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Self-medication: Hindrance to COVID treatment & cure

self medication

Dilip Sharma
DIMAPUR, MAY 25: As COVID-19 positive cases are surging at Dimapur district and most people with mild symptoms are advised home isolation, many have resorted to self-medication either out of panic or fear of going to a testing centre.
Doctors never recommend people to take medications without proper consultation and tests. However, many people tend to rush to pharmacies to get medicines for fever, cough and other ailments, which are easily available over the counter.

But when the COVID-19 pandemic is posing a serious threat to all sections of people, and even as doctors and medical experts are succumbing to the virus, self-medication may prove to be more dangerous.
A survey of several pharmacies at Dimapur revealed that quite a good number of people turn up asking for medicines similar to the ones prescribed to treat COVID-19 positive patients at various hospitals.
While the designated COVID Hospital at Dimapur has been prescribing certain medicines to people who are sent to home isolation, there are also “online prescriptions” available on social media platforms. These are highly sought after at pharmacies.
A well-known pharmacist told Nagaland Page that most people come looking for medicines to treat COVID-like symptoms, and even produce printed prescriptions, without headers showing names of hospital, clinics and doctors’ names
According to the pharmacist, these are “online prescriptions” circulated on social media.
Now that some private hospitals at Dimapur have started treating COVID-19 positive patients, it is understood that the patients are prescribed medicines according to their medical conditions. If the medicines are not available at the hospital, they go to the market.
However, pharmacists say that some people come without any prescription from any hospital.
The pharmacists maintained that there is no shortage of medicines, which are currently being prescribed for treatment of COVID-19 positive patients at Dimapur. They said that prescribed medicines mostly include Paracetamol, steroids, anti-viral medicines, etc., which are common and manufactured by numerous companies.
Expressing concern at the practice of self-medication, a pharmacist said that there is very little or almost no awareness about the dangers of self-medication, although the Government has been spending lakhs of rupees in creating awareness about and prevention of Coronavirus.
It may be mentioned that last year there was a directive from the Government to medical stores to keep record of people who come to buy medicines for fever, etc., but this year no such instructions have been issued either at the national or state level.
One pharmacist also told Nagaland Page that people have even come looking for Remdesivir, besides oxygen cylinders, to take care of patients at home.
He said that Remdesivir is used in dedicated COVID hospitals and not easily available over the counter. As for oxygen cylinders, he said that he does not keep them.
When contacted, a doctor of a private hospital told Nagaland Page that people who are experiencing COVID-like symptoms should go to hospitals for tests and consultation, instead of taking over-the-counter medicines.
The doctor, who also treats COVID patients currently, observed that many people are afraid to go to hospitals for COVID test for fear of stigma and discrimination.
She said that if people come to hospitals even after developing complications, it is easy for the doctors to provide treatments, but some people don’t understand that and take medicines on their own, which worsens their cases.
She also disclosed that even steroids cannot be administered to patients from the first day of treatment. If it is used, it can be harmful for the patients as it can exaggerate the medical conditions.
Stressing that people should avoid self-medication, she advised them to go to hospital and get tested for COVID, adding that medication depends on the condition of the patients.

Pointing out that COVID is a viral infection and not bacterial, she said that certain medicines taken by people are not actually meant for treatment of COVID and urged people to get proper treatment early.
She also said that prescriptions differ from patient to patient, and it is not advisable to take somebody’s prescription and start self-treatment. She added that some people come to hospital only when their oxygen level drops drastically. When the oxygen level is low, it is very late, she said.
Another doctor said that at the present juncture, there are some patients who are just popping antibiotics randomly and most of the time, they don’t complete the treatment.
He said that in such cases, it puts them at the risk of developing multi drug resistance. “…because steroids have also been indicated for treatment of COVID, and people have been self-medicating, it may cause lots of problems in the long run,” he said adding, “it could compromise the immune system and put them at risk of developing further infections.”
Citing example of the new fungal infection, “black fungus” or mucormycosis the doctor said these cases are probably due of indiscriminate use of steroids. He said that certain medicines have to be taken only after proper investigation and people might be taking some medicines even though they don’t need them.
A survey of medical stores in Dimapur also revealed that there is huge demand for steroids, manufactured by various companies. A wholesaler told Nagaland Page that there is a shortage of a certain steroid due to large-scale demand and even distributors from outside Nagaland cannot supply the required amount.
He also informed that other common medicines are readily available, although a multi-vitamin capsule went out of stock for a week.
Explaining the dangers of taking steroids, another doctor told Nagaland Page that steroid is a double-edged sword. He said that it reduces inflammation but if there is an active infection, it will flare up the infection.
“If a diabetic is taking steroid, it is going to increase the sugar. So steroid has to be used judiciously,” he said.
“We have to strictly monitor sugar because the black fungus that we are hearing of now, is an opportunistic infection… it is not a new fungus. It is a fungus which is all around us… as and when the immunity is low, it affects,” he said adding, “95% of the patients are due to uncontrolled sugar.”

On self-medication by some people, he said that if there is no active infection, antibiotics have no role.
“We give antibiotics when there is bacterial super infection. In some of the groups (social media), you see blood thinners…In hospitals, we use it but it is not unregulated. We check some blood parameters,” said the doctor.
He also said that some of the drugs can be bought over the counter such as multivitamins, etc, but for antibiotics, a doctor’s prescription is needed, without which pharmacists should not sell.
While one cannot simply stop people from going to pharmacies to get medicines with or without prescription, at this time of pandemic, the Health Department or the State Government needs to spread awareness on the dangers of self-medication, especially for COVID-related cases.