risk of heart disease- related death by more that 40 percent when used by patients with at least one heart disease risk factor. However, other research suggests that diabetics are less likely to benefit from aspirin. Therefore, the PPP group analyzed results for their study group, which included 1031 diabetics 3753 nondiabetics followed for around 4 years. Patients were randomly selected to recieve aspirin or no aspirin and vitamin E or no vitamin E.

Modified poliovirus targets brain Cancer Cells Under normal circumstances, being injected with the poliovirus would be considered a bad thing. But for a patient suffering from brain cancer, that could one day be an effective means of treating the disease. A modified form of polio has been tested in monkyes and kills cancer cells while leaving healthy neurons untouched. Now scientists writing in the December 9 issue of the proceeding of the National Academy of Science have shed light on The mechanism behind this selectivity.

The rise of the pharmaceutical sector of Bangladesh

In Bangladesh the pharmaceutical sector is one of the most developed hi-tech sectors within the country's economy. After the promulgation of Drug Control Ordinance - 1982, the development of this sector was accelerated. The professional knowledge, thoughts and innovative ideas of the pharmaceutical professionals working in this sector are the key factors for this developments. Due to recent development of this sector it is exporting medicines to global market including European market. This sector is also providing 97% of the total medicine requirement of the local market. Leading pharmaceutical companies are expanding their business with the aim to expand export market. Recently few new industries have been established with high tech equipments and professionals which will enhance the strength of this sector

LIST OF ESSENTIAL DRUGS

Sl.  Name of drugs  Dosage form as list 

1  Abacavir (ABC)  Oral Liquid, Tablet

2  Acetazolamide  Tablet

3  Acetylsalicylic acid  Suppository, Tablet

4  Aciclovir  Powder for injection, Tablet

5  Albendazole  Tablet (chewable) 

6  Allopurinol  Tablet 

7  Aluminium hydroxide + Magnesium  hydroxide Oral liquid, Tablet

8  Amitriptyline  Tablet 

9  Amlodipine Besylate   Tablet

10  Amoxicillin  Capsule or Tablet, Powder for oral liquid, Powder for injection

11  Ampicillin   Powder for Injection

12  Anti-D immunoglobulin (human)  Injection

13  Antitetanus immunoglobulin (human)  Injection

14  Artemether + Lumefantrine*  Tablet 

15  Artesunate  Injection, Tablet

16  Ascorbic Acid  Tablet 

17  Atenolol  Tablet

18  Atropine  Injection, Solution (eye drops)

19  Barium Sulfate  Aqueous suspension 

20  BCG vaccine  Injection 

21  Benzathine benzylpenicillin  Powder for injection 

22  Benzoic acid + Salicylic acid  Ointment or cream

23  Benzyl benzoate  Lotion

24  Benzyl penicillin  Powder for injection 

25  Betamethasone  Ointment or cream

26  Bleomycin  Powder for injection

27  Bupivacaine  Injection 

28  Calcium gluconate  Injection 

29  Carbamazepine  Oral liquid, Tablet (chewable), Tablet (scored)

30  Charcoal, activated  Powder

31  Chlorambucil  Tablet

32  Chloramphenicol  Eye drops, Eye ointment 

33  Chlorhexidine  Solution 

34  Chloroquine  Oral liquid, Tablet

35  Chlorpheniramine  Injection , Tablet

36  Chlorpromazine  Injection, Oral liquid, Tablet

37  Ciprofloxacin   Tablet or powder for suspension

38  Cisplatin  Injection

39  Clofazimine  Capsule 

40  Clotrimazole  Vaginal cream, Vaginal tablet

41  Cloxacillin  Capsule, Powder for injection, Power for oral liquid,

42  Condoms  

43  Cyclophosphamide  Powder for injection, Tablet

44  Dapsone  Tablet 

45  Dexamethasone  Injection

46  Dextran 70  Injectable solution

47  Diazepam  Injection, Tablet, Tablet (scored)

48  Didanosine (ddl)  Buffered powder for oral liquid, Capsule (unbuffered  enteric coated), Tablet (buffered chewable, dispersible)  

49  Diethylcarbamazine  Tablet 

50  Digoxin  Injection, Oral liquid, Tablet

51  Diloxanide  Tablet 

52  Diphtheria antitoxin  Injection 

53  Diptheria vaccine  Injection

54  Dopamine  Injection 

55  Doxorubicin  Powder for injection

56  Doxycycline  Capsule or Tablet, Tablet (dispersible)

57  DPT vaccine  Oral + Injection 

58  Efavirenz (EFV or EFZ)  Capsule, Oral liquid, Tablet

59  Enalapril  Tablet

60  Epinephrine (adrenaline)  Injection, Solution (eye drops)

61  Ergocalciferol   Capsule or Tablet, Oral liquid

62  Ergometrine  Injection 

63  Erythromycin  Capsule or Tablet, Powder for injection, Powder for oral liquid

64  Ethambutol  Tablet 

65  Ethinylestradiol + Levonorgestrel  Tablet 

66  Ferrous salt  Oral liquid, Tablet

67  Ferrous salt + Folic acid  Capsule, Tablet

68  Fluconazole  Capsule, Oral liquid

69  Fluorescein  Eye drops

70  Fluorouracil  Injection, Ointment

71  Fluphenazine  Injection 

72  Folic acid  Tablet

73  Furosemide  Injection, Tablet

74  Gentamycin  Injection, Solution (eye drops)

75  Gentamycin + Hydrocortisone   Ear drop

76  Glibenclamide  Tablet 

77  Gliclazide   Tablet

78  Glucose  Injectable solution 

79  Glucose with sodium chloride  Injectable solution

80  Glyceryl trinitrate  Tablet (sublingual)

81  Griseofulvin  Capsule or Tablet 

82  Haloperidol  Injection, Tablet 

83  Halothane  Inhalation

84  Heparin sodium   Injection

85  Hepatitis B vaccine  Injection

86  Homatropine  Solution (eye drops)

87  Human normal immunoglobulin  Intramuscular administration, Intravenous administration

88  Hydrochlorothiazide  Tablet (scored) 

89  Hydrocortisone  Powder for injection, Ointment or cream, Suppository

90  Hyoscine butylbromide  Tablet, Injection 

91  Ibuprofen  Tablet 

92  Indinavir (IDV)  Capsule 

93  Insulin Injection (Soluble)  Injection 

94  Isoniazide  Tablet, Tablet (scored)

95  Isoniazide + Ethambutol  Tablet

96  Isosorbide dinitrate  Tablet (sublingual)

97  Ketamine  Injection 

98  Lamivudine (3TC)  Oral liquid, Tablet,

99  Levamisole  Tablet

100  Levodopa + Carbidopa  Tablet   3

Sl.  Name of drugs  Dosage form

101  Levothyroxine  Tablet 

102  Lidocaine  Injection, Topical

103  Lithium Carbonate  Capsule or tablet

104  Lopinavir + Ritonavir (LPV/r)  Capsule, Oral liquid

105  Magnesium hydroxide  Oral liquid 

106  Magnesium sulfate  Injection 

107  Mannitol  Injectable solution

108  Measles vaccine  Injection

109  Mebendazole  Tablet (chewable) 

110  Mefloquine  Tablet 

111  Metformin   Tablet 

112  Methotrexate  Powder for injection, Tablet

113  Methyldopa  Tablet : 250 mg

114  Methylrosanilinium chloride (gentian violet)  Aqueous solution, Tincture

115  Metoclopramide  Injection, Tablet

116  Metronidazole  Injection, Oral liquid, Suppository, Tablet

117  Miconazole   Ointment/Ceam

118  Miltefosine  Capsule/Oral liquid  

119  Misoprostol  Tablet

120  Morphine  Injection, Oral liquid, Tablet, Tablet (prolonged release)

121  Naloxone  Injection 

122  Nelfinavir (NFV)  Oral powder, Tablet

123  Neomycin Sulfate + Bacitracin  Ointment 

124  Neostigmine  Injection, Tablet 

125  Nevirapine (NVP)  Oral liquid, Tablet

126  Nicotinamide  Tablet

127  Nifedipine  Immediate release capsule

128  Nitrofurantoin  Tablet 

129  Nitrous oxide  Inhalation

130  Nystatin   Oral Suspension 

131  Omeprazole   Capsule

132  Oral rehydration salts  Powder

133  Oseltamivir   Tablet

134  Oxygen  Inhalation 

135  Oxytocin  Injection 

136  Paracetamol  Oral liquid, Suppository, Tablet

137  Paromomycin  Solution for intramuscular injection

138  Peritoneal Dialysis Solution  Intraperitoneal dialysis solution (of appropriate composition)

139  Permethrin  Cream, Lotion

140  Pertussis vaccine  Injection 

141  Pethidine hydrochloride  Injection 

142  Phenobarbital  Injection, Oral liquid, Tablet

143  Phenoxymethylpenicillin  Powder for oral liquid, Tablet,

144  Phenytoin  Capsule, Injection, Oral liquid, Tablet, Tablet (chewable)

145  Pilocarpine  Solution (eye drops) 

146  Poliomyelitis vaccine  Oral

147  Polyvalent anti snake venom  Injection

148  Potassium chloride  Tablet, Solution

149  Povidone Iodine  Solution

150  Prednisolone  Tablet, Solution (eye drops)

151  Primaquine  Tablet 

152  Procainamide  Injection

153  Procaine benzylpenicllin  Powder for injection   

154  Procarbazine  Capsule

155  Proguanil  Tablet 

156  Promethazine  Oral liquid, Injection, Oral liquid, Tablet

157  Propranolol  Tablet 

158  Protamine sulfate  Injection

159  Pyrazinamide  Tablet, Tablet (dispersible), Tablet (scored)

160  Pyridoxine  Tablet 

161  Pyrimethamine  Tablet 

162  Quinine  Injection, Tablet

163  Rabies immunoglobulin  Injection 

164  Rabies vaccine  Injection

165  Retinol  Capsule, Tablet, Oral oily solution, Water-miscible injection

166  Riboflavin  Tablet 

167  Rifampicin  Capsule or Tablet 

168  Rifampicin + Isoniazid  Tablet

169  Rifampicin + Isoniazid + Ethambutol  Tablet 

170  Rifampicin + Isoniazid + Pyrazinamide  Tablet 

171  Rifampicin + Isoniazid + Pyrazinamide + Ethambutol  Tablet 

172  Ritonavir  Oral liquid, Oral solid dosage form

173  Salbutamol   Injection, Oral liquid, Respirator solution for use in nebulizers, Tablet

174  Salicylic acid  Solution

175  Saquinavir (SQV)  Capsule

176  Senna  Tablet 

177  Silver sulfadiazine  Cream

178  Sodium chloride  Injectable solution 

179  Sodium Chloride 3%   I/V fluid 

180  Sodium Chloride quartet strength (0.225%) +

Dextrose 5%  I/V fluid

181  Sodium Hydrogen Carbonate  Injectable solution, Soution

182  Sodium stibogluconate  Injection

183  Sodium thiosulfate  Solution

184  Spironolactone  Tablet 

185  Stavudine (d4t)  Capsule, Powder for oral liquid

186  Streptomycin  Powder for injection 

187  Sulfadoxine + Pyrimethamine  Tablet 

188  Sulfamethoxazole + Trimethoprim  Oral liquid, Tablet, Injection

189  Suxamethonium  Injection, Powder for injection

190  Tamoxifen  Tablet

191  Tenofovir disoproxil fumarate (TDF)  Tablet 

192  Tetanus vaccine  Injection

193  Tetracycline   Eye ointment 

194  Thiamine  Tablet 

195  Thiopental  Powder for injection 

196  Trimethoprim  Tablet 

197  Tropicamide  Eye drops

198  Tuberculin, purified protein derivative (PPD)  Injection

199  Valproic acid  Oral liquid, Tablet (crushable), Tablet (enteric coated)

200  Vecuronium   Injection

201  Verapamil  Injection, Tablet

202  Vinblastine  Powder for injection

203  Vincristine  Powder for injection  

204  Vitamin B-Complex (Vitamin B1- 5 mg + Vitamin B2-

2 mg + Vitamin B6 - 2 mg + Nicotinamide 20 mg) Tablet

205  Warfarin  Tablet

206  Water for Injection  Ampoule

207  Xylometazoline Hydrochloride   Nasal drops

208  Zidovudine (ZDV or AZT)  Capsule, Oral liquid, Solution for IV infusion injection, Tablet

209  Zinc sulphate  Oral liquid, Tablet

 

Drug addiction rise in Bangladesh

Drug addiction is noted to be on the rise in Bangladesh. Among the addictive drugs, the one of choice for most of the addicts seems to be phensydyl. This is because it is cheap and easily available. It used to be prescribed by doctors in the neighbouring country as a cough syrup but is actually an intoxicant with sedative effects on the users. It is smuggled in huge quantities into Bangladesh, because there is a lucrative market for the same here. The market is being sustained and enlarged by a nexus of the drug peddlers, some corrupt elements in the police department and their various shelter givers. 

Apart from phensydyl, other hard drugs such as heroin, cocaine, morphin, pethedine and newer ones, especially, for sexual stimulation such as yaba are being consumed by a growing number of users in the country. The addicts of these relatively costlier addictive substances are mainly young people from affluent families. But they also include senior persons and bored housewives and their numbers are increasing. Thus, there is no way to treat the threat from addiction as a small one in the context of Bangladesh. It is already a serious sociological or health and economic problem. Especially the drugs used for sexual stimulation have spawned dens of vice. Recent actions against such rackets showed to what alarming extent the rot has spread and its victims among otherwise genteel members of society. Allowing it to go unaddressed could spell disaster for notable sections of the population in the near future. 

Even a decade ago, clinics to treat drug addiction hardly existed. But now such clinics are to be spotted in many parts of Dhaka city signifying the rise in the number of drug addicts. The effect of drug use on the individuals and their families can be shattering. Bright students with highly prospective careers in view suddenly turned into pathetic imbeciles as they were habituated to drug through friends and other undesirable contacts. There are many families in Bangladesh today where a woman has lost her husband or son, or brother to addiction from which they could never recover. Even the ones who are thought to be reformed at the correction centres can be a drain on the resources of modest families. Cases of divorce in the country are going up as wives separate from drug addict husbands who proved to be burdens on and tormentors of their families. Drug addiction among the lower sections of the population too has an intimate relationship with crime. In most cases, such drug users operate occasionally as snatchers and robbers just to get some money to buy drugs. 

Therefore, the direct consequences of the drug addiction are loss of health and happiness, stresses on social and family lives and rise in crimes. The same can be translated overall as undermining national productivity.

Time is ripe for leaders at the highest level to wake up to the danger posed to healthy existence of society as more and more new addicts join the ranks of the hardcore ones. This slide must be arrested at all costs. The Drugs and Narcotics Department was created nearly two decades ago, especially to counter the production and availability of addictive drugs. But it has done little over the years to attain its given objectives. The corruption, allegedly, runs high in it. 

Thus, a plan has to be drawn up to shake off the corrupt ones in the Drug and Narcotics Department. New and more effective ways of operating will have to be introduced into this body. The corrupt elements in the police service, who have nexus with the drug dealers, will have to be removed. As a preventive measure, social awareness about the problem must be increased through ensuring a greater media focus on it and stepped up official publicity.