Post by Rick Watson on Jan 10, 2006 20:27:13 GMT -5
Memo to Medical Personnel
From: Pharmacy Director
Re: Overview of Drugs We Carry
If our primary mission is to reach areas with the gospel through medicine, then our primary instrument would be a drug, so a few words on what we carry. We do not attempt to be prepared to treat any and all aliments, just those that can be treated simply in a rural medical clinic setting, and those that have serious consequences if left untreated. Medical personnel are free, and encouraged to obtain other medicines that they would prefer to use and those will be dispensed.
The enclosed drug list has been worked on over the years using 3 criteria: (1) the anticipated need in the field, (2) relative effectiveness to other drugs, and (3) cost. Unfortunately, with the other things being equal, cost is an overriding consideration. We work on a very tight budget and must achieve the most “bang for our buck”. Americans tend to think that “best” mean most expensive, but that is not true here, and certainly not in an area were they have had almost no medical treatment.
A good example of our criteria and also to answer a question that seems to come up almost every year would be lice treatment. Human body lice and other parasites are a common problem in Honduras. Although the need is obvious, the cost and chance of effectively removing the problem have brought us to the decision to not carry lice treatments.
Treatment of lice requires (about 2 oz per person) a shampoo (the cheapest I can find is about $5-6 for 4 oz bottle), a spray for bedding (cost around $6-7), and washing all clothes at the same time in hot soapy water. Treatment of an average family would cost about $20 and take 4-5 minutes of teaching for each mother, assuming that they can handle the washing part. Since lice have few long-term serious health concerns and the chance of being effective is slim, we don’t carry lice medication. We start out with a few tubes of Elimite for serious cases of scabies, which can cause intense itching. However, Sandy for Cruzado can order “lice soap” for a reasonable cost and this is a good alternative treatment.
Antibiotics
Medical treatment of a wide range of infections is basic to our mission. Since there is little overuse of these products, there is very little resistance. Amoxicillin (still a classic here in the states) is our main antibiotic. It is broad spectrum, very effective and low in cost. As a back up we have Doxycycline. (Another oldie, but goodie.) Very effective in a broad range of infections, especially in soft tissue infections, of which we see a lot. We will often have limited numbers of brand name antibiotics that have been donated, but the supply is inconsistent and changes from group to group.
Treatments of infections in children are almost completely with Amoxicillin (250mg suspension and chewable). Doxycycline tablets can be used in older children and teenagers for the same soft tissues infections. Others such as Zithromax, and Keflex are often available; ask you pharmacist. Inject able antibiotics such as Rocephlin or Ancef are usually available in limited numbers.
For fungus and girl thingyl infections there is Flagyl, Diflucan, and girl thingyl cream.
Anti-inflammatory (and pain):
We carry no narcotic pain relievers, but with little exposure to pain relievers, what we do carry is effective. Our main drug acetaminophen 500mg for adults and teenagers, and liquid and 180 mg chewable for children is used for any pain or fever. The backup for pain and main drug for arthritis is Ibuprofen 600mg tablets and liquid for more sever pain and high fever in children. Medrol dospak(generic) for steroid treatment.
Colds/Cough/Allergy/Asthma:
Great deal of asthma and upper respiratory congestion. Albuterol tablets and syrup for prevention of wheezing and restrictive airways. Albuterol inhalers for shortness of breath. Use the antihistamine/PSE syrup(Dimetapp) for allergies, congestion, and colds. Guaif. DM for just cough and combination (Guaif/DM/PSE) for treating all three (the most common product we use). We have a high dose GG/PSE tablet for adults and a lower dose one for children. For simple congestion, plain Sudafed does the trick. We do carry drugs to treat eye and ear infections.
Stomach and G.I. Tract:
Another very common area of problems is the G.I. tract. Our two primary drugs are Generic Zantac or Pepcid for hyperacidity and Gen. Donnatal tablets and liquid for non-specific stomach pain.
Benadryl capsules and liquid have many uses (even for treatment of nerves or for sleep) Mylicon drops for gas in babies. Antacid liquid and tablets, but limited supply.
Skin Conditions:
Second only to upper respiratory infections in occurrence are widespread skin problems in children and adults. Again Benadryl is a major use here, as well as creams. Hydrocortisone creams for simple rash, nystatin or tolnaftate cream for fungus, and the combination(triamcinolone/nystatin) for a rash of unknown cause or where there could be both, which is very common. This is our main cream. Silvadene for burns and some Elimite for severe cases of scabies.
Purely medical treatments such as suture kits, gauze, pads, etc. are left to the medical personnel.
From: Pharmacy Director
Re: Overview of Drugs We Carry
If our primary mission is to reach areas with the gospel through medicine, then our primary instrument would be a drug, so a few words on what we carry. We do not attempt to be prepared to treat any and all aliments, just those that can be treated simply in a rural medical clinic setting, and those that have serious consequences if left untreated. Medical personnel are free, and encouraged to obtain other medicines that they would prefer to use and those will be dispensed.
The enclosed drug list has been worked on over the years using 3 criteria: (1) the anticipated need in the field, (2) relative effectiveness to other drugs, and (3) cost. Unfortunately, with the other things being equal, cost is an overriding consideration. We work on a very tight budget and must achieve the most “bang for our buck”. Americans tend to think that “best” mean most expensive, but that is not true here, and certainly not in an area were they have had almost no medical treatment.
A good example of our criteria and also to answer a question that seems to come up almost every year would be lice treatment. Human body lice and other parasites are a common problem in Honduras. Although the need is obvious, the cost and chance of effectively removing the problem have brought us to the decision to not carry lice treatments.
Treatment of lice requires (about 2 oz per person) a shampoo (the cheapest I can find is about $5-6 for 4 oz bottle), a spray for bedding (cost around $6-7), and washing all clothes at the same time in hot soapy water. Treatment of an average family would cost about $20 and take 4-5 minutes of teaching for each mother, assuming that they can handle the washing part. Since lice have few long-term serious health concerns and the chance of being effective is slim, we don’t carry lice medication. We start out with a few tubes of Elimite for serious cases of scabies, which can cause intense itching. However, Sandy for Cruzado can order “lice soap” for a reasonable cost and this is a good alternative treatment.
Antibiotics
Medical treatment of a wide range of infections is basic to our mission. Since there is little overuse of these products, there is very little resistance. Amoxicillin (still a classic here in the states) is our main antibiotic. It is broad spectrum, very effective and low in cost. As a back up we have Doxycycline. (Another oldie, but goodie.) Very effective in a broad range of infections, especially in soft tissue infections, of which we see a lot. We will often have limited numbers of brand name antibiotics that have been donated, but the supply is inconsistent and changes from group to group.
Treatments of infections in children are almost completely with Amoxicillin (250mg suspension and chewable). Doxycycline tablets can be used in older children and teenagers for the same soft tissues infections. Others such as Zithromax, and Keflex are often available; ask you pharmacist. Inject able antibiotics such as Rocephlin or Ancef are usually available in limited numbers.
For fungus and girl thingyl infections there is Flagyl, Diflucan, and girl thingyl cream.
Anti-inflammatory (and pain):
We carry no narcotic pain relievers, but with little exposure to pain relievers, what we do carry is effective. Our main drug acetaminophen 500mg for adults and teenagers, and liquid and 180 mg chewable for children is used for any pain or fever. The backup for pain and main drug for arthritis is Ibuprofen 600mg tablets and liquid for more sever pain and high fever in children. Medrol dospak(generic) for steroid treatment.
Colds/Cough/Allergy/Asthma:
Great deal of asthma and upper respiratory congestion. Albuterol tablets and syrup for prevention of wheezing and restrictive airways. Albuterol inhalers for shortness of breath. Use the antihistamine/PSE syrup(Dimetapp) for allergies, congestion, and colds. Guaif. DM for just cough and combination (Guaif/DM/PSE) for treating all three (the most common product we use). We have a high dose GG/PSE tablet for adults and a lower dose one for children. For simple congestion, plain Sudafed does the trick. We do carry drugs to treat eye and ear infections.
Stomach and G.I. Tract:
Another very common area of problems is the G.I. tract. Our two primary drugs are Generic Zantac or Pepcid for hyperacidity and Gen. Donnatal tablets and liquid for non-specific stomach pain.
Benadryl capsules and liquid have many uses (even for treatment of nerves or for sleep) Mylicon drops for gas in babies. Antacid liquid and tablets, but limited supply.
Skin Conditions:
Second only to upper respiratory infections in occurrence are widespread skin problems in children and adults. Again Benadryl is a major use here, as well as creams. Hydrocortisone creams for simple rash, nystatin or tolnaftate cream for fungus, and the combination(triamcinolone/nystatin) for a rash of unknown cause or where there could be both, which is very common. This is our main cream. Silvadene for burns and some Elimite for severe cases of scabies.
Purely medical treatments such as suture kits, gauze, pads, etc. are left to the medical personnel.