Self-medication and drug misuse

Self-medication means to take drugs without getting permission from a doctor or without following the advice of a pharmacist. The drug could be bought without prescription in pharmacy or be available in family pharmacy. Self-medication drugs are considered to be safe for an appropriate use for the treatment of pathologies classed as "minor”. However, data about their efficacy and risk remain insufficient and non transparent. The authors describe the danger of self-medication and the misuse of these drugs by several examples, such as per os nasal decongestants used for common cold which should induce rare but serious adverse effects (cardiovascular or neurologic adverse effects). In fact, the absence of clear distinction between the different statutes of health products facilitates their status changes. The increasing shift from "medicines” to less regulated products, the trivialization of their use by the public and their increasing consumption require to raise the awareness of consumers and health professionals. Furthermore, during the COVID-19 pandemic, several products were marketed as medical device as virucidal agent (nasal spray) without any efficacy. In conclusion, taken into account the increase use of products (drugs, food supplement, medical device…) in self-medication, it should be necessary to dispose an independent public database for self-medication drugs with validated guidelines and to guarantee the marketing of these drugs with a favourable benefit/risk ratio by an active pharmacovigilance for detection of rare or serious adverse effects. © 2022 l'Académie nationale de médecine L'automédication est définie comme la prise d'un ou plusieurs médicaments, sur sa propre initiative sans avis médical et sans le conseil d'un pharmacien. Le médicament peut être acheté sans ordonnance en pharmacie ou être présent dans la pharmacie familiale. Les médicaments utilisés en automédication sont utilisés pour le traitement des pathologies dites « mineures » avec un profil d'effet indésirable « sécurisant » lorsqu'ils sont utilisés de manière appropriée. Néanmoins, pour nombreux de ces médicaments, les informations concernant leur efficacité et leur risque s'avèrent insuffisantes et non transparentes. Les auteurs décrivent les dangers de l'automédication et leur mésusage à travers divers exemples, comme l'utilisation des décongestionnants oraux dans le rhume pouvant générer des effets indésirables rares mais graves (effets indésirables cardiovasculaires ou neurologiques). En effet, la porosité des frontières entre les différents statuts des produits de santé facilite leur changement de statut. L'augmentation des passages du « médicament » aux produits plus faiblement réglementés, la banalisation de leur utilisation par le public et leur consommation croissante nécessitent la sensibilisation des consommateurs, mais aussi des professionnels de santé. Durant la pandémie de la COVID-19, plusieurs produits ont été commercialisés comme dispositif médical comme agent virucide (spray nasal) sans aucune efficacité. En conclusion, face à une utilisation croissante des produits (médicament, complément alimentaire, dispositif médical…) en automédication, il est nécessaire de disposer d'une base d'informations grand public, indépendantes, présentant une recommandation de médicaments validés par des experts et de garantir le maintien sur le marché des médicaments avec un rapport bénéfice/risque favorable, grâce à une pharmacovigilance active pour la détection des effets indésirables graves ou rares. © 2022 l'Académie nationale de médecine

Automédication et mésusage

Résumé L'automédication est définie comme la prise d'un ou plusieurs médicaments, sur sa propre initiative sans avis médical et sans le conseil d'un pharmacien. Le médicament peut être acheté sans ordonnance en pharmacie ou être présent dans la pharmacie familiale. Les médicaments utilisés en automédication sont utilisés pour le traitement des pathologies dites « mineures » avec un profil d'effet indésirable « sécurisant » lorsqu'ils sont utilisés de manière appropriée. Néanmoins, pour nombreux de ces médicaments, les informations concernant leur efficacité et leur risque s'avèrent insuffisantes et non transparentes. Les auteurs décrivent les dangers de l'automédication et leur mésusage à travers divers exemples, comme l'utilisation des décongestionnants oraux dans le rhume pouvant générer des effets indésirables rares mais graves (effets indésirables cardiovasculaires ou neurologiques). En effet, la porosité des frontières entre les différents statuts des produits de santé facilite leur changement de statut. L'augmentation des passages du « médicament » aux produits plus faiblement réglementés, la banalisation de leur utilisation par le public et leur consommation croissante nécessitent la sensibilisation des consommateurs, mais aussi des professionnels de santé. Durant la pandémie de la COVID-19, plusieurs produits ont été commercialisés comme dispositif médical comme agent virucide (spray nasal) sans aucune efficacité. En conclusion, face à une utilisation croissante des produits (médicament, complément alimentaire, dispositif médical…) en automédication, il est nécessaire de disposer d'une base d'informations grand public, indépendantes, présentant une recommandation de médicaments validés par des experts et de garantir le maintien sur le marché des médicaments avec un rapport bénéfice/risque favorable, grâce à une pharmacovigilance active pour la détection des effets indésirables graves ou rares. Summary Self-medication means to take drugs without getting permission from a doctor or without following the advice of a pharmacist. The drug could be bought without prescription in pharmacy or be available in family pharmacy. Self-medication drugs are considered to be safe for an appropriate use for the treatment of pathologies classed as "minor”. However, data about their efficacy and risk remain insufficient and non transparent. The authors describe the danger of self-medication and the misuse of these drugs by several examples, such as per os nasal decongestants used for common cold which should induce rare but serious adverse effects (cardiovascular or neurologic adverse effects). In fact, the absence of clear distinction between the different statutes of health products facilitates their status changes. The increasing shift from "medicines” to less regulated products, the trivialization of their use by the public and their increasing consumption require to raise the awareness of consumers and health professionals. Furthermore, during the COVID-19 pandemic, several products were marketed as medical device as virucidal agent (nasal spray) without any efficacy. In conclusion, taken into account the increase use of products (drugs, food supplement, medical device…) in self-medication, it should be necessary to dispose an independent public database for self-medication drugs with validated guidelines and to guarantee the marketing of these drugs with a favourable benefit/risk ratio by an active pharmacovigilance for detection of rare or serious adverse effects.

ADVERSE EFFECTS OF IVERMECTIN IN SARS-COV-2 PATIENTS

Through a literature review in high impact journals, it was determined that ivermectin, besides being a drug widely recogni-zed for its ability to treat and control parasitic infections, has several relevant clinical actions, such as the possibility of era¬dicating onchocerciasis or “river blindness”, considering this fact as a triumph of humanity by the WHO in 2009. The broad-spectrum antiviral potential of this drug against a variety of RNA viruses is raised, due to its ability to specifically inhibit nuclear transport mediated by α/β importin, capable of blocking nuclear trafficking of viral proteins. The proposed anti-SARS-CoV-2 action of ivermectin involves its binding to the IMPα/β1 heterodimer that will bind to the coronavirus cargo protein causing the viral load to reduce the antiviral response of the host cell, improving the clinical conditions of the patient. Several clinical trials of the use of ivermectin in relation to COVID-19 have shown that this drug could produce a slight improvement in its symptomatology, so this literature review aims to determine the pharmacokinetics and adverse effects of ivermectin, as a possible treatment of SARS-CoV-2. © 2022, University of Cienfuegos, Carlos Rafael Rodriguez. All rights reserved.

Impact of the COVID-19 outbreak on the reporting of adverse drug reactions associated with self-medication.

OBJECTIVES: The primary objective of the present study was to describe the characteristics of adverse drug reactions (ADRs) linked to self-medication that were notified to the French Pharmacovigilance Database (FPVD) during the COVID-19 outbreak in 2020 first wave. The secondary objective was to compare the characteristics of these ADRs in 2020 with those notified during the same calendar period a year previously. MATERIAL AND METHODS: We analyzed ADRs recorded in the FPVD between March 15th and May 31st, 2020 vs. the same dates in 2019. Only ADRs linked to self-medication were analyzed. Descriptive statistics were used to obtain an overview of the types and characteristics of these ADRs. RESULTS: Of 3114 ADRs notified to the FPVD during the COVID-19 period in 2020, 114 (3.7%) were linked to self-medication. The equivalent proportion in 2019 was 1.6% (113 out of 7097). Half of the ADRs notified in 2020 were "serious". The median age of affected patients was 30.5, and 22% of the ADRs concerned children. Of the 114 ADRs linked to self-medication, 107 (66%) were for prescription-only drugs. The three mostly frequently suspected ATC classes were analgesics, psycholeptics, and antibacterials for systemic use. The most frequent ADRs were general disorders, gastrointestinal disorders, and nervous system disorders. The main difference between the non-COVID-19 period and the COVID-19 period was the higher proportion of medication errors during the latter. CONCLUSION: The present study is the first to have reported on ADRs linked to self-medication and notified during a COVID-19 outbreak. Further studies of self-medication patterns and their consequences in a pandemic context are mandatory and effective information on medication use (including self-medication and its dangers) during a pandemic is essential.

Self-medication practice with analgesics (NSAIDs and acetaminophen), and antibiotics among nursing undergraduates in University College Farasan Campus, Jazan University, KSA.

OBJECTIVE: Self-medication practices are widely practiced globally as major form of self-care for pain management. Unfortunately, with COVID-19 pandemic, prescription only drugs are now increasingly being self-prescribed. Present study was therefore, conducted to generate data on self-medication practice with analgesics using non-steroidal anti-inflammatory drugs (NSAIDs) and acetaminophen, and the antibiotics among nursing students of University College Farasan Campus. MATERIALS AND METHODS: A cross-sectional descriptive study was conducted among 177 study participants (20±3 years) between December 2019 to February 2020 using questionnaire. Data analyses were done using origin software (6.1, Illinois, USA). Significance was considered at P<0.05. Study was conducted in Department of Nursing, University College Farasan Province, a premier educational institute of Farasan Island affiliated to Jazan university, KSA. RESULTS: Self-medication practices were high among nursing students (n=154 participants, 87%). Acetaminophen was highest used drug for analgesic purposes without prescriptions (n=101 participants, 57%). Among NSAIDs, Ibuprofen was most preferred for various analgesic purposes (n=35 participants, 20%) followed by diclofenac (n=9 participants, 5%) and meloxicam (n=5 participants, 3%). Azithromycine was the only antibiotic used by participants (n=4 participant, 2%). Most common causes of self-medication were headache (45%), menstrual pain (23%) and fever (14%). Main reason for self-medications was lack of time to consult doctor (68%). Furthermore, self-medication was significantly associated with study year (P<0.003). CONCLUSION: Results give rise to concern for general well-being of future nursing workforce. There is need to implement educational actions and awareness programmes to limit self-medication practices among educated youth of this beautiful Island.