“I’ve been coughing for three days now, I’d like to have the best cough mixture.”
This is a common request that I receive as a pharmacist. Naturally, when it comes to medications, we would like to have the best there is.
So, does the best cough mixture or medication actually exist?
Whenever I receive requests like these, I would maintain my usual composure and start gathering more information on the patient’s condition.
“I see. If that’s the case, I would recommend that you take this cough mixture.” I said while passing a bottle of cough mixture to the patient.
“Is this the best cough mixture?” The patient questioned me skeptically.
“No, unfortunately it is not because the “best” cough mixture does not exist. I recommend this cough mixture because you have a chesty cough while your phlegm is especially thick and difficult to expel.”
Nope, the best cough mixture or medication does NOT exist. If it does, we, the healthcare professionals will be more than happy to have it. Imagine how much easier our work will become if we just have to dish out the “best” cough mixture or sore throat medication without putting any thoughts to it.
Every medication has its own medical properties, side effect profile, etc. Some are suitable for a dry cough, while others are good for phlegm. We suggest medications to patients based on their symptoms, acceptability of side effects and any possible risk(s) they pose. Furthermore, some medications may be contraindicated in patients with certain conditions, worsening their disease, or there may be interactions with other medications that the patients are taking, thereby causing problems to health. Let’s take a certain group of painkillers known as NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) as an example. Patients with history of heart attack should avoid these medications as it can increase the risk of another attack (except for low dose aspirin indicated for blood thinning). When taken together with corticosteroids, NSAIDs can increase the risk of gastric ulcers by several folds. Even common medications such as cough mixtures and painkillers are so complex in nature, hence it is impossible to label a medication simply as the “best”.
If you ever wonder why your pharmacist always ask so many questions when you want the “best”, that’s because the “best” does not exist. Nevertheless, rest assured your pharmacist will pick the most suitable medication for you!