MY VILLAGE PEOPLE!
Author: Pharm. Precious Chinonso Ikechukwu.
It was a sunny afternoon in the south-south region of Nigeria. A woman walked into a community pharmacy looking very frustrated. “I’ll like to see the pharmacist” she said as soon as she entered in a desperate voice. Pharm. Tina, the pharmacist on duty responded, “Good afternoon ma, How may I be of assistance”
The patient, Mrs. A, blurted out "Pharm, please help me, my village people are after my life!" and went on to complain about a dry, stubborn and persistent cough that had been troubling her for over 3 months.
When Tina clerked further, she discovered that the patient was 40 years old, had been to the hospital and had taken various medications including antibiotics such as Amoxillicin 500mg, Azithromycin 500mg and even just recently finished Augmentin 625mg which she took twice daily for one week, prescribed by a pharmacist she had earlier complained to. Prior and even in addition to the antibiotics, she had taken various cough syrups.
All these medications only provided temporary relief as the cough would surface again immediately she was done with them. The cough never really stopped. Even as she was talking, she started coughing and choking and had to pause to drink water and recollect herself.
Mrs. A complained that the frequency of the cough was becoming alarming, socially it was becoming an embarrassment to both she and her husband; she couldn’t stay amongst people for long because within intervals of a few minutes, she would be coughing aggressively causing people around to throw worried and irritated looks her way.
“Have you been subjected to any form of test such as tuberculosis test?" Tina asked to which the patient replied "Yes". She had gone to a renowned reference hospital and had undergone various tests, though she couldn’t remember the names of all the tests but all had come back negative including the tuberculosis test. Tina further asked if she had undergone covid-19 test. She replied she was planning on doing that but just decided to go to another pharmacy to complain one last time and possibly get a different set of drugs from the ones she had taken.
And then it hit Tina! She asked the patient "Madam, do you have any known medical condition” . “Yes, I do" . She was a known hypertensive patient. Tina nodded and asked what medications she was on presently, the patient listed Vasoprin 75mg, Amlodipine 10mg and LISINOPRIL 10mg. Tina smiled, there it was, the suspected culprit.
Pharm. Tina asked her how long she had been on the medications, she said she has been taking the antihypertensives for some years now including the first two drugs she mentioned but when she went to the hospital for a routine check-up, the attending doctor added the third drug Lisinopril 10mg and this was over 3 months ago, Eureka!! Tina screamed in her head.
A worried Tina asked her if she had gone back to her doctor since or even complained of this cough to him. She replied that he was a consultant doctor and wasn’t always around. It was the resident doctors who had been attending to her since then. They checked and confirmed that her blood pressure was stable, sent for a series of tests and prescribed the various medications she had been taken for the cough.
Tina then went on to tell the patient “Madam, based on our interaction, this drug, Lisinopril is most likely the cause of your severe dry cough. You see, dry cough is one of its common side effect and you are obviously experiencing this.” Mrs. A’s eyes popped out. "You mean it has been my medication all along?" Tina replied "Yes, from all possible indications". Tina then proceeded to tell her to discontinue the drug immediately but to look for a way to contact the consultant doctor who placed her on the drugs for a review especially as her blood pressure was now stable. Pharm Tina went on to place her on another cough syrup which is effective in treating dry and troublesome cough, Vitamin C 1g daily and Zinc 50mg tablets to aid her recovery and again referred her for a sputum test in a medical laboratory to rule out any micro-organism.
One week later, a very happy Mrs. A picked up a phone call from Pharm. Tina, the cough has now stopped. Her sputum test had shown no micro-organism present and the medications she was given to aid her recovery produced excellent results. Her social life was back on track and she finally had her peace of mind. She was full of gratitude and appreciation to Pharm. Tina. Her last words on the phone call were "Pharm, It wasn’t my village people after all!". They both laughed.
Image credit: All images except otherwise stated were sourced from google.
Editor-in-Chief: Pharm. Tonuewa, Sejoro
National Public Relations Officer: Pharm Ozuluoha Chioma Cynthia
A publication of Editorial Committee, Pharmaceutical Society of Nigeria - Young Pharmacists Group 2021/2022