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    The EDL and INN: their importance in maternal and child health.

    El-Borolossy AW

    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.
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