INTERVIEW: TOXIC DRUGS

Dr. Banoth Chandrashekar (B.C) has a B.Pharm and PharmD post baccalaureate. He is a NABH consultant and runs Jan Aushadi medical store in Hyderabad. The following excerpts are from an interview he gave to Prabeer Sikdar @ Daily Health News Digest (DHND) on different aspects of Jan Aushadi and pharmacy practice.

DHND: 1. How is a Jan Aushadi medical store different from a normal pharmacy store?

B.C: Jan Aushadhi Medical stores are different from existing pharmacies in terms of cost & branding. In Janaushadi medicines comes with its generic name rather than on brand name.

The concept of Jan Aushadhi was introduced by central government, especially for the people, who cannot afford medicines due to which  they take half the dose. Resultantly, they will not get fully treated and get affected by secondary ailments.

DHND: How many Janaushadi centers are there in Telangana?

B.C: There are now 41 Jan Aushadhi Medical stores in Telangana including five in Hyderabad. My store is located at  #Plot No 1094/D, Allwyn Colony, Phase-1, Behind Abhayanjaneya Temple, Kukatpally, Hyderabad, Telangana-500072.

DHND: 3.  What difference does it make for a patient to buy medicine /drugs from a store run by a pharm D graduate?  How is ur expertise different from a regular d pharm guy?         

B.C: It is a fact that 60-70% pharmacies don't have working pharmacists. Though most of these pharmacies are financially sound, they can neither advise patients on drug usage nor its contra-indications and safe administration properly. This is because the level of learning of D.pharm varies from B Pharm, M Pharm & PharmD graduate.

In fact, D.pharm holder is only trained on dispensing activities, while PharmD graduates are trained on clinical usage. Their level of learning will help community through therapeutic drug monitoring. Drug disposition & drug burden can be reduced with observational studies.              
                       

DHND: 4.  Why do we see negligible number of Pharm D graduates manning drug stores in the country?

B.C: Pharmacy practice is most neglected practice in India as unlike in Western countries, a pharmacist is not considered as important health worker in India.

Over the years, unqualified people been running pharmacies and concerned authorities are silent about it. As a result, pharmacies turned into grocery stores and most qualified pharmacists are ashamed to work in pharmacy.

B.Pharm or M.Pharm graduates generally aspire to get into industries, while PharmD passouts aim to work as clinical pharmacist or as clinical research associate or in pharmacovigilance.

 My intention of opening pharmacy was to make pharmacies as drug information center rather than only dispensing by which pharmacist role could be understood by people. I wanted to leave a trail and I think many people will start seeing me.

DHND: 5. When is the right time for a patient to change drug dosage? What criteria need to be followed?                      

B.C: Most of chronic patients I see continue to take medications on time but they fail to take advice related to diet & exercise. Medicine can revive person health only when lifestyle modifications are done.

Only Drug administration will lead to drug deposition. Right drug, right dose and right time can be done by therapeutic drug monitoring.                        

For instance, most diabetic patients only take fasting & post lunch blood sugars as their parameters but they may end up in co-morbid conditions. So, it necessary check their liver profile, kidney profile, cardiac profile  from time to time. All this parameters will help in developing right regimen.

DHND: 6. What advice would you give to people, who buy drugs from unqualified pharmacists?                       

B.C: I suggest people to take medicines from qualified pharmacists as they are totally ignorant about drug-drug & drug-food interactions, which when neglected will land one with bigger problem.

 You might have taken medicines from the quacks many time did he ever told you to avoid alcohol when you take paracetamol? Most widely sold over the counter, alcohol & paracetamol have serious drug interaction, which causes hepatotoxicity (liver damage). 

Liver cirrhosis patients shouldn't take pain killers but did your pharmacist tell you ?                       

It must be remembered that drugs can be medicines in supervision of doctor or pharmacist and it can be toxin with self medication or on the advice of quacks. This is not all as drugs have side effects including adverse drug reactions. 

Hence, only qualified pharmacist can help you in avoiding them.