Chinedum Babalola
Chinedum Peace Babalola (née Anyabuike) FAS, FAAS is a Nigerian Professor of Pharmaceutical chemistry and Pharmacokinetics.She teaches Pharmacy at the University of Ibadan, FAS, and FAAS[1] while also being the first Vice Chancellor of Chrisland University, Nigeria
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[edit]- This is called adverse drug reaction and it could occur with the intake of many drugs because no drug is 100 per cent safe. A particular one is the hypersensitivity to sulpha-containing drugs. It also occurs with drugs that contain amino compounds
- Some drugs are expected to be taken after food, some are to be taken on an empty stomach. For drugs that should be taken in an empty stomach, studies have shown that when taken with food, there is an interaction which may reduce their effectiveness. Rather such drugs can be taken about 30 minutes before food.
- Pharmacy is one of the best professions in the world and was rated by Forbes in January 2015 as the best health care profession in the USA.
- Drugs are poisons
- When individuals take a drug, the body’s ability to break this down fast is dependent on the availability of the enzyme that does this in the body. In some people, it is fast while in others it is either mild or moderate.
- Also, the rate at which the body is able to breakdown a drug could be genetic modified. So, it is possible based on a person’s genetic makeup to predict those that may react to some drugs. This makes some people’s reaction to particular drugs genetically.
- However, where the body’s ability to breakdown sulpha-containing drugs to safe compounds is slow, it ends up being changed into products that are not safe. This causes the adverse drug reaction that people experience.
- Almost any drug can cause an adverse reaction. Reactions range from irritating or mild side effects such as nausea and vomiting to life-threatening anaphylaxis. Common symptoms of a drug reaction include hives, itching of the skin or eyes, skin rash, swelling of the lips, tongue, or face and wheezing.
- Most allergic reactions occur within hours to two weeks after taking the medication and most people react to medications to which they have been exposed to in the past. This process is called “sensitisation.” However, rashes may develop up to six weeks after starting certain types of medications. Rarely, blisters and bleeding inside the skin or the inner surfaces of the intestines may occur. Unfortunately, if it is the life threatening anaphylaxis, it could be fatal. So, it is important to educate people about these possible reactions to drugs.
- Also, one of my children also reacted to septrin syrup as a baby. At two years, when he was given Fansidar, an antimalarial drug that also contains Sulphur, he almost died. Because the tongue was red and the inside of the mouth was red, they suspected measles. Unfortunately, nobody suspected a reaction until much later that a consultant paediatrician doctor linked his condition with Stevens – Johnson syndrome. Based on this experience, I started a study on pharmaco-genetics, which entail looking at how gene can help predict a person’s reaction to a particular drug.
- The first study was on proguanil, a prophylactic antimalarial in healthy and sickle cell individuals. The study found that in persons with sickle cell, about one per cent of them breakdown the drug slowly while it was five per cent in healthy persons. This shows that there is genetic difference between the two groups of people.
- The second study was on hypersensitivity of sulpha drugs in healthy people and people living with HIV. About 15 per cent from our survey reported various types of reaction to sulpha drugs. However, a breakdown of the data showed that hypersensitivity of sulpha drugs in people living with HIV was far higher.
- One thing that is important to note is that drugs are poisons; there is no drug that really does not have its side effect. That is why the drug regulatory body based on pharmacovigilant sometimes recall some drugs from the market if high levels of adverse drug reactions are reported.
- Quinine is one of the oldest drugs in the pharmacopeia and during the time, chloroquine was failing, quinine came useful for the treatment of severe malaria until the ACT came on board. Being a drug that can be used to treat cerebral malaria, a life threatening form of malaria, only the quinine suppository would be useful in the rural areas where chances of giving it by intravenous injection may not be possible.
- Work on quinine suppository has been on for so many years. Preliminary studies on the quinine suppository in rabbits indicated that it had antimalarial properties. However, the bioavailability is low. At the moment, one of our investigators is currently working in the USA on increasing its bioavailability to get an optimum product that will release the necessary level that they need. This will then be followed by more clinical trials.
- Practice of combining antibiotic with anti-malarials is very common in Nigeria, are there possibilities of such a practice affecting the effectiveness of these drugs? From studies carried out many common antimalarials reduce the effectiveness of common antibiotics, thus promoting resistance in disease-causing germs to these antibiotics.
- In most of the studies, there were between 50 and 80 per cent reduction in the effectiveness of these antibiotics. This is something people, especially healthcare providers should be mindful of.
- Given that the drug–drug interaction occurs at the absorption level, such problem is ruled out when it is given in the injection form. Also, the time of their administration can be separated by between two to three hours to ensure the full benefits of the two drugs are assessed.
- Pharm D means Doctor of Pharmacy. Pharm D programme globally is a curriculum that was developed to make the pharmacy profession more patient-oriented. All along, the pharmacy curriculum in Nigeria was more products-oriented. But there is more to the role of pharmacists than handing over medicines to patients.
- They should be able to clack the patient like a doctor to know medicines taken, how they are feeling, any need to change their medicine or dosage regime and so on. This is about individualised medicine. Nobody should die of drug reaction, if things work as they should. Handling over medicines, a pharmacy technician can do that. But information the patient needs about the drug should be provided by the pharmacist.
- So, Pharm D will be a more encompassing programme that will make a pharmacist able to handle all of these and pharmacists of this generation. Of course many people will be helped and many ill-healths arising from drug will be averted.
