Onyesom I, Okolo A. C, Mabiaku T. O, Anyanwu E. B, Awusi V. O, Umukoro D. O. Identification of the Types and Effects of Pre-Packaged Pain Relief Medications ("ogwu oseso") among the Ukwuani and Urhobo People of Delta State Nigeria. Biomed. Pharmacol. J.2008;1(2)

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Manuscript received on :August 16, 2008
Manuscript accepted on :September 22, 2008
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I. Onyesom^¹, A. C. Okolo^², T. O. Mabiaku^³, E. B. Anyanwu^*,  V. O. Awusi^³ and D. O. Umukoro^³

^¹Department of Medical Biochemistry, Faculty of Basic Sciences. Delta State University Abraka Nigeria. ^²Department of Physiology, Faculty of Basic Sciences. Delta State University Abraka Nigeria. ^³Department of Family Medicine, Faculty of Clinical Sciences, Delta State University Abraka Nigeria.

Abstract

Majority of the Ukwuani’s and Urhobos are peasant farmers involved in daily manual labour. This result in muscular and skeletal aches and pains at the end of such labour. To achieve relief, the patent chemist shop owners sell pre-packaged analgesics combinations popularly known as "Ogwu Oseso" which means "body pain medicine" to these aching people. The types and effects of these "Ogwu Oseso" are yet to be documented. The study involved the administration of self-administered questionnaires to twenty-fo

Keywords

Oguwu-Oseso"; analgesics; brufen; novalgin; drugs

Introduction

The average Nigerian adult is commonly involved in one muscular activity or the other in order to earn a living and continue to survive. Most Nigerians call this “hustling” for daily needs. Due to the daily occurring muscular-skeletal activities, the populace is usually affected with body pains and aches in various parts of the body and so, purchase of body pain medicines from across the counter to help relief pains is high. At the patent medicine stores, already packaged analgesics containing different combinations of analgesics are sold to the aching clients. These pre-packaged analgesic combinations are known as “Ogwu-Oseso” which means “body pain medicine”. These contain different combinations and the customer buys the package that he is accustomed to and that he can readily afford to buy on a regular basis.

The aim of the present study is to identify the types and associated side effects of the pre-packaged “Ogwu Oseso” among the Ukwuanis and Urhobos of Delta State, Nigeria.

Materials and Methods

Research communities

Consenting chemist shop owners/attendants from twelve communities were selected from Abraka (n=7 communities), Ethiope East Local Government Area, and Obiaruku (n = 5 communities), Ukwuani Local Government Area both in Delta State, Nigeria.

Respondents

A total of twenty-four (24) chemist shop owners-two from each community were interviewed in order to obtain some information regarding the use, types and associated side effects  of pre-packaged analgesics (“Ogwu Oseso”).

Information collection

Responses to the research questions were obtained from the respondents by semi-0structured questionnaires which were self-administered.

Results

The information obtained from the survey are shown on Table 1 and 2. Table 1, shows that overall, there was a high purchase of the packaged analgesics in the study communities. About 83.33% of the respondents reported that most of their customers purchase the analgesic mixture as packaged by them on a daily basis, but others (16.69%) say some customers buy weekly.

There were more male customers (66.67%) than females (16.67%). This is expected since men are more involved in manual labour and physical jobs that require exertion of muscles.

Most of customers’ jobs are hard exercises such as farming (62.96%), manual labour (14.82%), “Okada” (motorcycle) riding, (7.41%), and others were civil servants (7.41%), traders (3.70%), and commercial drivers (3.70%).

The respondents claimed 79.17% customers’ achieved total relief, and 20.83% say their mixture achieved temporary relief.

Table 1 also reports some side effects of the chemist packaged analgesic mixtures. Such side effects which are often the complaints of customers include: abdominal pain (26.92%), passing out blood in stool (15.38%), nausea and vomiting (11. 54%), coughing out blood (7.69%), passing out black stool (7.69), while 30.77% reported no obvious side effects.

Table 1: Information on purchase and side effects of “Ogwu Oseso” (chemist packaged analgesics) in Abraka and Obiaruku Communities, Delta State, Nigeria.

The main reason given by the customers for patronizing chemist shops include poverty (50.00%), but 25.00% say because the pains were usually minor and 16.67% appreciates the quick response given to them by the chemist shop owners.

Table 2 shows the different drug combinations packaged in groups. Eleven groups were identified, but the commonest groups of drugs are group III mixture which comprises Novalgin tablet + brufen tablet + brustan tablet + feldene capsule + ibex capsule; and group V mixture which comprises: brufen tablet + paracetamol tablet + indocid capsule + fesolate tablet.

Table 2:  Groups of the various analgesic drug combinations being purchased from chemist shops.

The drug-ibubrufen was included the most in the different groups. Seven (63.64%) of the identified eleven groups of analgesic mixtures had brufen.

Discussion

Analgesics are medicines that relief pains. One of the purposes of taking analgesic drugs is to relief pains and brings the sufferer back to a state of well-being (1). Pain and discomfort in everyday life are often treated with over the counter analgesic medicines. These drugs are remarkably safe, but some side effects can occur. Up to about 70% of the population in many countries use analgesics regularly, mostly for headaches and other pains (2).

Analgesics are primarily classified into narcotic analgesics, which include agents that are chemically based on the morphine molecule; non-steroidal anti-inflammatory drugs (NSAIDS) including salicylates, and acetaminophen (1).

Pain and aches are of various grades and intensity such as very severe, severe, moderate, and slight or no pain at all (1).

Although pain syndromes may be different, the common factor is a sensory pathway from the affected organ to the brain. Analgesics carry out their functions at the level of the nerves either by blocking the signal from the painful part of the body, or by distorting the reading of the signal at the brain level.

The various pain killers have different abilities in suppressing various types of pains. The expectation of pain management is that the patient should not be subjected to the return of the pain.

Individuals involved in daily muscular exerting activities experience fresh aches and pain on a daily basis. This leads to a daily requirement of these pre-packaged analgesics mixture for relief.

Several of these analgesics agents are to be taken with precautions. The narcotic analgesics are contraindicated in patients with respiratory depression. The NSAIDS may be hazardous to patients with peptic ulcer disease or an ulcer history. They are to be taken with care by patients with renal insufficiency (1). NSAIDS are ulcerogenic and may cause kidney problems. People who take analgesic drugs frequently may be at an increased risk of end-stage renal disease (ESRD) (3). Apparently, healthy male adult who take analgesic agent frequently had no significant risk of developing hypertension (4).

In our country, Nigeria, these analgesic drugs are readily available over the counter and there is no legislation regulating their sale and consumption. Agaba, et al. (2004) reported analgesic abuse in Jos, Nigeria which commonly involved paracetamol, analgesic mixtures and NSAIDS (5). They suggested then, that there should be legislation for the sale and consumption of these drugs.

The NSAIDS produce gastro-intestinal upsets such as gastric irritation and haematemesis and other types of bleeding. They can also cause gastric and duodenal ulcers.

In our survey, results show that 26.92% of the customers developed abdominal pain after taking the analgesic mixture. This was probably due to the ulcerogenic activity of the NSAIDS in the drug combinations. Another group passed frank blood per rectum, which signifies heavy upper gastro-intestinal bleeding. While another group passed black stool. These are known complication of NSAIDS drugs.

These complications were treated in various ways by the shop owners. Some of the patients were given antacids, while some were asked to stop taking the drug for a while or to stop doing hard jobs. Others were given antibiotics such as tetracycline, flagyl and lomotil agent for those who developed diarrhea.

Despite the reported complications, 79.17% claimed that their aches and plain usually go away on taking the “Ogwu Oseso”. Another 28.83% reported only a temporary relief which may necessitate intake of a more potent mixture.

The general public has a lot of trust on these mixtures since 94.44% of the customers in the survey went back at other times to purchase another pack of the “Ogwu Oseso”.

Majority of the customers who take “Ogwu Oseso” are individuals who are involved in daily hard labour, hence men take more than women, study indicates (Table 1). Most of the customers are peasant farmers who use crude implements (cutlasses, hoes) and daily paid labourers who are hired for any type of manual jobs. As expected, they usually return home late with aches and pains all over their bodies and “Ogwu Oseso” usually come to their rescue from such pains.

In more developed regions with better awareness, many patients use some form of alternative medicine to get relief from aches and pains, from back pain, and other muscular skeletal pain. The common methods used by these patients were message therapy, acupuncture, chiropractice and herbal therapy, thereby avoiding the ingestion of drugs (6).

Healing and the relieving of aches and pains is a personal and subjective experience involving the meaning the individual ascribes to distressing events (7).

The NSAID drug brufen occurred most frequently in the different mixtures (Table 2). This probably explains the reason of the complication reported by the customers, with all of them being related to gastro-intestinal upsets seen in adverse effects of NSAID. Consider for example, the quantity of NSAID in group III mixture – the most commonly purchased and group X (Table 3).

Table 3: The NSAID compositions of group III and X drug packages.

These are large quantities of brufen to be taken at once and then on a regular basis as the need arises.

The survey identified poverty as the major reason why certain population still patronize these pre-packaged analgesic mixtures in spite of the associated side effects and health risks. The populace needs to be more empowered for a better financial position, and widespread health education should be initiated. Also health institutions should develop faster way(s) to respond to the needs of population. Government policy should set a target to realize the “health for all” jingo.

References

1. Schild, H.O. (1983). Analgesic drugs. In: Applied Pharmacology. 12th Edition. The English Language Book Society and Church Livingstone. Pp 278-294.
2. bbott, F.V., and Fraser, M.I. (1998). Use and abuse of over-the counter analgesic agents. Journal of Psychiatry and Neuroscience. 23(1):13-34.
3. Perneger, T.V., and Whelton, P.K., and Klag, M.J. (1994). Risk of Kidney failure associated with the use of acethminophen, aspirin, and nonsteriodal anti-inflammatory drugs. New England Journal of Medicine. 331 (25):1675-9.
4. Kurth, T., Hennekens, C.H., Sturmer, T., Sesso, H.D., Glynn, R.J., Buring, J.E., and Geziano, J.M. (2005). Analgesic use and risk of subsequent hypertension in apparently healthy men. Achieves of Internal Medicine. 165(16):1903-1909.
5. Agaba, E.I., Agaba, P.A., and Wigwe, C.M. (2004). Use and abuse of analgesics in Nigeria: a community survey. Nigerian Journal of Medicine 13(4):379-382.
6. Drivdahl, C.E., and Miser, W.F. (1998). The use of alternative health care by a family practice populations. Journal of the American Board of Family Practice. 11(3): 193-199.
7. Egnew, T.R. (2005). The meaning of healing: transcending suffering. Annals of Family Medicine; 3(3):255-262.