Related Experiment Video
Updated: Aug 8, 2026
In Silico Modeling Method for Computational Aquatic Toxicology of Endocrine Disruptors: A Software-Based Approach Using QSAR Toolbox
Published on: August 28, 2019
Assessing the impact of a regulatory intervention in Pakistan
1Department of Paediatrics, King Edward Medical College, Lahore, Pakistan.
Insights
Deregistering paediatric antimotility drugs in Pakistan reduced their availability but did not eliminate their use. Blackmarketing and substitution with adult formulations highlight the need for further interventions.
Area of Science:
- Pharmacology
- Public Health
- Pediatrics
Background:
- In 1990, Pakistan deregistered paediatric formulations of antimotility drugs.
- Preliminary data suggested a decrease in paralytic ileus in children with acute diarrhoea post-deregistration.
Purpose of the Study:
- To assess the effectiveness of the regulatory intervention (deregistration) of paediatric antimotility drugs.
- To identify any ongoing issues or alternative therapies used after deregistration.
Main Methods:
- A small-scale survey was conducted in 1993 across Pakistan.
- The survey assessed the availability of deregistered products and identified substitution patterns.
Main Results:
- Deregistered paediatric antimotility drugs were largely withdrawn from retail outlets.
- Blackmarketing of a specific paediatric antimotility drug was observed in one city.
- Irrational therapies, including the misuse of adult formulations, were substituted for deregistered paediatric drugs nationwide.
Conclusions:
- Deregistration alone is insufficient to halt the use of antimotility drugs in children.
- Regulatory interventions must be complemented by efforts to modify patient attitudes and physician prescribing habits.
- Addressing the misuse of paediatric antimotility drugs requires a multi-faceted approach beyond simple product withdrawal.
Abstract:
In 1990 paediatric formulations of antimotility drugs were deregistered in Pakistan. Although preliminary research data suggests the incidence of paralytic ileus in children suffering from acute diarrhoea has fallen, cases continue to be recorded. A small-scale survey conducted in 1993 to assess the effectiveness of the regulatory intervention conclusively proved that while the deregistered products had been successfully withdrawn from the overwhelming majority of retail outlets, blackmarketing of a paediatric antimotility drug was taking place in one city. The results also indicated that throughout the country the deregistered formulations were being substituted by other irrational therapies, including the misuse of adult formulations. As a regulatory intervention, therefore, deregistration needs to be accompanied by efforts to change patient attitudes and physician prescribing habits.
