> **来源：[研报客](https://pc.yanbaoke.cn)** # Summary of Samoa's Essential Medicines List 2022 ## Core Content and Objectives The Samoa Essential Medicines List (EML) 2022 was reviewed with the aim of improving healthcare by: - Phasing out outdated medicines - Introducing new medicines currently prescribed nationally - Promoting rational prescribing through identifying prescribing privileges - Identifying the list of essential medicines available in district hospitals - Supporting planning for the Medicines Tender 2022–2024 - Achieving cost savings on the annual medicines budget The review was based on the WHO Model List of Essential Medicines, March 2021, and followed the WHO definition of essential medicines as those that are most important for satisfying the health needs of the majority of the population. The selection criteria included public health relevance, efficacy and safety evidence, and cost-effectiveness. ## Key Information The EML includes a wide range of medicines grouped by therapeutic class and includes details on: - **Prescribing Authority**: Indicates the level of medical personnel authorized to prescribe each medicine (e.g., MI – Medical Intern, JR1 – Junior Registrar 1, etc.) - **Availability in Rural Hospitals**: Specifies whether the medicine is available (Y), not available (N), or is a controlled drug (CD) or emergency trolley (ET) item ## Main Sections and Medicines ### 1. Anaesthetics - **General Anaesthetics and Oxygen**: - **New entries**: etomidate, isoflurane, sevoflurane - **Available in rural hospitals**: nitrous oxide, oxygen - **Prescribing authority**: HOU, CS (for most), JR2/SR (for some) - **Local Anaesthetics**: - **Available**: ephedrine, lignocaine - **Prescribing authority**: JR2/SR - **Sedation for short-term procedures and emergencies**: - **Available**: midazolam, nitrous oxide - **Prescribing authority**: JR2/SR ### 2. Analgesics, Antipyretics and Related Agents - **Non-Opioids and NSAIDs**: - **Available**: aspirin, diclofenac, ibuprofen, indomethacin, naproxen - **Prescribing authority**: MI/JR1 (for most), JR2/SR (for some) - **Opioid Analgesics**: - **Available**: codeine, fentanyl, morphine, oxycodone, pethidine - **Prescribing authority**: JR1, HOU, CS - **Medicines for Gout**: - **Available**: allopurinol, colchicine - **Prescribing authority**: MI/JR1 - **DMARDs for Rheumatoid Disorders**: - **Available**: methotrexate, hydroxychloroquine - **Prescribing authority**: JR1 ### 3. Anti-Allergics and Medicines for Anaphylaxis - **Available**: adrenaline, loratidine, promethazine - **Prescribing authority**: MI/JR1 ### 4. Antidotes and Other Substances for Poisonings - **Non-specific antidotes**: - **Available**: fullers earth, activated charcoal - **Specific antidotes**: - **Available**: acetylcysteine, atropine, calcium gluconate, naloxone - **Prescribing authority**: JR2/SR ### 5. Anticonvulsants/Antiepileptics - **Available**: carbamazepine, diazepam, levetiracetam, phenobarbitone, phenytoin, sodium valproate - **Prescribing authority**: JR1, JR2/SR ### 6. Anti-Infective Medicines - **Anti-Helminthics**: - **Available**: pyrantel - **Anti-Bacterials**: - **Available**: amoxicillin, amoxicillin + clavulanic acid, flucloxacillin, gentamicin, meropenem, metronidazole, doxycycline, ciprofloxacin, clindamycin, sulfamethoxazole + trimethoprim - **Prescribing authority**: JR1, JR2/SR - **Anti-Fungals**: - **Available**: clotrimazole, nystatin, griseofulvin - **Combination Anti-Infective and Anti-Inflammatory**: - **Available**: miconazole + hydrocortisone - **Anti-Virals**: - **Available**: acyclovir ### 7. Anti-Migraine Medicines - **Available**: sumatriptan, propranolol - **Prescribing authority**: JR2/SR ### 8. Anti-Neoplastic and Immunosuppressive Medicines - **Immunosuppressives**: - **Available**: dexamethasone, prednisolone - **Cytotoxic Medicines**: - **Available**: cyclophosphamide, hydroxyurea - **Hormones and Anti-Hormones**: - **Available**: tamoxifen - **Prescribing authority**: JR2/SR ### 9. Anti-Parkinsonism Medicines - **Available**: benztropine, benzhexol, levodopa + carbidopa - **Prescribing authority**: JR2/SR ### 10. Medicines Affecting the Blood - **Anti-Anaemia Medicines**: - **Available**: ferrous salt, folic acid - **Coagulation Medicines**: - **Available**: heparin sodium, phytomenadione, protamine sulphate, tranexamic acid - **Prescribing authority**: JR1, JR2/SR ### 11. Blood Products and Plasma Substitutes - **Plasma Substitutes**: - **Available**: gelatin - **Plasma Fractions**: - **Available**: factor VIII, normal human immunoglobulin - **Prescribing authority**: JR2/SR ### 12. Cardiovascular Medicines - **Anti-Anginal Medicines**: - **Available**: atenolol, diltiazem, isosorbide mononitrate, metoprolol - **Anti-Arrhythmic Medicines**: - **Available**: adenosine, amiodarone, flecainide, sotalol - **Anti-Hypertensive Medicines**: - **Available**: amlodipine, captopril, cilazapril, enalapril, felodipine, losartan, methyldopa, nifedipine, quinapril - **Heart Failure Medicines**: - **Available**: dobutamine, dopamine, digoxin, metaraminol, metoprolol succinate - **Anti-Thrombotic Medicines**: - **Available**: aspirin, clopidogrel - **Lipid-Lowering Agents**: - **Available**: atorvastatin, simvastatin ### 13. Dermatological Medicines (Topical) - **Anti-Fungals**: - **Available**: clotrimazole, miconazole, miconazole + hydrocortisone, gentian violet - **Anti-Infectives**: - **Available**: gentian violet, clotrimazole - **Anti-Inflammatory and Antipuritic**: - **Available**: miconazole + hydrocortisone - **Scabicides and Pediculicides**: - **Available**: not specified - **Prescribing authority**: JR1, JR2/SR ### 14. Diagnostic Agents - **Ophthalmic Medicines**: - **Available**: not specified ### 15. Disinfectants and Antiseptics - **Available**: not specified ### 16. Diuretics and Other Drugs Affecting the Genitourinary Tract - **Diuretics**: - **Available**: not specified - **Other drugs**: - **Available**: not specified ### 17. Gastrointestinal Medicines - **Available**: antacids, anti-emetics, anti-haemorrhoidal, anti-inflammatory, anti-spasmodic, laxatives, anti-diarrheal - **Prescribing authority**: JR1, JR2/SR ### 18. Hormones, Endocrine Medicines, and Contraceptives - **Available**: androgens, estrogens, progestogens, ovulation inducers, insulins, anti-diabetic agents, thyroid hormones - **Prescribing authority**: JR1, JR2/SR ### 19. Immunologicals - **Available**: sera and immunoglobulins, other immunological agents - **Prescribing authority**: JR1, JR2/SR ### 20. Muscle Relaxants and Cholinesterase Inhibitors - **Available**: not specified ### 21. Ophthalmic, Ear, and Nose Preparations - **Available**: anti-infective, anti-inflammatory, combination, local anaesthetics, miotics, mydriatics, surgical aids, artificial tears - **Prescribing authority**: JR1, JR2/SR ### 22. Gynaecological and Obstetric Medicines - **Available**: medicines for obstetrics and gynaecology - **Prescribing authority**: JR1, JR2/SR ### 23. Psychotherapeutic Medicines - **Available**: medicines for psychotic, mood, generalized anxiety, and sleep disorders, ADHD - **Prescribing authority**: JR2/SR ### 24. Medicines Acting on the Respiratory Tract - **Available**: anti-asthmatics, nasal decongestants, cough preparations - **Prescribing authority**: JR2/SR ### 25. Solutions Correcting Water, Electrolyte, and Acid-Base Disturbances - **Available**: oral and parenteral solutions - **Prescribing authority**: JR1, JR2/SR ### 26. Vitamins and Minerals - **Available**: not specified ### 27. Medicines for Intensive Care - **Available**: not specified ### 28. Medicines for Neonatal Care - **Available**: not specified ## Acknowledgements The review was supported by: - **Director General of Health**: Leausa Take Naseri - **Deputy Director General for Hospital & Clinical Services**: Dr. Glen Fatupaito - **Deputy Director General for Public Health**: Tagaloa Dr. Robert Thomsen - **Heads of Units for Clinical Services and Pharmaceutical Services Manager**: Lilomaiava Aharoni Viliamu - **Pharmacy Team**: Principal Pharmacists (Brenda, Santoria, Penaia, Leolasi) - **World Health Organization (WHO)**: Provided funding and support for the review and dissemination ## Conclusion This EML aims to enhance the availability of essential medicines, promote rational use, and support cost-effective healthcare planning. It reflects the current national prescribing practices and includes both new and existing medicines, with clear guidelines on availability and prescribing privileges.