Pills Zone

Ciprofloxacin is the new kid on the block. For many years Ampiclox especially Beecham was the poster drug for antibiotic abuse. From those who believed it was a contraceptive, could prevent sexually transmitted infections, heal withlows and absesses (Popularly called boils). The interesting thing was how all these could be achieved with just one capsule of Ampiclox 500mg. We had an interesting chat with Ampiclox 500 These days Ampiclox is getting really good competition from Ciprofloxacin (an antibiotic belonging to the class of fluoroquinolones) how ? you might wonder! Ciprofloxacin is a broad spectrum antibiotics, this means that it is capable of working for a wide range of bacterial infections and this can be an advantage. However its misuse especially when unnecessary can result in reduced effectiveness. Malaria and Typhoid always together? Its very common to hear patients insist that they want to treat typhoid fever alongside malaria because they believe it always comes together. Even on speaking to a pharmacist who informs them that typhoid fever is not as common they still insist. The truth is that the absence of classical symptoms like diarrhea, stomach pain,  and vomiting already indicates that an individual cannot have typhoid fever. Despite the above information, many patients insist on taking antibiotics for a non-existent typhoid. Ciprofloxacin is the drug of choice here especially as it is not so expensive compared to other members of the ‘’floxacin’’ (quinolone) class. These practice is now so widespread since Ciprofloxacin is a relatively cheap antibiotic. We earlier described it as broad spectrum so it is helpful for treating many other serious infections. Important to add and at a reasonable cost but that becomes really difficult if used wrongly by a lot of people. Taking an antibiotic unnecessarily is basically exposing the antibiotic to these bacteria and giving the bacteria enough time and several opportunities to learn how to bypass the antibiotic. Once these bacteria achieve that the drug no longer works and we have what experts call antimicrobial resistance. The Real Impact of Antibiotic Misuse Imagine that instead of using Ciprofloxacin which can cost less than 1000 naira  for a urinary tract infection, a patient has to get another antibiotic. Which probably could cost 3 times more to treat the same infection simply they abused Ciprofloxacin on earlier occasions. Or the patient now has to be admitted to take injections when Ciprofloxacin taken orally for a few days would have done the magic. This is real life impact of abusing antibiotics. In more serious cases getting an antibiotic that would work gets more difficult. When Ciprofloxacin stops working the about 4 other members of the ’’floxacin’’ class might stop working as well for such a patient (cross resistance). A very good number of female patients use Ciprofloxacin whenever they seem to have a vaginal infection because it appears ”effective”. The challenge with this approach is that some infections are fungal which ciprofloxacin doesn’t work for or protozoal infections. This is why testing to know the kind of infection before taking medications is better. In addition, Ciprofloxacin has a number of side effects and possible adverse effects so before taking it you need to be sure that you really need it. A better Approach When next you feel you have typhoid speak to your pharmacist about the symptoms you have and if necessary a test will be recommended after which you can get treated if the test shows you have a typhoid infection. Most likely you don’t have typhoid because typhoid is much more serious than most people believe it is. Antibiotics should be taken only when necessary to get the best results and also ensure that we have antibiotics that can work when we really need them.      

Pharmacists are an important link between Patients and their Doctors, this is why we play a vital role in communicating how patients can get the most of their treatments. As a Pharmacist who has seen a lot in everyday practice both in the hospital and in the community. I have to admit that a lot is being left unsaid as regards patient responsibility. I believe a patient is a part of the healthcare team and so needs to understand his/her role, after all they are the ones who directly benefit when quality care is provided. As a patient you might be wondering; “Isn’t it just to show up at the Clinic or Pharmacy with my complaints and get  attended to, which role again? Frankly it’s not enough to just show up. Patients too have their own responsibilities when it comes to their health and must work together with the health professionals to get the best treatments. Patients need to get more invested and proactive with their healthcare as against being passive partners in the healthcare system. Medical professionals rely a lot on patient feedback to guide their decision making, for example, with medication history. The Nigerian health system is yet to have a centralized patient record system so doctors and Pharmacists have to rely on the patients to provide this information. Knowing your Meds As a patient it’s important you keep tabs on the medicines you take and how you respond to them even if it means having a diary for it. Good enough, tech solutions in the form of mobile apps like ADHERE®️ are now available to help you. A colleague and I joked recently about how easy it is for individuals to remember players in their football clubs and or the number of songs in their favorite music artist’s album. However, these persons forget the names of the medicines they are taking or took just a week back. This is even more surprising for those on the so-called lifetime meds like drugs for high blood pressure or diabetes. Just as medical professionals work around the clock to improve the quality of services, patients must have a clear picture of what kind of services to expect. The pharmacist is sure to pay more attention to medicines and medication use. Which is why pharmacists wonder why patients get diagnosed for chronic diseases like Diabetes, High Blood pressure or Arthritis and don’t know what medicines they were given in the past or what such drugs are supposed to do. As a patient it is your right to ask! Some Wrong Practices Some private clinics have this bad practice where patients are given drugs in envelopes without names. For whatever reason that is totally unacceptable as every patient deserves to know whatever medications they are taking. It gets really annoying when such patients need to get more and the pharmacist is now given the very thankless job of identifying such pills. Another thorny issue is with written prescriptions. A lot of social media banter has been made about the terrible handwriting of some physicians and how pharmacists seem to always figure out whatever was written. This is quite worrisome because there is a risk of misreading the prescription. This leads to the patients getting the wrong medication or a wrong dose or for the wrong duration of time. Truly some of the letters in a prescription are not in English but every single letter/number of each word should be clear even for you the patient to see. That way you can be sure that the pharmacist easily understands what’s written without having to speculate. This might sound extreme but whenever you get such prescriptions where you can barely make out the letters/words kindly ask your physician to rewrite it. It’s your health that is at stake and you should look out for yourself as much as possible. Be intentional about your health, a lot depends on it Oluwatomi Olusanya (B.Pharm UPH)

OPINION PIECE.. It wasn’t surprising that the trending hashtag on Nigerian Twitter following the Federal Government’s ease of lockdown restrictions was centered around supplements as “Immunity Boosters.” In fact, social media platforms, especially WhatsApp and Facebook groups were full of very lengthy posts telling the readers which combinations of vitamins and dietary supplements would boost their immunity against the COVID’19 virus. The information contained in these posts provided varied greatly from one group to the other and often sketchy with details and evidence to support their claims, Just like the early days of the outbreak in Lagos, Vitamin C and D alongside trace minerals like Zinc, Calcium, Selenium and Magnesium supplements flew off pharmacy shelves as Nigerians raced to purchase these “Immunity Boosters.” Whether these vitamins and dietary supplements offer any benefit is sometimes difficult to determine and only time in most cases would tell. The global vitamins and dietary supplements market consists of over 90,000 different products and brands; valued at 140.3 Billion US Dollars in 2020. So, between the coronavirus pandemic and our increased awareness regarding personal health and wellbeing the market is expected to grow by 8.6% in the coming years as a surge in demand for immune boosting supplements continues to be the trend. These supplements come as pills/tablets, capsules, chewable, powders, drinks, oils, bars and each claim “a better version of yourself”: with stronger bones, thinner waistlines, flawless skin, healthier intestines, better sex lives with more potent sperm. They tell of how this product can ensure you stay one-step ahead of age, dodge disease and cheat death! On the whole, we (75% of twitter respondents) believe them. Recent surveys suggest that 33% of Nigerians take at least one supplement and 10% take as much as 3. But should we? I mean, are we smarter; stronger, faster or in any way healthier because of these daily pills?…. Download our April magazine to see full article and lots of other great content

In the last few years, I have heard numerous rumors from some of my undercover agents about how members of the antibiotic association are terribly frustrated with +234 people. I even heard about a planned strike and I was really curious about their grievances. I pulled all my connections in the antibiotic community and a prominent member agreed to have a sit down with me:  Ampiclox Beechams 500. Miss Beechams is a founding member of the Antibiotics Association and in this tell-all interview with Olusanya Oluwatomi, she speaks about the struggles she and her colleagues face daily the line of duty… Excerpts below: Miss Beechams, thank you so much for speaking with Healthy Naija today despite your very busy schedule. Ampiclox 500: Thank you very much for having me, I and my comrades deeply appreciate the work you do at Healthy Naija, teaching Nigerians about what we do as the Antibiotics Association. Frankly I will love to say that my schedule is too busy because Nigerians like to call my attention to matters that don’t concern me. Really. How? Ampiclox 500: Every morning, I’m called to terminate pregnancies. Like…how is that even my job? Just this morning, I got over 600 DMs from people who had unprotected sex; guess what? They wanted me, Ampiclox to come and prevent them from having an STI or getting pregnant, I am like what the heck!! Postinor 2 and Condoms are just in their offices sleeping, gisting and watching Netflix why can’t Nigerians call them to do their jobs?  I’m really fed up. Which mic are you using…this one, abi? Let me say this for the record: I, Ampiclox 500 Beechams I am an antibiotic, my job is to treat bacterial infections! Wow that’s so much stress for you and your comrades with so much unwarranted demand for your services. Ampiclox 500: Yes!!! And I’m not just speaking for myself, my cousin Metronidazole (you know him as Flagyl) has become a scapegoat of some sort. See, whenever those Green White Green people finish “chopping life” and develop a running stomach, they won’t even disturb Loperamide  (Lemotil) that can stop the diarrhoea, quickly, they will drag my poor cousin Flagyl into the toilet with them. Uhmmm…kinda true but they believe flagyl can help na or even with tetracycline AMP 500: Pls don’t even bring Tetracycline here, he is one of our big ogas you people should stop disturbing him for minor things, I don’t want to vex (Rolls eyes). Ahhh..Sorry please be calming down. So, when should Nigerians call you?  Cause I heard some of your colleagues are considering changing their phone numbers Ampiclox 500: hahaha, now you are talking, (clears throat) … I don’t want just anybody to call me, I only want calls only from Doctors and Pharmacists, trust me once there is a prescription I will be there immediately. You see..eeeh, I actually love my job of kicking out actual bacteria and trust me all my colleagues do, passion wan choke us sef. So once there is a prescription, no issues you will be available? Ampiclox 500: Yes oh! Like instantly I will show up and be there as long as is needed. But there is another problem oh… Uhmmm…problem no dey finish for una side o Ampiclox 500: Mtchew…it’s you people that are the problem. When there is a prescription and I arrive ready to work, you people will not still let me do my job well. Most of them take me in based on vibes and insha Allah or as ‘’the spirit leads’’ even when they were told the correct time interval which can be 6,8 or 12 hourly depending on if its 4,3 or 2 times daily. So, the timing must be precise for you to work well? Ampiclox 500: Exactly, which is why our association has been begging your people to download the ADHERE app on the play store, this app sends reminders at the exact time we should be taken but as usual, you people have coconut head and you insist that you know what you are doing, no wonder your country is the way it is. Why so blunt? Don’t you think as long as they feel better, the end justifies the means? Ampiclox 500: Not at all! When the timing is not followed or you people stop taking us before the prescribed time, mostly because you feel better, this is what happens: You give those yeye bacteria room to escape as they’ve learnt all our killing tactics. They will start raising shoulders for us and when next we come to do our jobs, they will just overpower us but las las it’s you people that will suffer it sha. That’s kinda scary though Ampilox 500: Stay there and be speaking English, you suppose fear… (shining her eyes) … fear catch you Naija people! Cause when those germs become stubborn you will need to spend more or even empty your account to pay for our big-big  Ogas (Like Colistin, and Tavanic) to take care of the situation. You can be so unlucky that our chairman can’t even work. Shebi, you people have plenty of money? Haa… Nooo! madam, life has not been easy under Uncle Bubu. Anyway, thank you for granting us this interview, I see your phone is already beeping Ampiclox 500: Mtchewww, someone wants to flush his system and he is texting me. I think I should just leave this country for you people. Check out the rest of our April magazine content. Download for 1000 naira

Drugs are substances which when taken into the body changes the way our body functions via several ways and so are used for; 1. Management of chronic diseases i.e. those that don’t have a cure e.g. Diabetes 2. Treatment of diseases e.g. Antimalarial are used to treat Malaria 3. Prevention of diseases e.g. Hepatitis Vaccines are used to prevent hepatitis. Drug substances are usually made with other components and presented as medicines which can be taken directly by a patient. However, it’s noteworthy that full benefits can only be derived when medicines are used appropriately. Below are four things you should understand before taking any medication: 1. Why you need the medicine. 2. How, when and how long they are to be taken. 3. How to store the medicines? 4. Possible effects of not taking the drug as instructed. The information above can only be provided by the pharmacist who is the drug expert or sometimes the physician. According to recent research a large number of drug related problems are due to self-medication i.e. using a medication without professional advice. This is a dangerous practice because of the reasons below: 1. Reliable information on proper drug use can only be gotten from health professionals especially the pharmacist. 2. Some Drugs have varying doses for different conditions and groups of persons like the young children, elderly, obese or very slim persons. 3. Certain Drugs when used together can interact and produce harmful effects. 4. Some drugs are not to be used at all in certain conditions e.g. in persons with diseases that affect the liver, kidney or during pregnancy. #AskthePharmacist #Healthy Naija

The Life-Saving challenge educates current and potential users of the Adhere App on the importance of A+ (90-100%) adherence to prescribed medications for better health outcome. Medication nonadherence for patients with chronic diseases is extremely common, affecting as many as 40% to 50% of patients. These patients are prescribed medications for management of chronic conditions such as diabetes or hypertension. This nonadherence to prescribed treatment is thought to cause at least 100,000 preventable deaths. Adherence refers to a process, in which the appropriate treatment is decided after a proper counseling with the patient. It can be defined as “the extent to which a person’s behavior, in taking medication, following a diet, and/or executing lifestyle changes, corresponds with agreed recommendations from a health care provider”. Adhere is a health focused mobile application designed to alleviate the prevalence of medication non-adherence in patients living with chronic diseases (HIV/AIDS, HYPERTENSION, DIABETES etc.) and are on long-term medications for better morbidity and reduced mortality. The resulting decline in medication non-adherence may lead to less emergency room visits and hospitalizations. Adhere offers a simple and reliable structure for patients on long term treatments (HIV/AIDS, Hypertension and Diabetes… etc.) to keep track of all their medications With 3 tools… The Pillbox:  A virtual container, which provides a push notification at the exact time each of your medication should be taken and automatically keeps a MEDICAL HISTORY at the end of every treatment. Pharmacy Locator: a GPS enabled feature to locate the nearest pharmacy in your current location. Pill Zone: a direct link for the most insightful, easy to understand and relevant drug information content (via healthnaija.ng) Check out @Adhere_app on all social media platforms to learn more about “The Life-Saving Challenge”. Download Adhere from your App Store.  

The average person is definitely not a fan of taking drugs orally and the reason is simple, no one enjoys popping bitter and terrible smelling pills into their mouths. The phrase ”A bitter pill to swallow” captures this succinctly, it’s a real struggle I must admit. Various illnesses force us to and the most common response is to take them for the shortest time possible and this is one of the reasons a lot of people don’t finish their dosage regimens. Several coping mechanisms have come into play to avoid the bitter tastes of these medications. Funny as some of them may sound, they range from using sweet soft drinks to placing them in morsels of eba or pounded yam. According to this WebMd article most drugs are bitter cause they are plant based and require a lot of special formulation to be made more easier to swallow. This begs the question some patients have kept asking over the years. Why can’t all drugs be sweetened like the popular colored Vitamin C? Here are 3 possible reasons…. Cost of Production This is a less significant reason however it can be a reason, there are different additional ingredients that come with an actual drug for it to be presented in the form it is taken. So, for example a 500mg paracetamol tablet is definitely going to weigh far more than 500mg if it is weighed. Sweetening agents are one of these possible additional ingredients and the cost of buying them, the process of adding them or the technology to incorporate them into a tablet for example can increase production costs. These depends on the drug in question as well. This leaves the drug producers with a decision on whether it is really important to sweeten them especially since a major consideration is ensuring that the drug cost remains as low as possible. Incompatibilities When formulating medicines, the end goal for the production pharmacist is to ensure that the medicine is formulated in a way that ensures that when a patient takes it the drug works in a particular way. The ingredients are added to ensure that the drug works in a particular way. Not all of these ingredients go together and that is why any ingredient that is not absolutely necessary or capable of affecting the normal action of the drug is dropped. Sadly, our favorite sweetening agents are sometimes sacrificed to ensure that the drugs we use can work as effectively as we want it to. I’m sure you would prefer taking bitter medications for a few days and get better than sweet meds that aren’t as effective. Type of Medication The type of medication sometimes plays a role in determining if drug producers consider sweetening as very important. A medication for high blood pressure which could be taken for life will be higher on the priority of drugs to be made less foul tasting. Same applies to smell compared to an antibiotic usually taken for 3 days to one week. The reason a medication isn’t sweet can be due to one or a mixture of any of these 3 factors discussed above. The most important point to take away is the importance of taking medications according to prescription. This is the only way to get maximum benefit from them. Always feel free to ask your pharmacist about alternative drinks you can use to take your medication if water doesn’t do it for you. Oluwatomi Olusanya (B.Pharm UPH)

Pharmacist: Ma’am, take one capsule of this drug every 8 hours for 5 days Patient: Isn’t that the same thing as three times a day Pharmacist: Not really Why 3 times a day is not the same as every 8 hours You are probably familiar with your pharmacist telling you to take a medication every 8 hours or every 12 hours, depending on if the drug is to be taken twice or three times a day. You might feel like why doesn’t the Pharmacist just say three times a day or twice a day here is why… Patient A was told to take a drug 3 times a day, he took the first dose at 8.30am after breakfast, the next at 2.10pm and the last at 8.00pm in the night. This is three times, isn’t it? but this is very far away from the actual time interval the drug needs to be taken for effectiveness. This patient took the second dose 5 hours 40 mins after the first (nothing close to the 8 hours) and took the third 5 hours 50 mins after the second Ideally the patient ought to have for example taken at 6.00am, 2.00pm and 10.00pm. This seemingly little disparity can have a huge impact on how the drug works. Effects of dosage timing on treatment results Drugs are formulated with very precise properties and the dose intervals are set in a particular way. This is to ensure that as the blood levels of the first dose start falling below the level it can exert its effect on the body, the next dose is taken. This is how most drugs work and taking at the exact dosage intervals is even more important for antibiotics and antifungals. Not sticking to the correct time can allow the microbes to somehow escape the drug. This leads to such infections not clearing completely and possibly coming back in the nearest future. Patient A in our example takes the next dose before the correct time (like 5 hours 40 mins as against 8 hours. This can lead to a greater than necessary amount of the drug in the system and that can mean more severe side effects. The opposite effect occurs when the subsequent dose is taken late. The drug might fail to reach the required blood concentration to sustain the drugs effect. If it’s an antibiotic it might fail to adequately deal with the microbes. Adhere, a tech solution Adhere totally prevents these potential problems by sending timely reminders at the exact time the medications should be taken. I am sure you are always with your mobile phone, let’s partner with you and get the best of your medications Download Adhere on Google Play store… Check out adhere on twitter  

Traditional medicine has been saving lives for centuries but has recently been pushed to the background in the mainstream healthcare system. This is mainly due to it not being standardized and regulated, thus it’s gradually becoming a neglected aspect of medicine. In Africa, before the existence of modern medicine, we have used this form of medicine to protect and restore health. Interestingly, it is still used significantly in rural areas some of which lack health facilities. According to Achalu I.  traditional medicine refers to health practices, methods, knowledge, beliefs that uses plant, animal or mineral based medicine, spiritual or manual techniques to treat, diagnose and prevent illness or disease. There are two major sub-groups under African Traditional Medicine; The Herbalist: They specialize in using drugs in form of herbs to treat local disease effectively. Diviners: they believe in the intervention of spirits to cure disease Others are traditional healers who believe in the power of ancestors to heal, the traditional birth attendants, bone setters, etc. Problems Affecting African Traditional Medicine As effective as this for of medicine can be, most persons are against it due to reasons such as: Unprofessional attitude of the practitioners Poor hygiene Poor treatment facilities Multiple complications/ side effects Possible Solutions Statistics in Nigeria have shown that majority of the population still live in the rural areas and get to be attended to by traditional medicine practitioners. Traditional African societies remain deeply connected to some ancient cultural practices and these traditional healers are seen as reliable. In line with this there is a need to seek ways to incorporate this alternative system into the mainstream health system. China has done something similar and achieved remarkable results. Training of the traditional practitioners while putting up strategies to encourage safe health practices is very important. Funding research to scientifically prove the efficacy of such herbal cures can take these remedies to a global scale and bring economic benefits to such areas. WHO is halfway through implementing the strategy 2014-2023 and their aim is to develop standards based on reliable information. This is to support its member states to provide safe, qualified and effective traditional and contemporary medical services and their appropriate integration into health system. New drugs can definitely emerge from African Traditional Medicine to become global brands. Happy African Traditional Medicine Day Africa To the World Oluchi Goodness