Drug

Drug chemicals voluntarily or involuntarily introduced into the body in order to enhance or suppress a biological function. Most drugs in use are medicines. But nowadays some drugs in use contain nicotine and alcohol which enhance or suppress the function of the nervous system.

Essential drug any medicine considered as indispensable for treatment of a disease. Drugs are substances of defined chemical nature, and are produced synthetically or are obtained from natural sources such as plants. All life-saving drugs are admittedly essential drug's, but whether a certain drug will be placed in the essential drug's list of a country will, in a large measure, be determined by whether the disease occurs in the country or even whether the disease constitutes a major health problem in the country. Most countries of the developing world maintain a list of essential drugs and in this undertaking the World Health Organisation offers assistance. In the past, and particularly during 1980s, the essential drugs list of Bangladesh included some 200 products. The list has been enlarged in the 1990s, a decision which coincided with two important events. One was the country's transition to a market economy that began in the early 1990s, and the other was the national health policy, which was much discussed in preceding decades and in the 1990s, but is yet to be enacted in the country. [Zia Uddin Ahmed]

Antiasthmatic drug medicine used to prevent, inhibit or treat asthma. The various therapeutic agents or antiasthmatic drugs which are generally used in Bangladesh in the treatment of asthma are (i) chromolyn sodium (disodium chromoglycate); taken prophylactically, it effectively prevents antigen-induced release of histamine and other mediators; (ii) methylxanthine drugs (theophylline, aminophylline, theobromine and caffeine); (iii) bronchodialators such as adrenaline, ephedrine, epenehrine (with and effects), isoprenaline (with effects), and metaprotrenol, salbutamol, albuterol, tebutaline, bitolterol, carbuterol and ebuterol (2 selective drug); (iv) corticosteroids (beclomethasone, betamethasone, dexamethasone, prednisone, methylprednisone, triamcenolone, etc). It is believed that these drugs act by inhibitory tendencies or by modifying the respiratory inflammatory response in the airways. [Sitesh Chandra Bachar]

Antidiarrhoeal drug any chemical substance administered to a person to treat and/or prevent diarrhoea. Three clinical syndromes of diarrhoea are acute watery diarrhoea, dysentery, and persistent diarrhoea. An estimated 73.5 million episodes and 0.26 million deaths occur each year in those under 5 years of age. Approximately 95% of the children can be treated using only oral rehydration therapy (ORT), commonly known as orsaline, and continued feeding. Some medicines are categorized as antidiarrhoeal drugs. These include adsorbents (eg smectite, attapulgite, kaolin, activated charcoal, cholestyramine etc) and antimotility drugs (eg tincture of opium, camphorated tincture of opium, paregoric, codeine, diphenoxylate with atropine, and loperamide hydrochloride). Antisecretory drugs (eg chlorpromazine, bismuth subsalicylate) should not be used, since the dose required to produce an antisecretory effect often cause excessive sedation. Bismuth subsalicylate decreases the number of stool and subjective complaints in adults with travellers' diarrhoea. The overuse of antidiarrhoeal or antiprotozoal agents often delays the initiation of ORT. [Md. Omar Faruk Khan]

Antidysenteric drug medicine used to treat dysentery (diarrhoea with blood in stools frequently caused by Shigella). Enteroinvassive Escherichia coli may cause severe dysentery as Shigella does. Entamoeba histolytica causes dysentery in older children and adults but rarely in children under 5 years of age. About 10% of all diarrhoeal episodes in children under 5 years are dysenteric, but these cause about 15% of all deaths attributed to diarrhoea. Children with dysentery usually have shigellosis. However, in presence of E. histolytica infection, antiamoebic therapy are also given. Four key points for its treatment are antimicrobials, fluids, feeding and follow-up. Trimethoprim, sulfamethoxazole, nalidixic acid and ampicillin are the most common 'anti-dysenteric' drugs. Although treatment is recommended for 5 days, there should be a substantial improvement after 2 days. Metronidazole is the drug of choice for amoebic dysentery including those caused by E. histolytica. It is recommended to make rational basis of use of these drugs after identifying the causative microorganism to stop abuse and/or toxic manifestation with these agents. Children with signs of dehydration should be offered recommended fluids. Feeding should be continued normally to prevent malnutrition.

Antihelmintic drug chemical substances used to treat helminth or worm infections. The parasitic worms that cause infections in man or other host animals are generally members of the phyla Platyhelminthes and Nematoda. The infection is endemic in unhygienic regions of the country and is largely transmitted by water. Some of the most effective anti-helmintic drugs are: Albendazole which is active against most nematodes and some cestodes; and Diethylcarbamazole citrate which is used in the treatment of filarial infections, mainly lymphatic filariasis and loiasis. Because reactions due to death of the parasite can be severe, it is sometimes replaced by ivermectin, which is used in the treatment of onchocerciasis; it reduces the microfilarial load without producing unacceptable reactions. Levamisole hydrochloride is active against a range of worms, used mainly in roundworm and hookworm infections. Mebendazole is active against most nematodes and some cestode worms. It is poorly absorbed and is used principally in intestinal nematode infections. Piperazine is used in the treatment of roundworm and thread worm infections. It is usually well tolerated but can produce severe neurotoxicity at high doses. [Md. Omar Faruk Khan]

Crude drug unrefined natural substances of plant and animal origin having therapeutic properties and pharmacological actions. These substances in the natural state comprise whole plants, their morphological or anatomical parts, saps, extracts, secretions or other constituents; whole animals, their anatomical parts, glands or other organs, extracts, secretions or other constituents of their organs. Crude drugs are used as therapeutic agents in many traditional medicinal preparations in Bangladesh. Most often extracts, infusions, decoctions or distillates are used as ingredients of these preparations. They are also used in preparing modern allopathic medicinal products.

In Bangladesh numerous crude drugs are prepared from local plant and animal sources while many more are imported from foreign countries for use in the preparation of Unani, Ayurvedic and Homeopathic medicines. Many of them are also used in Hekimi, Kaviraji and Folk medicine practices in the country. Some of the official crude drugs available in Bangladesh are Abroma bark, Acacia, Aloes, Amlaki, Arjuna, Asoka bark, Asparagas, Babchi, Black Cumin, Calotropis, Capsicum, Cassia fruit, Castor, Cathranthus, Chaulmoogra, Cinnamon, Colocynth, Colophony, Coriander, Eucalyptus, Fenugreek, Garlic allium, Ginger, Henna, Herpestis, Hydrocotyle, Indian Ipecac, Indian Sarsaparilla, Indian Senega, Indian Squill, Kalamegh, Kurchi bark, Lemongrass, Linseed, Myrobalan, neem, Nux-vomica, Papaya, Peppermint, Rauwolfia, Sesame, Stramonium, Turmeric, Vasaka, and Withania. [Abdul Ghani]

Drug of biological origin drugs or chemicals of medical importance which are derived from different biological sources like plants, animals (including human), or microorganisms. Drugs which are derived from humans include (i) whole blood and blood components, (ii) antibodies and isoagglutinins, and (iii) hormones. Whole blood and blood components are drawn from selected donors under rigid aseptic precautions. Among hormones, chorionic gonadotrophins, obtained from the urine of pregnant women, are used as drugs.

Antibiotic substances are produced as a result of the metabolic activities of living cells which inhibit, at very low concentrations, the growth of microorganisms. Commonly used antibiotics are: aminoglycosides- gentamycin sulphate from Micromonospora purpura, kanamycin sulphate from Streptomyces kanamyceticus, neomycin sulphate from Streptomyces fradiae, streptomycin sulphate from Streptomyces griceus; penicillins derived from various Penicillium species)- ampicillin, amoxycillin, cloxacillin, methicillin, penicillin G, benzathine penicillin etc; tetracyclines- chlortetracyclines from Streptomyces aureofaciens, and doxycline from Streptomyces spp.

Bacterial vaccines (a suspension of whole bacteria whether killed or attenuated) include the bcg vaccine; cholera vaccine obtained from Vibrio cholerae; pertusis vaccine obtained from bacilli Bordetella pertusis; plague vaccine obtained from Persinia pestis; and typhoid vaccine obtained from Salmonella typhae.

Some hormones and enzymes such as glucagon, insulin, cortisone E, and pancreatin- obtained from animal organs such as the pancreas have important medicinal uses.

Vitamin A and D, obtained from the liver of fresh codfish, are widely used to supplement the deficiency of these two vitamins. [Sitesh Chandra Bachar]

Topical drug chemical agent or medicine applied to the surface of the skin or mucous membrane for local or systemic action. Many topical drugs are formulated as antibiotics, antiseptics, corticosteroids, antineoplastics, local anaesthetics, antianginal, and antihypertensives. Some chemicals applied topically are simply protective or sunscreening agents, adsorbents, demulcents, emollients, or repellents against biting or annoying insects. Topically applied ointments may be antibiotics (bacitracin, chlortetracycline, neomycin), antifungal agents (benzoic acid, salicylic acid, zinc undecenoate), antinflammatory agents (betamethasone valerate, flucinolone acetonide, hydrocortisone and its acetate, triamcinolone acetonide), antipruritics (drugs that relieve itching)-benzocaine, coal tar, antiseptics (ammoniate mercury, zinc oxide), astringents (calamine), and counterirritants (capsicum oleoresin, iodine, methyl salicylate). Antibiotics and antibacterials help in warding off infections.

Several pharmaceutical companies in Bangladesh namely Beximco, Fisons (BD), Glaxo (BD), Square, etc produce topical drugs and chemical agents in various dosages under different trade names. These include Lindex cream (Linane), Hexitane cream, Savlon cream, Skinalar-N cream, Benzoic acid and salicylic acid ointment, Bentovate ointment, etc. [Md. Saiful Islam]

Drug eruption Also known as drug allergies, the term implies a to cutaneous eruption developed from the use of a drug systemically, viz, by mouth, inhalation, etc. Drug allergies occur when there is an allergic reaction to a medication. This is caused by hypersensitivity of the immune system, leading to a misdirected response against a substance that does not cause a response in most people. The body becomes sensitized by the first exposure to the medication. The second or subsequent exposure causes an immune response. 'True' drug allergies involve the production of antibodies and the release of histamine and other chemicals. Most drug allergies cause minor skin rashes and hives.

Cases of drug eruptions are very common in Bangladesh, but there is no known way to prevent development of a drug allergy. For people who have a drug allergy, avoiding the medication is the best means to prevent an allergic reaction. [Md. Shahidullah]

Drug addiction use or overuse, usually by self-administration, of any drug in a manner that deviates from the prescribed pattern. When these substances are used without any medical need and the user becomes severely dependent on them, it creates the situation called drug addiction or substance abuse.

Drug addiction is, however, not a new phenomenon and dates back to the beginning of civilisation when people turned to agriculture and discovered naturally growing plants whose consumption was associated with altered moods and pleasant feelings. In parts of this subcontinent cannabis and opium has been a substance of abuse since old times. Use of alcoholic liquor also was common but addiction to alcohol was always socially unacceptable.

Drug abuse in Bangladesh today has reached an alarming level due to availability of a wide variety of drugs in the underground market. A very common drug of abuse is the anaesthetic phencyclidine, also commercially known as phensidyl. It is available as a syrup in the black market and is smuggled into the country from neighbouring countries, particularly from India. The Department of Narcotics of the Government of Bangladesh estimates that at present (year 2000) there are about 2.1 million phensidyl addicts in the country. Most addicts are young males and females; some to the poorer classes; a substantial number being students in their teens and young adults from higher socio-economic brackets. According to some studies, about 40% of phensidyl users come from upper class families, 30% from middle class one, and 30% from lower class background. Use of pethidine injection is common. A potent painkiller of the morphine family, the drug is available on prescription, and is not difficult to obtain through contrived means. Local pharmaceutical companies also produce the drug. Substances such as heroin are smuggled into the country and sold through secret outlets. Heroin addicts are common in the upper class of society.

Drug addiction is increasingly becoming a social problem in Bangladesh. In the past, habit-forming substances locally available were few in number and less readily available. Today the world has shrunk due to improved communication, allowing for rapid movement of merchandise and enhancing simultaneously the illegal trade in drugs and narcotics. In addition, there is the enormous burden of a very sizeable population of frustrated youths who have no work because of the poor economic condition of the country, and who therefore, turn to drugs as an escape channel. In addition to phencyclidine (phensidyl) they use cannabis, heroin, and its synthetic derivatives such as methadone, sleeping pills, tranquillisers, sedatives, and similar other drugs.

The number of drug addicts is steadily increasing in the country, and female addicts are increasingly becoming more and more noticeable. In fact, the number of female drug addicts has increased five times in the last five years. In response to this alarming situation many drug addiction treatment clinics have been established in major cities of the country, but their number is inadequate relative to the gravity of the problem.

Rehabilitation efforts in Bangladesh targeted at drug addicts are also inadequate. Drug dependence is rampant since its availability is the prime determinant, not its cost. This situation has developed in Bangladesh since the 1980s. Rehabilitation efforts for drug addicts can be both costly and time-consuming. The Community Drug Addiction Institute, Tejgoan, Dhaka, was established in 1989, under a government scheme to rehabilitate drug addicts. Its facilities were meagre at the beginning. Despite the increase in the number of drug addicts, its facilities have deteriorated in recent years. Today the institute is virtually non-functional. Although there are many rehabilitation centres that have been established in the private sector in many cities and towns since the mid-1990s, these are inadequately staffed and lack in necessary trained personnel and medical facilities such as equipment. [Zia Uddin Ahmed]

Rational use of drugs treatment based on reasoning and general principles; or use of any medicine exercising reason, sound judgement, or good sense. Drug is a general term that refers to any chemical substance which when taken by a living organism, may modify one or more of its functions. As a rule drugs are used in treatment of diseases. However, in the context of the expression 'rational use of drugs' one is led to assume that certain types of drugs are the targets to which this expression pertains more closely compared to other drugs. The two common categories of drugs important in this context are antibiotics and those drugs that are habit-forming. The former is an essential class of drug that saves millions of lives every year throughout the world. Nevertheless its use can still be 'irrational'; that is, it may be used excessively, often with consequences that are not socially harmful but which tend to defeat the very medical purpose for which the drug is used. Excessive use of antibiotics almost always leads to the development of genetic strains in the target bacterial population that exhibit resistance to the killing effect of the drug. The latter category of drugs, that is, habit forming drugs, do not have such consequences but are socially undesirable since addiction is the usual end result, and the associated outcome is a painful social burden for the family and the country.

Once a particular bacterium becomes resistant to a certain antibiotic and establishes itself in the community by replacing the sensitive type, the doctor loses a powerful weapon. Rational use therefore implies two levels of the use of an antibiotic. One is not to use an antibiotic indiscriminately without performing the full range of tests to ascertain that the antibiotic is the correct one for the offending pathogen and that its use is clinically well-justified. The other level is to ensure patient compliance- that is, to see that the full course of the drug is taken even if disease symptoms disappear after a few doses have been taken. As incomplete course fails to completely eliminate the bacteria and many survivors are left with some of the genetic raw materials needed for subsequent development of resistance, which they readily acquire after only a few exposures to the antibiotic.

Regulating the use of antibiotics is a formidable problem in Bangladesh. A country of 130 million people with a high level of infectious diseases caused by viruses, bacteria and parasites, Bangladesh depends on antibiotics for saving lives. But the country has only about 2.6 doctors per 10,000 people, one of the lowest in the world. Thus, antibiotic use under proper medical supervision only accounts for a small fraction of the population. Again, the prescription procedure is less than ideal. That is, prior identification of the pathogen and its sensitivity to the drug is rarely determined before the drug is prescribed. In medically supervised cases, however, the problem of patient compliance is minimised to some extent; one can be reasonably sure that the patient will at least complete the full course. However more alarming is the fact that with increasing level of health awareness created by programmes carried out by government and non-governmental organisations (NGOs), and due to proliferation of drug stores in remote areas of the country where antibiotics are readily available, vast quantities of antibiotics are sold in the country without valid medical authorisation.

Many quack doctors and even ordinary villagers are today familiar with brand names of many drugs including antibiotics. They have vague ideas about their use and in many cases 'prescribe' them for themselves as well as others. Low-cost antibiotics, the front-line arsenal for the common people, rapidly become useless because of resistance development. Because of the very high man-to-doctor ratio, it is not also possible at present for the government to control antibiotic use in a rational manner. Furthermore, sub-standard antibiotic production and illicit sales of these drugs is also not uncommon.

Uncontrolled use of antibiotics is also responsible for another and more alarming type of drug resistance which is known as multi-drug resistance. This phenomenon is characterised by the fact that the pathogen becomes simultaneously resistant to a series of antibiotics. In recent years this problem has assumed a near crisis proportion in the case of serious illnesses such as tuberculosis.

With respect to habit-forming drugs, the situation in Bangladesh is not any more encouraging. Medicines such as analgesics, tranquillisers, painkillers, sleeping peels etc are in use without prescription. Phencyclidine, an anaesthetic with psychological and behavioural effects affecting moods and inducing dreamlike states and bizarre perceptual experience, is a potent drug of abuse in Bangladesh as well as many other countries in the region. The drug is very widely used by way ward children and young adults with anti-social habits. [Zia Uddin Ahmed]

Drugs Act, 1940 an Act that regulates the import, export, manufacture, distribution, and sale of drugs in the country. It was originally enacted by the Government of India on 10th April 1940 and was subsequently modified to suit the changed circumstances, and adopted by the Pakistan Government on 21st January 1957. It was adapted in Bangladesh in 1974 vide Bangladesh Laws (Revision and Declarations) (Amendment) Act-1974 as Act No. LIII of 1974.

This Act, on the one hand, seeks to regulate the import of drugs into the country so that no sub-standard and harmful drugs find their way in, and on the other, it exercises control over the manufacture of drugs so that no substandard or spurious drugs are produced in the country. As the handling, compounding, dispensing and distribution of drugs require specialist's attention, the Act also provides for the regulation of sale and distribution of drugs whereby only qualified and trained persons can undertake the handling, compounding, dispensing and distribution of drugs.

By this Act the import of certain classes of drugs is permitted only under the licenses or permits issued by relevant authorities appointed by the Government. All classes of drugs imported in the country are, however, required to comply with the prescribed standards and are to be labelled and packed in the manner prescribed in the Schedule. Licenses are also required for the manufacture of all classes of drugs and for the sale or distribution of drugs in the country. Regular control over the manufacture and sale is exercised by periodic inspection of licensed premises by drug inspectors who are specially appointed for the purpose under the Act. Surveillance over the standards of drugs is maintained by taking samples from drugs, manufactured or offered for sale, and by getting them tested in the Central Drugs Laboratory.

Certain Drug Rules are framed under the provisions of the Act, which prescribe the manner of labelling and packing the various classes of drugs. There are 20 schedules to the rules, which deal with the list of forms, drugs, medicines, poisons, rates of fees to be paid for analysis of drugs, life period of drugs, etc.

A 'Drugs Technical Advisory Board' constituted under this Act advises the government on technical matters arising out of the enforcement and administration of the Act. The 'Drugs Consultative Committee' advises the Government and the Board to ensure the administration of the Act throughout the country. [Abdul Ghani]

Drugs (Control) Ordinance, 1982 an Ordinance which controls the manufacture, import, distribution, and sale of drugs in Bangladesh. This Ordinance was made and promulgated by the Chief Martial Law Administrator of the People's Republic of Bangladesh on 11th June, 1982 as Ordinance No VIII of 1982. The provisions of this Ordinance are additional to, and not derogatory of, the Drugs Act, 1940.

Through this Ordinance, the government has constituted (i) a Drug Control Committee consisting of a Chairman and a varied number of members appointed by the government from time to time to perform such functions as are specified in the Ordinance, and (ii) a National Drug Advisory Council consisting of a Chairman and such other members as the government may appoint from time to time.

Under this Ordinance, (i) no medicine of any kind can be manufactured for sale or be imported, distributed or sold unless it is registered with the licencing authority; (ii) no drug or pharmaceutical raw material can be imported into the country except with the prior approval of the licencing authority; (iii) the licencing authority cannot register a medicine unless such registration is recommended by the Drug Control Committee; (iv) the licencing authority may cancel the registration of any medicine if such cancellation is recommended by the Drug Control Committee on finding that such a medicine is not safe, efficacious or useful; (v) the licencing authority is also empowered to temporarily suspend the registration of any medicine if it is satisfied that such a medicine is substandard; (vi) the government may, by notification in the official gazette, fix the maximum price at which any medicine may be sold and at which any pharmaceutical raw material may be imported or sold; (vii) no person is allowed to manufacture any drug except under the personal supervision of a pharmacist registered in Register 'A' of the Pharmacy Council of Bangladesh; (viii) no person, being a retailer, is allowed to sell any drug without the personal supervision of a pharmacist registered in any Register of the Pharmacy Council of Bangladesh; and (ix) the government may, by notification in the official Gazette, establish Drug Courts as and when it considers necessary.

There are provisions, under this Ordinance, of different kinds of penalties (fines, imprisonment, withdrawal of registration, cancellation of licences, etc) for defaulters of any of the above regulations.

The National Drug Advisory Council advises the government on measures to be adopted for the implementation of the national drug policy; on measures to be taken for the promotion of local pharmaceutical industries and the production and supply of essential drugs for meeting the needs of the country; on matters relating to the import of drugs and pharmaceutical raw on materials; and measures for the co-ordination of the activities of the various ministries, agencies and persons dealing with the manufacture, import, distribution, and sale of drugs. [Abdul Ghani]

Drug policy A course of action adopted and pursued by the government for rational use of substances used in medicine either externally or internally for curing, alleviating, or preventing a disease or deficiency. Bangladesh was the first country in the world to introduce the principles of Alma-Ata and the essential drug concept into practice through the adoption of a drug policy in 1982. The major objectives of the National Drug Policy were as follows: 1. to prepare a basic list of 150 essential drugs and a supplementary list of 100 specialized drugs; the basic list was subdivided into three levels of use; 12 drugs for village workers; 45 drugs for primary health care; and all 150 drugs for tertiary care; 2. to use generic names for the manufacture and sale of the 45 primary care drugs; 3. to prepare and publish a National Formulary by 1983; 4. to eliminate product patents and limit the use of process patents; and 5. to revise the 1940 Drug Act to include a registration system for Ayurvedic, Unani and homeopathic medicines; 6. to enforce good manufacturing practices (GMP), including adequate quality control; control of labeling and advertising; price control; prescription control of toxic/poisonous and habit-forming drugs; 7. to establish special drug courts, and heavy penalties; 8. to regulate technology transfer and licensing agreements with foreign collaborators; 9. to restrict of ownership of retail pharmacies to professional pharmacists only; 10. to set up a National Drugs Control Laboratory by 1985; 11. to prevent Trans National Corporations (TNC) from manufacturing simple products like common analgesics, vitamins, antacids; 12. to establish registered retail pharmacies, under the supervision of qualified pharmacists, at every government hospital; and 13. to strengthen drug administration by training all upazila health administrators to act as drug inspectors.

Before the adoption of the Drug Policy on June 12, 1982, the market had more than four thousand drugs, most of which were useless, ineffective or even harmful. The Drug Act of 1940 was inadequate for the control of prices of pharmaceutical raw materials and pharmaceutical products. The Act also failed to prevent the production of substandard and spurious drugs on the market or regulate unethical promotion, and prevent proliferation of harmful and useless drugs. In April 1982 the government appointed an expert committee to review the situation of drug market of the country and produce recommendations for a National Drug Policy. [Muniruddin Ahmed]

Dangerous Drugs Act, 1951 Law enacted to control production, sale, trade, distribution and use of drugs which are habit-forming on repeated use and produce undesirable, sometimes dangerous side-effects. Coca, Opium and Indian Hemp (Cannabis), their chemical constituents, and derivatives of the constituents constitute dangerous drugs. Therapeutically they are principally used as analgesics. But these drugs often produce many undesirable side-effects such as euphoria, changes in mood, mental clouding, respiratory depression, hypotension, nausea and vomiting, inhibition of defecation and urination, and alterations of the endocrine and autonomic nervous systems. As these substances are habit-forming and cause addiction, their unrestricted use is a danger from the social point of view. In view of the degenerative effects of these drugs on individuals it became necessary to restrict their use to bonafide medical purpose only.

The Dangerous Drugs Act, 1930 was passed by the Indian Legislature in 1930. This Act was adopted by the Government of Pakistan in 1951 as the Dangerous Drugs Act, 1951 with appropriate amendments to suit the changed circumstances. Dangerous Drugs Act, 1951 is also operative now in Bangladesh to control various operations relating to dangerous drugs in the country.

Under this Act, cultivation, collection, preparation, possession, import and export of coca plant, hemp, opium poppy, prepared opium and their products are totally prohibited; and production of opium, manufacture of preparations of dangerous drugs, and import and export of dangerous drugs are permitted under the authority of proper licences issued by the government. The following substances have been defined as Dangerous drugs in the Act:

Coca leaf including young twigs of either Erythroxylon coca or E. truxillense or their varieties or any other species of Erythroxylon or their mixtures containing more than 0.10% cocaine.

Opium which consists of either the exuded coagulated latex of the capsules of Papaver somniferum or the capsules in their original form or cut, crushed or powdered form or their mixtures with or without neutral materials added containing more than 0.20% morphine.

Hemp which consists of either the leaves, small stalks, flowering and fruiting tops of Cannabis sativa. Female plants and all their processed or prepared forms such as ganja, sidhi, bhang, charas, hashish (the extracted resin) or any drinks made from them or their mixtures with or without neutral materials added.

Manufactured drugs These include formulated coca derivatives, medicinal hemp, and opium derivatives in different forms.

Any person who indulges in any operation, such as possession, manufacture, sale, etc, relating to dangerous drugs without proper authority is liable to punishment with imprisonment up to 2 years or fine or both on first conviction and with imprisonment up to 4 years or fine or both on any subsequent conviction. Depending on the type of offence committed, the degree and type of punishment also varies within certain rules specified under the Act. Procedures of all types of operation relating to dangerous drugs and the legal actions that can be taken against different types of offenders have been described in this Act. [Abdul Ghani]

Drug administration The organisation that regulates drug manufacturing, import and quality control of drugs in the country. In Bangladesh, the formal name of the organisation is Directorate of Drug Administration, an organ of the Ministry of Health and Family Welfare. The office of the Directorate is located in Tejgoan industrial area, Dhaka.

The Directorate of Drug Administration issues licenses for import of raw materials for different drugs and packed drugs from a selected list to pharmaceutical companies and importers. It also monitors quality control parameters of marketed drugs through an agency called the Drug Testing Laboratory, which is located in the Institute of Public Health at Mohakhali and is equipped with standard testing facilities.

The Directorate has under its administrative purview also the indigenous systems of medicine called Ayurvedic and Unani systems. The Homeopathic system of medicine is not, however, under the regulatory control of the Directorate. There is in fact no regulatory body in the country for homeopathic medicine perhaps for the practical reason that testing and monitoring methods are not standardised because of inadequate scientific understanding of the system. The system, indeed, has attained the status of a handy home remedy in Bangladesh and in other countries where it is practised. [Zia Uddin Ahmed]