Going through the pages of Student Formulary
Underscoring that producing the Sri Lanka Students’ Formulary (SLSF) was “no easy task”, Specialist Physician and Professor in Pharmacology, Prof. Priyadarshani Galappatthy took the audience through the book, explaining in meticulous detail what it is all about.
What is a ‘Student Formulary’, she asked, replying that it consists of a core list of commonly-used drugs that are prescribed by junior doctors, typically about 100 drugs. A limited formulary offers students a learning target that is “realistic and attainable”.
These student formularies are a component of the core curriculum in clinical pharmacology by the British Pharmacological Society (BPS). A few countries and universities such as the Queen’s University in Belfast, Ireland and the Southampton University in the United Kingdom have produced them, while some have introduced electronic formularies. However, there are no records of any student formularies from Asia or the low/middle income countries, she said.
Going back in time, she referred to the setting up of the Formulary Committee in 1957 which published the Ceylon Hospitals’ Formulary in 1959. This formulary is said to have been done single-handedly by Prof. Senaka Bibile. Then in 1994, the Sri Lanka Hospitals’ Formulary edited by Prof. Laal Jayakody came into use. Now, the Sri Lanka Student Formulary of 2018 has been published, a project initiated by Prof. Kusum de Abrew in 2010.
“The SLSF is a source of reference of commonly prescribed medicines in the country and is meant for medical and other allied healthcare undergraduates as well as first contact doctors,” says Prof. Galappatthy, reiterating that it is to promote the rational use of medicines among junior prescribers and trainees. It will help promote the application of clinical pharmacology knowledge in clinical practice among junior prescribers. But that is not all – the SLSF is “different” to the usual formularies.
While providing details of dosage forms and doses, it also gives information on the mechanisms of action of a drug; pharmacokinetics (how the drug is absorbed, distributed, metabolized and excreted over time); pharmacodynamics (the effect the drug will have on the body); important drug interactions; side-effects; cautions; contraindications; prescribing in special situations such as when the patient is pregnant or lactating or when the patient has renal or hepatic impairment; practice points; and patient advice.
The formulary includes details of about 300 individual drugs grouped into 19 sections ranging from anti-infective medicines to endocrine medicines; from anaesthetic medicines to medicines acting in the eye, ear, nose and throat; from immunologicals to immunosuppressants, to name a few.
It also gives an insight into the most commonly prescribed 100 drugs in the five major specialties (medicine, surgery, obstetrics & gynaecology, paediatrics and psychiatry) in the Colombo group of hospitals.
The SLSF Formulary Committee comprises Editors cum Contributing Authors Prof. Kusum de Abrew (Chairperson); Prof. Priyadarshani Galappatthy (Convener); Prof. Laal Jayakody, Dr. Chamari Weeraratne and Dr. Priyanga Ranasinghe.
The other Contributing Authors are Dr. Sachith Abhayaratna, Dr. Piyusha Atapattu, Dr. Dinithi Fernando, Dr. Chiranthi Kongala Liyanage and Dr. Vipula Bataduwaarachchi. Secretarial assistance had been provided by Inoka Gammune.
While the Health Ministry had provided the funding through the MSD, 5,000 copies have been printed by the Government Printer at a cost of Rs. 1.5 million. The SLSF is to be sold at cost to make the next print self-sustaining.