How Do Pills Know Where to Go?
Clive Cannon has been the chemist in Wainuiomata since 1986. There, he is known as "the happy chemist" and is renowned for (inter alia) playing the piano in his pharmacy. Twice he has won Top Pharmacist awards and once the "Top Shop". He remembers how in the old days pharmacies had a distinctive smell and pharmacists used to concoct their own preparations, such as morphine and chloroform for coughs, and Gee's Linctus from heaven knew what. Nowadays pharmacists are no longer allowed to make their own, and dispense only commercially made and registered drugs. They also provide advice and reassurance and for many they are at the coal face of the health system.
The ideal medication will provide the smallest possible dose with the least side effects for the greatest effect and will involve the fewest pills for the longest permanence. But as many people know the reality is that many people take multiple pills. After a heart attack, for instance, a patient may be given separate pills to thin the blood, to prevent clots, to smooth the arterial surfaces and possibly to slow the heartbeat, etc. Clive explained the anomaly in an informative and most entertaining talk.
We should think of pills as locks to open up a specific receptor. However, such locks often partially open other receptors which can lead to side effects which then need their own medication. Also, sometimes the body's liver changes some drugs. Sometimes a particular drug does not completely cure a condition, but simply increasing the dose could be ineffective, if the effects plateau, or more dangerously, if an excessive dose becomes toxic. It is better in such a situation to add another medication than to increase the dose.
In answering questions Clive made the following comments:
- Natural medicines do have a place, but beware the term "natural". Digitalis is natural, as is arsenic.
- Fish oil may well be beneficial.
- It is important to keep a balanced diet.
- There is about to be a real problem with medicinal cannabis as the Health Department gave interim approval to a number of local suppliers but the time limit to meet standards has ended and that approval will be withdrawn, leaving medicinal cannabis legally available only from one local (expensive) producer or (very expensive) overseas suppliers.