Introduction
Iraqi J Pharm Sci, Vol.21(2) 2012 Misuse of appetite-stimulant drugs in Babylon
31
Misuse of appetite- stimulant drugs in Babylon
#
Shafaq K. Saleh*
,1
*Babylon University , College of Pharmacy, Babel, Iraq
Abstract
Drug misuse is defined as using of drugs for a non-therapeutic or non-medical purpose. In
Iraq drug misuse is a major problem because almost any drug can be easily obtained from pharmacies.
Appetite- stimulant drugs are example of drugs that are widely used without a prescription. The study
included 230 patients who use these drugs in Babylon. A questionnaire included the following
questions ; age, sex, marital state, the reason for use the drug , whether the drug is prescribed by
physician or not , type of drug used , the frequency of daily dose and lastly the extent of side effects of
the drugs used. The results showed that the age range of 35% of subjects were (17-21) years old and
70% of participants were females. The study also showed that 62% of them are unmarried and the
reason for use, in 48% of subjects, was to increase the body weight. Furthermore, this study revealed
that about 68% of those subjects utilized these drugs without prescription and the steroids are the most
drug type used (33%). Additionally, 44% of subjects used these drugs twice daily and 80% of subjects
who used steroids developed marked side effects. It can be concluded that there is a misuse of appetite-
stimulant drugs in subjects participated in this study and most of these drugs are not used on
therapeutic or scientific bases.
Key words : Misuse of drug , appetite-stimulant, dexamethasone.
سىء استعمال األدوية انمحفزة نهشهية في محافظة بابم
*شفق كاظم صانح
،1
. ، ثبثو ، اىؼشاق جبٍؼخ ثبثو ،مييخ اىصيذىخ *
الخالصة
األدويخغيش اىؼيَيخ . في اىؼشاق يشبع سىء اسزؼَبه وسىء اسزؼَبه اىذواء هى اسزؼَبه اىذواء ىألغشاض غيش اىطجيخ
واىزي رصشف ثذوُ وصفخ اىَحفضح ىيشهيخ األدويخوٍثبه رىل فهب ٍِ اىصيذىيبد ثسهىىخ وثذوُ وصفخ طجيخوثئٍنبُ اىنثيشيِ صش
جَؼىا ثصىسح ٍززبثؼخ وثطشيقخ االسزجيبُ ٍَِ اسزؼَيىا هزٓ األدويخ , ٍشاجغ في ٍحبفظخ ثبثو 032. اىذساسخ رضَْذ طجيخ
وجيخ, أسجبة اسزخذاٍهب , وهو هى ٍىصىف ٍِ قجو اىطجيت أو ال و مزىل ُسئيىا اىَزضَِ األسئيخ اىزبىيخ : اىؼَش ،اىجْس، اىحبىخ اىض
% ٍِ هؤالء 33ػِ ّىع اىذواء اىَسزخذً، اىجشػخ اىذوائيخ اىيىٍيخ وأخيشا هو رٌ حذوس آثبس جبّجيخ أو ال. أظهشد اىذساسخ أُ أػَبس
% 84% ٍْهٌ مبّىا غيش ٍزضوجيِ. ومبُ اىسجت ػْذ 20 % ٍْهٌ إّبس . ومزىل أظهشد أ12ُسْخ و 07-71اىَشاجؼيِ رزشاوح ثيِ
% ٍِ اىَشاجؼيِ اىزيِ يسزخذٍىُ هزٓ األدويخ يسزخذٍىّهب ٍِ غيش 24في اسزخذاً هزٓ األدويخ هى ىضيبدح اىىصُ .ثبإلضبفخ إىى إُ
% ٍِ اىَشاجؼيِ 88ئج إُ % ٍِ ثيِ أّىاع هزٓ األدويخ . إضبفخ إىى رىل ثيْذ اىْزب33وصفخ طجيخ واىسزيشويذاد رشنو ّسجخ
% ٍِ اىزيِ اسزخذٍىا اىسزيشويذاد قذ ػبّىا ٍِ اآلثبس اىجبّجيخ ىهزٓ األدويخ. ٍِ هزٓ اىْزبئج 42يسزخذٍىُ هزٓ األدويخ ٍشربُ يىٍيب و
نثيش ٍْهب يَنِ أُ ّسزْزج إُ هْبك سىء اسزؼَبه في األدويخ اىَحفضح ىيشهيخ ضَِ اىَجَىػخ اىَشبسمخ في اىذساسخ في ثبثو واى
رسزخذً ثطشيقخ غيش ػيَيخ أو طجيخ .
ديكساميثازون . االدوية انمحفزة نهشهية ، ، اندواء ستعمالاسىء انكهمهت انمفتاحية:
Introduction
Drug misuse can be simply defined
as using of drugs for a non-therapeutic or non-
medical purpose
(1)
. Drug misuse is a term used
commonly for prescription medications with
clinical efficacy
(2)
. In Iraq drug misuse is a
widely spread problem because almost any
drug can be easily obtained from pharmacies
and drug stores. Appetite-stimulant drugs are
widely used without a prescription or medical
supervision to gain body weight and improve
outlook.Appetite stimulant drug is any drug
which increases the appetite. Several studies
have indicated that there is a strong association
between self-perceived weight status and
weight control behavior
(3,4)
. Paradoxically, in
many developing communities like Iraq,
fullness is culturally associated with beauty,
prosperity, health and prestige, while slimming
is perceived to be a sign of ill health or
poverty, so utilizing these drugs to increase
body weight in order to improve the shape of
subject
(5-7)
. Cyproheptadine hydrochloride is
an antihistaminic /anticholinergic and
antiserotonergic agent
(8)
. In Iraq
cyproheptadine is available in two
pharmaceutical dosage forms; tablets and
syrup and widely used as an appetite stimulant.
# Based on oral presentation in the eighth scientific conference of the College of Pharmacy /University
of Baghdad held in 23-24 February 2011
1
Corresponding author E- mail : shafaqpharm@yahoo.com
Received : 19/12/2011
Accepted : 26/5/2012
http://en.wikipedia.org/wiki/Prescription_medication
http://en.wikipedia.org/wiki/Anticholinergic
http://en.wikipedia.org/wiki/Antiserotonergic
Iraqi J Pharm Sci, Vol.21(2) 2012 Misuse of appetite-stimulant drugs in Babylon
32
Dexamethasone is an anti-
inflammatory and immunosuppressant. One of
its side effects is increased appetite leading to
significant weight gain and therefore misused
for this purpose
(9)
. In Iraq dexamethasone is
available in different pharmaceutical dosage
forms like tablet, syrup and injection.
Betamethasone is another glucocorticoid
steroids with anti-inflammatory and
immunosuppressive properties
(10)
. In Iraq
betamethasone is available in different
pharmaceutical dosage forms as tablet and
injection. Tonics include mainly vitamins and
minerals , are available in different
pharmaceutical dosage forms like tablet, syrup
and injection .
This study was conducted to verify
the misuse of appetite-stimulant drugs by
people attending private pharmacies in
Babylon.
Subjects and Method
The descriptive cross section study
was conducted from March 2010 to July 2011
on a consecutive sample of 230 subjects, in
Babylon. The subjects were collected from
patients attending three private pharmacies in
different locations to buy different types of
appetite-stimulant drugs.A questionnaire was
constructed and included the following
questions: age, sex, marital state, reason for
using the drug , whether it is prescribed by
physician or used with out prescription , type
of drug used, frequently daily dose used, and
extent of side effects in the subjects of study.
Results and Discussion
Variation of age
The results showed that 18 subjects
(8%) using appetite-stimulant drugs were
under 12 years old , 56 subjects (24%) were
between 12-16 years old, 80 subjects (35%)
were between 17-21 years old, 60 subjects
(26%) were between 22-45 years old and 16
subjects (7%) were more than 45 years old
(Figure 1). These numbers indicated that
appetite-stimulant drugs are used mostly by
teenagers and young adults .
Variation of sex
The results indicated that 69 of the
subjects (30%) used appetite-stimulant drugs
were males and 161 (70%) were females at a
ratio 1:2.3 as females always tend to improve
their look as concluded from the answers of
participants during interviewing .
Marital state
The study revealed that 143 (62%)
of subjects who used appetite-stimulant drugs
were single (unmarried), while 87 (38%) of
them were married. These results indicated that
the unmarried subjects, perhaps most of them,
are trying to increase their body weight to
improve their shape and to look more
attractive & healthy by other people.
The reason for using appetite-stimulant drugs
When the subjects of study were
asked about the reason for using appetite-
stimulant drugs, 110 (48%) of them attributed
the cause to low body weight, while 85
subjects (37%) used it to improve shape and
outlook, and 35 subjects (15%) said that they
used it just for general health (Figure 2). These
results indicated that most of the subjects using
these drugs were either to increase body
weight or for better outlook.The desirability of
a particular body size is not simply an
autonomous, individual choice, but is mediated
by cultural factors. In some countries there is a
desire to lose weight but in other countries
there is a desire for fullness
(11)
.
Drug prescribed by physician or not
The results showed that only 74
subjects (32%) used appetite-stimulant drugs
prescribed by physician or under medical
supervision while 156 subjects (68%) used
these drugs without physician prescription,
these results showed that there is a great
misuse of such drugs and most of them are
used without prescription or supervision by
medical experts.
Type of appetite-stimulant drugs used
Seventy six of the subjects used
steroids (33%) , while 62 subjects used
cyproheptadine (27%), 28 of them used
tonics(vitamins and minerals) (12%), and 46
subjects used combinations of these agents
(28%) (Figure 3), and these results showed that
steroids and cyproheptadine are the most types
used locally because they believe that steroids
are the most effective and fast drugs to
increase body weight (based on the community
experience).
Frequency of daily dose of appetite-stimulant
drugs
Ninety two subjects (40%) used
these drugs once daily, 101 subjects (44%)
used it twice a day, 32 subjects (14%) used it
three times a day while only 5 subjects (2%)
used it more than three times a day (Figure 4).
These results indicated that most of subjects
prefer to use the drugs 1-2 times a day rather
than several times per day as it is more
convenient .
Side effects
According to our findings ,only
10% of the subjects used general tonics
suffered from side effects, mostly gastric
http://en.wikipedia.org/wiki/Glucocorticoid
Iraqi J Pharm Sci, Vol.21(2) 2012 Misuse of appetite-stimulant drugs in Babylon
33
problems (like nausea), 50% of the subjects
used cyproheptadine experienced sleepiness
and headache while 80% of subjects who used
steroids suffered from sever side effects ( like
edema, acne, dry scaly skin and increased
sweating) (Figure 5). Cyproheptadine causes
drowsiness as is common with first-generation
antihistamines. Nausea and vomiting are noted
commonly in people with neuromuscular
disorders. Cyproheptadine can also cause over-
sleeping (10 hours) in children and adolescents
(12)
.
Figure 1: Variation of age
Figure 2: Reason for using appetite-
stimulant drugs
Figure 3: Type of appetite-stimulant drugs
used
Figure 4: Frequency of usage of appetite-
stimulant drugs per day
Figure 5: Drugs and their side effects
Conclusions
The results obtained from this study,
showed that there is a misuse of appetite-
stimulant drugs in the subjects participated in
this study in Babylon which are not used on
therapeutic bases and without physician
supervision. The misuse of appetite-stimulant
drugs is high among young age females and
used by unmarried more than married subjects.
Most of the subjects used these drugs to
increase body weight and improve out look
(not due to diseases) and most of them prefer
to take appetite-stimulant drugs twice a day.
Dexamethasone was widely used appetite-
stimulant drug and the majority of subjects
used steroids had suffered from sever side
effects.
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