Thursday, January 26, 2006
These meds good to have on hand, in case of sudden illness

By Anthony Policastro
Nanticoke Memorial Hospital,
Medical director

About seven years ago I wrote an article on stocking your medicine cabinet with over-the-counter medications. There have been some changes to this group of medications since that time. I decided to provide an update. Minor illnesses are common. They also come suddenly. They frequently occur when the pharmacy is closed. Therefore, it is a good idea to have medication handy for these minor things. Last month, I provided a list of equipment for roadside emergencies. I would like to provide some over-the-counter remedies you could use for minor illnesses. One of the best medications to have is acetaminophen. The commonest brand name is Tylenol. There are other manufacturers as well. The adult sizes are regular and extra-strength. Two extra-strength tablets contain the same amount of acetaminophen as three regular tablets. Childhood doses come in tablets, liquid and drops. Acetaminophen has many uses. These include fever and pain from acute illnesses, pain from trauma, pain from insect stings and other causes of pain. Because it is used so commonly, people do not have a lot of respect for it. They look at it as something that only relieves minor pain. However, it can provide more relief than you would expect. Acetaminophen is the only medication I use for my migraine headaches. It works well. It also is relatively safe. Aspirin can cause problems with blood clotting. That is why we use it in small doses for people at risk of heart attack. It also causes stomach upset in some people. It has been associated with Reye's syndrome in children with influenza or chickenpox. For these reasons, aspirin is not used much anymore. Acetaminophen is much safer. A second useful medication is Ibuprofen. It also relieves pain and fever. It comes in adult and childhood preparations as well. Its advantage over acetaminophen is that it also relieves inflammation. If you have pain that has lasted for awhile, there could be some inflammation. If you have tendonitis from overusing a muscle, inflammation is present. Ibuprofen can soothe the pain and help the inflammation. For simple pain and fever I like acetaminophen better because it has fewer side effects. Another versatile drug is diphenhydramine. The brand name is Benadryl. It can relieve itching. Therefore, you can use it for bug bites. It is used for chickenpox. People with hives take it. It can help allergic symptoms of any sort. For a minor acute allergic reaction, it is the drug of choice. It is useful for preventing mild vomiting. I frequently use it to prevent car sickness in children. It is sedating. Therefore, it is helpful in people who can not sleep because of allergies. Because of this sedation, do not drive after using it. Caution must also be exercised in older individuals. It can cause urine retention in the bladder of these individuals. A newer over-the-counter antihistamine is loratidine. The brand name is Claritin. It does not cause the same sedation as diphenhydramine. However, it does not have the multiple uses that Benadryl does. If you have allergic symptoms and do not want the sleepiness of diphenhydramine, loratidine is a good substitute.

The last time I wrote about over-the-counter medications, I suggested pseudoephedrine (Sudafed) for the common cold. Because of side effects, it is no longer recommended routinely. The best substitute at this time is to use a nasal spray. The generic name is oxymetazolone. The brand name is Afrin spray. It works very well. The usual way to use it is in a two-step approach. You use one spray in each nostril. You wait 10 minutes for that to clear the lower passageway. Then you use a second spray in each nostril. It is only used twice a day. It is only used for three days (6 doses). Longer use than that can have your nasal lining become dependent upon it just to breathe normally. The condition has a great medical name. It is called rhinitis medicomentosa. Chloraseptic mouthwash is useful for pain in the mouth. I like it for strep throat. It can also be used for canker sores or for other causes of mouth pain. It usually numbs the taste buds too. Therefore, wait about 10 minutes after using it before eating something. Otherwise, your food will have no taste. There are a variety of preparations available for acid indigestion or heartburn. Tums with calcium, Maalox, Mylanta, or Gaviscon are examples. They all work quickly and have few side effects. The newer heartburn preparations have more side effects. Continued symptoms of this type can suggest a more serious condition. Therefore, they should only be used when symptoms are occasional. I did not include medications for cough. Coughing serves a useful purpose. It gets infected fluids out. There may be times when a cough medication is indicated. That is not usually on the first night of coughing. You can wait until the pharmacy opens. I also did not include remedies for vomiting and diarrhea. The best treatment for those is using small amounts of fluids. They both are an attempt by the body to get rid of infected fluids. You can prolong the symptoms with too many medications. In addition, the side effects of vomiting and diarrhea medications are higher than with other medications. I do offer a caution about these or any other medication. They all have side effects. If you have another medical condition, check with your doctor before using them. If you are on another medication, be careful about adding a second one. Many medications cause no problem when used alone. However, when you use them in combination, they can create side effects. These medications are those that you might need for relief at night when the pharmacy is closed. There are other over the counter medications. They are not usually for acute problems. You can wait until you contact your physician for advice about them.