Download Pill poppers, beware - National University Hospital

Pill poppers, beware
Pulse, The Sunday Times (Sunday, 28 February 2010)
By Nicholas Yong
Savvy Singaporeans are self-medicating, but doctors warn of risks
Housewife Anastasia Ng, 58, who often gets the runs, can anticipate the medication a general practitioner
would prescribe for her condition - ultracarbon pills or Lomotil, and some muscle relaxants for the stomach.
'Doctors' fees are quite expensive these days. I don't want to fork out $28 plus for something that I can just
get at the pharmacy,' she said.
Graduate student Cynthia Elizabeth Tang, 29, also prefers to get her own medication from the pharmacy.
'GPs generally provide the same kinds of medicine, especially for the common cough and cold, and these
are available in pharmacies. You can always find generic drugs there,' said Ms Tang, who added that she
has become an 'expert' at reading the labels on over-the-counter drugs.
Madam Ng and Ms Tang are just two of many Singaporeans who prefer to self-medicate for common and
small ailments rather than consult a doctor.
Senior physician Dr Wong Wei Mon of the Raffles Medical Group noted that they may be part of a trend. He
said: 'Patients are more educated, busier and they can lay their hands on drugs online and across the
Causeway or from other neighbouring countries.'
Could it be that people can buy more drugs, which used to be prescription- only, over the counter (OTC)?
Ms Quek Zhi Yuan, a pharmacist at the National University Hospital, said no, adding that down-regulation is
strictly regulated by the Heath Sciences Authority.
'Usually, drugs which have been down-regulated are those that have been on the market for a long time and
widely used by patients, so that the safety profile is adequately monitored. Even with down-regulation of
drugs from prescription-only to OTC, restrictions may be set in place,' she said.
Medical professionals that LifeStyle spoke to noted that there are pros and cons to ill people taking matters
into their own hands.
Ms Quek of NUH said: 'Responsible self-medication helps to move patients towards greater independence
in making decisions about management of minor conditions and symptoms.'
On the flip side, the possible dangers of self-medication include misdiagnosing and taking the wrong
medication, taking the right medication but in the wrong doses, and mixing medications in dangerous
combinations.
Mixing paracetamol with muscle relaxants, which already contain paracetamol, the main ingredient in
Panadol, carries the risk of overdose.
Cardiac patients who are on blood thinners should be careful about taking aspirin or anti-inflammatories, as
it can increase the risk of bleeding. Consuming panax ginseng also reduces the efficacy of warfarin, a blood
thinner.
Self-medicating may also mask a more serious illness by treating the symptoms rather than the disease.
Dr Rupert See of the Raffles Medical Group recalled a patient who consulted him after a week of selfmedicating with Po Chai Pills and Panadol did not relieve her stomach pains.
Her 'stomach ache' turned out to be acute appendicitis - her appendix had even perforated due to the delay.
While she eventually made a full recovery, her hospital stay was prolonged due to complications from the
perforation.
Another patient who had taken antacids for hiccups for two weeks, actually had a rare type of food poisoning
contracted from eating seafood.
He said that, as a guide, one should not self-medicate for more than a week, especially if the symptoms
persist.
Madam Ng and Ms Tang both agree on the need to consult a medical professional if the drugs do not work.
Ms Tang said: 'I already know my usual ailments very well, but if it's something new or I feel like it's quite
serious, I will go to the doctor.'