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Stomach Ulcer

INTRODUCTION

As the country is getting tougher, more people are developing peptic ulcer disease, PUD. Simply put, PUD is a wound inside your oesophagus, stomach or intestinal walls. Naturally, if you had a wound on your skin, air blowing over it will cause it to clot and seal up. This is not so, however, in PUD where the wound is constantly bathed in different fluids including gastric acids, foods and spices, alcohol and carbonated drinks etc. Imagine you pour acidic water or pepper water on that wound on your skin, it would probably get worse right? It’s a no brainer therefore that we must watch what we eat if we have PUD, time we eat, quantity of food we eat etc.

CAUSES

PUD results when our stomach acid eats away at the walls of our gut. This happens under 2 circumstances:

  1. when the bacteria, Helicobacter Pylori, destroys the protective mucous membranes of the stomach walls, or
  2. due to the effect of a class of medications called NSAIDs. Ibuprofen, diclofenac, naproxen and aspirin all belong to this class of drugs. The NSAIDS also destroy the protective walls of the gut.

Some rarer causes include being acutely sick and the immune system becomes so compromised, or having a surgery or prolonged usage of steroids.

WHO IS LIKELY TO GET PUD

The following conditions increase your likelihood of getting PUD:

  1. being elderly
  2. Taking NSAIDs and steroids concomitantly, or prolonged use of NSAIDs alone
  3. Taking alcohol and cigarettes
  4. being a woman
  5. having a family history of PUD
  6. having liver, kidney or other chronic diseases

HOW PUD MAKES YOU FEEL

Stomach ulcers have some classical symptoms. It could give you :

  1. pain in your stomach or your back. This pain may stop briefly when you take an antacid or when you eat. It may be worse at night. Sometimes the pain may bring several levels of discomfort when you lie down, seat or stand. It can get terrible atimes.
  2. heartburn
  3. dark stool
  4. bloating and purging
  5. nausea and vomiting
  6. weight loss

HOW TO KNOW IF YOU HAVE PUD

PUD is easily diagnosed in the laboratory. Your doctor or pharmacist may direct you to run an occult blood test (OBT) which detects blood in your stool, and a H.Pylori test, to check if you have the bacteria. Doctors may also require you to run an endoscopy, x rays or scan to know the location of the ulcers.

TREATMENT

It is untrue that PUD cannot be treated. It is easily treated over several weeks if you can adhere to instructions. A faithful intake of drugs and adherence to the non drug treatment improves the outcomes of treatment.

The drugs used may include

  1. Proton pump inhibitors e.g omeprazole, esomeprazole
  2. H2 receptor antagonists e.g. cimetidine, ranitidine
  3. Gastroprotective agents e.g. sucralfate, antacids
  4. Antibiotics for h.pylori

Non drug instructions includes:

  1. Time of food. An ulcer patient should endeavour to eat very early in the morning. Also, time when you eat: don’t wait till you are hungry before you eat. If you wait till acid comes out (when you are hungry) you may be worsening the wound.
  2. Water is the best antacid. Consume large quantities of it, even in the middle of the night (personal experience).
  3. Avoid or reduce intake of any food that worsens the symptoms you feel. Such food may include: beans, milk, meat, oranges, apple, pineapple, garden egg, peppery and fried foods, any bottled or carbonated drink including soft drinks, malt, alcohol, glucose drinks.
  4. Natural or unsweetened yoghurt is your friend, as is water melon, banana, and cucumber. Pap is also a good food for ulcer patients.
  5. Exercise and eating balanced meals help in most illnesses.

PUD may get completely healed within 2 months of proper adherence to treatment. However, ulcer could reoccur, especially when the H.pylori wasn’t completely eradicated initially or in cases of continued usage of NSAIDs.

BUST THE MYTHS

Contrary to popular folklore:

  1. ulcer is not caused by not eating enough food
  2. milk will not stop ulcer but may actually worsen it. Milk will reduce the pain momentarily, but because it produces gas and also causes more acid to enter the stomach, it will definitely make it worse.
  3. ulcer can be treated. Don’t listen to anyone who tells you otherwise
  4. ulcer is not caused by eating too much peppery or spicy foods.

PUD and ARTHRITIS

Patients with arthritis, whether rheumatoid, osteo or gouty, normally have pains that make them take pain medicines frequently. For this class of patients, taking NSAIDs is contraindicated. However, there are NSAIDs that contain another content that tries to protect the stomach walls. For example, the products with the combination of diclofenac/misoprostol or diclofenac/cholestyramine. Misoprostol replaces the prostaglandins that stimulate the production of the protective mucous membranes and reduce the secretion of acids while cholestyramine binds bile acids which is thought to be involved in the formation of ulcers. Neither of these combinations have the magic bullet to really protect ulcer patients and must be consumed with caution and with food.

Arthritis patients could benefit from other pain medications not NSAIDs.

NOTES FROM PHARMPLUG

Our pharmacist is always available to hear you out, advise you on the best course of action and monitor your treatment. Ulcer can be treated if done properly. If you have arthritis and ulcer, we could help you get your drugs at cheaper rates if you pre-order or send us your prescription.

Be health smart: save time, energy and money.

 

 

 

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Sexual Dysfunction Series

One May argue what men enjoy about sex seeing that he spends all his energy during the act for 'harder, harder', making the woman enjoy the act. With critical thinking however, one will discover that the major takeaway from any sexual activity for the man is the feeling of power and ego when he's able to satisfy his woman. Consequently, when men are not able to be the man in his bedroom duties, it evokes a lot of psychological pain which can affect his life and productivity. This inability to perform sexual functions effectively is termed sexual dysfunction SD.

SD manifest in different ways. It may present as weak erection, low libido, premature ejaculation, inability to get erect after the first round or inability to ejaculate. However, whichever way it presents, it is the most embarrassing and heart-wrenching events that can happen to any man.

Weak erection or Erectile Dysfunction, ED, is the inability to achieve or sustain a strong enough erection in order to have a successful penetrative sex. It can be caused by several factors, e.g.
1. Certain health conditions like hypertension, diabetes, high cholesterol, obesity, low testosterone levels or hormonal imbalance, kidney disease and depression
2. Certain prescription medication e.g. Amlodipine for treating hypertension, Escitalopram for depression, hydrochlorothiazide etc.
3. Stress and anxiety
4. Relationship problems
5. Age, sometimes
6. Too much alcohol
7. Tobacco products including cigarettes and marijuana
8. Surgery e.g. prostate surgery
9. Pornography and masturbation

Weak erection is now so common and is no longer an old man's disease. Young men aged 25 to 35 years now presents more for the same issue.

Treatment options
There are various options of treatment available, both drug and non drug. One may need to try out several options before finding one that works for him. There are different herbal and Orthodox drugs available. We shall review different products and answer the question 'is it good for me?'
Orthodox :
1 tadalafil 
2 sildenafil 
3 vardenafil 
4 testosterone replacement
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How To Recognize Fake Drugs

Many years ago, I saw a bottle of Ampiclox suspension by Beecham, that contained baby food that had ampiclox powder sprinkled around the bottle. May God bless the soul of Prof Dora Akunyili who fought the battle of fake drugs, without regards to her life.

Unfortunately, 12 years after her tenure, the dilemma of fake drugs is getting strong again. A fake or adulterated product can be a product that contains a different active ingredient(s) than it claims to contain, contains lower than normal quantity of the active ingredient, contains the right active ingredient but is being sold using the name of a different popular brand or  has an altered expiry date. The Nigerian pharmaceutical market is replete with these types of product and unfortunately for consumers, if you don’t know, you may never know.

Nafdac started the use of scratch cards to verify original brands but it’s depressing to know that even fake products now have scratch cards that tell you the fake product is original. So what can you do as a consumer?

1. Always buy your drugs from a reputable source. The suppliers of fake products consider the standard of a pharmacy/shop before having the morale to supply such products.

2. Look carefully at the lot no, manufacturing and expiry date before buying. Most malpractice will center around there.

a. Check to confirm the date on the drug packet is the same as that on the card. Get suspicious if they aren’t the same. 

b. Don’t buy if you don’t see any date at all on the card

c. Check if there’s variance between the lot/batch no on the packet vis a vis the date on both packet and card. For example, packet may bear lot no 1asdf and expiry date, 12/08/22 but in the card you may see lot no, 1asdf and expiry date 12/08/20.

d. Look well to be sure all the characters of the date are similar. If you see one that looks altered, it’s probably altered.

e. As a pharmacist, before purchasing, look to be sure all products bear a common lot no and date. A particular batch/lot must have the same date. If they have varying dates, there’s malpractice somewhere.

f. Different categories of drugs have a particular shelve(active) life. Multivitamins may be around 2 years, while some antibiotics may be around 2-3 years. Be suspicious if it’s unnecessarily longer than normal.

3. Quality of the packet. One that is not deeply and actively involved in purchases will never be able to spot a fake product. Sometimes, the quality of the fake is so sophisticated that you may choose the fake when placed with the original e.g. fake purple/black caps of a popular brand. However, no matter how sophisticated it may be, there’s always subtle differences that may come as a result of colour difference, character of expiry date, an omitted detail etc. 

4. Price. If it’s cheaper than normal, it may be fake. Be careful when buying drugs that seem to be a lot cheaper.

5. Popular, fast moving or expensive brands. Be more cautious when buying these types of products as they are more prone to faking. 

Like I said earlier, if you don’t routinely handle products, you may not notice fake products easily. The better thing to do is to purchase your medicines from reputable pharmacies. I pity people that enter inside the market to buy medicine, and that’s not saying all of the traders there are bad. 

Pharmplug has made it easy for you to order or refill your prescription easily and conveniently at the comfort of your home or office. Our platform aggregates hundreds of retail and wholesale pharmacies around town, thus we ensure the availability and accessibility of your quality meds, at better prices for you.
 
…Be health smart: save time, energy and money.
 
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Using Pharmplug for shopping for Drugs

Purchase, Delivery and Return Policy

To serve you best, please note the following policies:

  • Products purchased from our online platform will get to the owner within 2 hours, inside Enugu town and within 24 hours outside Enugu city but inside Enugu state. For emphasis, Enugu town includes: Asata, Ogui rd, Okpara ave, Newhaven, Independence layout 1, coal camp, New market, GRA, Achara layout, Transekulu and Golf. Orders outside Enugu state will be delivered within 48 hours depending on distance and courier company. 
  • Delivery within Enugu town attracts a N500-700 charge, inside Enugu town only. Purchases above N20,000 will be delivered free of charge
  • Controlled drugs cannot be purchased from the platform without a proper and verified prescription from a doctor
  • We do not accept any cash payment. All payments must be made online or via POS on delivery.
  • Kindly be precise when selecting your products and quantity. In a case of wrong selection after payment, please read the section of our policy on returning products after purchase.
  • Our online consultation is designed to help you discover, understand and treat/manage your health condition. Please feel free to consult the pharmacist or our doctors to get a prescription for some health issues.   
  • Products received and signed off in good condition may not be accepted back for a refund especially if it’s a cold chain drug, it’s destroyed in any way, or is presented beyond 24 hours after purchase. Products purchased, after proper examination and assessment of storage, can be accepted back on compassionate grounds, for example, the death of a patient.
  • Delivery costs are non-refundable. In the event of a refund, the delivery costs will be deducted from the refund value.
  • If you can’t find your desired product on the pharmacy floor, please send the name of the medication to customerservices@pharmplug.com, and we shall source it within 48hours. In the case of refund, if the product can’t be sourced within 48 hours, money will be refunded.    

Steps in the Purchase process

Step 1: log onto the system. Enter our pharmacy floor by opening our website or our Pharmplug mobile app.

Step 2: Fill your Prescription. If you have a prescription or a list of items to purchase, kindly search by category or by typing the name of the product on the search bar. Then, select the product and quantity and add to your shopping cart. Kindly go through the description of your chosen product to be sure it conforms to your needs and that you don’t react to any of it’s ingredients. If you don’t have a prescription, kindly ‘Ask Pharm Josy’ to direct you on what to purchase.

Step 3: Check out and pay. After selecting your chosen products and quantities, kindly check out and proceed to payment. There are various payment plans: you may decide to pay online or pay on delivery via POS. 

Step 4: Receive product from dispatch. Our delivery man will call you on arrival at your location. 

Step 5: Examine products. Prudently examine your products to ensure they meet your specification and are of good packaging and quality. Kindly reject if the product is not what you ordered for or is damaged.

Step 6: Refund or replacement. In the event a product is rejected, your refund or replacement will be processed immediately. You will kindly indicate the reason for any rejection. Money paid will be transferred back to the account number you provide.