Disposal of unused/unwanted medicines, Using medicines safely: A trip down memory lane

This story was published in the Ghanaian Times about 10 years ago. The issues are still relevant. Continue reading…

A few weeks ago, I heard of a story of accidental poisoning of a 4-year-old boy who had swallowed a quantity of Chlordiazepoxide 10mg capsules. According to the grandpa, the Chlordiazepoxide was prescribed for a relation for alcohol withdrawal who used to live with them some time ago. The relation had since relocated and was surprised how the grandchild found this drug, which apparently was lying somewhere around the house without his knowledge.

A check under symptoms for an indi­vidual who has consumed overdose of chlordiazepoxide revealed the following- low body temperature, difficulty staying awake, mental confusion, low blood pressure, irregular (and or rapid) heart­beat, respiratory depression, impaired motor functions (impaired reflexes), impaired coordination, impaired balance, blurred vision, rapid side-to-side move­ment of the eyes, dizziness, seizures, muscle weakness, coma etc.

After this near-fatal incident, the senior citizen went through every corner of the house to retrieve all unused and unwanted medicines and returned such medicines to his health care provider for safe disposal through the Disposal of unused/unwanted medicines pro­gramme (DUMP). I must commend the Food & Drugs Authority (FDA) for their continuous support of DUMP. I believe there are many persons who have similar unused/unwanted medi­cines at home.

There was another story of a student who swallowed about 20 tablets of Atenolol 100mg of the father for very strange reasons. Again in this particular instance the daddy had stopped taking the Atenolol for high blood pressure af­ter series of rather low pulse rate. Even though he was switched over to a new antihypertensive, he still kept the Ateno­lol 100mg at home till the incident with the daughter when he was compelled to retrieve and return all unused/unwanted medicines for safe disposal.

There is another common occurrence in many homes we have visited especial­ly with the elderly. There was an incident where the oldman had children spread out between four different countries abroad. The oldman was a known hypertensive diabetic with arthritis. We discovered medicines sent from each child from each of these locations. A number of the medications were du­plications. For example we found three different versions of Aspirin- 75mg, 81mg, 100mg. Since the science support­ing the use of low dose Aspirin to pre­vent heart attacks many have obtained the product Over-the-counter (OTC) without discussing the benefits versus the risks with their health care provider. There are some persons with aspirin allergy who obviously should take such a medication. There also others with high risk of bleeding which would obviously be worsened by aspirin and therefore should also not take the product.

We found four different brands of glucosamine preparations. There were also three different versions of Ibupro­fen preparations with varying strengths likely to relieve the old man of his waist pains. This taken together with Aspirin puts the elderly at much much higher risk of internal bleeding. There were also several cholesterol lowering prepa­rations as well as several multivitamins. It was quite a haul of medicines on returning from that particular residence.

As we approach the end of the year can we kindly make it part of the things-that we would kindly go through our medicine cabinets or first aid boxes (or anywhere we keep medicines at home) and clean them of any unlabelled med­icine, unused/unwanted medicine and return such to our regular health care facility for safe disposal.

In the course of DUMP we have had to retrieve opened eye drops, ear drops, nasal drops from some homes because the owners thought they could still use them at another time if the problem re­curred. We have had to retrieve opened bottles of antibiotics suspensions, cough mixtures, analgesics, antacids from the refrigerators of several persons. Some were opened about two months ago but somehow the owners thought they could still use these products again for their children.

I must also commend many others who have gotten on board the DUMP ship. You could get stopped at least expected places by clients. At church worshippers sometimes come along with unused/unwanted medicines for safe disposal. At school, other parents could walk up to you with unused/unwanted medicines for safe disposal.

There was one unique incident. A parent came over with several bottles of Benylin with codeine retrieved from the ward’s room (This product has been withdrawn from the market by the Regu­latory Authority). The ward had a drug problem and seemed to relapse notwith­standing several rehabs. He believed the ward had overcome the drug problem but became suspicious of frequent use of Benylin with codeine. The ward seemed to come back home with anoth­er bottle of the product. He deduced what was going on after cross-checking with his pharmacist. The ward had lit­erally substituted the codeine in Benylin for the hard drug he was on previously. I believe not many consumers are aware that codeine is also an opioid.

So for some of us no matter the odds we would continue the DUMP campaign because of its close linkage to the safe use of medicines in the country.

EDWARD O. AMPORFUL

CHIEF PHARMACIST

COCOA CLINIC.