Mistakes made in buying Medications !!

  Being part of the Health care sector, I am seeing the end to end cycle of a medical drug; I have learnt quite a bit of this supply chain from close quarters since we are one of the leading Distributor for many MNC based pharma companies primarily focusing in and around Trichy area. I see quite a lot of mishaps happening in the supply chain and would like to point out some major flaws that is happening and this can be useful information for kids who are away from their parents. 

   First and foremost let us know the common practice followed in India. "Health Checkup" is considered a bad omen and many skip this fearing that it will open can of worms. People normally has a family doctor and preference is always given to doctors who speak friendly. If a doctor whose qualification and education may be far superior compared to his counterparts still people has a soft corner for doctors with 'Friendly' nature. Once medications are prescribed patients take that medicine and have a practice of keeping one or two month stock in hand. Once they have consumed the medications they have a habit of giving the used strip to either their driver/maid or a care taker to buy medicines on their behalf in case they are not able to go themselves. Some people who are Tech savvy use apps to order online and in some cases kids do the purchase on behalf of their parents. These are some of the common practices followed in India. 

   Let us try to understand how Retail medical shops work. Normally a retail shop may have license to sell quite a large pool of medicines which includes but may not be limited to Oral drugs, syrups, capsules, sachets, Diapers, Consumables like paste, powder, creams, soaps etc., Based on the location they open from 9 am or 10 am in the morning and work as late as 9 or 10 pm in the night. They may have two shift of workers to cover their schedule and overlap of workers to cover up peak hours. Ideally hiring a Pharmacist would be the best and this is what followed in all western countries but this is where I see a major blunder happening in India where most of the workforce have very little knowledge on pharma industry. Obviously you may see experienced folks but that is merely to inject some knowledge to new folks but guys are hired and fired as and when needed. The problem is these guys wear Doctor's hat and disrupt the whole efficacy in the process. Companies promote their brands in popular retail outlets and representatives take a commission based on sales and these representatives canvass retail stores to sell their product and meet the target. 

  High Blood pressure in India is as common as a stunt sequence in a mass masala movie; Diabetes is even more common and can be compared to number of people visiting Renganathan street on a particular day. When people start taking medications they just have to continue for a long time. When doctor prescribes a medicine they usually buy it from the same store. Problem happens when they switch medicines which can happen either due to miscommunication or carelessness from people who buy the medicines. Let us assume you take Aspirin regularly which lowers chance of heart attacks as it works by preventing platelets from sticking together which decreases formation of harmful blood clots. Acetaminophen is a medical composition which is used relieve pain from headache, muscle ache, tooth ache etc., Normally people who take Aspirin should not take drugs containing Acetaminophen since combination of both can sometimes lead to fatal events. But unless you have an educated Pharmacist how do you expect an employee to know information regarding medications. Some medications are restricted to take aftyer intake of Alcohol, pregnancy women should avoid certain medication, lactating mothers should avoid some, if people take steriods then some medications are restricted. There are several Ifs and But's and only a Doctor (who has a reason why he/she got a degree) should be consulted before you take medications. 

   Now coming to the second mistake people make while taking medications - Wrong strength of the dose. People forget to miss dose for one day or one course (AM/PM) and then decide to take double dose which may not go well with the body. Let us see an example ...Alprazolam is a common medical composition which many people take to treat anxiety which relaxes nerves, calms brain activity giving way to good night's sleep. But excessive dose of alprazolam can cause coma, respiratory depression and death. Similarly people take over dose of medications for Chronic diseases like Diabetes, Blood Pressure etc., without realizing consequences of their actions. Once again it is always advisable to consult a physician before making any small decision regarding your medications. 

  Now coming to the next mistake people make in taking medications - Take medicines which are contradictory to each other thereby making the overall process ineffective. For example if a young lady takes contraceptives to prevent unplanned pregnancy but at the same time takes anti-seizure drug phenytoin which stimulates excessive production of  an enzyme that metabolizes estradiol which is nothing but a component of low dose contraceptives. Contraceptives are cleared more rapidly in women taking phenytoin thereby increasing risk of unplanned pregnancy. 

Let me conclude some key takeaways:

1) Change of a brand and change of a composition are two different things 

2) Be cautious when you have someone procure medicines on your behalf

3) Never go by friend's advice on medications since every case is different - what works for ABC may not work for XYZ

4) Don't get carried away seeing the flash offers in retail outlets which may prompt you to change medications

5) Do not decide on the strength of the dose by yourself

6) Be informed on contradictory medications 

7) It is high time you start trusting your physician before making any small decision on medications. 

Next Blog: Vasanth & Co