Responsible Use of Medicines

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2 Responsible Use of Medicines Responsible use of medicines implies that the stakeholders of health care system such as doctors, pharmacist nurses should ensure that the patient receives right medicines, at right time and uses then appropriately and benefit from them. Also the patients and caretakers of the patient are equally responsible in the feat of the rational therapy by adhering to the therapy and complying with the orders of the health care professional.

3 Examples of irresponsible use of medicines Unnecessary use of medicines: Use of antibiotics for viral flu, colds and sore throat- antibiotics are antibacterial drugs and do not act against infections caused by viruses Pressurizing doctors to give you injection when it is not needed Incorrect use of medicines: eg. Swallowing chewable tablets, wrong doses, missing doses,overdosing etc. Using ineffective medicines and medicines with doubtful efficacy: The belief that vitamins are a cure for weakness and fatigue is often the reason why patients demand for them Self medication-with antibiotics, with medicines given for someone else, with left over medicines from previous prescription etc., using steroids for quick muscle growth Not completing course of antibiotics Leaving the long term prescribed treatment halfway

4 Consequences of irresponsible use of medicines Side effects, Adverse drug reactions Failure of standard therapy, relapse of disease Antibiotic resistance Prolonged illness and hospitalization Increased health care expenses

5 When you visit your Doctor About all your health problems and recent illnesses. Do not hide any information About all your medicines (including allopathic, Ayurvedic, homeopathic, or any other type) you have been currently taking. In case of chronic diseases (e.g. diabetes, hypertension, arthritis etc.), treatment may vary from time to time depending on the condition of the illness. Therefore, it is important to visit your doctor regularly for follow up/ check up. Inform your doctor/dentist If you are allergic to any medicines or if you experience any severe adverse effect with any medicine If you are pregnant or planning to become pregnant or if you are breastfeeding. Your doctor will take due care in prescribing

6 While buying your medicines Rx Always buy your medicines from a licensed pharmacy/medical store. Look for the pharmacy license displayed. Do not buy medicines from unauthorized sellers. Always carry a prescription with you to the pharmacy. Always present a proper prescription of a Registered Medical Practitioner to the pharmacist while buying prescription medicines. Before you leave the pharmacy check your medicines for names, strength/ potency, dosage form, quantity, expiry date and that they are consistent with your prescription Ensure that the medicines you receive are in good condition with no leakage, damage or breakage. Ask your pharmacist for instructions for taking your medicines and any precautions to be taken. Ask your Pharmacist s advice while buying Non- prescription medicines. Do not use the same old prescription for buying medicines again unless the doctor advises so. Always ask for a bill and preserve it until you finish taking all the medicines you purchased.

7 While taking your Medicines... Follow the instructions of the doctor. Read the medicine label carefully in sufficient light. It is essential to take medicines in right dose and for complete duration as prescribed by the doctor. Medicines need to be taken at the same time everyday. In case if one forgets, then it should be taken as soon as remembered but not if it is almost time for next dose. Double dose should never be taken. Medicines taken orally should be taken by sitting in upright position and should never be taken while lying down.

8 While taking your Medicines...cont d Pain killers and some medicines should be taken after food and not on empty stomach. Whereas some medicines need to be taken before food. Take the advice of your doctor or pharmacist whether to take your medicine before or after food. There are different types of medical devices such as inhalers used in treatment of asthma. It is necessary to learn it s usage technique from your doctor or pharmacist. Do not take any medicines during pregnancy or while breastfeeding without consulting your doctor.

9 Taking your liquid orals Measure the prescribed dose of liquid oral medicines with a measuring cup or measuring spoon provided with the bottle. Shake the bottle well before use while taking suspension/emulsion so as to disperse it uniformly. Reconstitution of suspensions Some oral suspensions come as dry powder that has to be reconstituted. Shake the bottle to loosen the powder. Add boiled and cooled water up to the given mark on the bottle. Shake to disperse the powder evenly. Make up the volume with remaining quantity of boiled and cooled water up to the given mark. The reconstituted suspension has to be stored in a refrigerator, and used with 5 7 days (as stated on the label).

10 Taking Your Tablets and Capsules Do not crush or break or cut tablets unless the doctor or pharmacist advises to do so. Some tablets are chewable tablets. Such a tablet should be placed in the mouth and chewed thoroughly till it is powdered. Then swallow the powder, and drink a glass of water. Some tablets are dispersible tablets. Do not swallow them. Such a tablet should be placed in a cup or a spoon containing 5-10ml of water and allowed to disperse completely into a suspension. Then swallow the whole quantity. Mouth dissolving tablets should not be swallowed whole. Such a tablet should be placed in the mouth, allow it to dissolve in the oral cavity and mix with the saliva., and then swallow the saliva. Sub-lingual tablets should be placed under the tongue and allowed to dissolve there. Do not swallow sublingual tablets. Capsules should be swallowed whole with a glass of water, do not open the capsules.

11 Using your eye drops Once opened, eye drops should be used within one month. Note down the date of opening on the cover/label of the bottle. The tip of the eye drop should not be contaminated by touching with hands or any other surfaces. Eye drops should be used in a lying down position.

12 Storing Your Medicines At Home Check the label of each medicine to know how it is to be stored: Label storage condition Temperature range Cool 8 o - 30 o C. Cold 2 o 8 o C (in a refrigerator but not in the freezer) DO NOT keep medicines near the windows, gas stove, heat source, or the sink. DO NOT keep in the kitchen or bathroom. If a medicine is not stored properly then it may lose its potency earlier than the expiry date mentioned on the pack. All tablets/capsules strips/bottles can be kept in one box inside a cupboard and liquid medicines can be kept in a suitable tray. It is useful to make a list of all medicines at home and periodically, expired, unused medicines can be checked and disposed off safely.

13 Storing your medicines at home If nothing is mentioned on the label, keep in cool, dry place, away from sunlight, protect from moisture, freezing and extensive heat Keep all medicines away/out of reach of children and pets Keep all medicines away from Sunlight, Heat, & Moisture.

14 Know about types of your medicines... Some medicines are called as prescription medicines. These are medicines which by law can be sold by the pharmacy only against the prescription of a Registered Medical Practitioner (Allopathic Doctor/Dentist/Veterinarian).Majority are Prescription Medicines. Eg Antibiotics, steroids, cardiac drugs, medicines for psychiatric disorders, most painkillers, antiulcer drugs etc. They can be dangerous if not taken as per the doctor s advice or taken without being prescribed by a doctor. They need to be used carefully. Do not self-medicate with these medicines. These medicines can be identified by a Red line at the left of the label, a Rx sign in red on the left top of the label, and a boxed warning which says "To be sold by retail only against the prescription of a Registered Medical Practitioner only". Schedule G drugs bear on their label Caution- it is dangerous to take this preparation except under medical supervision Eg Metformin, Promethazine, etc. NRx is written in red colour on the left top corner of the label of some medicines those which fall under the Narcotic Drugs and Psychotropic Substances Act. XRx is written on top left corner in red on the label of drugs falling under Schedule X. Eg Ketamine, Methylphenidate, Oseltamivir, etc.

15 Schedule H and NRx drug labels

16 Non-prescription or OTC (Over the counter) medicines Non-prescription or OTC (Over the counter) medicines are allopathic medicines which by law can be purchased by a customer without the prescription of a doctor or can be recommended by the Pharmacist. OTC medicines are relatively safe and can be self-medicated; however, they too can cause side effects and thus need to be used carefully. They are often advertised to public Eg: Paracetamol, asprin, vitamins, minerals, antiseptic creams, calamine lotion etc. Some of these medicines are available in other stores too. Discuss with your pharmacist and seek your pharmacist s advice while choosing non-prescription medicines. By law, there is no compulsion for a prescription for sale/purchase of Ayurvedic, Unani, Siddha and Homeopathic medicines. However, these medicines too are not totally free of side effects, and need to be used diligently/with due care and with an advice of the respective expert.

17 Some OTC medicines

18 Advertisements of medicines Do not fall prey to misleading advertisements making false claims and experiment on yourself. It is best to consult your doctor. Do not get lured by misleading advertisements and play with your health and body No medicine is absolutely safe. It is dangerous to self- medicate based on advertisements. Certain diseases are incurable. Do not prey to advertisements which make claims to cure hair loss/baldness, increase sexual prowess/pleasure, increasing of height, vitality, fairness of skin, memory, slimming or weight loss, weight gain, diseases like diabetes and AIDS. Before taking such products ensure that the company is trustworthy, check for the phone number, address, website provided on the label, and whether claims look reliable, reasonable, scientifically proven. Keep the bills of such purchases.

19 Medicines and children Do not give your medicines to children as they may require different quantity and type of medicine depending on their illness, severity and body weight. Do not give your children medicines given for other children even if symptoms are same Do not give any medicines to your children without consulting doctor. Do not take medicines in front of your children, do not send your child to pharmacy for buying medicines.

20 Tips for safe use of medicines Some symptoms are similar but cause of illness may be different. Hence even if symptoms are similar, do not take medicines given for somebody else. Medicines can have certain side effects. Enquire with your doctor or pharmacist about the same. Some medicines may cause drowsiness. Enquire with your doctor or pharmacist. It is necessary to complete the course of antibiotics, anti- TB drugs etc. otherwise the infection causing the illness may relapse later in a more severe form. Treatment of chronic diseases like diabetes, hypertension etc. usually need lifelong treatment and hence it is necessary not to stop the treatment in between without consulting the doctor. Ayurvedic, homeopathic, unani, and other herbal medicines can also have side effects and hence even these medicines must only be taken with medical advice. Never take alcohol with medicines. This can be potentially harmful.

21 Summary Medicines are like double edged sword, they are very useful if they are used in a proper way while they can be unsafe and harmful if used irrationally and irresponsibly All medicines have to be taken as per the direction given by the doctor or pharmacist to get maximum benefit Ask your doctor or pharmacist if you have any doubts about your medicines before using them to avoid adverse effects and be safe Do not self medicate with prescription medicines and avoid over use of OTC medicines Adherence to the therapy, proper storage of medicine is important to achieve safe and effective therapy Using medicines responsibly and rationally will assure safety, quick recovery and reduce occurrence of side effects,will reduce wastage of medicines and overall will help improve health

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