The
Dangers of Self-Medication
Yolanda
R. Robles, PhD
It is a common
practice among our people to use a medicine when experiencing discomfort
such as headache, runny nose, cough, fatigue and stomachache. The
fact that these symptoms seem to disturb us from time to time makes
it easier for us to decide on our own what to buy from a nearby
drug outlet. Self-medication, as a practice, is defined by International
Pharmaceutical Federation (FIP) and the World Self-Medication Industry
(1999) as, “the use of nonprescription medicines by people
on their own initiatives”. It is expected that individuals
may resort to self-medication. However, when is it proper and when
is it not?
Drugs are classified
as either over-the counter (OTC, nonprescription) or prescription
(Rx) drugs. OTC drugs are those which can be obtained from a drug
outlet without a doctor’s prescription. To this group belongs
the pain relievers, fever and cough medicines, antacids, anti-diarrheal
drugs, laxatives, cold preparations, vitamin supplements and some
ointments, to name a few. The label on the container of these products
clearly states that, “If symptoms persist, consult your doctor”.
Any of these drugs should be taken on a short-time basis only, and
not on a prolonged period unless already prescribed by a doctor
for maintenance use.
There is a concept known as responsible
self-medication. It is when a person makes informed choices about
their medications with the help of health professionals, not necessarily
doctors, who can advise them when and how to use OTC medicines.
Health professionals, particularly pharmacists, have to assist,
advice and inform patients whenever they have physical complaints
or when choosing medicines for their health problem. Manufacturers
are likewise admonished by FIP to provide necessary information
on their products for people to read. If people are properly informed,
they are more likely to choose and use the right medicines correctly.
Thus, they are empowered to take care of their own health without
the fear of committing mistakes.
How can self-medication harm people? First,
is the wrong choice of drugs. According to a local survey,
many people ask advice on medicines from their relatives, friends
and neighbors. The latter judge effectiveness of drugs from their
own experience then use it as a basis for giving advice. The problem
with that practice is, while there is commonality in symptoms of
diseases, the extent and nature of a disease may not be the same.
Thus, rather than helping solve the problem, the chosen drug may
contribute to the problem or aggravate the condition. Let us take
asthma, for example. It is characterized by wheezing, cough and
difficulty of breathing. For cough, a friend may recommend an antitussive
(anti-cough). When such drug is given, the sick person may find
it more difficult to breathe due to accumulated pleghm. A bronchodilator
and an expectorant could have been used instead.
Second is the problem of contra-indications.
What is good for Juan may not be good for Juana because the latter
is allergic or hypersensitive to the medicine of Juan even when
they have the same condition. Also, the cause of the medical condition
may be different. In hypertension, for example, a doctor may give
a patient a b-blocker but to another he will prescribe a diuretic.
Because the nature of hypertension in these two patients is not
the same and will require different drug treatment.
Third, the problem of adverse drug interactions.
Even OTC medications are not harmless if used improperly. They are
notorious for producing undesirable effects like reduced effectiveness,
reduced absorption of another drug and also of increasing the possibility
of toxicity from another drug. This problem is common among people
who use many drugs for various ailments. It is not safe to add a
drug to a therapeutic regimen without the knowledge of the prescriber.
This problem is also encountered with herbal supplements which can
be bought from groceries and health shops. They were implicated
in many adverse drug interactions with prescription and non-prescription
medications. Again, their concomitant use with maintenance drugs
must be communicated with prescribers.
All of these problems carry a cost,
not just in terms of pesos (Php) but also in terms of health and
well-being of a person. While self-medication is more economical,
wrong self-medication may be even more costly and dangerous. It
is a virtue to seek advice from well-informed health professionals
who have access to scientific information before they give advice
to laymen on the use of OTC medications. If such is true for OTC
medications, how much more for prescription (Rx) medicines.
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