Right and Wrong use of modern medicine. Lesson from Book "Where there is no doctor"

| COMMUNITY HEALTH CSL. al
47/1, (First Floor) St. Marks Road, “aes —
Rangalore - 560 001, aes . |

RIGHT AND WRONG USES
OF MODERN MEDICINES —

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published by the

Voluntary Health Association of India
C-14 Community Centre
Safdarjung Development Area
New Delhi 110016

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CHAPTER

RIGHT AND WRONG USES
OF MODERN MEDICINES

Some medicines sold in pharmacies or village stores can be very useful. Others
are of no value. Also, people sometimes use the best medicines in the wrong way,
so that they do more harm than good. To be helpful, medicine must be used
correctly.

Many people, including most doctors and health workers, prescribe far more
medicines than are needed—and by so doing cause much needless sickness and
death. |

There is some danger in the use of any medicine.

Some medicines are much more dangerous than others. Unfortunately, people
sometimes use very dangerous medicines for mild sicknesses. (| have seen a baby
die because his mother gave him a dangerous medicine, chloramphenicol, for a
cold.) Never use a dangerous medicine for a mild illness.

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Guidelines for the use of medicine:

1. Use medicines only when necessary.

2. Know the correct use and precautions for any medicine you use (see the
_ GREEN PAGES). os

3. Be sure to use the right dose.
4. |f the medicine does not help, or causes problems, Stop using it.

5. When in doubt, seek the advice of a health worker.

6. Always check the expiry date (\ast date before which to use) of the medicine. If
the medicine is given after this date, it may do more harm than good.

Note: Some health workers and many doctors give medicines when none is
needed, often because they think patients expect medicine and will not be
satisfied unless they get some. Tell your doctor or health worker you only want

62

medicine if it is definitely needed. This will save you money and be safer for your
health.

Only use a medicine when you are sure it is needed

and when you are sure how to use it.

THE MOST CANGEROUS MISUSE OF MEDICINE

Here is a list of the most cornmon and dangerous errors people make in using
modern medicines. The improper use of the following medicines causes many
deaths each year. BE CAREFUL!

1. Chloramphenicol (Ch/ioromycetin) (p. 401)

The popular use of this medicine for simple diarrhea and other
mild sicknesses is extremely unfortunate, because it is so risky.
Use chloramphenicol only. for very severe illnesses, like typhoid
(see p. 229). Never give it to newborn infants.

2. Oxytocin (Pitocin), Pituitrin, and Ergonovine (Ergotrate) (p. 424)

Unfortunately, some midwives use these medicines to speed up
childbirth or ‘give strength’ to the mother in labor. This practice
is very dangerous. It can kill the mother or the child. Use these
medicines only to control bleeding after the child is born (see
0.312).

3. Injections of any medicine

The common belief that injections are usually better than
medicine taken by mouth is not true. Many times

medicines taken by mouth work as well as or better than
injections. Also, most medicine is more dangerous
injected than when taken by mouth. Use of injections

should be very limited (read Chapter 9 care

4. Penicillin

Penicillin works against only certain types of infections. Frequent use of penicillin

for sprains, bruises, or any pain or fever is a great mistake. As a general rule, injuries
that do not break the skin, even if they make large bruises, have no danger of
infection; they do not need to be treated with penicillin or any other antibiotic.

Penicillin ointment or powder used.on the skin can make the person sensitive to
penicillin.

Penicillin is dangerous for some people. Before using it, know its risks and

precautions you must take (see p. 70 }

63

5.__Injections of penicillin with streptomycin (p. 400).
a Pen streptomycin

here are many familiar brands names.
These medicines are used too much and often for the wrong
reason. They should not be used for colds for two reasons

la. They do not work against colds and flu..
1b. They can cause serious problems, sometimes deafness
or death.

2. Give streptomycin for treatment of tuberculosis only.
If you give it for any other disease, the person may
become resistant to streptomycin, and then will have
to take more expensive medicines to cure tuberculosis.
Do not give this medicine for any other disease.

6. Vitamin B72 and liver extract (p. 425)

These medicines do not help anemia or ‘weakness’ except in

rare cases. Also, they have certain risks when injected. They

should only be used when a health worker has prescribed them
>.< after testing the blood. |n nearly every case of anemia, iron pills
fo) will do more good (see p. 147)*

7. Other vitamins (0.424)

As a general rule, DO NOT INJECT VITAMINS. Injections are more dangerous,
more expensive, and usually no more effective than pills.

Unfortunately, many people waste their money on syrups, tonics, and ‘elixirs’
that contain vitamins. Many lack the most important vitamins (see p.139'). But
even when they contain them, it is wiser to buy more and better food. Body-
building and protective foods like beans, vegetables, fruits,e€99S, and meat.
are rich in vitamins and other nutrients (see p.129 -131). Giving a thin, weak
person good food more often will usually help him far more than giving him
vitamin and mineral supplements.

A person who eats well does not need extra vitamins.

THE BEST WAY TO GET VITAMINS:

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64

For more information about vitamins, when they are necessary, and the foods |
that have them, read Chapter 11, especially pages 129 and 138

8. Calcium
Injecting calcium into a vein can be extremely dangerous. It can —
‘oe quickly kill someone if not injected very slowly. Injecting

SS calcium into the buttocks sometimes causes very serious
abscesses or infections. ;

Never inject calcium without first seeking medical advice!

| Note: !n countries where people eat a lot of corn or
other foods prepared with lime, it is foolish to use calcium injections or tonics (as
is often done to ‘give strength’ or ‘help children grow’). The body gets all the
calcium it needs from the lime.

9. ‘Feeding’ through the veins (Intravenous or ‘I.V.’ solutions)

In some areas, persons who are anemic or very weak spend their last paise, to
have a liter of |.V. solution put into their veins. They believe that this will make
them stronger or their blood richer. But they are wrong!

Intravenous solution is nothing more than pure water with some salt or sugar in
it. It gives less energy than a large candy bar and makes the blood thinner, not
richer. It does not help anemia or make the weak-stronger. |

Also when a person who is not well trained puts the |.V. solution into a vein,
there is danger of an infection entering the blood. This can kill the sick person.

Intravenous solution should be used only when a person can take nothing by
mouth, or when he is badly dehydrated (see p.183).

Only a trained health worker should give these solutions.

If the sick person can swallow, give him a liter of water with a little sugar and
salt (see Rehydration Drink, p.182). It will do as much for him as injecting a liter
of |.V. solution.

For people who are able to eat, nutritious foods do more to
strengthen them than any type of I.V. fluid.

65

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10. Laxatives and Purges (p. 417)

It is always dangerous to give a laxative or purge to a baby or
to anyone who Is very weak, dehydrated, or has severe pain
in his belly. Unfortunately, people often believe that purges
bring back health or clean the bad things out of the body. In
Chapter 1 it is explained that purges or strong laxatives
nearly always do more harm than good.

To learn the correct uses of laxatives and enemas, see p. 21.

WHAT TO EAT WHEN TAKING MEDICINES

Many people believe that they should avoid eating certain foods like brinjal
tomato, curds, oranges, guavas, eggs, meat and cooking oil when they take any
medicine. They think all medicines will do harm if they are taken with these foods.
This is not true ! No medicines causes harm juat because it is taken with these foods.

But in case of some illnesses, certain foods can make the illness more severe
because the body cannot digest these foods: | 3

PM ici tcev nc «5.s00s0sdaccemceae see p 149

UEC OIOIIIG, 6.5. ..5:10cvsherkseectes see p. 371

high blood pressure..............00cc00., see p.148

gall bladder problems...........ccccccccccccs, see p.375
stomach ulcers and heart burn..............0....... see p.150
urinary tract infection in children........... see p. 357°

Certain foods can cause serious damage in these illnesses, whether or not any
medicine is being taken. Certain medicines will cause bad reactions if a person
takes alcohol (see metronidazole, page 407

66

WHEN SHOULD MEDICINE NOT BE TAKEN?

There are situations when, without a doubt, it is best not to use certain
medicines:

1. Pregnant women or women who are breast feeding should
avoid all medicines that are not absolutely necessary.
(However, they can take vitamins or iron pills without
danger.)

2. With newborn children, be very careful when using
medicines. Whenever possible look for medical help before
giving them any type of medicine. Be sure not to give too
much. :

3. A person who has ever had any sort of allergic reaction—
hives, itching, etc.—after taking penicillin, ampicillin, a
sulfonamide, or other medicines, should never use that
medicine again for the rest of his life because it would be
dangerous (see Dangerous reactions from injections of
certain medicines, p. 83).

4. Persons who have ulcers or heartburn should avoid
medicines that contain aspirin.

5. There are specific medicines that are harmful or dangerous
to take when you have certain illnesses. For example, persons
with hepatitis should not be treated with antibiotics or other
strong medicines, because their liver js damaged, and the
medicines are more likely to poison the body (see p.210).

6. Persons who are dehydrated or have disease of the kidneys should be especially
careful with medicines they take. Do not give more than one dose of a medicine
that could poison the body unless (or until) the person is urinating normally. For
example, if a child has high fever and is dehydrated (see p.88), do not give him
more than one dose of aspirin until he begins to urinate, Néver give sulfa to a
person who is dehydrated.

The book Where There I $s No Doctor is available
at Rs 29/- plus postage. Multiple copies of reprints
of various chapters are also available, |

Please write to:

Publications Officer

Voluntary Health Association of India
C-14 Community Centre :
Safdarjung Development A rea

lhi 110016
New Delhi Re. 2.50

Summary: | COMMUNITY HEALTH CSL. al  47/1, (First Floor) St. Marks Road, “aes —  Rangalore - 560 001, aes . |    RIGHT AND WRONG USES  OF MODERN MEDICINES —    YS  .    53  ons os  wen es   " et  as, |  : ted)  =. 3  a's,  Lora    _ This is a reprint from    4 here if Ss No Doctor    _ (Indian adaptation )    ae  >  Me  2  ! Seat  ~e  aor  =    published by the    Voluntary Health Association of India  C-14 Community Centre  Safdarjung Development Area  New Delhi 110016    61  COM Me ALT    -   …