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Your Health Blog

    The Well-Stocked Medicine Cabinet

    Dr. Jung Smith, Family Medicine, Deaconess Clinic  01/09/2015

    It’s 2:30 a.m.  You (or your child) has a fever and stomach upset.  You go to the medicine cabinet, and the only thing you can find is some muscle rub and itch cream.  Going to the store in the middle of the night is the last thing you want to do!

    I think it’s wise to have a stash of basic medications for everyone in the family, so I want to share information about various over-the-counter medications, to help you decide what you should have in YOUR well-stocked medicine cabinet.

    For fever, headaches and pain

    • Aspirin:  This is a long-time favorite among fever reducers and painkillers.  However, it has a couple of side effects that should be noted.  Aspirin can cause stomach irritation, and it also interferes with blood clotting.  That means individuals who are already on blood thinners, or anyone about to have surgery should not take it. Anyone under the age of 18 should also not take it, as aspirin is linked to Reye’s syndrome, a rare condition that causes swelling of the brain and liver.
    • Ibuprofen or naproxen sodium:  Ibuprofen (often known as Advil and Motrin) and naproxen sodium (Aleve and Naprosyn) are effective pain killers; however, like aspirin, they can irritate the stomach.  They also have the added benefit of being anti-inflammatory, so they can help with swelling and inflammation.
    • Acetaminophen:  This may be a better choice for anyone wanting to avoid the stomach upset of the other medications.  However, anyone taking acetaminophen pills (like Tylenol) must avoid other products that also contain the drug, as overdoses can harm the liver.  (Combination cold/cough remedies are an example.)
    • Note:  There is no need to buy both the regular and extra-strength versions of these medications.  Anyone who needs a larger dose can simply take an extra pill.  Also, all of these painkillers can cause problems if mixed with alcohol.  Anyone who has two or more drinks per day should talk with a doctor about painkiller usage.



    For digestive problems

    • For heartburn:  Chewable tablets (Rolaids and Tums) can help relieve heartburn, which is the result of stomach acid backing up and irritating the esophagus.  They work by temporarily neutralizing the acid.  These medications also provide calcium.  Maalox or Mylanta (liquid aluminum hydroxide and magnesium hydroxide) provide longer-lasting relief.  Finally, having an acid reducer on hand, such as Tagamet, Prilosec, Pepcid or Prevacid, can be helpful in dealing with—or even preventing—a heartburn issue related to a fantastic pizza or enchilada.
    • For upset stomach:  Many people swear by Pepto Bismol (liquid, chewable or tablet) for helping with stomach ailments.   There is no harm in a couple of appropriate doses.  Also, for nausea, medication designed for motion sickness (such as Dramamine) can be helpful.
    • Constipation/diarrhea:  Overall, be wary of treatments for these issues.  While there are lots of constipation remedies out there, I and many other doctors discourage their frequent use.  The body can actually become dependent on them for regular bowel movements.  (Occasional use of fiber-based products like Metamucil are less likely to be habit-forming.)  Chronic constipation should be evaluated by a doctor, as it can be caused by a diet deficient in fiber, or a more serious health problem.  Occasional attacks of diarrhea can be treated with medications like Imodium or Kaopectate; however, letting the illness run its course may help your body get rid of the problem (food poisoning or virus) faster.  Keeping hydrated with clear liquids is key in this instance.  I recommend that parents keep Pedialyte on hand for small children suffering from vomiting or diarrhea.



    For colds and coughs

    • Decongestants:  When your nose is stuffy and runny, pseudoephedrine (Sudafed) and phenylephrine can be really helpful.
    • Cough medicine:  If you have a wet, “productive” cough, use a medication with guaifenesin, an expectorant, to help loosen the mucus so you can cough it up.  (Robitussin PE and Mucinex are examples).  For a dry, hacking cough, look for the cough suppressant dextromethorphan.
    • Combination medications:  There are number of “cold and cough,” “cold and flu,” etc. types of medications out there.  If taken exactly as directed, and not mixed with additional medications (like extra acetaminophen), they can be helpful in allowing you to sleep (night time formula) or function during the day (day formula).
    • Vicks VapoRub:  I know that for generations, people have used and trusted Vicks VapoRub.  It can be a helpful, effective treatment, but should only be used as directed.  Putting it under/in the nose, or on children younger than 2, is not recommended.  However, Vicks does offer a product called Vicks BabyRub, which can be used for infants 3 months and older, to help them breathe more comfortably.



    For allergies

    • Antihistamines:  Diphenhydramine (in Benadryl) and some other medications can relieve sneezing, runny nose and itchiness, but can cause sleepiness.  Others, such as loratadine (in Claritin) can have similar effects but are less/non-sedating.



    For rashes, bug bites & other skin problems

    • Calamine lotion:  It may seem old fashioned, but this pink liquid sooths itching from rashes and bites.  It’s also a great treatment for weepy rashes, like poison ivy.
    • Benadryl gel:  I personally like this gel for relieving itches.  Because it’s applied to the skin, it relieves the local problem without as many systemic side effects.  Also, as a clear gel, there is no residue.
    • Antihistamine cream/cortisone:  These can relieve intense itching.  The antihistamine cream helps relieve the trigger of the itching (histamine).  Cortisone (often in a 1% cream/ointment), relieves a persistent itch by reducing the inflammation and triggers.
    • Muscle rub:  Anti-inflammatory skin cream can significantly help reduce muscle soreness from exercise or overuse.  Because some of the ingredients are absorbed into your bloodstream through the skin, use these creams as directed.

    Moving on from medications, I want to also recommend some first aid supplies and tools to have on hand for minor illnesses, burns and injuries.

    Tools

    • Thermometer:  Quality digital thermometers (oral or ear canal) are accurate, and a good choice for avoiding glass or mercury from more traditional thermometers.  For babies, rectal thermometers are most accurate.
    • Magnifying glass & tweezers:  For removing splinters, insect stingers or ticks.
    • Humidifier:  Having a humidifier in the room with someone with a stuffy nose can help improve sleep and comfort, while thinning secretions.
    • Heating pad:  Can help ease sore muscles or lower back pain.

    Standardized measuring spoon, dropper or medicine cup:  If the medication you’re taking doesn’t come with its own calibrated dosing tool, make sure you have one on hand.


    First aid

    • Bandages:  A box of adhesive strips—particularly in assorted sizes—is always a good idea.  Large gauze pads (which can be cut down as needed) and some bandage medical tape can adequately dress most burns, cuts or scrapes.  Also, butterfly bandages can help pull together the edges of a cut, helping it heal with less scarring.
    • Antiseptic cleanser:  For rinsing out cuts and scrapes.  Many have an anesthetic to help reduce pain and stinging.  Note:  Hydrogen peroxide is no longer recommended, as it can damage healthy tissue as well as kill germs.
    • Antibiotic ointment:  Helps protect and moisten minor cuts and burns.



    Storage tips and other suggestions
    Now that I’ve given you a list of suggestions for your medicine cabinet, I want to address how you store these medications and supplies.

    The term “medicine cabinet” often makes people think of the mirrored cabinet over the sink in a bathroom.  However, this is not a great place to store medications.  Medicines and first aid supplies should be stored in a cool, dry, dark place.  So consider a designated clear storage tub that you keep in a hall closet or in the pantry.  (High up—out of the reach of children—is another benefit of this location.)

    If you’re really wanting to feel organized, preparing a small kit for your purse, workbag, diaper bag and suitcases can help you feel prepared no matter where you are.  Remember, though, to keep medications away from children.

    Finally, make an effort a couple of times a year to go through your medicines and discard and replace any expired medications.  A good tip would be to do this when the time changes—similar to when you change the batteries in smoke detectors.  Expired medication is less effective and can even be toxic.
    I hope these suggestions and tips have given you helpful ideas on how to feel more prepared for whatever ailment may come your way.

    Dr. Jung Smith practices family medicine at Deaconess Clinic Mary Street.  She is currently accepting new patients of all ages.  Visit her web page for more information, or to request an appointment.
     

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