NON-STEROIDAL ANTI-INFLAMMATORY DRUGS VS. PARACETAMOL: DRUG AVAILABILITY, PATIENTS’ PREFERENCE AND KNOWLEDGE OF TOXICITY
Abstract
Background: Self-medication is a common practice which is influenced by level of education, society factors and health care facilities availability. In our region, Pakistan, it is very common and awareness regarding prescription implementation needs to be ensured. Hence the current study highlights the preference, availability and knowledge of toxicity of non-steroidal anti-inflammatory medications and paracetamol in Pakistan. Method: It was a Descriptive, cross sectional, conducted in Rawalpindi and Islamabad, Pakistan from May to august 2012. A total of 1000 questionnaires comprising of 21 questions were distributed to the persons with age groups from 18 years to 40 years. Non-probability convenience sampling technique was used for results deduction. Data was analysed using descriptive statistics. Results: The most commonly used medicine was Mefenamic acid (n=191, 40.8%). Paracetamol was second on the priority list (n=146, 31.3%). About 178 out of 467(38.1%) used these medications for headache. Very few responders knew about the toxic doses of the medicines they used. Only 52 (11%) were aware of the raised bleeding tendency being the most common side effect of acetylsalicylic acid and 129 (28%) were aware of liver damage by paracetamol toxicity. Conclusion: In Pakistan, common people take NSAIDs and Paracetamol without prescription and majority of them are unaware of the side effects of these medicines. This is the reason it is important to make the general public aware of the problems they may face if they misuse or over use the drugs without the prescription.Keywords: Aspirin; paracetamol; Non-steroidal Anti-inflammatory Drugs; Paracetamol; Drug availability; Patients’ Preference; Knowledge; ToxicityReferences
http://www.thefreedictionary.com/self-medication
Banerjee I, Bhadury T. Self-medication practice among undergraduate medical students in a tertiary care medical college, West Bengal. J Postgrad Med 2012;58(2):127–31.
Montastruc JL, Bagheri H, Geraud T, Lapeyre-Mestre M. Pharmacovigilance of self medication. Therapie 1997;52(2):105–10.
Martins AP, Miranda Ada C, Mendes Z, Soares MA, Ferreira P, Nogueira A. Self-medication in a Portuguese urban population: a prevalence study. Pharmacoepidemiol Drug Saf 2002;11(5):409–14.
McAuliffe WE, Rohman M, Santangelo S, Feldman B, Magnuson E, Sobol A, et al. Psychoactive drug use among practicing physicians and medical students. N Engl J Med 1986;315(13):805–10.
Lee D. Drug utilization in Panama. J Clin Epidemiol 1991;44(Suppl 2):31S–8.
Dong H, Bogg L, Rehnberg C, Diwan V. Drug policy in China: pharmaceutical distribution in rural areas. Soc Sci Med 1999;48(6):777–86.
Juha H.O. Turunen, Pekka T. Mäntyselkä, Esko A. Kumpusalo, Riitta S. Ahonen, Frequent analgesic use at population level: Prevalence and patterns of use. Pain 2005;115(3):374–81
David Bjorkman, Nonsteroidal anti-inflammatory drug-associated toxicity of the liver, lower gastrointestinal tract, and esophagus. Am J Med 1998;105(5):17–21
Dear, James W., and Daniel J. Antoine. "Stratification of paracetamol overdose patients using new toxicity biomarkers: current candidates and future challenges." Expert review of clinical pharmacology 2014;7(2):181–9.
Wilkes JM, Clark LE, Herrera JL. Acetaminophen overdose in pregnancy. South Med J 2005;98(11):1118–22.
Higuchi K, Umegaki E, Watanabe T, Yoda Y, Morita E, Murano M, et al. Present status and strategy of NSAIDs-induced small bowel injury. J Gastroenterol 2009;44(9):879–88.
Wallace JL, Hogaboam CM, Kubes P. Immunopathology of NSAID-gastropathy: inhibitory effects of interleukin-I and cyclosporin A. Ann N Y Acad Sci 1992;664:400–7.
Lee WM. Drug-Induced Hepatotoxicity. N Engl J Med 2003;349(5):474–85.
Duncan P, Aref-Adib G, Venn A, Britton J, Davey G. Use and misuse of aspirin in rural Ethiopia. East Afr Med J 2006;83(1):31–6.
Agaba EI, Agaba PA, Wigwe CM. Use and abuse of analgesics in Nigeria: a community survey. Nig J Med 2004;13(4):379–82.
Nyamongo IK. Home case management of malaria: an ethnographic study of lay people’s classification of drugs in Suneka Division, Kenya. Trop Med Int Health 1999;4(11):736–42.
Nshakira N, Kristensen M, Ssali F, Whyte SR. Appropriate treatment of malaria? Use of antimalarial drugs for children’s fevers in district medical units, drug shops and homes in eastem Uganda. Trop Med Int Health 2002;7(4):309–16.
English M, Marsh V, Amukoye E, Lowe B, Murphy S, Marsh K. Chronic salicylate poisoning and severe malaria. Lancet 1996;347(9017):1736–7.
Jenkins C, Costello J, Hodge L. Systematic review of prevalence of aspirin induced asthma and its implications for clinical practice. BMJ 2004;328(7437):434–7.
Gunnell D, Hawton K, Murray V, Garnier R, Bismuth C, Fagg J, et al. Use of paracetamol for suicide and non-fatal poisoning in the UK and France: are restrictions on availability justified? J Epidemiol Community Health 1997;51(2):175–9.
Ali SE, Ibrahim MI, Palaian S. Medication storage and self-medication behaviour amongst female students in Malaysia. Pharm Pract (Granda) 2010;8(4):226–32.
Hussain S, Malik F, Hameed A, Ahmad S, Riaz H. Exploring health-seeking Behavior, medicine use and self-medication in urban and rural Pakistan. South Med Rev 2010;3(2):32–4.
Hassan NW. Medical knowledge and attitude of patients, a survey. J Pak Med Assoc 1981:31(7):146–8.
Published
Issue
Section
License
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.