The complete story of the deaths in Punjab institute of cardiology Punjab Pakistan. Normally there are almost no pharmacists in PIC and because of that many problems arise. The most major complication occurred recently.
Main issue:
In PIC there were some patients that were given the medicine and this medicine caused their death. The medicine was taken as donation and was free of cost. The companies given these medicines for their advertisement and check how these work. One of these medicines caused the death of many people.
Main cause:
When the tests were done it was found that ISO-TAB tablets Eferoz Karachi was responsible for that and this was because they used an antimalarial drug as binder in the tablets. These were heavily contaminated with the pyrimethamine. This caused the serious bleeding in the patients and that caused all the deaths.
Some details:
ISO TAB Details:
It is an Anti-Anginal medicine that has Isosorbide-5-mononitrate in it. It is used for the treatment of Angina associated with Coronary Artery Disease. It has three brands Isotab-20 / Isotab-40 / Isotab-XR These are in tablet form and are in concentration 20mg / 40mg / 60mg.
Eferoz company:
12, C Block-6, P.E.C.H.S., Off. Sharah-e-Faisal, Karachi-75400 – Pakistan
This is the company that makes the ISO TAB in original but the investigators are saying that the medicine that caused the death was fake and was not the original product of the Eferoz.
Pyrimethamine:
Pyrimethamine is a medication used for protozoal infections. It is commonly used as an antimalarial drug (for both treatment and prevention of malaria), and is also used (combined with sulfadiazine) in the treatment of Toxoplasma gondii infections in immunocompromised patients, such as HIV-positive individuals. Pyrimethamine interferes with tetrahydrofolic acid synthesis from folic acid by inhibiting the enzyme dihydrofolate reductase (DHFR). Tetrahydrofolic acid is needed for DNA and RNA synthesis in many species, including protozoa.
What caused the deaths?
This is evident that this medicine is used for the suppression of the DNA synthesis so as this will suppress the bone marrow and also effect the production of the blood components like the RBC and also the other components. This will cause the swear bleeding just like the symptoms that appeared in dengue. In both cases the agent is disturbing the blood component production at Bone marrow level.
Cure:
The main cure for that effect was to administer the folic acid to the patents but the fact is, It was not given at that time that is why there are so many deaths.
Questions:
Who manufactured that medicine (ISO TAB)?
How that reached the Punjab institute of cardiology?
Who allowed it in PIC?
Why once the deaths were stated no cure could be found?
Answers:
The PIC and all the other areas in Pakistan is lacking one of the major component of the heath field, that is a qualified pharmacist. The PIC did not hire pharmacists as many as the hospital should have. There are no pharmacists so medicine was approved by the doctor that’s something unacceptable. The cure was not found as there was no correct record that from where the medicine are coming and where they are being administered as this is best done by a pharmacist. Now to one main point that who manufactured that medicine. This is still under investigation but the fact is it reached the PIC due to negligence of the government. If there was proper law enforcement then this would not have happened. Who will do that law enforcement, only a loyal pharmacist can do that and only a loyal pharmacist can do that.
By:
Anam Masood BPD01091147 , Faraz Maqsood BPD01091021 University of Lahore