THE patients’ right to ask questions of their healthcare provider is the starting point for best treatment outcomes since a better understanding of their disease conditions and how they can actively contribute to their healing are key success factors. Firstly, ensure that the person you are engaging for advice is duly qualified to adequately address your concerns by identifying them in the pictured certification which is displayed for the public scrutiny in the case of a pharmacist. Some of the questions you may need definitive answers for are listed below.

Q: If I am experiencing severe pain can I double-up the dose of the pain medication so I may get relief in a shorter time?
A: No. Such practice is unsafe since it compromises your other organs (stomach, liver and kidneys which breakdown, metabolise and excrete medications) and may worsen your condition if there is some unknown impairment.

Q: How long after drinking medication do I see an effect?
A: The time lapse varies with different drug formulations and the disease condition you are treating. When a drug in tablet form enters the body it generally takes about half an hour before it is bioavailable but it can be shorter if the formulation is a capsule, liquid gel, dispersible tabs, effervescent tabs, chewable, sublingual or liquid. However EX(extended release), SR (slow release) and MR (modified release) formulations may take a longer time to be absorbed into the blood but their advantage is that it stays a longer time in the body requiring less frequent dosing. So the effects can be evident for pain killers, blood pressure or blood sugar meds which are visibly measured. However, for other disease conditions such as fungi present either on the skin, scalp, fingernails or toe nails, it takes a longer time to treat since the MIC (minimum inhibitory concentration) of the drug to eradicate such micro-organisms must be maintained for a period ranging from several weeks to months depending on the severity of the condition.

Q: I am having trouble swallowing my pills. Can I crush the medications?
A: It is not advisable to alter the formulation such as crushing tablets, opening capsules, splitting or cutting medications for various reasons. Some chemical compounds have a bad taste and hence patients will not comply with dosing, while other medications may be rendered inactive due to exposure to stomach acid or may cause irritation to the stomach lining. Disruption to the drug delivery technology, where incremental doses are designed to be released at specific times, can cause initial toxicity levels and subsequent lower therapeutic levels. So the list of products that should not be crushed are SR (slow release), EC (enteric coated), EX (extended release), MR (modified release), LA (long acting), CR (controlled release), SA (sustained action). The innovative drug delivery technology is utilised mainly by branded products although a few commonly used generics have this feature where a controlled amount of drug is released into the body over a prolonged period, removing the need for multiple dosing. Regular generic tablets can be film/ sugar coated or scored (those with a line dividing the pill into two). Only the latter may be cut using a tablet cutter to ensure precise amount of milligrams.

Q: Isn’t brand name medication better than generic? Why else would it be so much more expensive?
A: The generic drugs are at least 80 per cent cheaper than the branded ones since there is an associated high cost to conduct clinical trials to prove safety and effectiveness prior to releasing on the market. However, the generic equivalent does almost the same job since it contains the same amount of active ingredients. Since 2013 OECD (Organisation for Economic Co-operation and Development) countries supported generic medications where pharmacists were allowed to substitute generics for branded products. The screening and approval process vary from country to country by their respective authorities (in USA the FDA, in Europe, the EMA and in Guyana the FDD) to ensure quality generic drugs, using bioequivalence studies.

Q: What are the necessary information to volunteer to the pharmacist?
A: Always inform the pharmacist if you have any allergies, if you are currently on any medication (both OTC and POM), pregnant or breastfeeding or buying or collecting treatment on behalf of someone. Usually there are alternatives in the event of allergies, pregnancy and breastfeeding. Medications were earlier categorised as A, B, C, D or X for pregnancy risk or birth defects depending on the trimester. However, this classification was modified in 2015 to show safety in pregnancy, lactation and female and male reproductive potential on a more individualised manner measuring risk to benefit.

Q: Is it safe to buy medications online?
A: E-pharmacy or online pharmacy may be convenient but has its limitations, and, for sure, safety issues since many of the online platforms do not require proper storage of the meds nor guarantee that the meds are not counterfeit. It is estimated that 25 per cent of pharmaceuticals distributed in the developed and developing countries are counterfeit. So individual assessment of the entity using criteria of physical inspection of warehousing and storage conditions, involvement of qualified pharmacists in operational procedures (who will understand the importance of the watchful eyes of the FDD and FDA) and observe the necessary protocols in the event of a product recall, are some measures to ensure you are receiving a quality product and not just a cheap counterfeit alternative.

For further advice consult the pharmacist at Medicine Express PHARMACY located at 223 Camp Street, between Lamaha and New Market Streets. If you have any queries, comments or further information on the above topic kindly forward them to medicine.express@gmail.com or send them to 223 Camp Street, N/burg. Tel #225-5142.