Hejsan Svejsan

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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 Zealand
Canada
Denmark
Germany
Ireland
Netherlands
United Kingdom
Sweden
United States of America
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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

1. Ministry of Health sends formal application to
   WHO-HQ, Geneva

1. National Centre sends sample reports to the UMC

the UMC
WHO-HQ Geneva

1. UMC notifies WHO-HQ that reports are compatible

1. WHO-HQ advises Ministry of Health of admittance
   to the Programme

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Algeria
Africa -WHO
Official member
Associate member
Democratic Republic of Congo
South Africa (1992)
Madagascar
Morocco (1992)
Sierra leone
Tunisia (1993)
Botswana
Tanzania (1993)
Eritrea
Zimbabwe (1998)
Ethiopia
Egypt (2001)
Uganda
Ghana (2001)
Zambia
Nigeria (2004)
Mozambique (2005)
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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
Warburgia salutaris (Bertol. f.) Chiov.
Syn Warburgia breyeri Pott. Warburgia
ugandensis Sprague Chibaca salutaris Bertl. f.
Common names Pepper bark tree, Pepperbasboom
(Afr.), Shibaha (Tsonga),
Amazwecehlabayo (Zulu), Isibaha (Z, V), Manaka
(Venda), Sebaha (Sotho)Muthiga (Kikuyu), Sogdom
(Amharic), Msokonoi (Swahili)
Uses Expectorant, Chest infections, Sinusitis,
Malaria, Venereal diseases, Stomach ulcers,
Toothache and Dermatological disorders
Chemistry
warburganal
muzigadial
polygodial
mukaadial
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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 not
• contain artemisinin. For example Visitors of the
  ancient
• palaces in the forbidden city in beijing can find
  nice
• artemisia annua plants pushing left and right as
  weeds,
• but these plants do not contain artemisinin

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Artemisia annua L.
The average artemisinin concentration in plants
of European origin range from 0.03 to 0.22
(dry leaves weight basis) artemisinin,
but a clone from China could contain up to 1.1
artemisinin
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Artemisia annua L.
1,8-Cineole leaf pesticide, insectifuge,
herbicide
Alpha-Pinene leaf herbicide, insecticide,
pesticide, insectifuge, insectiphile
Artemisic-acid plant pesticide
Artemisinin flower leaf antimalarial, pesticide,
schizonticide, herbicide
Beta-Pinene plant herbicide, insectifuge,
pesticide
Beta-Sitosterol plant pesticide, antifeedant
Borneol plant herbicide, insectifuge,
pesticide, insect-repellent
Camphene plant insectifuge, pesticide
Camphor leaf antifeedant herbicide,
insect-repellent, insectifuge, pesticide
Caryophyllene-oxide plant antifeedant,
insecticide, pesticide
Cuminaldehyde leaf larvicide, pesticide
Delta-Cadinene plant pesticide
Deoxyartemisinin plant pesticide
Menthol plant pesticide, termiticide
Ocimene plant insecticide
P-Cymene plant herbicide, insectifuge, pesticide
Scopoletin plant herbicide, pesticide
Terpinen-4-ol plant herbicide, insectifuge,
pesticide
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Artemisia annua L., flower, leaf
ARTEMISININ
Antimalarial
Antitumor
Antiviral
Calcium-Antagonist
Cytotoxic
Herbicide
Immunomodulator
Neurotoxic
Pesticide
Plasmodicide
Schizonticide
Teratogenic
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Artemisia annua L. leaf
Artemisinin ???
Dihydroartemisinin
Artesunate
Arteether
Artemether
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Artemisinin Synthesis
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Artemisinin can be synthesized,

• but
• synthetic compound is unlikely to be economically
• competitive with the naturally produced compound

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• Case report

WHO Record number Country Ghana Type of
report Spontaneous report/Hospital Age 54
Years Sex Female Adverse Reaction(s) Face
oedema Oedema periorbital Outcome Not
recovered  Suspected Drug Artesunate Drug
administration data 200 Milligram Oral
Total Indication MALARIA Concomitant
Drug(s) Nifedipine 20 Milligram Oral per
Day Rechallenge action Rechallenge Rechallenge
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 derivatives

• There 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
Agastache cana (Hook.) Woot. Standl.
Azadirachta indica Juss f.
Cymbopogon nardus (L.) Rendle
Melissa officinalis L.
Pelargonium citrosum Vanleenii
Pelargonium graveolens L'Her. ex Ait.
Nepeta cataria L.
It is ten times more effective than DEET at
repelling mosquitoes
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Mosquitos 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...Youve hit on artery
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Mystic Herbal balm ?
Mystic Herbal balm ?
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