People have different attitudes and beliefs towards health and disease, which are mostly based on their traditions & customs. They also differ in their faith and understanding of medical science.
As doctors we always try to educate them the concept and working of modern medical science. There are so many steps between taking a prescription and stopping of medicine. A proper understanding of these steps, is absolutely essential. More often than not, success or failure of the treatment depends on these small things.
Make sure that prescription is written clearly
You should be able to read names of the drugs as well as other instructions. Clarify if any doubt. Dispensing of wrong medicine by chemist due to misinterpretation is very common and could lead to dangerous consequences. Similarly dosages should be understood clearly. Ingesting 5 ml drug instead of 0.5 mls or 1 spoon full [5.0mls] for 1 ml is very frequent
Ask how to prepare the medicine
Drugs are usually in form of tablets, capsules, syrups or drops. Tablets are of two varieties, one has to be swallowed directly, and others called dispersible tablets have to be prepared by adding water to it. Syrups may be ready diluted or be in dry form, which is to be prepared by adding water. Regarding preparing liquids instructions are written on bottle. Read them carefully. Mostly there is a mark on the bottle upto which water is to be added. Some bottles do not have mark but are supplied with measuring cup to add water.
Quantity of the drug to be given
Measurement of quantity is easy for tablets and capsules. Syrups and drops are supplied with measuring cup or dropper. Cups are marked at different levels like 2.5ml, 5.0ml and 10.0ml. Likewise droppers are also marked like 0.2ml, 0.4ml, 0.6ml, 0.8ml and 1.0ml. Always use these cups and dropper for accurate measurement. Alternatively one can use a disposable syringe, which are available without needle. Measurement is very accurate and it is very convenient to give medicines using disposable syringe.
Some doctors write medicines in spoons rather than mls. Do remember mostly TSF is meant by a teaspoon full and is equal to 5.0ml. But commonly available spoons at home vary in size any thing from 2.5ml to 7.0ml so quantity of drug given may not be the desired one. Always use measuring cup, dropper or disposable syringe for accurate dosages.
Frequency of the dosage
Frequency of the dosage is usually determined by the type of drug and the severity of the disease. For different frequencies doctor use different abbreviations or symbols. Some of the commonly used abbreviations are OD –once a day, Bid – twice a day [12 hrly], TDS-three times a day [8 hrly], QID- four times a day [6 hrly], SOS- whenever required, HS- at the bed time. Make yourself familiar with these abbreviations and whenever in doubt clarify from your doctor
Timing of the dosages should be chosen in such a way that as far as possible proper interval between two dosages is maintained and it doesn’t disturb child’s routine. E.g.- BD dosage could be given at 8 am and 8 pm while TDS dosage could be given at 7 am, 3 pm and 11pm.
Relation to meal
Always ask whether drug should be given empty stomach or full stomach. Some drugs work better with empty stomach on the other hand there are drugs that can cause gastric irritation when given with empty stomach.
Signs of deterioration
Ask about the signs and symptoms to be watched during the course of the medicine. Presence of certain signs like adequate frequency of urination during loose motion, or return of appetite during the course of jaundice are reassuring signs showing improvement. On the other hand presence of certain signs during the course may indicate worsening condition like failure to passing urine or drowsiness during loose motions and fast breathing and bluish discoloration of lips during the course of pneumonia. Be watchful about these signs because they require immediate medical attention.
Side effects of the drugs
No drug is free from side effect but mostly they are innocuous [harmless] and require no treatment. Like red colored urine by some anti T.B. drugs and black colored stool on oral iron therapy. But some times severe allergic and other problems may occur, so ask your doctor about side effects to be observed and reported.
When to report back for recheck
In most of the mild illnesses patient is called back at the end of the course but timing and the frequency of revisits is determined by the severity and the type of the disease. In some long-term treatments where drugs are to be given for long duration [e.g. treatment of T.B. or treatment of epilepsy] periodic checkups at monthly or bimonthly interval is needed . It is to see the progress of the disease as well as watch for the complications of the disease and side effects of the medicines.
Cross check the medicine given and medicine written on the prescription.
Never accept a substitute
Happens very frequently. Chemist will give you all possible reasons like—it is the same medicine with different name, company has closed, not available any where etc. check 2 or 3 chemist and if still not available call back your doctor and ask for substitute or alternate medicine.
Always insist on bills
Never accept medicine without proper bill. A proper bill with batch number will at least work as deterrent to chemist for giving wrong medicine.
Check the expiry date
Do not accept medicines whose expiry date is very close.
Take full course
Very often it is seen that medicines are not given for full duration prescribed. This habit should be discouraged because insufficient dosage is not able to cure the disease, which may resurface later. Apart from this insufficient dosage is the main reason for development of resistance in which drugs become ineffective. Estimation of full course is easy with tablets and capsules. But in case of syrups and drops single bottle may not be sufficient, so calculate the total dosage required and buy full course.
Chemist is not a doctor
Never take professional advises from chemist. They are always very keen to use there superficial knowledge and try ‘ hit & trial ‘ method. This could prove extremely dangerous. Similarly do not discuss the usefulness and effects of the drugs with the chemist. At the best they will confuse you.
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