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close this bookAids Home Care Handbook (WHO, 1993, 178 p.)
close this folderPart II: Reference Guide
close this folderChapter Seven: General guide on the use of medicines
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View the documentTeaching notes on the use of medicines
View the documentMedicines commonly used to treat symptoms in people with AIDS

Teaching notes on the use of medicines

It is essential that anyone taking medicines (whether prescribed or bought from a shop) follows the instructions for their safe and effective use. Medicines not taken according to instructions can be useless or even harmful, causing further illness. It can be very confusing for a person and their family when they are provided with several different medicines, all with different instructions. You must make sure that your patients and their families know how to take the medicines you recommend.

There is some danger in the use of any medicine.

Whenever you recommend a medicine, it is a good idea to give the patient and the family written instructions. This can be useful to anyone involved with the care of a sick person. Someone can always be found to read it. You should explain the instructions and ask the patient or members of the family to repeat them to you. Make sure they understand. Below is an example of a written schedule.

To help remind people who cannot read when to take their medicine, you can give them a note like this:


Figure

In the blanks below the pictures, draw the amount of medicine they should take and explain carefully what it means.

Here are three examples:

(a) This means one tablet four times a day: one at sunrise, one at noon, one at sunset, and one in the middle of the night.


Figure

Written medicine schedule

Name of medicine

Purpose

Description

When to give

Comments

Aspirin or paracetamol

for fever, headaches, pain

white tablet

take 1 or 2 at least every 8 hours

take with meals or food

Calamine lotion

for itching and irritated skin

tan liquid

apply to skin as necessary

do not take by mouth

(b) This means half a tablet three times a day.


Figure

(c) This means two teaspoonfuls twice a day.


Figure

How to use medicines

People may have been advised to take medicines by a health care worker or may have decided to buy their own medicines without such advice. In either case, people must know how to use medicines correctly to get the most benefit from them and to avoid any harmful effects.

How can people learn about medicines?

You, the health care worker, should give people the information they need to know. The people who sell medicines may also be helpful but remember, their primary goal is to make money through selling. Instructions about taking any medicine and the name of the medicine should be written on the container it is sold in.

For any medicine a person has been given, they should know and understand the answers to the following questions:

· Why has it been prescribed?
· How will it help them?
· How should it be taken?
· For how long should it be taken?
· What side-effects, if any, should they watch for?

The ability to use medicines correctly is very important for health and safety. All labels should be checked by the person before they leave the health centre or shop. If the label says:

· Keep cool - the medicine should be kept out of sunlight and out of damp places.
· Shake - the medicine should be shaken for a full minute before measuring out each dose.

How should medicines be taken?

It is important to take medicines as near as possible to the time recommended. Some medicines should be taken only once a day, but others must be taken more often. If the person does not have a clock, it does not matter. If the directions say "1 tablet every 8 hours", they should take three a day: one in the morning, one in the afternoon, and one at night. If they say "1 tablet every 6 hours", they should take four a day: one in the morning, one at midday, one in the afternoon, and one at night. Before they leave the health centre or the shop with the medicine they must be sure they understand how often to take it. If the directions say:

· On an empty stomach - the medicine should be taken at least one hour after a meal, or 30 minutes before a meal.

· With meals - this can also mean with snacks. People should make sure that they have eaten something before taking the medicine.

If vomiting occurs immediately after taking a medicine, the dose should be taken again. But if the vomiting occurs 20 or more minutes after taking the medicine, the dose should not be repeated.

Advice for people who are giving medicines to children

· Liquid medicines can be squirted slowly into the side of the child's mouth with a dropper or syringe, or poured from a spoon.

· Always praise a child after he or she has taken medicine.

· If the medicine tastes bad, tell the child so in advance.

· If a pill cannot be swallowed, crush it and mix it with the smallest amount possible of something the child likes to eat. However, do not "hide" medicine in food or the child may begin to refuse food.

· If the child vomits immediately after taking a medicine, give the dose again. But if vomiting occurs 20 or more minutes after taking the medicine, do not repeat the dose.

Medicines to be used with caution in people with AIDS

There are certain medicines that can have more side-effects, or can cause more problems, in people with AIDS. People should be aware of which these are so that they can watch for any reactions they might have to them. They include medicines commonly given to treat infections, and medicines that are used only rarely:

· the anti-tuberculosis medicine, thiacetazone, often called "thiazina"
· sulfonamides
· steroids.

Steroids (such as cortisone and hydrocortisone) deserve special mention. These medicines suppress the immune system and so they are particularly dangerous for people with AIDS because their immune system is already weakened by the disease. Steroids worsen the problems that come with AIDS by reducing even further the body's ability to fight off common infections. People with AIDS should only take steroids after very serious consideration by a medical doctor. They should only take them as part of the treatment for another problem.

Which medicines should people use?

The next section describes the medicines that might be used at home for treating the symptoms that can develop in people with AIDS. They are grouped here according to the symptoms they are used to treat. For example, medicines used to treat pain are listed under the heading, "Medicines for pain". The symptoms themselves and how they can be treated at home are described in Chapters Five and Six.