1.Study of medicines used for skin diseases
Duumaam I, Khurelbaatar L ; Dungerdorj D
Mongolian Medical Sciences 2010;152(2):58-61
INTRODUCTION:
One of the main issues on the National drug policies in countries of the world and in Mongolia is the proper usage of
the drug. In this frame, we need to study and to implement the methodical basis to use drug market drug marketing
theoretical principles . They are: to improve and to follow new standard in diagnostics and diseases treatments prevailing
in our country, to stop inappropriate usage of drugs, to implement the drug program of national necessity, to determine the
drug usage in the proper way, and to organize the control properly.
According to the statistic report of 2002 through 2008, the rate of skin disease was ranked as 8 (4.5%) among common
diseases, and as 7th (4.07%) among aimag level, but on the other hand the skin disease rate has increased by 59213
cases compared between 2002 and 2008.
GOAL AND OBJECTIVES: The main goal of the study was to determine the drug needs used in dermatological diseases
where the results were compared with the current standard and to develop future recommendations to improve the proper
usage of medicines.
MATERIALS AND METHODS: In order to calculate the drug cost and demands, the main marketing methods were used such
as calculation of past, current and future prognosis of drug demands. For example:
∎ The calculation of drug expenditure
∎ Calculation of drug demands by number of registered disease cases
∎ Development of the future prognosis of the disease based on the assessment of experts
RESULTS: 1092 patients who were hospitalized in 2007 and 2008 in National Center of Dermatology, 464 patients who
were hospitalized in the epidermis department of the general hospital of 12 provinces, totally 1725 patient’s medical
histories were chosen for drug usage in this research work. Average, patient day 12,7, males 867(50,3%) females
858(49,7%) children 283 (16,4%), adults 1442 (83,6%) participated in the research work. From all patients who are
hospitalized are: patients who are in the hospital for the first time 1090 (63,2%), patients hospitalized for the second time
635 (36,8%). About patients who discharged from the hospital: 1055(61,2%) patients were recovered, and 670
(38,8%) patient’s health conditions were improved. Here is the approved diagnosis in the frame of the research work:
dermatitis 605 (35.1%), Psoriasis 355 (20,5%), eczema 266 (15.4%) is leading the list.
DISCUSSION: According to research on the drug proper usage, each drug used for patients treatment was calculated
upon the drug type, quantity, and patients percentage and it is concluded by its classification of analogical quantification.
They are: Patient percentage who treated and recovered with preparations against Gistamin 62.8, Patient percentage
who treated and recovered with antibiotics and preparations against bacterium 72.8, Patient percentage who treated and
recovered with drugs of Corticosteroid group 87.4, Patient percentage who treated and recovered with viricide 16.9, Patient
percentage who treated and recovered with antidote and sorbent 21, Patient percentage who treated and recovered
with drugs promoting the body organs, organ system functions 81.7, Patient percentage who treated and recovered with
Preparation for skin casting 51, Patient percentage who treated and recovered with disinfection preparations 45.
2. TECHNOLOGICAL STUDY OF PREPARING DICLOFENAC GEL
Battsetseg B. ; Khurelbaatar L.
Mongolian Pharmacy and Pharmacology 2013;2(1):48-49
Introduction: It is required to develop drug formulations and increase local preparations substituting the import preparations. The utilization of a new drug formulation of diclofenac gel is an example of a medicine which is encouraged to be prepared locally. Diclofenac gel is a cyclooxygenase inhibitor, which is a non-steroidal anti-inflammatory drug (NSAID) taken to reduce inflammation and as an analgesic reducing pain in certain conditions. It is important to develop technology and standard for diclofenac gel type of medicine in Mongolia.In 2010, domestic manufacturers produced about 30- 40 percentage of demand in Mongolia. However, there are many manufacturers that produce the same type of medicines. This shows that there is a need for local manufacturers to meet local demand. It is an indication of urgency in bringing in new technologies, new drug formulations, activating drug research and scientific work in domestic drug industry.Based on research, in 2011, non-steroidal anti- inflammatory drugs were the most sold drugs, which had a market share of 29.2%. Also in 2010, non- steroidal anti-inflammatory drugs of gel formulation had a market share of 130 million Tugriks.In 2011, there were nine different manufacturers of diclofenac gel have been registered to Mongolian Medicine Registrar/LICEMED/. They are:-Clafen 1%-20.0 produced in Antibiotice Ltd, Romania-Feloran 1%-60.0 produced in Bаlkanpharma Troyan AD, Poland-Almiral1%-10.0/25.0 produced in Medochemie Ltd, Cyprian-Olfen 1%-20.0 produced in Mepha Ltd, Switerland-Voltaren 1%-20.0/50.0 produced in Novartis pharma,Switzerland-Dicloran Plus 1%-30.0 produced in Unique pharmaceutical laboratories, India-DiclofenacAcri 1%-30.0 produced in Acrihin Ltd, Russia-Diclovit 1%-20.0 produced in Nijpharm, Russia-Diclomol 1%-20.0 produced in Win Medicare Ltd, India.These gels are packaged between 20-60 grams and the are price ranges from 2,700-12,000 Tugriks.In the world, nowadays diclofenac gel is most commonly produced.Diclofenac gel is colorless, and it penetrates the affected area quickly and effectively. The gel has an advantage of delivering full drug concentration to the affected area quickly, while it is convenient and pleasant to use.Purpose of study: The purpose of study’s to develop a Diclofenac gel technology for the first time in Mongolia. In order to reach my purpose, which owe as follows:• To determine convenient ingredients and gel baseof gel formulations• To develop a layout explaining gel manufacturingtechnology• To formulate raw ingredients based on the developed of the gel• To develop an evaluation and quality control systemfor producing gelMaterials and methods: Research work was done at the Monos School of Pharmacy and Drug Research Institute.Triethanolamin and Glycerin from Tsetsuuh LLC, Diclofenac sodium, hydroxypropylmethylcellulose, and menthol from Monos Pharm LLC, Carbomer 940, Ultrez-21 and Propylenglycol from Monos Cosmetic LLC were used for this research.To determine the drug ingredient: To determine gel formulations, primary and secondary ingredients were chosen carefully to maintain chemical compatibility and stability.Developed gel formulation was checked forquality control, which includes drug content, pH,appearance/Homogeneity/, and viscosity by Russian Pharmacopoeia XI and Mongolian Primary Pharmacopoeia. Permeability studies and skin irritation test was performed by USP.Result: First, carbopol concentrations of 0.5%, 1.0%, 1.5% and 1.2%, Ultrez-21 concentrations of 0.5%,0.8%, and 1%, and hydroxypropylmethylcelluloseconcentrations of 3%, 4%, 5% were prepared as gel formulations.Of those, carbopol concentrations of 1.2% and 1.5%, and Ultrez-21 concentrations of 0.8% and 1.0% were relatively better compared to other concentrations in terms of meeting drug content, appearance, pH level, and viscosity requirements. 0.2 gram of Menthol was added to provide comfort and pleasant odor when gel is applied as well as providing release of diclofenac sodiumFinal products were compared to similar diclofenac gels in the market in terms of pH level, drug content, skin irritation, and release of active substance. Of those final products, Ultrez-21 concentration of 1% resulted to be the most similar to the diflofenac gels in the market that satisfy the qualities mentioned above.Conclusion:1. The Ultrez-21 1% is determined to be the best gelling agent and 0.2 gram of Menthol is determined to be the best amount for increasing drug permeability.2. Developed technological procedure for preparingdiclofenac gel.3. To determine criteria for quality control, gel drug content, appearance, pH and viscosity were shown to be the most convenient measures.
3. PRESCRIBING BEHAVIOR AND PHARMACEUTICAL MARKETING PROMOTIONS
Ankhtsetseg B. ; Khurelbaatar L.
Mongolian Pharmacy and Pharmacology 2013;2(1):54-
Irrational use of medicines is a major problem of worldwide. WHO estimates that more than half of all medicines are prescribed, dispensed or sold inappropriately, and that half of all patients fail to take them correctly. This incorrect use may take the form of overuse, underuse, and misuse of prescription or non- prescription medicines.And WHO ascribing that there are four common problems for irrational use;• Polypharmacy /use of too many medicines/• Overuse of antibiotics and injections;• Failure to prescribe in accordance with clinicalguidelines;• Inappropriate self-medication.This list estimates us an irrational use of prescription medicines is common problem of irrational use of medicine. And so there are many factors contributing irrational use of prescription medicines. But substantial factor is inappropriate unethical promotion of medicines by pharmaceutical companies. Most prescribers getmedicine information from pharmaceutical companies rather than independent sources such as clinical guidelines. This can often lead to overuse. Some countries allow direct-to-consumer advertising of prescription medicines, which may lead to patients pressuring doctors for unnecessary medicines.Many developing and developed countries ascribing that to protect the public health by assuring prescription medicine information is truthful balanced and accurately communicated.Irrational use of medicines and problem of pharmaceutical promotions are determined here in above by WHO and FDA.Our health care system can’t yet determine that “How to marketing promotion for prescription medicines affects prescribing behavior?” and how we can complete problems of promotions of prescription medicines.It is essential that under today’s circumstances this deficiencies are immediately identified and eliminated, and the directions for further course of action are appropriately determined.
4.The Pharmacological and Phytochemical Study Review of some Species of Iris Grown in Mongolia
Oyunchimeg B, Badamtsetseg B, Lkhagva L., Khurelbaatar L
Mongolian Pharmacy and Pharmacology 2017;10(1):9-16
The genus Iris belongs to the family Iridaceae and comprises of over 300 species and fifteen species of genus Iris are found in Mongolia. Iris has long history of use in various indigenous systems of medicine as alternative aperients, stimulant, cathartic, diuretic, gall bladder diseases, liver complaints, dropsy, purification of blood, venereal infections, fever and bilious infections and for a variety of heart diseases. Rhizomes of Iris are rich source of secondary metabolites and most of these metabolites are reported to possess anticancer, antiplasmodial, anticholinesterase, enzyme inhibitor and immunomodulatory properties. Approximately more than two hundred compounds have been reported from the genus Iris, which includes flavones, isoflavones, glycocides, benzoquinones, triterpinoids, stilbene glycosides and organic acids. In this article, we reviewed the published results of phytochemical and pharmacological studies of some Iris species which are grown in Mongolia.
5.Blood Collection Techniques and Limits
Davaasambuu T., Badamtsetseg B., Lkhagva L., Khurelbaatar L.
Mongolian Pharmacy and Pharmacology 2017;10(1):30-34
Purpose: The document outlines the preferred methods for collecting blood from laboratory animals and blood collection volume and frequency limits. Blood collection for experimental purposes must comply with researchers of the Drug research institute (DRI) approved protocol, including approved collection techniques, volumes, and frequencies. The Department of Pharmacology researchers train investigators in various collection techniques. The researcher may collect blood for veterinary care purposes using accepted clinical techniques ensuring volumes collected do not adversely affect animal health.
Blood Collection Limits: The DRI limits one time survival blood collection to 7.5% of an animal’s blood volume in most circumstances. Serial blood sampling limit vary by species, strain and frequency of blood collection. The DRI may require monitoring for anemia (using assays such as hematocrit and/or serum protein levels) when repeated collection of larger volumes are required. Blood collected for diagnostics or other veterinary procedures must be considered when evaluating total volume available for experimental use. In all cases blood collection volumes should be limited to the minimum volume that will allow for successful experimentation or diagnostics.
6.Hypothesis of effects for ellipin on cancer cells Molecular mechanisms involved
Bayanmunkh A ; Khurelbaatar L ; Lkhagva L
Mongolian Medical Sciences 2014;169(3):8-13
The Ellipin, derived from bovine liver, is a newly developed agent containing several important fattyacids and may have anticancer effects on cancer cell in vitro culture. This Ellipin preparation containmany PUFAs and those are important molecules for membrane order and function; they can modifyinflammation-inducible cytokines production, eicosanoid production, plasma triacylglycerol synthesisand gene expression. Recent studies suggest that anti-proliferation effect on in vitro cancerous cell linese.g. J62, Raji, Hela, K582, and in vivo it minimized and decreased the growth of U14 cervical cancer inmice and suppressed the growth of its S37 sarcoma cells, increased the area of dead cancer cells, anddecreased the angiogenesis. Also it can be cancer chemopreventive and auxiliary agents for cancertherapy. The Ellipin could alter cancer growth influencing cell replication, cell cycle, and cell death.However, the effects of the Ellipin function on tumor growth in vivo have not been studied completlyand the mechanisms remain unclear. The question that remains to be answered is how, which pathwayEllipin can affect so many molecular ways inside cancer cell. We hypothesize that Ellipin’s mixture ofunsatured fatty acids effect inductor molecules in cancer gene which inhibits a repressor protein bindingto promotor and synthesis signaling molecules (caspase protein, TNF- ¹) in liver cancer cell. Also italter membrane stability and modifing cellular signalling.
7.Fatty acid composition of sea-buckthorn (Hippophae rhamnodes L. ) oil
Badamtsetseg S ; Bayanmunkh A ; Lkhagva L ; Khurelbaatar L
Mongolian Medical Sciences 2014;169(3):47-50
IntroductionSea buckthorn is known to be one of the vitamin-rich berries in the plant kingdom and has beencredentialed as highly valued for healthy living, improving well-being, enhancing lifestyle, and preventingthe disease. Widely recognized in Northern regions of Europe and Asia, Hippophae rhamnodes hasbeen used medicinally for thousands of years. Both of seed and pulp oil have tocopherols, carotinoids,as well as ω-3 and ω-6 fatty acid families. The seed oil is highly unsaturated, with proportions of linoleic(C 18:2n-6) and α-linolenic (C18:3n-3) acids between 30-40% and 20-35%, respectively, whereas thepulp oil is more saturated containing high amounts of palmitoleic (C16:1n-7, 16-54%) and palmitic acids(16:0,17-47%). Many researchers including Laagan B., Avdai Ch., Tsendeekhuu Ts., Vernik S. R.,Jamyansan Y., Badamkhand D., Odonmajig P have determined content of berry, fatty acid compositionof sea buckthorn pulp and seed oil since 1970 in Mongolia. However, total fat and fatty acids compositionof Hippophae rhamnodes general is known, limited reports exist dealing with comparative differencesin fatty acid composition of Hippophae rhamnodes grown in Mongolia. Therefore, we analyzed thecomposition of fatty acids pulp oil and seed oil in sea buckthorn grown in Mongolia.Materials and MethodsPulp and seed oil were produced in Monos Food Co Ltd., and fatty acid methyl ester were analyzedusing Agilent Packard Gas Chromatograph (GC) (Model HP-6890 Agilent Packard) with mass-spectrumdetector (Model HP MSD 5973N).ResultThe results indicated that unsaturated fatty acids in the seed oil (85.4%) and in pulp oil (62.5%) arehigher than saturated fatty acids of seed oil (14.6%) and pulp oil (37.1%) respectively. The mostimportant factor defining the nutritional value of oil is ratio of unsaturated fatty acids present in oil. Theseed oil contains palmitic acid (10.8%), oleic acid (20.3%), limoleic acid (42.9%), α-linolenic acid (5.6%),Eicosadienoic acid (14.7%). Pulp oil of Hippophae rhamnodes has palmitic acid (35.4%), palmitoleicacid (38.5%), oleic acid (including Vaccenic acid) (6.6%) and linoleic acid (10.4%). The palmitic acid andpalmitoleic acid ratio in pulp oil was more than in seed oil. While oleic acid, linoleic acid and α-linolenicacid in seed oil have a higher ratio than that of pulp oil. It shows that unsaturated fatty acids in seed oilare much higher than pulp oil.ConclusionUnsaturated fatty acids in the pulp oil contain 62.5%, including essential fatty acid ω-3, 6, 9 (18.2%);it is content of 29.12% in unsaturated fatty acids. While, unsaturated fatty acids of seed oil contains85.4% in total fatty acid and essential fatty acid contains 96.72% in unsaturated fatty acid. It can thus beconcluded that seed oil is better than pulp oil because the former contains essential fatty acid.
8. Blood Collection Techniques and Limits
Davaasambuu T. ; Badamtsetseg B. ; Lkhagva L. ; Khurelbaatar L.
Mongolian Pharmacy and Pharmacology 2017;10(1):30-34
Purpose: The document outlines the preferred methods for collecting blood from laboratory animals and blood collection volume and frequency limits. Blood collection for experimental purposes must comply with researchers of the Drug research institute (DRI) approved protocol, including approved collection techniques, volumes, and frequencies. The Department of Pharmacology researchers train investigators in various collection techniques. The researcher may collect blood for veterinary care purposes using accepted clinical techniques ensuring volumes collected do not adversely affect animal health.Blood Collection Limits: The DRI limits one time survival blood collection to 7.5% of an animal’s blood volume in most circumstances. Serial blood sampling limit vary by species, strain and frequency of blood collection. The DRI may require monitoring for anemia (using assays such as hematocrit and/or serum protein levels) when repeated collection of larger volumes are required. Blood collected for diagnostics or other veterinary procedures must be considered when evaluating total volume available for experimental use. In all cases blood collection volumes should be limited to the minimum volume that will allow for successful experimentation or diagnostics.
9. STUDY RESULT OF DRUGS SUPPLY FOR PEPTIC ULCER
Ulambayar L ; Khurelbaatar L ; Munkhbat S ; Tserenlkhagva R ; Oyuntsetseg KH
Mongolian Pharmacy and Pharmacology 2013;2(1):15-
Introduction:Structure and Function of the digestive organ diseases in that commonly occurred Ulcer Disease (PUD) is becoming one of the major diseases in the population furthermore it is tending to increase and peptic ulcer malignity is in the fourth leading tumor which causes to death.80% of the patients who has Gastric ulcer, 80 % of the patient who has PUD, has helicobacter pylori infections.Mongolian statistics data estimates that there are in total 355256 structures and function of the digestive organ diseases were registered in 2011. 25.2 % of stationary disease, 74.8% of is ambulatory diseases from them stationary disease of PUD are 3.74 %, ambulatory disease of PUD are 4.84%.Purpose of the study: Indicate the substantial supply of essential drugs of PUD in the stationary and ambulatory treatment.The study material and method:Diagnosis of PUD 2010-2012, The retrospective study has been done on the history of 393 stationary patients in the Gastroenterlogy Department of Orkhon, Uvur-Khangai, Khovd, Dornod’s regional center for diagnosis and, State Central Clinical Hospital, Clinical Hospital-2, Hospital-3 named after Mr. Shastin, Hospitals in Songini Khairkhan District and Nalaikh Districtbut also 107 ambulatory patient’s substantial supply of prescribed drug treatments were compiled by cross sectional studies which is specifically developed study card.WHO advised the drug supply “ Managing drug supply, the selection, the procurement, distribution and use of pharmaceuticals ” method by Jonathan D. Quick, Jamas R. Rakin, Richard O.Laing, Ronald W.O’Connor, Hans V.Hogerzell, M.N.G.Dukes, Andrew and Кобзарь л.в, дрёмова н.Б, глембоцкая г.т мнушко з.н. Statistic was developed and implemented excel, SPSS16.0 programme.Result of the study: In the study 500 people wereabove 20 and average age is 48.36±14.44.As a tertiary Level hospital 27, As a secondary Level hospital 18,Regional Center for Diagnosis 21, ambulatory treatment 22 kinds of drugs were used in PUD’s treatment. Omeprazolum 380, Metronidazolum 242, Sylcoseryl 227 were used.163380.15 tugrug (Mongolian currency) budget is required for Stationary treatment of Peptic Ulcer Disease (PUD) but 987540.95tugrug budget is required for ambulatory treatment.Conclusion:As a tertiary Level hospital 27, As a secondary Level hospital 18 and Regional Center for Diagnosis used 21 kinds of drugs for PUD.22 kinds of tablets were used for Peptic Ulcer Disease in an ambulatoryAs the result of the study 163380.15 tugrug for PUD’s stationary treatment, 987540.95 are required for PUD’s ambulatory treatment.
10. STUDY WORK FOR STRUCTURE OF THE WAREHOUSE OF THE PHARMACEUTICAL WHOLESALE CENTER AND THEIR ACTIVITIES.
Otgonbileg B ; Uranchimeg M ; Khurelbaatar L
Mongolian Pharmacy and Pharmacology 2013;2(1):51-
Foundation of the research: The issues of safety and qualified medicine industrial, supplyment and maintenance is the counterpart of national security policy about any nations. Mongolia has been importing over 80% of domestic demand of medicine.New drugs have accessed into marked and medicine distributors or suppliers, pharmacies have established as many, thus its generating the needs to improve the legal environ for to reach the new level of quality control, medicine suppliers structure and activities, then also to verify the safety of imported or local medicine.May having formulize the requirements of medicine warehouse, remodify the standard of Medicine Supply Organization can be the first step to solve the problems which Medicine Supply Organization has been facing.The purpose and goals of research work: Submitting following goals in the frame of the purpose to analyze the condition of the Medicine Supply Organization’s warehouse, study the foreign country’s GSP and utilize the standard instruction of medicine warehouse by determine the method of access it into Mongolian bigger Medicine Supply Organization. Thereof:1.Make analysis and assessment on the current condition of Mongolian Medicine warehouse.2.Conduct the research work based on the guidance of World Health Organization, European UnioN warehouse standard and other foreign country’s warehouse standard.3.To utilize the medicine warehouse standard guidance for Mongolia.The methodology: Have selected and incorporated with 5 top company which are operating as medicine importer based on value of imported products for last 3 years and 3 The pharmaceutical wholesale center which had lesser scope and totally means 8 companies.We used following methods such as observation study, open review survey, schematic and comparative study, method of interview and review and documentation method.THE RESULT OF RESEARCH WORK: Even though,those research involved organizations have met with the requirements of MNS 5530:2009 Medicine Supply Organization Standard by 71%, and risk assessment was in low risk category as by 20% under the State Specialized Inspection Agency, but accordingly with the World Health Organization’s formulized GSP’s guidance, it haven’t freezing and cooling chain storage condition of medical product storage. Research involved The pharmaceutical wholesale center provides activity supervision indication of GSP’s guidance by 30%, required parts of warehouse structure by 43% and supportive parts of warehouse operation by 22%.CONCLUSION:1. However, that research involved the pharmaceutical wholesale center have reached 71% of the requirement of MNS 5530:2009 standard of Medicine Supply Organization and fitted in low risk category as 20% according with the risk assessment of State Specialized Inspection Agency, but was lower by 68% than building construction standard and activities according with the GSP’s guidance.2. Have determine the solutions for resolvable factors which are unreached the requirements of GSP based on the study of World Health Organization, European Union GSP requirements, Kazakhstan, Bulgaria, Germany and Russian by linked it with the condition of research involved organizations.Utilized the Mongolian medicine warehouse standard guidance.