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Subject:
From:
Tony Cisse <[log in to unmask]>
Reply To:
The Gambia and related-issues mailing list <[log in to unmask]>
Date:
Wed, 10 Nov 1999 11:16:33 +0000
Content-Type:
text/plain
Parts/Attachments:
text/plain (95 lines)
Ousman,

As you say I share your concern, and the use of expired
products has serious and scary implications.

On a point of clarification however, Oral Rehydration Salts
(ORS) are not strictly speaking antidiarrheals, i.e. they do
not prevent diarrhea, rather they just replace vital minerals
which are lost through diarrhea. Some years ago before ORS
was widely available people were advised to make their own
ORS consisting of boiled water, salt and sugar (I've forgotten
the proprtions). I can even recall a public information poster
to that effect. Antidiarrheals are a very different thing, and are
infact very dangerous. Poducts such as "Lomotil" and others
have the effect of "freezing" the bowels, leading to the
diarrhea (and therefore the bacterial causing it) remaining in
the body for a certain length of time. This can actually cause
death, especially in young infants.

Whether expired ORS specifically present any health risk or
not, I am not qualified to say, and is anyway beside the
point. Dispensing expired drugs, or indeed any other product
(such as food products) should be illegal. If one starts to
make exceptions how is one to judge what is a "safe"
expired product from an "unsafe" one? Whilst Chief
Pharmacists may be able to distinguish between the two,
other members of staff might not be able to tell and a
precedent would have been made which could extend to
more dangerous products.

If there was a shortage of ORS would it not have been better
just to resort to the previous "home-made" method as
advised by the Health Authorities in the past?

Yeenduleen ak jaama

Tony

>>> Ousman Bojang <[log in to unmask]> 9/November/1999
03:55pm >>>
Christenson,
I share this concern with you. This is very scary. I can
understand the need
of drugs in the Gambia, but for a pharmacist to declare that
"an ordinary ORS
doesn't have any side effects. Even if it has expired" she
said. That is very
misleading. There is no antidiarrheals drugs free from side
effects just like
any other drugs.
Some of the side effects infact are constipation and the
adverse reactions of
using expired drugs are more likely compared to usable
ones.
What is more alarming to me is the fact that the pharmacist
admitted that
they do dispense "Expired drugs" whiles they wait on new
ones. There is no
excuse for this. They should know their inventory and be
responsible enough
to know when to place an order.
I do not know about the way  drugs are regulated in the
Gambia, but hence
they are not manufactured there, there is no reason why we
should not heed to
the manufacturers' recommendations. There should be
standards to be followed
that every manufacturer of drugs follows and are tested to
enhance the
efficacy, biovailability, potency, purity, potency and safety
and toxicity
before being supplied to the consumers.
I hope there is a law in the Gambia that guarantees the
consumers some rights
where by they could take lagal action against such. There is
no acceptable
excuse to dispense expired/wrong meds or dasages to the
people.

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