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ection 1: Anaesthetics

1.1 GENERAL ANAESTHETICS AND OXYGEN

ether, anaesthetic (1c) (2) inhalation

halothane (2) inhalation

ketamine (2) injection, 50 mg (as hydrochloride)/

ml in 10-ml vial

nitrous oxide (2) inhalation

oxygen inhalation (medicinal gas)

¤thiopental (2) powder for injection, 0.5 g, 1.0 g

(sodium salt) in ampoule

1.2 LOCAL ANAESTHETICS

¤bupivacaine (2, 9) injection, 0.25%, 0.5%

(hydrochloride) in vial

injection for spinal anaesthesia,

0.5% (hydrochloride) in 4-ml ampoule

to be mixed with 7.5% glucose solution

¤lidocaine injection, 1%, 2%

(hydrochloride) in vial

injection, 1%, 2% (hydrochloride)

+ epinephrine 1:200 000 in vial

injection for spinal anaesthesia,

5% (hydrochloride) in 2-ml ampoule

to be mixed with 7.5% glucose solution

topical forms, 2–4% (hydrochloride)

dental cartridge, 2% (hydrochloride)

+ epinephrine 1:80 000

Complementary drug

ephedrine (C) injection, 30 mg

(For use in spinal anaesthesia (hydrochloride)/ml in

during delivery to prevent hypotension) 1-ml ampoule

Explanatory Notes

When the strength of a drug is specified in terms of a

selected salt or ester, this is mentioned in brackets; when it

refers to the active moiety, the name of the salt or ester in

brackets is preceded by the word "as".

Many drugs included in the list are preceded by a box (¤) to

indicate that they represent an example of a therapeutic

group and that various drugs could serve as alternatives. It

is imperative that this is understood when drugs are selected

at national level, since choice is then influenced by the

comparative cost and availability of equivalent products.

Examples of acceptable substitutions include:

¤ Hydrochlorothiazide: any other thiazide-type diuretic currently

in broad clinical use.

¤ Hydralazine: any other peripheral vasodilator having an

antihypertensive effect.

¤ Senna: any stimulant laxative (either synthetic or of plant

origin).

¤ Sulfadiazine: any other short-acting, systemically active

sulfonamide unlikely to cause crystalluria.

Numbers in parentheses following drug names indicate:

(1) Drugs subject to international control under: (a) the

Single Convention on Narcotic Drugs (1961); (b) the Convention

on Psychotropic Substances (1971); or (c) the

United Nations Convention against Illicit Traffic in Narcotic

Drugs and Psychotropic Substances (1988).

(2) Specific expertise, diagnostic precision, individualization

of dosage or special equipment required for proper use.

(3) Greater potency or efficacy.

(4) In renal insufficiency, contraindicated or dosage adjustments

necessary.

(5) To improve compliance.

(6) Special pharmacokinetic properties.

(7) Adverse effects diminish benefit/risk ratio.

(8) Limited indications or narrow spectrum of activity.

(9) For epidural anaesthesia.

(10) Sustained-release preparations are available. A proposal

to include such a product in a national list of essential

drugs should be supported by adequate documentation.

(11) Monitoring of therapeutic concentrations in plasma can

improve safety and efficacy.

Letters in parentheses following the drug names indicate the

reasons for the inclusion of complementary drugs:

(A) When drugs in the main list cannot be made available.

(B) When drugs in the main list are known to be ineffective or

inappropriate for a given individual.

(C) For use in rare disorders or in exceptional circumstances.

(D) Reserve antimicrobials to be used only when there is

significant resistance to other drugs on the list.

Drugs are listed in alphabetical order.

WHO Model List (11th revision December 1999)

¤ Example of a therapeutic group. Various drugs can serve as alternatives.

atropine injection, 1 mg (sulfate)

in 1-ml ampoule

chloral hydrate syrup, 200 mg/5 ml

¤diazepam (1b) injection, 5 mg/ml

in 2-ml ampoule

tablet, 5 mg

¤morphine (1a) injection, 10 mg (sulfate or

hydrochloride) in 1-ml ampoule

¤promethazine elixir or syrup, 5 mg

(hydrochloride)/5 ml


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