- The prescription is a barrier to prevent patients from treating themselves. The general rule is that the medications prescribed by the doctor were prescribed for the specific illness with which we contacted him at the moment - says Rafał Janiszewski, owner of the Advisory Office providing services in the field of he althcare organization for medical entities and legal entities. patients.
Anna Tłustochowicz: Let me start with a hypothetical situation: I have some antibiotic left, which a dermatologist prescribed me for acne a few months ago. Then it helped, but now the spots are back. Can I take the same antibiotic until the end?
Rafał Janiszewski:The general rule is that the medications prescribed by the doctor were prescribed for the specific illness with which we came to see him. The lady asked about an antibiotic and it is very good that our conversation begins with this.Antibiotics are prescribed for various diseases.They are often associated mainly with the treatment of upper respiratory tract infections, but it may be just mentioned acne, cystitis or a wound that is difficult to heal. The whole spectrum of infections, infections. And what is the key? The fact that every infection, or every infection, can be caused by a different microorganism. Now I am not referring to the case of acne, but very often the symptoms are very similar as before, but it is not the same disease anymore.
So the antibiotic won't work?
Of course it did not work, because if it is e.g. an upper respiratory tract infection and a few months ago it was caused by a bacterium that turned out to be sensitive to this antibiotic, but today it is e.g. a viral infection. And for viruses, antibiotics don't work.
We do not take antibiotics ourselves.
The general rule is that we should consult a doctor every time. But there can be exceptions! Now I will come back to the acne you mentioned. He is a chronic ailment and when the doctor prescribes an antibiotic, then - during this visit to the doctor - we should ask whether, in the event that acne returns, we can use the antibiotic we are prescribed.
It's worth itknow, however, that the general rule when it comes to antibiotics - the rule with WHO guidelines, with the world standard, is that before they are administered, a culture and an antibiogram should be performed.This is a test during which a sample is taken which is sown, the bacteria are grown, and then various antibiotics are applied to them, and the bacteria are further cultured. After a few days, we can see which antibiotic they die from.
To which antibiotics are they sensitive?
But also, what antibiotics are resistant to! And then the doctor prescribes an antibiotic in a targeted manner. But I would like to emphasize: this antibiotic will help me with this disease with which I came to the doctor today!
Because the throat infection I get in a few months may already be caused by a virus.
Yes, but it may also be the same bacteria. But she's not sensitive to that antibiotic anymore.
Is it for other medications the same as for antibiotics?
We have, of course, various groups of drugs that doctors prescribe to us in case of various illnesses, incl. chronic diseases whose symptoms appear from time to time and, thanks to medication, improve, but may come back.
Migraine?
For example migraine, asthma. In the cases that I am talking about now, the drugs prescribed by the doctor, we will be able to reapply when the symptoms appear again. Just see: in this case, it is the doctor who prescribes a specific drug for a chronic disease, who says: "If a relapse occurs, if symptoms appear again after some time, then please take this drug in such and such dose for so many days" .
It is a very bad practice to take medication from someone!My aunt is being treated for hypertension, and because I also have it, I will save myself time, which I would "lose" at the doctor …
And the money for the visit, if it was private …
Also. And I'll take my aunt's medicine. I have come across such cases that it helped her or him, it will also help me.This is a very bad and very dangerous action!Drugs are firstly selected for a given illness, but secondly - for this particular patient in a specific situation. And the drug, which is so great for my aunt's hypertension, may not only not work that great for me, but it may even be harmful.
Why?
Because the mechanisms of action of antihypertensive drugs vary and depend on the causes, but also on the individual clinical evaluationspecific patient. And the reasons may be different. It may be atherosclerosis, but it may also be other diseases. And now, we took the drug from my aunt, he seems to be working because the blood pressure is going down, but the disease will continue. And this can lead to really serious consequences. For example, heart rhythm disturbances.
Hypertension is said to be the "silent killer".
Therefore, we must always remember that the drug is not assigned a disease.
The drug is for the patient who has the disease!
I met, but people "lend themselves" to sedative medications.
Me too. And you have to remember that there are many drugs that affect our psyche. It is commonly said that we take them "to calm down" or "to sleep", but similarly:these are different groups of drugs and the doctor prescribes the drug to a specific person, taking into account a number of factors,starting from age and ending with the general he alth of the patient. Such carefree use of drugs, after which a friend felt perfectly well, can be dangerous. May affect blood pressure, heart rate.
So again - we need to consult a doctor.
Yes, because the golden rule is:"We don't cure disease! We treat a person who has this disease. ” Medicines may have similar indications, but they may be very different. And that's why the doctor interviews us, checks our general he alth, comorbidities, and medications we already take, and only on this basis selects for us, not for our family and friends, who will have the same symptoms as us - specific drug. Let us consider why it is even so that a certain group of drugs is dispensed to patients only on the basis of a prescription? Not only because they can be dangerous, toxic, poisonous …
Narcotic.
Yeah, of course. But most of all, the reason is thatthe correct selection of this drug can only be determined by a doctorwho is able to predict its impact not only on the disease, but on our body in general.
The prescription is not a barrier to access to a dangerous substance, although of course also, as in the case of the narcotic substances mentioned by the lady,it is a barrier so that patients do not heal themselves.Finally, I left a very important point. Treatment of children.
Especially now, when the children went to nurseries, kindergartens, schools - they are sick with power.
Children often suffer from recurring illnesses and infections. The parents then go to the doctor, who prescribes the drug.Sometimes it is an antibiotic. Now, what are some parents doing with the next infection? He says to himself: "Oh, I still have some of that syrup or spray left, and the child is ill the same as the last time, he has a runny nose, so I'll give him this drug".
Not allowed?
No! And often parents do that, and even at the first symptoms they start taking the drug already. Where at this stage, it is not needed at all! Not only that,it can be very dangerous.
We remember that drugs are not drops. Drugs burden the liver and kidneys.
This is a necessary evil of course, but we remember that each illness in a child is different. It may not be a bacterium at all, or a bacterium other than before, or a virus, or it may be an allergic reaction that does not mean that the child is allergic. It's just that his immune system is just developing. At the same time, remember thatin children, disease processes are fast , often even dynamically, and the use of drugs that are registered as prescription in children must be very seriously balanced. And I see in the ordinances of doctors that pediatricians prescribe drugs to children with great care.
Coming back to antibiotics for a while, their careless use may cause them to stop working for us.
We are becoming resistant to antibiotics as humanity. Antibiotic protection policy and global guidelines say clearly not to use them hastily: without cultures and antibiograms. At one point it so happened that antibiotics became ubiquitous and when a bacterium attacks us, it becomes more and more difficult to find an antibiotic to which it will be sensitive.Therefore, there is no doubt that when a child becomes ill again, it must not be given an antibiotic that was left in the cupboard after the last illness!By giving it, we can change the symptoms and later, when the child does not recover and we finally go to the doctor, he will no longer see the clinical picture. The drug relieved the symptoms, e.g. it reduced the fever, but it only masked the disease, not cured it. The disease process is still going on, and in children, as I have already mentioned, it can happen very quickly. Today we focused on prescription medications, but I would also like to mention over-the-counter medications.
Over-the-counter medications have a fairly broad effect, so the patient is less likely to achieve a therapeutic effect if taken alone.
At the same time, the leaflet always contains information that if this effect does not appear after two, three or five days, it should beconsult a doctor. It may just turn out that our he alth problem does not fit within this broad spectrum of drug action.
So taking them is not only pointless, but it can also be dangerous.
Drugs that are available over the counter are fairly safe. This is why they are so accessible.However, we must not forget that these are drugs.Some substances have small doses, but they can be overdosed, some of them can simply harm us.
Expert
Rafał Janiszewski, owner of the Advisory Office providing services in the field of he althcare organization to he althcare entities
Speaker, organizer of many trainings and conferences on he alth protection and patient rights. In the years 1998-1999 an employee of the Office of the Government Plenipotentiary for the Implementation of the General He alth Insurance. Author of over 20 books on he althcare organization and he alth care financing standards. In 2005-2007, he was an expert of the Presidium of the Parliamentary He alth Committee, as an advisor on he alth services. Co-author of the general study as part of the Pharmaceutical Pricing and Reimbursement project for the European He alth Commission.
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