Medicines need to be safe and effective to produce desired outcomes. A poison in a safe hand,they say become medicine and a medicine in a wrong hand becomes a poison. A thalidomide in a safe hand is used to treat cancer and some form of skin conditions caused by leprosy. In an unsafe hand thalidomide causes Phocomelia,a form of birth defects characterized by the absence of limbs in affected children.
One of the first recorded safe use of medicine is found in the Bible book of Genesis where God anaesthesized Adam prior to a surgical procedure in which a helper was made for him from his ribs. This sentiment is also shared by some Islamic scholars.
The history of the use of medicine predates written words. When Adam and Eve needed wisdom they turned to medicine-the tree of knowledge which grew the forbidden fruits. This God-planted medicine was fast acting, safe and effective as their eyes were opened immediately they consumed the medicinal fruits. When the ancients needed a cure for their diseases and wanted to live forever,they turned to medicine- the elixir of life also known as the elixir of immortality. The second scenario involved the ancient Greeks taking ambrosia,the so called ectar of the gods which was believed to confer immortality to the gods. The ancient Chinese during the Quin Dynasty also sought for immortality from drugs,a concoction laced with mercury was taken for this purpose. Unfortunately the mercury concoction killed the first Quin emperor who only wanted to live forever.
Medicines need not only be affordable. They should also be effective and safe to produce desired outcomes-to prevent,cure,treat a disease and relieve symptoms.
A medicine according to the FDA is considered safe when its benefits outweighs its known risks.With safe and effective medications,diseases and conditions such as diabetes, Hypertension, HIV can be effectively managed to the points where patients quality of life are not affected.
Safe and effective medications prolongs and improves the quality of life. Marriages,homes and national security are sustained by safe and effective medicines.
Unsafe and ineffective medicines may be cheaper but the bitterness of the adverse effects remains long after the sweetness of the low price is forgotten. Diethylene glycol,an industrial solvent and an ingredient in antifreeze and brake fluids which is far cheaper than the safer glycerine was incorporated into ‘My pikin’, a baby teething mixture in Nigeria.The damage was enormous. Mothers from Zaria to Lagos watched helplessly as their lovely cuties came down with diarrhoea, vomiting, fever and convulsions. Most of the affected children could not pass urine for several days. Prayers were offered. The gods had no answers. Homes were shattered. A picture of human suffering with 84 official baby deaths was painted across the country as of February 16,2019. These deaths were caused by sheer human error driven by greed and regulatory negligence.
There seems to be confusion even among Pharmacists about the safety and effectiveness of drugs after the expiry date. Some drugs may still be safe and effective after their expiry date but the National Health Service(UK) has warned that under no condition must expired medicines be used. Reconstituted antibiotics,dry antibiotics powder that requires boiled and cooled water to be added to them before use should be discarded after 7 days of reconstitution. Similarly eye drops and ear drops should not be used after 1 month of opening.
Some countries have found a way to standardize herbal medicines and marry the use of their traditional medicines with the orthodox medicines. China is way ahead in this regard. Nigeria and other African countries are not making much progress in the use of African traditional medicine. Dubious traditional medicines damages the kidney,liver and other body organs. Restrain should therefore be exercised in the use of herbal products. Herbal products must not be combined with orthodox medicines.
Medicines would become safe and effective when Doctors,nurses,Pharmacists,Laboratory scientists work in concert with the patient in an environment of trust and respect for what each health professional and patient is bringing to the healthcare table.
In order for healthcare and medicines to be safe and effective healthcare providers should commit to updating their knowledge and skills regularly,giving the right medications to the right patient in the right dose and through the right route at the right time and above all Nurses,Pharmacists,Doctors and other healthcare providers must commit to working together as one team,open and transparent. Pharmacists in particular must commit to explaining to their patients how to use their medications correctly. The Doctors must commit to using the required procedures for each delivery they perform. A culture of patient safety should also be practiced by every healthcare provider.
The 5 Moments for Medication Safety that every patient must observe according to the World Health Organization are explained in the paragraphs below.
Starting a Medication: What is the name of this medication and what is it for? What are the risks and possible side effects?
Taking my Medication: When should I take this medication and how much should I take each time? What should I do if I have side effects?
Adding a Medication: Do I really need any other medication? Can this medication interact with my other medications?
Reviewing my Medication: How long should I take each medication? Am I taking any medication I no longer need?
Stopping my Medication:When should I stop each medication? If I have to stop due to an unwanted effect,where should I report this?