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Order-No.:
E.22(15)Med./74/Pt.
Dated 6.3.2000
Whereas, it was brought to the
notice of the State Government that high profits in
pharmaceutical industry has led to a large number of
drugs and medicinal products under various brand names
and number of them have been reported to be irrational
combinations as per WHO criteria. As a first step
towards promotion of rational use of drugs on the basis
of efficacy, safety, suitability and cost effectiveness,
the State Government had constituted an Essential drug
List Committee (EDLC) comprising of highly qualified
professionals and clinical specialists of various
disciplines to prepare an Essential Drug List (EDL) for
the State of Rajasthan.
And, whereas this EDLC circulated the National
Essential Drug List along with WHO criteria for
selection of Essential drugs amongst all the principal
user-institutions viz. Principals & Controllers of
all six Medical Colleges of the state, all Directors of
Medical health Services, Rajasthan running different
national programmes with a request to examine the
National Essential Drug List in their respective
institutions looking into the health needs of the people
providing treatment facilities at different levels of
State health care institutions and send their
suggestions and comments in this regard. After receiving
the observations and comments of these Principal use
institutions, the Essential Drug List committee
deliberated and finalised the Essential Drug List (EDL)
for the State of Rajasthan availing the expertise of a
WHO representative as the member of the EDLC and
submitted to the Government.
The State Government is pleased to accept the
report of the EDLC and hereby declare it as Rajasthan
State Essential List (RSEDL-2000) for the State of
Rajasthan (Annexure-I) with the following Guidelines.
1.
The doctors of the state working under Government
shall prescribe and use medicines out of the RSEDL only
as far as possible. Deviations in prescription outside
the RSEDL would be subject to scrutiny by an
“Authorised Medical Authority” to be constituted by
the Government.
2.
The EDL would serve as a positive list for the
public servants and pensioners. Therefore, medicines to
these categories would be reimbursable only from EDL.
Medicare Relief Card holders would also be prescribed
medicines only out of this list claiming reimbursement
of Medicare care. This would prevent unnecessary
prescribing and save money to Government exchequer.
However, in case of severe/chronic illness and life
threatening situations supported by the recommendations
of “
Authorised medical Authority” to be notified
separately, the reimbursement to these categories
outside the RSEDL could be considered by the Government.
3.
Procurement of drugs and medicines in government
hospitals and institutions would continue to be on the
basis of existing drug list of the government as this is
reported to be sufficient to take care of 90-95% cases
of illness. Broadly, 75% of the budget of a hospital
should be spent for procuring medicines from the list.
Remaining 25% budget should be spent to procure
medicines from EDL. This ratio of expenditure could be
relaxed by the government on receipt of specific
proposals from an institution through HOD with this
recommendation. Store Purchase Organization of Medical
& Health Department would circulate the approved
rate contract for all medicines in the EDL on the basis
of which the CM&HO’s. PMO’s and Suptds, Medical
Collage Hospitals would procure medicines as per their
demand.
4.
After the approved rate contract is circulated to
all concerned. It would be the responsibility of the
in-charge of the medical institution to ensure that
medicines in the approved rate contract are available in
the hospital and dispensed on priority. To the following
categories free of cost:
I.
Medicare Relief Card holders
II.
Emergency cases
III.
Other extreme poor categories like destitute,
beggars, orphans, senior citizens and widows unable to
afford treatment costs. Decision on this would be taken
discretely by in-charge of the hospital and in this
absence by another doctor authorised by him for this
purpose. Since budget is limited it is expected to use
the discretion with utmost caution.
A
separate account of drug dispensation to each of the
above category would be maintained Separate Drug
dispensation counters be opened in each Hospital.
5.
The RSEDL is not static and would be periodically
revised by EDLC, which may be constituted by the
Government from time to time to cope up with the changed
environment and rational need of the prescribing.
6.
Principals & Superintendents of Medical
Collages would ensure that teaching of the Essential
Drug List is included in the curriculum of graduate and
post graduate Medical students and adequate time is
provided for its teaching.
7.
All in-charge of the Government hospitals.
Principals and Superintendents of Medical Collages.
Directors of Medical Health Services would take
immediate steps to ensure compliance of the EDL in their
hospitals. They should convene meeting of the doctors
and sensitise them on use of EDL. Similarly, they should
also take steps to sensitise the Private Medical
Practitioners on the use of this list for the general
benefit of the public.
This order issues with the
concurrence of FD vide ID No. 684/Fs/2000 dated
24.2.2000
1)
Drugs marked with an asterisk (*) are to be
considered as complimentary drugs, i.e.Those that are
used if the other drugs there are not available or they
are required for specific patients, situations or
locations for valid reasons.
2)
The names of drugs are followed by the letters
given below to indicate their need at various levels of
medical care:
P-
Primary Health Care
S-
Secondary Health Care
T-
Tertiary Health Care
U-
Universal
3)
Although the drugs are listed by their peu
categories, these are not necessarily meant to be use as
prescribing guidelines. A drug that may deserve to be
included in a particular category may not be found
there, as it may already be included in another
category.
Essential
Drugs List
|
S.No.
|
Drugs
Name |
Type |
|
1. Anaesthetics
|
|
|
1.1 Gen. Anaesthetics
& Oxygen
|
|
|
|
Ether
Halothane
Isoflurane*
Ketamine
Nitrous Oxide
Oxygen
Thiopental sodium
|
S, T
S, T
S, T
S, T
S, T
U
S, T
|
|
1.2
|
Local Anaesthetics
|
|
|
|
Bupivacaine HCl
Ethyl Chloride
Ligncocaine
|
U
U
T
|
|
1.3
|
Preop. Medication &
Sedation for short term Procedures
|
|
|
Atropine Sulphate
Diazepam
Morphine
Promethazine
Glycopyrrolate
|
U
U
S, T
U
T
|
|
2.
|
Analgesics, Antipyretics
& ASAIDS and Drugs used to treat Gout
|
|
2.1
|
Non-opioid Analgesics
|
|
|
|
Acetyl Salicylic Acid
Allopurinol
Diclofenac
Ibuprofen
Paracetamol
|
U
S, T
U
U
U
|
|
2.2
|
Opioid Analgesics
|
|
|
|
Pethidine (HCl)
Pentazocine
|
S, T
S, T
|
|
3.
|
Anti Allergics & Drugs
used in Anaphylaxis
|
|
|
Chlorpheniramine
Pheniramine
Cetrizine
Dexamethasone
Epinephrine
Hydrocortisone Sodium Succinate
Prednisolone
Promethazine
|
U
U
U
U
U
P, S, T
S, T
U
|
|
4.
|
Antidotes and other
Substances used in Poisoning
|
|
4.1
|
Non specific
|
|
|
|
Activated charcoal
Atropine
|
U
U
|
|
4.2
|
Specific
|
|
|
|
Anti snake venom
Deferoxamine
Methylthioninium Chloride (Methylene Blue)
Naloxone*
Pralidoxime (2-PAM)
Sodium Nitrate*
Sodium Thiosulphate*
Penicillamine*
|
U
S, T
S, T
S, T
U
S, T
S, T
S, T
|
|
5.
|
Anticonvulsants
|
|
|
|
Carbamazepine
Clonazepam
Diazepam
Phenobarbital
Phenytoin Sodium
Sodium Valproate
|
U
T
U
U
U
U
|
|
6.
|
Anti-Infective Drugs
|
|
|
6.1.1
|
Intestinal Anthelmintics
|
|
|
|
Albendazole
Niclosamide
|
U
S, T
|
|
6.1.2
|
Antifilarials
|
|
|
|
Diethylcarbamazine
|
U
|
|
6.2
|
Antifilarials
|
|
|
6.2.1
|
Penicillin’s
|
|
|
|
Amoxycillin
Amoxycillin + Clavulanic Acid
Ampicillin
Cloxacillin
Benzathine Benzyl penicillin
Benzyl Penicillin
Procaine Benzyl penicillin
|
U
T
U
U
U
U
U
|
|
6.2.2
|
Other Antibacterial
|
|
|
|
Amikacin*
Cephalexin*
Chloramphenicol
Ciprofloxacin
Co. Trimoxazole (Trimethoprim Sulphamethoxazole)
Doxycycline
Erythromycin
Gentamycin
Metronidazole
Nalidixic Acid
Nitrofurantion
Norfloxacin
Tetracycline
Reserve Anti-Bacterial Amoxycillin + Clavulanic
Acid
Cefototaxime
Cefazolin
Ceftriaxone
|
S, T
U
S, T
S, T
U
U
U
S, T
U
U
U
S, T
U
T
T
T
T
|
|
6.2.3
|
Anti-Leprosy
|
|
|
|
Clofazimine
Dapsone
Rifampicin
|
T
U
U
|
|
6.2.4
|
Anti-Tuberculosis
|
|
|
|
Ethambutol
Isoniazid
Pyrazinamide
Rifampicin
Streptomycin
PAS
Rifampicin + Isoniazid
Rifampicin + Isoniazid + Pyrazinamide
|
U
U
U
U
U
U
U
U
|
|
6.3
|
Anti-Fungals
|
|
|
|
Amphotericin
Griseofulvin
Ketoconazole
Nystatin
Clotrimazole
|
T
S, T
S, T
S, T
P
|
|
6.4
|
Antiprotozoal Drugs
|
|
|
6.4.1
|
Antiamoebic &
Antigiardiasis
|
|
|
|
Diloxanide Furoate
Metronidazole
Tinidazole
|
S, T
U
U
|
|
6.4.2
|
Antileishmaniasis Drugs
|
|
|
|
Pentamidine
Sodium Stilbogluconate
|
S, T
S, T
|
|
6.4.3
|
Antimalarial Drugs
|
|
|
|
Chloroquine
Primaquine
Quinine
Sulfadoxine + Pyrimethamine
Artesunate
Mefloquine
|
U
U
U
U
S, T
S, T
|
|
6.5
|
Anti-Viral Drugs
|
|
|
|
Acyclovir*
|
S, T
|
|
7.
|
Antimigraine Drugs
|
|
|
7.1
|
For treatment of acute attack
|
|
|
|
Acetyl Salicylic Acid
Dihydro Ergotamine
Paracetamol
|
U
S, T
U
|
|
7.2
|
For Prophylaxis
|
|
|
|
Propranolol
|
U
|
|
8.
|
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