Tuesday, December 22, 2015

Times when you could do without (or with) a prescription

You could do without a prescription when you:

Have a common cold & flu

As seasonal common cold is arising from virus (influenza type c), you could hop to your nearest pharmacist to get medications for symptomatic relief. This is because viral cold is usually self-limiting and would recover when your body's immune system wins the virus, unlike bacterial infections which are often more severe. For example: paracetamol for a mild fever, expectorant or suppressant for cough, loratidine for your runny nose...

BUT if your symptoms persist for more than a week, has a fever that does not subside in 3 days, has wheezing or signs of breathlessness or cough up purulent colored phlegm, it's time to pay your doctor a visit. Those may point to a more severe infection such as MERS or even bacterial infections like pneumonia.

Have a wart or corn

You could go for over-the-counter treatments like Duofilm liquid or  corn plasters which both contain salicylic acid. This chemical will make the hardened skin layer peel over time, turning the area white initially.  It works for both corn and warts.
Another otc choice for wart is Wartner, which freezes off the wart. Wart is a viral-induced skin problem. A wart has a cauliflower-like appearance and may gradually grow bigger. Unlike warts, corn can't be freeze-off.
Children or diabetic persons may need doctor's advice before any self-treatment.

Have hereditary hairloss

That is if your parent(s) have hair loss problem as they age and you find yourself in their footsteps, you could hop to the pharmacist to get some hair tonics or this topically applied medication call Minoxidil. It works for both male and female baldness in most cases but if no results is seen within 6 months of use, you would probably want to visit your doctor to seek for alternative.

If you think your hair loss problem is due to dietary deficiency, you could take some hair supplements (usually containing amino acids, collagen and some herbs). If you think you are suffering from some scalp disease which resulted in the hair loss then it is important to first get it treated. People who are taking long-term medications or have any medical condition should first let your pharmacist know before seeking self-treatment.

Have mild-moderate eczema

Eczema is an allergy induced skin condition where there's itching, rashes and possibly dryness (which exacerbates the itch). It can occur at any age and be triggered by food or allergens in the environment.

For mild cases which resolve by themselves, avoidance of allergens and a good moisturizer to protect the skin would usually serve well as prevention measures. For bothersome cases in which you can't identify what things you need to avoid, you could visit a doctor for a skin-prick test. Sometimes to your dismay, it could be things that are hard to avoid eg. haze, dust-mites.

Nevertheless, moisturizer and a soap-free cleansers are the first line of remedy. For moderate cases, you may need anti-histamine tablets and steroid cream in addition for treatment.

For severe or persistent cases, despite self-treatment with the above, you may require stronger prescription therapy from doctor. Once the inflammatory condition has been controlled, you could consider stepping down to self-treatment and prevention. Avoid prolonged use of steroid creams as they could thin the skin or make the area under treatment more prone to skin infection.

Constipation and mild diarrhea

For constipation, you could get laxatives over the counter and they can be broadly classified as for short-term fast relief or for longer term slower relief. The fast relief ones are usually senna tablet, bisacodyl tablet or suppository and enemas. These are not recommended for prolonged regular usage as they can cause dependence (lazy bowel) and abdominal cramps. The slower relief ones but safe for long term use are lactulose, fibres and probiotics. Lactulose and fibres would take about 2-3 days for onset, may be milder in effect and occasionally cause bloating, so you might want to start low and continue them for a while.
Drinking more water, healthy lifestyle and having a balance diet can't be emphasized enough for people who suffer from long term constipation.

Diarrhea may prove a bit more complex in terms of the choice of therapy because it may arise from various causes:
traveller's diarrhea or pathogenic diarrhea, irritable bowel syndrome, medications or colon diseases (cancer, inflammatory bowel disease etc).

Any diarrhea with fever, blood in stool, severe cramps or persisting beyond 2 days should warrant a doctor's visit.

The first-line of treatment is NOT to simply stop the diarrhea but to drink re-hydration salt with enough fluid to prevent getting dehydrated. Taking charcoal pills (available over-the-counter) may help in the initial phase of food poisoning or traveller's diarrhea. If you are certain that your diarrhea is mild or not pathogenic in nature, then you could take Lomotil (diphenoxylate) or Imodium (loperamide) which are medications to reduce your gut movement in stopping the diarrhea. This is because you wouldn't want to have the bacteria or toxins continue manifesting in your intestines or simply mask away the diarrhea without knowing its cause.

For prevention of traveller's diarrhea, you could take probiotics on a daily basis to 'strengthen' your gut. Although it's best to abide by the rules of “boil it, cook it, peel it, or forget it”. Any antibiotic treatment warranted for pathogenic diarrhea would need a doctor's prescription.

Young children, the at-risk group (elderly, diabetic) or anybody with signs of dehydration should seek medical attention promptly.

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