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In: Annual technical report, 1992, [of the] World Health Organization [WHO]. Special Programme of Research, Development and Research Training in Human Reproduction. Geneva, Switzerland, WHO, 1993. 63-78. (WHO/HRP/ATR/92/93)This document contains the 1992 Annual Report of the Task Force on [the development of safe, effective, reversible, and acceptable] Methods for the Regulation of Male Fertility of the World Health Organization's Special Programme of Research, Development, and Research Training in Human Reproduction. In the area of hormonal methods, the Task Force is currently concentrating its research activities on 1) the evaluation of the functional capacity of sperm produced by men who have been suppressed to severe oligozoospermia, 2) the development of testosterone buciclate as an injectable method and as replacement therapy for hypogonadal men, and 3) the development of second generation progestogens and new gonadotrophin-releasing hormone antagonists as gonadotrophin suppressing agents. The safety and acceptability of hormonal methods for men remain a concern and topic of research activities. As an alternative to hormonal methods, the Task Force is continuing its search for a drug with a reversible, post-testicular action on the normal function of sperm stored in the epididymis. An ideal preparation would be quickly effective and quickly reversible. Collaborative studies in China also continue to investigate the antifertility action of pure compounds isolated from the plant species Tripterygium wilfordii. During 1992, the Task Force also continued its support of studies on three methods of vas occlusion: the no-scalpel method, a chemical sterilization method, and the polyurethane-plug. The efficacy and reversibility of silicone vas occlusion also remains under study. A training workshop on vas occlusion methods was attended by 32 participants in Indonesia in April 1992, and the safety of vasectomy continues to be monitored by the Task Force. This report notes the state of research on inhibin isolated from porcine follicular fluid and on the possibility of an immunization approach based on a vaccine against follicle-stimulating hormone. Two projects supported in 1992 sought to identify sperm surface proteins as putative immunogens. The report ends by recounting its investigator initiatives, its collaborative research programs, and its efforts in the area of information distribution. A summary describes 10 areas in which substantial progress was made during 1992.
In: Advances in international maternal and child health. Volume 7. 1987, edited by D.B. Jelliffe and E.F.P. Jelliffe. Oxford, England, Clarendon Press, 1987. 170-9.General principles of the WHO Essential Drug List (EDL) and the International Non-Proprietary Names (INN) list and their application to maternal and child health are summarized. 8 principles of good prescribing habits are introduced, such as careful dosing for infants, children, pregnant or lactating women, elderly, or those with liver or kidney disease. Most INN drug names are identical to the generic names used in the country of origin, but some are coined from common chemical or pharmacological stems. Drugs for pregnant women should be limited in number, and used with care since almost all cross the placenta and may not be tolerated by the fetus with its immature liver and kidneys. The most serious reason for restricting certain drug intake by pregnant women is the risk of teratogenicity, particularly in the 1st trimester. Potential teratogens include antiepileptics, barbiturates, cytotoxics, anticoagulants, and female sex hormones. Salicylates should not be taken near term. Opioid analgesics should not be used during labor. Drugs dangerous for the infant during breastfeeding include high dose oral contraceptives, the antithyroid drugs thiouracil and iodine, diazepam and lithium. Education and training in pharmacokinetics for personnel in maternal-child health should be included. Fixed combinations of drugs are not advisable: out of 220 drugs in the EDL, there are only 11 drug combinations.
WORLD HEALTH ORGANIZATION TECHNICAL REPORT SERIES. 1988; (770):1-63.This booklet incorporates both guidelines and criteria for establishing national programs for essential drugs, and a suggested list of approximately 250 essential drugs. It is important to emphasize that it is up to each country to decide whether to implement an essential drug policy, and how to adapt the list to their own changing needs. Guidelines for a national program include accepting recommendations by a local committee; using generic names and providing a cross index; providing a drug information sheet to accompany the list; regulation or constant testing of quality of the drugs; deciding on the level of expertise needed to prescribe each drug; administration of supply, storage and distribution. Choice of drugs is based on quality, bioavailability, safety, price and availability. Criteria for selection of drugs for primary health care involves evaluation of existing medical care systems, the national health infrastructure, trained personnel and available supplies, and the pattern of endemic disease. Each agent is listed by its international nonproprietary name (INN), is accompanied by substitutions and complementary drugs, and is described by its route of administration, dosage form and strength. Listings are by category and alphabetically.