Self-treatment

Laxatives faciUtate the passage and elimination of feces. These agents are used most commonly as self-treatment and are rarely prescribed by physicians. 

Great variety of parapharmaceutical products (PP) is available to customers and their part in self treatment is growing rapidly. But in Ukraine they do not pass proper standardization and there are no guaranties for their content and safety. 

Anodier problem can arise from the use of nonprescription cough medicine for self-treatment of a chronic cough. Indiscriminate use of antitussives by die general public may prevent early diagnosis and treatment of serious disorders, such as lung cancer and emphysema... 

Patients with photodamage can apply a lotion containing 25% glycolic acid for 6 months. In such cases an increase in total skin thickness of approximately 25% was reported, accompanied by an increased thickness of viable epidermis and dermis, an increased content of acid mucopolysaccharides, a greater collagen density and an improved quality of the elastic fibers. This could be defined as self-treatment. 

Glycolic acid can be applied simultaneously with TCA, which represents another technique for a medium-depth peel. Glycolic acid is also used in creams for self-treatment. Since complications such as hyperpigmentation, infection, irritation, and photosensitivity are very rare, it is well tolerated. 

Some antihistamines such as diphenhydramine, dimenhy-drinate, and meclizine are available without a prescription, making self-treatment convenient for patients. Antihistamines are available in a variety of dosage forms, including oral capsules, tablets and liquids. Liquid formulations are convenient for children or adults who are unable to swallow solid dosage forms. 

Assess the patient s symptoms to determine if selftreatment with OTC antifungal therapy is appropriate or whether the patient should be evaluated by a practitioner. Exclusions for self-treatment include infection of nails or hair, unsuccessful initial treatment, worsening condition, signs of secondary bacterial or systemic infection, or chronic medical conditions such as diabetes, immunosuppression, or impaired circulation. 

Ericsson CD Travelers diarrhea. Epidemiology, prevention, and self-treatment. Infect Dis Clin North Am 1998 12 285-303. 

The entry of drug companies into the herbal marketplace may result in dosage standardization for some products, and public and professional interests in herbs are likely to stimulate more research. However, with safe and effective medicines available, treatment with herbs rarely makes sense, and many of the conditions for which herbs are recommended are not suitable for self-treatment. 

The therapeutic efficacy of diverse mono and bis-quaternary pyridine aldoximes as antidotes against OP poisoning has been established in hundreds of publications, and three of them, 2-PAM (38), toxogonin (40) and HI-6 (41), are available in autoinjectors for post-exposure self-treatment or treatment by medical staff. For further information on the clinical use and potential side effects of these oximes the reader is referred to the reviews of Kassa, Eyer and of Marrs and colleagues . ... 

Prate DA. Self-treatment with herbal and other plant-derived remedies—rural Mississippi, 1993. MMRW Morb Mortal Wkly Rep 2004 44 204-207 (accessed... 

Delaying treatment or aggravating the condition with mixtures of impure and often unknown chemicals in inept attempts at self-treatment only makes things worse. However, by no means all, or even most, who sample the bewildering... 

Lethagen S, Ragnarson Tennvall G. Self-treatment with desmopressin intranasal spray in patients with bleeding disorders effect on bleeding symptoms and socioeconomic factors. Ann Hematol 1993 66(5) 257-60. 

In 1950, his health again failed. Every effort was made to save him he even attempted self-treatment which was successful in somewhat delaying... 

Discontinuation of self-treatment by the patient (= drop-out) is a critical point for the evaluation of studies. There are two dilferent types of drop-outs informative and non-informative. Non-informative drop-out means that no reason for the discontinuation is given this means that the patient stops taking medication by chance. Informative drop-out means that discontinuation occurs due to facts that give feedback for evaluation of the treatment, e.g. discontinuation due to drug-related side-effects. A comprehensive description of drop-out models can be found elsewhere [48]. 

Arundell E, Cistarnas M, Heaton A, Kunz K. Economic Implications of self-treatment of heartbum/nonulcer dyspepsia with non-prescription famotidine in a managed care setting. /. Manage. Care Pharm. 1996 2(3) 263-272. 

Food and Drug Administration (FDA) health claims" show that a relationship between a nutrient(s) or other substances and a disease or health-related condition, i.e., foods with soy protein, soluble fiber, and plant sterols, helps lower the risk of coronary heart disease (Table 8.5). These claims help individuals to select foods as either part of following recommended dietary guidelines, such as the TLC and Heart Healthy diets, or part of a self-treatment in response to You need to eat less fat and cholesterol and more fiber. ... 

Many commercial products have been developed that combine various nonnarcotic analgesics with other agents. Although data are lacking to support the efficacy of most of these formulations, many have proved popular among patients who use them fc>r self-treatment of minor painful conditions such as headache. 

Because ADRs are more likely to occur in the very young and the elderly, lower drug dosages may be indicated at these two extremes of the human life span. The elderly are more likely to have diseases such as cancer, coronary heart disease, dementia, diabetes mellitus, hypertension, and osteoporosis and may also have adverse nutritional reactions. Deficiencies in liver and kidney function can result in marked delay of drug detoxification and elimination. Constant review of established diagnoses and treatments is important to minimize the number of drugs administered, and care must be taken to determine whether other nutritional supplements and herbal products are being incorporated into self-treatment. 

Often called complementary and alternative medicine, this group of medical practices has also been termed unconventional, unorthodox, unproven, and even quackery. Because these terms have significant negative connotations, terms such as alternative medicine are preferred. Alternative medicine is not one form of medicine, but rather a diverse group of health practices that are outside of what is considered usual or conventional by the medical establishment. Alternative medicine spans the range of practices, from home remedies to manufactured products, from patient self-treatment to care by a skilled practitioner, from efficacious to potentially dangerous. Specific definitions of more common alternative medicine practices used in the United States are listed in Table 1. ... 

Blanc, P.D. et al. Use of herbal products, coffee or black tea and over the counter medications as self-treatments among adults with asthma. J. Allergy. Chn. Immunol. 1997, 100, 789-791. 

Heilborn H, Hjemdahl P, Daleskog M, Adamsson U. Comparison of subcutaneous injection and high-dose inhalation of epinephrine—implications for self-treatment to prevent anaphylaxis. J Allergy Qin Immnnol 1986 78(6) 1174-9. 

Propolis (SEDA-12, 410) (SEDA-13, 459) (SEDA-18, 4) or bee-glue is a resinous material used by bees to seal hive walls and to strengthen the borders of the combs and the hive entrance. It has antiseptic, antimycotic, and bacteriostatic properties and is found in cosmetics and natural products for self-treatment. 

Propolis can cause allergic contact dermatitis (4), and have been reported in HIV-infected patients (5-7). It has been associated with allergy after its use in cosmetics and in the self-treatment of various diseases. Although most cases involve allergic contact dermatitis arising from topical application, a few reports have described an allergic reaction after oral ingestion. Adulteration of propolis capsules with excessive amounts of lead has been reported from New Zealand (8). 

Two patients had oculosympathetic palsy after selftreatment with a shiatsu massager (169). A thorough diagnostic work-up, including MRI and MRA scans, identified dissection of the carotid artery as the cause of the problem. In the absence of other causes, the authors believed that the self-treatment had caused dissection. 

Phenolphthalein was once widely used as a laxative for self-treatment, often camouflaged in chocolate and thus hable to abuse or accidental use it is now obsolete. Skin rashes of various types are repeatedly reported, sometimes with pruritus. Pigmentation defects have been described. The most serious albeit rare adverse effect on the skin to have been rehably documented is toxic epidermal necrolysis. A fixed drug eruption with bullous eiythema multiforme is associated with auto-sensitiza-tion, and direct intracellular immunofluorescence is found (19). A hjrpothesis that phenolphthalein might increase the risk of development of adenomatous colorectal polyps has not been confirmed (20). 

Topical remedies are very popular in self-treatment and patients will often not report this, since they do not regard them as medicaments. Furthermore, patients often do not suspect that natural remedies cause adverse effects. Some substances lead to a considerable number of allergic reactions, for example chamomile extract and tincture of Arnica montana (15). Propolis also has pronounced sensitizing capacity (29), and sensitization to aged tea tree oil is being reported with increasing frequency (30). 

According to the most recent Utilization of Health Services Survey in 1991, 16 percent of the people used private facilities when they became ill. Self-treatment (buying pharmaceutical products from local drugstores) accounted for 18 percent of the services used. Private health facilities vary from modern hospitals, traditional hospitals, modern clinics, traditional clinics, pharmacies and drugstores as shown in Appendix Table 3. 

---