Ellen Campbell -Grizzle - PHARMACY TODAY WATER IS indispensable to the practice of pharmacy and to life. Every premises in Jamaica must have running water before registration as a pharmacy. Beyond cleaning and drinking, water is the most common vehicle (delivery agent) used in manufacturing liquid medicines to make sure that you get the correct dose of the active ingredients. It plays a crucial role in making your medicines safe.
There are many types of water. In making medicines, pharmacist distinguish between distilled, purified, potable, non-potable, sterile water or water for injection, among others. Each type has specific standard characteristics that determine the type of procedure or product in which it may be used. In the pharmacy, potable (suitable for normal household use) is commonly used to mix medicines to fill prescriptions. Potable water may be drawn from municipal water systems, wells, rivers or ponds.
Microbial contamination of oral liquids rooted in the use of potable water is an important concern. This problem may fluctuate based on the time of the year and temperature. Also defective piping systems are a contributing factor. Where there is doubt about the cleanliness of the water system, pharmacists use freshly boiled and cooled potable water.
How does your pharmacist use water to ensure that your medicine is safe and the right strength? Many antibiotic medications intended for use in children are sold to the pharmacy as a dry powder. The actual dose prescribed by the physician is based on weight and age of the patient. The pharmacist then calculates the amount of water in millilitres (mL) needed to accurately deliver the correct weight of the powder in milligrams(mg). This process is called reconstitution. Instructions for taking the liquid medication are then usually given in terms of teaspoonful (5mL), tablespoonful (10ml) or dessertspoonful (15mL).
After the product is prepared, an accurately calibrated plastic spoon is provided in the package. This you must use to take the medicine to ensure that you are swallowing the correct dose. Further, you may be advised to store the mixed product in a cool place to minimise the rate at which the product will degrade (break down). This instruction is given on a product to product basis.
There is concern that many Jamaicans do not comply with instructions that are intended to ensure safe and effective treatment. In fact, many adults feel that liquid medicines are designed for children. Some put the entire container to their mouth and swallow. This action may not only introduce unwanted microbes into the medicine but can lead to incorrect dosing.
It is important that you know about shelf life.(the period over which it is safe to take the medication). This is usually written on your label and should be brought to your attention during your use of medication counselling session with your pharmacist. There are, however, some tell tale signs of early product degradation- strange growth in the liquid inside the bottle or when you pour out the medication and colour change. You may notice a change of smell as some medicines do have distinctive odours. When these occur, even within the shelf life, contact your pharmacist.
Now you understand the special role that potable water plays in pharmacy and how it is used to make your medicines safe. However, persons of all ages must follow instructions given by the pharmacist when taking medication. Water is a most important life-giving source and should not be taken for granted. If you want to know more about how water is used to make medicines and keep you safe, ask your pharmacist, you have the right to know!
Ellen Campbell Grizzle is President of the Caribbean Association of Pharmacists (CAP) and Director, Information & Research, National Council on Drug Abuse (NCDA), Kingston, Jamaica.
