Saturday, May 06, 2006

Prescription Drugs

I started taking Pulmicort for my "WTC cough", and it seems to be working moderately okay so far. My mother however seemed to think I was committing a mortal sin for "self medicating" with a "prescription medication" and is currently praying for my soul.

I've never understood why certain drugs are "prescription drugs" while others are "over the counter." You can overdose on aspirin, but not on Zyrtec. Which one do you need a prescription for? Why does one need a prescription for Pulmicort? Can't overdose on it. No interactions. Lower incidence of allergic reactions than aspirin. Pregnant ladies can take it. Fine for use on infants. Why should something so innocent require a doctor's permission to take?

Actually, I'm even more pessimistic: Why should you need a prescription for Lipitor? If you have high cholesterol, your doctor will tell you, and then you go buy Lipitor. If you don't have high cholesterol, why would you buy Lipitor? I suppose that there are people out there would would take the drug as prophylaxis against high cholesterol, and they would be stupid, but you can't overdose on it. You can't hurt yourself with it (that I could find on the internet)... although I'm sure if you try, anything is possible. So why require a prescription?

Yes... there are thousands of drugs which should have prescriptions: Addictive, dangerous, and damaging drugs. But think about this: Who is going to go out and spend $1,200 on a month's supply of thalidomide (currently used in chemotherapy) just for the hell of it, if it were being sold over the counter? (Just a thought, that.)

Now this is not a post that says, "Always skip the doctor! Always self medicate!" There are 30 or 40 cholesterol-lowering medications out there, and it is possible (in fact it is likely) that several of them would be a better choice than Lipitor, and a doctor is the only person who can tell you which drug is best, and also (although you could do it yourself) a doctor is the only one who can monitor your cholesterol and make sure that it is under control.

But my point remains: A doctor's recommendation, in my book — for low end drugs — is pretty much the same as a doctor's permission... prescription. It's not a matter of worrying about the childish mindset of "why shouldn't I take this if I don't need a prescription?" but respecting the more adult mindset of "why would I take this if I don't have a recommendation?"

4 comments:

Anonymous said...

Bigger issue is mixing meds.

Can lead to death.

Jil Wrinkle said...

True. If you are taking 8 or 9 medications, the likelihood goes up and up... but as somebody who works in the medical industry, I can tell you that "death by interaction" it is rather diffult to accomplish.

There is no such thing as taking one innoccuous medicine and mixing it with another innoccuous medicine and winding up with a poison.

Most of the time what will happen is that one drug will cancel another one out, therefore nullifying what might be a life-sustaining therapy. It is very rare that one drug will amplify another... accidentally. There is no example that one drug mixed with another will create poison.

So, "can lead to death" is true only in something like taking a drug that nullifies the effect of anticoagulant therapy, which leads to the stroke that said therapy was trying to prevent.

Still, taking a few minutes to read the instructions that come with every package of medication (or looking it up on the internet) will tell you immediately if the drug that you have purchased will interact with any other drug you are taking. Personally, I always read that stuff.

(Oh... and it is just as likely that the Allerest or Robitussin that you bought over the counter will have some affect as low-end corticosteroid or what-have-you.)

Remember, I am only talking about low-end, low-grade, low-effect medications here.

Anonymous said...

suprised you are even taking about needing a script to get any meds in Pattaya.

Jil Wrinkle said...

You need prescriptions in Thailand to get "serious" drugs... i.e. drugs that control heart rate, blood thickness, drugs that are addictive such as OxyContin and morphine, sleeping pills, et cetera.

For most everything else (drugs where you need to put in an effort to harm yourself with, as opposed to accidentally/easily), you can go to a pharmacy to purchase.

And I'm not talking about needing a script for medications in Pattaya, but in America, where exceptionally weak, harmless drugs still require you to go in and shell out $80 for a doctor visit just for a prescription slip.