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Transcript of 1 WHO Collaborating Centre for International Drug Monitoring Dr. Mohamed Farah the Uppsala...
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WHO Collaborating Centre for International Drug Monitoring
Dr. Mohamed Farah
the Uppsala Monitoring Centre
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WHO Drug Monitoring ProgrammeFounding Members 1968
Australia New ZealandCanada Denmark Germany Ireland Netherlands
United States of AmericaUnited KingdomSweden
WHO Drug MonitoringProgramme
WHO Drug MonitoringProgrammeFounding membersFounding members
1968
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WHO Programme for International Drug Monitoring
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WHO Collaborating Centrethe Uppsala Monitoring Centre
• established as a foundation 1978
• based on agreement Sweden – WHO
• international administrative board
• WHO Headquarters responsible for policy
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Signalling ProcedureWhat should be achieved?
• Signals should not be missed
• Signals should be found early
• ‘False’ signals should be kept to a minimum
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Process for joining WHO Programme
1. Ministry of Health (or equivalent) designates National Centre
Ministry of Health
National Centre
the UMC
WHO-HQGeneva
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52. Ministry of Health sends formal application to WHO-HQ, Geneva
3. National Centre sends sample reports to the UMC
4. UMC notifies WHO-HQ that reports are compatible
5. WHO-HQ advises Ministry of Health of admittance to the Programme
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Official member
Morocco (1992)
South Africa (1992)
Tunisia (1993)
Zimbabwe (1998)
Ghana (2001)
Nigeria (2004)
Mozambique (2005)
Associate member
Botswana
Democratic Republic of Congo
EritreaEthiopia
Madagascar
Sierra leone
Uganda
Zambia
Algeria
Egypt (2001)
Tanzania (1993)
Africa -WHO
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Nomina si nescis, perit et cognitio rerum. (Carl von Linné, Critica botanica)
If you do not know the names, the knowledge about the things vanishes as well.
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Isibhaha
Syn: Warburgia breyeri Pott.; Warburgia ugandensis Sprague; Chibaca salutaris Bertl. f.
Uses: Expectorant, Chest infections, Sinusitis, Malaria, Venereal diseases, Stomach ulcers, Toothache and Dermatological disorders
Chemistry
warburganal muzigadial polygodial mukaadial
Warburgia salutaris (Bertol. f.) Chiov.
Common names: Pepper bark tree, Pepperbasboom (Afr.), Shibaha (Tsonga), Amazwecehlabayo (Zulu), Isibaha (Z, V), Manaka (Venda), Sebaha (Sotho)
Muthiga (Kikuyu), Sogdom (Amharic), Msokonoi (Swahili)
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Artemisia annua L. leaf
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Artemisia annuua L.The plant can grown in many places but it may notcontain artemisinin. For example: Visitors of the ancientpalaces in the forbidden city in beijing can find niceartemisia annua plants pushing left and right as weeds,but these plants do not contain artemisinin
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Artemisia annua L.
but a clone from China could contain up to 1.1 % artemisinin
The average artemisinin concentration in plants of European origin range from 0.03 to 0.22 % (dry leaves weight basis) artemisinin,
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Artemisia annua L.
1,8-Cineole: leaf pesticide, insectifuge, herbicideAlpha-Pinene: leaf herbicide, insecticide, pesticide, insectifuge, insectiphile
Artemisic-acid: plant: pesticideArtemisinin: flower leaf antimalarial, pesticide, schizonticide, herbicideBeta-Pinene: plant: herbicide, insectifuge, pesticideBeta-Sitosterol: plant: pesticide, antifeedantBorneol: plant: herbicide, insectifuge, pesticide, insect-repellentCamphene: plant: insectifuge, pesticideCamphor: leaf antifeedant herbicide, insect-repellent, insectifuge, pesticideCaryophyllene-oxide: plant: antifeedant, insecticide, pesticideCuminaldehyde: leaf: larvicide, pesticideDelta-Cadinene: plant: pesticideDeoxyartemisinin: plant: pesticideMenthol: plant: pesticide, termiticideOcimene: plant: insecticideP-Cymene: plant: herbicide, insectifuge, pesticideScopoletin: plant: herbicide, pesticideTerpinen-4-ol: plant: herbicide, insectifuge, pesticide
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Artemisia annua L., flower, leaf
ARTEMISININ
Antitumor
Antiviral Calcium-Antagonist
Cytotoxic
Herbicide
Immunomodulator
Neurotoxic
Pesticide
Plasmodicide
Schizonticide
Teratogenic
Antimalarial
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Artemisia annua L. leaf
Dihydroartemisinin
Arteether Artesunate Artemether
Artemisinin 青蒿素
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Artemisinin Synthesis
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butsynthetic compound is unlikely to be economicallycompetitive with the naturally produced compound
Artemisinin can be synthesized,
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Case report
WHO Record number:Country: GhanaType of report: Spontaneous report/HospitalAge: 54 Years Sex: FemaleAdverse Reaction(s): Face oedema; Oedema periorbitalOutcome: Not recovered Suspected Drug: ArtesunateDrug administration data: 200 Milligram Oral TotalIndication: MALARIAConcomitant Drug(s): Nifedipine 20 Milligram Oral per DayRechallenge action: RechallengeRechallenge outcome: Reaction recurred
Nifedipine: 17 Face oedema 29 Oedema periorbital
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ArtemetherTotal number of reports 44
Agitation 6 Headache 9 Paroniria
Anorexia Hypoplasia cerebellar Stomatitis
Ataxia cerebellar Fra Insomnia Sweating increased 2
Confusion Jaundice Urine abnormal 2
Confusion Fra Nausea 2 Vision abnorma
Dizziness 9 Neurosis Vomiting 2
Eye malformation Zaf
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Artesunate Reports 22260
Anxiety 8 Alopecia 8 Agitation 341 Face oedema, Gha Abdominal pain 11
Ataxia 2 Cheilitis 29 Anorexia 513 Fever tha,Vnm Allergic reaction Zaf
Delirium Coughing 2 Asthenia Gha Gingival bleeding 2 Dizziness Gha, 1439 Th
Dyspnoea Nausea 990 Bullous eruption Hallucination 20 Hypoaesthesia Tza
0anaemia Epistaxis 3 Confusion 195 Hyperventilation Oedema periorbital Gha
Insomnia 6 Flatulence Depression 53 Hypotension Gha Paranoid reaction 6
Naevus Haematuria Diarrhoea 207 Palpitation 241 Paroniria 52, Gha 1
Rash 2 Jaundice 61 Headache 1161 Spasm generalized Rash maculo-papular 6
Pallor 85 Melaena Stomatitis 40 Urine abnormal 2 Rash erythematous 24
Purpura Pharyngitis vomiting 720 Urticaria 3, 1 Vnm Sweating increased
Pruritus 47 Tachycardia Anaemiah aemolytic 2 Thrombocytopenia 2
Tinnitus 3 Vision abnormal 168
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Artemisinin and derivativesThere is a fear that improper use of artemisinin and its
derivatives will spur the malaria parasite to evolve to
resist treatment with the compounds, something that has
happened to all previous malaria therapies
Spread of chloroquine
resistance of Plasmodium falciparum
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Natural Mosquito Repellents
*It is ten times more effective than DEET at repelling mosquitoes
Agastache cana (Hook.) Woot. & Standl.
Azadirachta indica Juss f.
Cymbopogon nardus (L.) Rendle
Melissa officinalis L.
Nepeta cataria L.*
Pelargonium citrosum Vanleenii
Pelargonium graveolens L'Her. ex Ait.
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Mosquito’s natural enemy
Mosquitofish
Bat 600/h
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If you think you're too small tobe effective, you have never been in
bed with a mosquito!
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Thank you for your attention!
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Is it acceptable that an African child dies of malaria every 30 seconds when safe and effective treatment is available.
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”Pull out, Bettyl Pull out...You’ve hit on artery”
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Mystic Herbal balm ?
Mystic Herbal balm ?
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