mercy ships formulary 2006-2007. the good samaritan parable (1) luke 10:30-35 the good samaritan and...
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Mercy Ships Formulary2006-2007
The Good Samaritan parable (1)
Luke 10:30-35
The Good Samaritan and Scarce Medical Resources
Reproduced by permission from
Christian Scholar's Review XXIII:3,
March 1994, pp. 360-373.
The Good Samaritan parable (2)
Sanctity – the respect of humanity Compassionate care
Just care
Scarcity – limited resourcesBe honest: acknowledge our limitations
Be humble: acknowledge our interdependence
The Good Samaritan parable (3)
Scarcity – Need for StewardshipRational selection of treatment options
• Maxillofacial Surgeries• Eye Surgeries & Care• Dental Surgeries & Care• VVFs & Orthopaedics• Community Health
The Good Samaritan Parable (4)
Scarcity – Need for StewardshipRational selection of medicines
• WHO essential medicines list www.who.int/medicines/
• IDA available generics www.idafoundation.org
• Annual regular donor sources
Optimise resources (financial/human)• procurement & inventory management• medicines administration, dosing & prescribing• Optimise space• Minimise wastage (esp. expired meds)
Mercy Ships Formulary
History of development
July 2002 first essential drugs LIST established fromM/V Anastasis 2002 outreach experience
Sep 2002 work started on first formulary BOOK draftDec 02 - mar 03 first draft review & proof readingApr - Jun 2003 test pilot during active outreach, volunteers’
Continuous feedback from field & IOCJul - Aug 2003 final draft review & proof readingAug - sep 2003 200 copies printed at USD 3.00 per bookNov 2003 training materials and books distributed to
ships, IOC and other land bases
Mercy Ships FormularyHistory of development
2003 - 2004 continuous feedback and update of LIST (e.g. New MSL requirements, different availability in IDA catalogues, changes from WHO recommendations.)
Jan 2005 work started on second BOOK editionJuly 2005 latest WHO essential list publishedSep 2005 attended WHO/UNICEF essential medicines
technical briefing seminar in Geneva, decision to include WHO notes/guidelines
Dec 2005 final draft review & proof readingFeb 2006 200 copies printed for distribution
Mercy Ships FormularyReview involved current and ex-volunteers, of long & short term experiences, from developed & developing countries
Proof reading involved 32 personnel, including administrators, anaesthetists, surgeons, physicians, nurses, pharmacists, radiographers/lab techniciansIT & printing support
Second edition proofreaders include health professionals of diverse backgrounds and specialties outside of MSI
Third edition planned in two years, formulary list to be reviewed and updated every six months
Mercy Ships FormularyDosages based on:
WHO model formulary 2004/6, www.who.int/medicines/ British national formulary, www.bnf.org
The Micromedex healthcare series online, www.micromedex.comEssential drugs practical guide, Doctors without borders or MSF www.msf.org
Online networks: « HIF-net at WHO », www.inasp.info « E-DRUG », www.essentialdrugs.org/edrug« Afro-net », SATELLIFE www.healthnet.org
Mercy Ships Formulary First edition made available for free downloading on www.drugref.org since November 2003.
3229 reads of the article1053 downloads of the formulary .doc file931 downloads of the formulary .pdf file.
Also available on www.ms-information.org and the Anastasis intranet
Requests for use include: community health centres in Kenya, hospital in Nigeria, university in India, hawaii www.wheelchair-kauai.com
Mercy Ships FormularyFormulary (F) medicines:
336 items [former list 327 items] 126
Outreach-critical medicines
Consistent availability
Sought actively as donations
Purchased from the international dispensary association (IDA) www.idafoundation.org
• Assured quality generics, supplier to agencies/NGOs e.G. UN, UNICEF, MSF
Mercy Ships FormularyDonation (D) medicines:
Additional 55 items [former list 37] 6
Medicines totally dependent on donations
Regular donors • E.G. Tylenol, Alcon eye preps
High cost
Third-line treatments
Drugs with generic alternatives
Mercy Ships Formulary
Hands-on session
Mercy Ships Formulary
Table of contents
Preface: how to use the bookEML – WHO essential medicines list item
MSL – mandatory sailing list item
N/CD – narcotics/controlled drugs°
PS – psychotropic substances°°Legal requirements for records & stock
Mercy Ships FormularyBibliography & acknowledgements
Introduction to essential medicines
Prescription writing guidelinesSee abbreviations at the end of the book
Main chapters 1-14 – BNF model Gastrointestinal system, anaesthetics(New) WHO notes and recommendations
e.g. Treatment of dehydration
Mercy Ships Formulary
Appendices: prescribing in children, pregnancy, breastfeeding, elderly
(New) table of drugs to avoid or use with caution in pregnancy & breastfeeding
Index: search by - Generic name (acetaminophen or paracetamol) Brand name example (Tylenol) Pharmacological category (NSAIDs) (New) disease or indication (angina)
Table of values, conversions & unitsAbbreviations
Mercy Ships Formulary
Chapters, listed by physiological systemsE.G. Cardiovascular system, ENT --- BNF model
Sections, listed by pharmacological categoriesE.G. Antacids, Penicillins --- BNF model
Medicines, listed A-Z by generic name (with brand name examples)
E.G. Ketoconazole (Nizoral)
Comment/cautions notes
Mercy Ships Formulary
Features to be considered for addition in future editions (feedback from first ed.):
Table of Drug Interactions
Table of Drugs vs. Pregnancy - done
Table of Drugs vs. Breast-feeding - done
Search by diseases/indication in Index - done
Mercy Ships Formulary
Feedback & suggestions:Formulary Editor/Pharmacist [email protected]
Current Pharmacist
Current Crew Physician
Current Ward Supervisor
Mercy Ships Formulary
‘Go and do likewise.’
Luke 10:37