Vol.13, No 2, 2006 pp. 94 - 97
UC 615.22.03(497.11)

THE USE OF CARDIOVASCULAR DRUGS IN NIŠ REGION OF SERBIA
Radmila M. Veličković-Radovanović1, Slobodan M. Janković2, Marina Z. Avramović1, Svetislav Kostić1
1Institute of  Nephrology and Hemodialysis, Department of Clinical Pharmacology, Clinical Centre, Niš, Serbia
2Centre for Clinical & Experimental Pharmacology, Clinical Centre, Kragujevac, Serbia
E-mail: farmakoterapija@yahoo.com

Summary. Cardiovascular disease mortality is high in Serbia. Analysis of cardiovascular drugs utilization in the population is the basis for the assessment of cardiovascular pharmacotherapy appropriateness. The aim of this study was to analyze the out-of-hospital cardiovascular drug utilization in the Niš region of Serbia & Montenegro. Using the ATC/DDD methodology, we analyzed the utilization of cardiovascular drugs dispensed on prescription in the Niš region in years 2003 and 2004. The study was retrospective, based on data obtained from Central City Pharmacy Niš, and results were expressed in DDDs/1000 inhabitants/day. The most frequently prescribed drug in 2003 and 2004 was enalapril (31.16 and 41.71DDDs/1000 inhabitants/day, respectively). The consumption of other ACE inhibitors was much less (7.36 and 10.83 DDDs/1000 inhabitants/ day, respectively). The next most commonly used drugs were a selective beta blocker and a ACE inhibitor (atenolol-8.49 DDDs/1000 inhabitants/day; cilazapril 6.48 DDDs/1000 inhabitants/day in 2003). The use of amlodipine significantly increased in 2004 (from 6.41 in 2003 to 10.21 DDDs/1000 inhabitants/day in 2004), while that of nifedipine decreased (from 4.45 in 2003 to 3.82 DDDs/1000 inhabitants/day in 2004).  Marginal use of diuretics was noted (4.4 DDDs/1000 inhabitants/day in 2003, and 5.5 DDDs/1000 inhabitants/day in 2004). This analysis pointed to significant therapeutical irrationalities in the Niš region, which could be overcome by targeted education of the prescription-givers.
Key words: Utilization of drugs, cardiovascular system, defined daily dose

UPOTREBA KARDIOVASKULARNIH LEKOVA U NIŠKOM REGIONU
Kratak sadržaj: Analiza upotrebe kardiovaskularnih lekova u populaciji čini osnovu za procenu racionalnosti kardiovaskularne farmakoterapije. Radi uporedjivanja sa drugim populacijama, upotreba lekova se izražava kao broj definisanih dnevnih doza (DDD) na 1000 bolesničkih dana, ako se radi o populaciji  hospitalizovanih bolesnika  ili na 1000 stanovnika na dan, ako se radi o opštoj populaciji. Cilj ove studije bio je da analizira vanbolničku upotrebu kardiovaskularnih lekova u regionu Niša. Koristeći ATC/DDD metodologiju, analizirali smo upotrebu kardiovaskularnih lekova na osnovu broja propisanih recepata u niškom regionu, u 2003 i 2004 godin. Retrospektivna analiza je bazirana na podacima dobijenim iz Centralne gradske apotekarske ustanove. Rezultati su prikazani brojem DDD/1000 stanovnika/dan. Najčešće propisivani lek u 2003. i 2004. bio je Enalapril (31,16 : 41,71 DDD/1000 stanovnika/dan). Najviše korišćeni beta blokator je bio Atenolol (8,49 DDD/1000 stanovnika/dan). ACE inhibitor Cilazapril se nalazi na trećem mestu  po broju propisanih recepata u 2003g (6,48 DDD/1000 stanovnika/dan). Upotreba  Amlodipina značajno je povećana u 2004. (6,41 : 10,21 DDD/1000 stanovnika /dan), a Nefedipina smanjena (4,4 : 3,82 DDD/1000 stanovnika/dan). Zabeleženo je marginalno korišćenje diuretika (4,4 : 5,5 DDD/1000 stanovnika/dan), statina i drugih ACE inhibitora, osim Enalaprila i Cilazaprila. Ova analiza  je pokazala  značajne terapijske iracionalnosti u farmakoterapiji kardiovaskularnih oboljenja, koje se mogu prevazići odgovarajućom  edukacijom.
Ključne reči:   Upotreba lekova, kardiovaskularna oboljenja, definisana dnevna doza