Think twice before you pop a pill bought over the counter

Serena has a cold. She cannot afford to miss work today because she has an important meeting. She stops at the local pharmacy and asks for a remedy. The salesman at the pharmacy gives her a combination `cold tablet' and an antibiotic. Sunanda has burning and pain when she passes urine. There are some antibiotic tablets left over from when her sister-in-law had similar symptoms so Sunanda takes two of those. This tendency to take `a pill for every ill' is not only dangerous for you but has profound implications for future generations. Self-medication is an unfortunate tendency which a large number of people fall prey to. When they are sick, they do not consult a physician. They either self-medicate or take the advice of somebody they know. Right from office colleagues to domestic servants, everyone thinks he or she is a medical authority. If you have a fever, cold, cough, constipation or indigestion, friends or even total strangers will quickly volunteer their favourite remedy, often unasked. Almost everyone you meet has an `unbeatable' cure for whatever ails you! A pill for every illWe have become a society which demands a `pill for every ill'. With pharma companies investing huge amounts of money in research and development of new medicines, there has been a drug explosion of alarming proportions. Due to the economics involved, drug companies are reaching out to the consumer with direct advertising and the provision of over-the-counter (OTC) remedies. A large number of potent drugs are thus available to the individual for self-medication. Unfortunately, unlike buying a TV or other consumer items, a layperson may not have enough knowledge to judge whether a drug can harm her or cause unwanted side effects. The availability of potent and dangerous drugs has increased considerably with economic advancement. This situation is further worsened in our country by the fact that most prescription drugs are available to the layperson without the physician's prescription. As people vary greatly in their sensitivity to drugs, an appropriate dose for one person can be an overdose for another. A drug may also cross-react with another drug that the person is already on. Thus, the layperson is ill-advised in subjecting herself to potentially dangerous self-medication. Drugs and pregnancy Be careful, particularly if you are pregnant, of taking medications without consulting a physician. There are a few drugs which can cause abnormalities in the baby, especially when consumed in the first three months of pregnancy. Very often, consumption of a newly introduced drug might cause anxiety, because there might not be enough information available on its safety profile. When it comes to painkillers, tried and tested pain medications like paracetamol might be a better bet than trying out a newfangled drug. Abuse of antibioticsMost people are not aware that coughs, diarrhoea and the common cold are usually caused by viruses and are self-limiting. People tend to assume that antibiotics are appropriate treatment, when actually antibiotics do not act on viruses. The medical fraternity also tends to overprescribe and abuse antibiotics. We entered the 20th Century with infections being the leading cause of death in the population. Alexander Fleming ushered in the era of antibiotics and humanity was saved enormous pain and suffering because of these drugs. Unfortunately, the overuse and abuse of antibiotics has given rise to new generations of bacteria, which have evolved to become resistant to these antibiotics. In other words, the antibiotics have no effect on these bacteria. Simple bacteria like staphylococci have become resistant and are now implicated in life threatening illness and even death. Therefore, in the 21st Century, we are again facing disaster from infections. Do it for your children: by overusing antibiotics, we are helping the evolution of bacteria which will not respond to most antibiotics. Hospitals are already seeing patients whose infections are responding only to astoundingly expensive antibiotics. If you want your children and grandchildren to be safe, think twice before you pop that pill. Though it is an exaggeration to say that the only safe drug is the one that is not consumed, there is a kernel of truth in there. Self-medication is an indulgence we must avoid.

GITA ARJUN

(The author is a Chennai-based obstetrician and gynaecologist with a special interest in women's health issues)

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