Good things should be shared, can medicine be shared as well?

【Pharmacist consultation clinic】

Patient: "I was diagnosed with high blood pressure a while ago, and the doctor prescribed me some medicine. Although I take it every day, I still have frequent headaches. Two days ago, when I was chatting with Sister Zhang, she recommended me a very useful antihypertensive drug. I came to the doctor today to get it prescribed for me, but he refused to prescribe it for me. The doctor asked me to come to you, and you can give me your opinion."

Pharmacist: "What medicine do you want to be prescribed?"

Patient: "Oh, let me tell you, Sister Zhang said this medicine is very effective in lowering blood pressure. She used it and it worked very well for her, so she recommended it to me! Usually, the things she recommends to me are very effective, so why doesn't the doctor let me use it?"

Pharmacist: "Don't worry. Antihypertensive drugs are different from other things. If you don't control them well, you will easily feel dizzy. You are so old. If you fall and break a bone, your children will be very worried."

Patient: "But my blood pressure was too high before. Shouldn't I switch to a more effective medicine?"

Pharmacist: "You have just been diagnosed with hypertension. The initial treatment dosage is relatively conservative. It will be adjusted slowly based on your blood pressure control. Don't worry."

Pharmacist reminder:

Because everyone's blood pressure level is different, and the comorbidities are also different, hypertensive patients need individualized medication. Some people have complications, such as complications of important organs such as the heart, brain, kidneys, and eyes, but some people do not have complications. Some people have good economic conditions, while others have poor economic conditions. These are all factors that affect the selection and use of drugs. Therefore, hypertensive patients need individualized medication, which means that it must be combined with the patient's blood pressure level, comorbidities, and the patient's economic situation for drugs. Individualization means combining individual conditions, treating specific patients specifically, and treating specific diseases specifically.

When prescribing medication, doctors must consider each patient's physiological condition, pathological state, gender, age, and concomitant conditions, and refer to their own examination results before prescribing treatment. Then, they will make adjustments based on the patient's reaction after taking the medication. Therefore, other people's medications are definitely not suitable for you, and your medications are not suitable for others.

Moreover, for patients with hypertension, antihypertensive treatment must first be stable and then reach the target. If blood pressure fluctuates due to inappropriate medication, it will increase the risk. Sudden and large fluctuations in blood pressure can induce acute cerebrovascular events at any time, such as cerebral hemorrhage or cerebral infarction. Therefore, the most important thing about antihypertensive treatment is that it is stable and effective.

Antihypertensive drugs are divided into two types: acute and conventional. For patients with sudden and substantial increases in blood pressure, especially those with fluctuating headaches, emergency antihypertensive treatment is required to prevent and treat cerebrovascular accidents; however, for most patients, the increase in blood pressure occurs gradually, and some patients already have very high blood pressure and do not have any discomfort. When measuring blood pressure, it is often found that in many cases, emergency antihypertensive drugs are not needed, and conventional antihypertensive drugs once a day are sufficient. Even if the effect is not good, there is no need to take acute antihypertensive drugs routinely. Instead, you should record the monitored blood pressure and see a doctor to adjust the medication. It is not recommended to take antihypertensive drugs that others think are effective, even for twins, because there are almost no patients in the world with exactly the same physiology and pathology.

So other people’s medicines are not suitable for you. Patients can feel when their blood pressure is not well controlled, but some diseases cannot be detected when they are not well controlled. It is very scary to use other people’s medicines blindly. The condition may have worsened and you don’t feel it yet. When organ failure occurs, it is too late because you don’t look like him (her)!

【References】

[1] Chinese Medical Association, Chinese Medical Journal, Chinese Society of General Practice, et al. Guidelines for diagnosis and treatment of hypertension in primary care (2019)[J]. Chinese Journal of General Practitioners, 2019, 18(4):301-313.