Safe Use of Medicines by the Consumers.

Department of Clinical Pharmacology & Therapeutics Kist Medical College, P.O. Box 14142 Imadol, Lalitpur.

The safe use of medicines by consumers is an important component of their rational use. Unfortunately, in developing countries like ours, consumers are often ignorant about the proper use of medicines. Studies have found lacunae in the consumer’s knowledge of how to use medicines. To ensure the proper use of medicines, the departments of Clinical Pharmacy and Pharmacology had started a Medication Counseling Center at the Manipal Teaching Hospital, Pokhara. The publication of this booklet by the Department of Drug Administration (DDA) in both English and Nepali is to be welcomed as an initiative towards promoting the safe use of medicines. The booklet has six sections titled ‘Self Care’, ‘Why do we need to know about safe use of medicines’, ‘How do we use medicines safely’, ‘General guidelines’, ‘Common medicines’ and ‘Technique of administration of medicine in special dosage forms’.
The book starts by describing self-medication and ‘responsible’ self-medication. Self-medication will continue to be important for various reasons in developing countries, and we welcome this initiative to inform the public about the risks, indications and limitations of self-medication. However, more information should be provided on this vital topic.
The booklet states that there are three ways to use medicines safely. These are, consulting a practitioner or health personnel, buying medicines from a reliable pharmacy, and reading the label. The information to be told to the doctor by a patient and the points to enquire about will be especially useful. The things to look for while assessing whether a pharmacy is reliable or not, will be very useful to the people of Nepal. These are however, just broad guidelines, and more detailed information may be necessary.
The instructions about how to obtain information about the medicines from the drug label and the doctor’s prescription is interesting. In Nepal, the drugs are often not dispensed in proper envelopes with instructions. Medicines are also sold in parts of a strip, and sometimes even loose, and the drug name and instructions may not be visible. The doctor’s prescription is often illegible. In these cases, obtaining information about medicines becomes difficult.
The topic on ‘How to store medicines’, mentions that medicines should be kept away from children. We often see cases where children are poisoned by the medicines meant for their parents, and would have liked more information on this topic. Child proof containers are not common in Nepal. Taking medicines properly gives instructions about their proper use in general. The unwanted effects of medicines have been very broadly defined. These are divided into mild, serious and very serious.
The fifth section deals with ‘Common Drugs’. The over the counter (OTC, Schedule GA drugs) drugs section very briefly describes analgesics and antipyretics, antihistamines, antacids, amebecides, ORS, vitamin B complex and anthelmintics. The boxes contain some very useful and interesting information like, ‘antacid tablets should not be swallowed whole without chewing’. The drugs available only with prescription (schedule KHA drugs), are the antibiotics among others. With the problem of antibiotic misuse and antibiotic resistance, the emphasis on antibiotics is proper. However, some information about other groups of drugs could also be given. In Nepal and many other developing countries however, most drugs are available over the counter without a prescription.
The section on administration of medicines in special dosages describes dispersible tablets, dry syrup, inhalers, eye drops, eye ointment, ear drops, nasal drops, nasal spray, suppository and pessaries. The Guide to good prescribing published by the World Health Organization contains a detailed and useful description of these dosage forms. We often counsel about the use of these dosage forms in the Medication Counseling Center of the Manipal Teaching Hospital. Medical students are taught about the use of these dosage forms. The diagrams accompanying these instructions help to put the message across in a simple manner.
This book is a good beginning by the DDA to improve the use of medicines by the consumers in Nepal. They should ensure that the booklet is widely available to the consumer, which is not the case at present. Detailed booklets about particular types of medicines and side effects, first aid in the case of poisoning etc. should be designed. We would like to congratulate the DDA on this maiden venture. The small size makes the booklet easily portable, and the print quality and the production values are good.

Conclusion

About the book:
Safe use of medicines by consumers. Published by the Department of Drug Administration, Bijulibazar , Kathmandu, Nepal.
E-mail:dda@healthnet.org.np