Ethical and Moral Decisions about Drugs
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General availability of different medical services worldwide provides mankind with many additional opportunities to maintain or amend people’s state of health. Moreover, new technologies and methods develop innovative approaches towards the field of pharmaceutics. Nowadays, people have almost no difficulty buying some kind of medicine. The tendency of mass self-treating is increasing every day.
According to the U.S. Environmental Protection Agency (EPA) (2010), the challenge concerning health care facilities demands the interest from the side of stakeholders to better manage unused medicines. Different health care facilities, such as hospitals, clinics, doctors’ offices, and long-term care facilities, need the guidance on how to utilize and dispose unused pharmaceuticals. The first step for any healthcare institution is to create a list of medicines generally used at the facility. The next step for managers is to identify the unnecessary pharmaceuticals and systematically check how they are controlled.
Therefore, it is necessary to identify the types of medicines. Most hospital pharmacies support the idea of special formulary, approved “for prescriptions to patients by attending physicians” (The U.S. Environmental Protection Agency, 2010). Besides, it is possible to purchase pharmaceuticals, which are not included in the list, for special needs and urgent occasions. “Purchasing records” can show all the pharmaceuticals available in the healthcare facility’s stock. Such technique is much better than simple notes about medicines on the list. In order to develop a formulary, the manager of department finds and verifies the following information about every type of drugs: national drug code (NDC), brand name and generic name, manufacturer, dosage(s), form (cream/liquid/tablet), and package size (The U.S. Environmental Protection Agency, 2010).
Agency of Healthcare Research and Quality (AHRQ) recommends becoming a member of a “healthcare team” (2011). Such a team includes professionals who are responsible for caring for patients: nurses, physician assistants and doctors. Special personnel should care for disabled people at home and provide them with drugs. Any hospital, as well as doctor’s office, is the main place to examine or treat patients. Evidently, management plays a significant role on every level of healthcare facility. Thus, a pharmacist is accountable to fill a prescription and answer questions cncerning medicines. AHRQ emphasizes on the importance for the team to possess relevant information concerning all the medicines, dietary supplements, vitamins and herbals that people use. In order to receive professional and rational assistance, a person should list his/her probable allergies, different discomforts when taking drugs, should not hide information about pregnancy, and should inform of all possible illnesses. The staff of the team can substitute the prescribed medicines with the cheaper ones if the reason lies in costs. Before taking medicine, a patient may ask doctor many questions, such as why it is necessary to use it, what the generic name or brand name it has, and if it is not dangerous to take such drugs. New prescription not always means that patients should stop taking other medicines. Healthcare team members should advice patients to combine different types of drugs or avoid some of them at all. They usually inform about frequency and time of taking medicines. Any questions related to drugs refilling, side effects, effectiveness of medicine and many others can be clearly answered by tolerant and professional healthcare team members (Agency of Healthcare Research and Quality, 2011). The team helps to monitor the whole process of treatment, starting with prescriptions of medicines and ending dealing with their effects on the patients.
Generally, there are such notions as ‘generic drugs’ and ‘brand-name drugs’. According to Jeffries (2012), the difference between them is obvious. There exists some equivalence of their chemical ingredients, but they are not the same. This fact explains why people often prefer cheaper medicines to more expensive brand-name drugs. Simultaneously, marketing representatives develop many programs and advertisements directed on the customers’ consciousness in order to demonstrate the advantages of brand-name pharmaceuticals. Hence, people think that the effectiveness of the generic drugs is lower and they may provoke additional risk. In this case, very few developers of such propaganda care about morality and ethics. People who tried brand-name drugs and got the expected result, clearly, never would use their cheaper equivalents. The US Food and Drug Administration supposes a generic drug as “identical, or bioequivalent”, and highlights only similarity of their active ingredients (Torrey, 2011). After all, many commercial orgnizations always improve their businesslike positions and do not pay enough attention to customers’ health. A lack of knowledge about drugs brings its impact on health and financial situation. The situation concerning controlled (also scheduled) drugs is different than is the case with generic drugs, because it presupposes strict control on each level of distribution and consumption (Texas State Board of Pharmacy, 2002-2004). Specialists state that these drugs’ potential causes great abuse. The source identifies five groups of drugs called ‘schedules’, based on their abuse risk. The first and second groups are related to very dangerous substances and include crack cocaine, LSD, heroin, marijuana, PCP, morphine and dextroamphetamine. They can provoke arduous psychological dependence; thus, they are used rather rarely even in extreme situations. Next three groups are not so dangerous and, in comparison with the drugs from previous levels, “have safe and accepted medical uses in the United States” (Texas State Board of Pharmacy, 2002-2004). Different kinds of anti-anxiety drugs, stimulants, non-narcotic analgesics, sedatives and tranquilizers have the greatest range of users. They also belong to generic medicines.
In order to supervise general situation concerning drugs and their influence on users, the processes of handling, storing and monitoring are indispensable. In addition, they help to evolve chemical characteristics of generic and controlled drugs. Hence, every department manager should follow these rules. Handling and storing drugs demand special requirements and regulations. Of course, these rules vary because of different types of medications. The pharmacists have to maintain elementary but very important conditions like relevant moisture temperature, light and shelf life. According to NDRI.com (n.d.), moisture level plays a major role for drugs and powder tablets, for instance, ephedrine, digitalis preparations and zinc chloride. Most drugs should not be stored in direct sun light. If stored improperly, such drug as ephedrine may decay, while bismuth salts, aminopyrine and quinine are able to change their color. The pharmacists should keep them in dark-colored containers and dark places. The source provided certain information about appropriate temperature that can vary from 2 to 10°C for biological drugs (NDRI.com, n.d.). The expiration date of drugs presupposes to get unavailable medicines out, despite good conditions of preservation. Besides, glass containers can deteriorate some drugs. As an example, soft glass, which contains some solution, decomposes the oxides under the influence of a high temperature. This process leads to the increase of the solution’s pH.
Generally, millions of generic drugs’ consumers still do not know how to preserve drugs at home or in other private places properly. Original medicine containers are always better than any others. In order to prevent freezing, liquid medicines should not be put into refrigerator. It is necessary to remember not to leave opened medicines, as the drugs’ integrity begins to deteriorate. In addition, any kind of unprescribed pills is dangerous for kids (NDRI.com, n.d.).
Deanna, an employee of the management department at a certain healthcare facility, often uses NSAIDs (or Nonsteroidal Anti-Inflammatory Drugs) for personal use. She says they help her to avoid pain. Naturally, the drug can partly relief her permanent warmth, redness and swelling (WebMD, n.d.). These symptoms are general for inflammation and need special treatment. She has tried the brand Advil and its generic name of ibuprofen. Sometimes Deanna takes Ecotrin or generic aspirin. As more experienced in the field of pharmaceutics, I always advice her to reduce a big dose of medicine she is used to take. In my opinion, it is better to substitute them for other drugs which can be more effective, less dangerous, and cheaper. In addition, she has to know the requirements of their preservation and storing at home. Besides, taking drugs home for personal use is wrong, if not a crime, as their amount has to be strictly monitored. After all, she has revised all the information listed about healthcare facility management, including personal treatment of patient and some ethnical aspects in the sphere of pharmaceutics, and successfully applied my recommendation.
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