Our batch did a drug utilization survey and we found out that a lot of Filipinos have shocking behaviors when it comes to the use of drugs. There are numerous incorrect usages of drugs especially when it comes to antimicrobial agents. Luckily, rate of drug misuse is very low when it comes to the pediatric age group.
I am not sure of the real reason behind the rampant misuse but the more likely reason is the lack of education and poverty.
Many people think that when the signs and symptoms of their condition are relieved, they can already terminate taking the prescribed drugs. It’s not supposed to be like that especially when it comes to antibiotics; many are actually confused with their proper use. Antibiotics should be indicated only by a doctor, and yes someone who is legitimate.
A simple cough could be self-limiting and may not need any antibiotic medications but based from our survey, many immediately resort to antibiotics. And when taking antibiotics, one should follow what’s being instructed by the doctor; if he said you should take it thrice a day for seven days, then you must medicate until the seventh day. Discontinuance and misuse of antibiotics paved way to the emergence of many resistant bacteria like MRSA and MDR-TB which are harder to target and kill.
Case: A farmer went to a sari-sari store.
Masakit ulo ko! Ale, pabili naman ng gamot na mag-asawa!
(My head aches, give me "gamot na mag-asawa")
In the barrios, "gamot na mag-asawa" is available in the sari-sari stores. It’s a combination of paracetamol and an antibiotic (usually amoxicillin). This combination’s packed by the sari-sari store owners without any knowledge of its use and possible deleterious effect/s.
*Headache is usually a benign symptom relieved by pain relievers, but also it is occasionally a manifestation of serious illness such as brain tumor, hemorrhage and meningitis.
Another common mistake of the people is the use of drugs without any direction from a doctor. When people get headaches, they immediately resort to Biogesic/Tylenol (paracetamol/acetaminophen). There’s nothing wrong in doing so but sometimes it’s more than just a simple headache* like what I have previously stated. In our survey, many self-medicate themselves; they take drugs without consulting first to their physicians. Did you know that many people rely more to the pharmacy vendors than to their doctors?
Case: In a popular drugstore.
Miss, ano ba maganda para sa ubo?
(What drug’s good for my cough?)
Sige bigyan mo ko ng isang bote.
(Alright, give me a bottle of that Rubitussin.)
Here’s another important thing to remember; an individual’s medical condition is different from the others; same is true with drugs. Propranolol which is an antihypertensive drug is not always suitable to all hypertensive patients. Doctors don’t just prescribe drugs because of a certain disease or medical condition; but we also look into the patient’s medical history and current condition (allergies, tolerance, etc.) to find a drug that is appropriate for them. For example, propranolol may not be given to patients who are hypertensive and at the same time asthmatic.
Case: Two diabetic patients talking to each other. The first one has type 2 diabetes and the other one has type 1.
Mabisa ang binigay ng doctor na gamot para sa aking diabetes.
(My doctor prescribed a very effective drug for my diabetes.)
Anong gamit mo?
(What drug is it?)
Metformin! Sige subukan mo din!
(Metformin! You should try it!)
There is such thing as maintenance drug especially for debilitating diseases. Hypertension and diabetes are examples of conditions that make use of maintenance medications. I encountered a lot of patients who only take their medications when they feel the need of taking so. For example, many hypertensive patients take their medications only when their BP is high or when they feel that their nape's throbbing or their head's aching. It shouldn't be the case. Maintenance drugs should be taken religiously by the patient except when advised by their doctor to cease already.
Lastly, there are conditions wherein use of drugs are of little help. Like in diarrhea, prevention from dehydration is the right thing to do. Many think that certain drugs such as loperamide (popular: Diatabs) will cure diarrhea; sometimes it can even worsen the case. Also, many coughs are relieved by fluid intakes alone and may not need any medications at all. Fever need not immediately require anti-pyretic like paracetamol because fever has a role in eliminating infectious agents especially in low grade fevers. In moderate to high grade fevers such as reaching higher than 38.5 degrees Celsius, paracetamol is already an indication.
Drugs have assorted efforts to eliminate certain disease entity. Their mechanism of actions are different and their indications depend on the patient's current situation, condition and medical history. They can either have palliative, symptomatic or curative effects but misuse of these agents can lead to more serious problems like injury, disability or even death.
I hope that this post serves as a lesson to those who use drugs wrongly. I think I’ll be doing more blogs like this. It’s like a free consultation, but more on like educating the readers and giving free medical advices.
Picture was taken from http://fcosmin.deviantart.com/art/Drugs-28725878