Notes from a Doctor's Practice

I am often called in the middle of the night by patients who have woken up with hives, a high fever or itching and don't have access to common remedies all of us should have in our medicine cabinet. Let's talk about what you need and why to save you the 1 AM trip to the pharmacy.

1) Pain relievers and fever reducers: The two you need are acetaminophen (Tylenol) and any NSAID (non steroidal anti-inflammatory drug) which includes ibuprofen, Advil, Motrin, or Aleve. For pain or fever you can alternate Tylenol with an NSAID every 4-6 hours because they are two very different medications that can work for you in tandem. An IMPORTANT thing to remember is that while Tylenol is a pain reliever and fever reducer it is NOT an anti-inflammatory so for certain types of pain (tooth pain, acute back pain) an NSAID may be more effective.

2) Antibiotic ointment: For cuts and scrapes you should have Polysporin or Neosporin (both similar topical antibacterials) in your medicine cabinet. I'm not a huge fan of cleaning simple wounds with alcohol or hydrogen peroxide. You can wash it with warm water and soap and apply one of the above topical ointments twice a day for a couple of days with a loose band aid.

3) Antacids for heartburn, upset stomach and bloating: Maalox and Mylanta (equivalent ingredients for the most part) are good for quick relief. The H₂ blockers like Zantac, Pepcid and Tagamet are also a must have as you can take those along with Mylanta or Maalox. Think of the Maalox as soothing and coating the stomach and the H₂ blockers following their lead and decreasing the effects of acid on the stomach and esophagus.

4) Allergies: Take advantage of the fact that these are now over the counter. The nonsedating antihistamines (Claritin, Zyrtec) with or without the Sudafed (the "D" part tagged on to the end of the name) should not make you tired and can work for most allergy symptoms.

5) Benadryl: I put this on its own because I think it's so important. Everyone should have Benadryl 25 mg tablets in their medicine cabinet. Benadryl will work for hives and itching from pretty much anything (poison ivy, animal allergies, medication allergies, food allergies). Benadryl's main side effect of making you sleepy is also why you can use it for occasional insomnia. Remember Tylenol PM is just Tylenol with Benadryl.

6) Cold and cough: Let's face it the over the counter cough medicines don't work great if at all. What will help some of the cold symptoms (stuffy nose, ear congestion, and sinus pain) is a decongestant like Sudafed. For a PRODUCTIVE cough where you are bringing up junk an expectorant like Mucinex (Guaifenesin) can work well to help you bring up that junk from your tight chest.

7) Hydrocortisone cream: Again I put this solo because of importance. A 1% topical hydrocortisone cream is essential for relieving itching and inflammation from many skin lesions. You will see many variations of this cream at a pharmacy with different names, with or without aloe, etc. You just need the 1% hydrocortisone cream. Use it to help you with any skin issue that ITCHES: bug bites, poison ivy or any contact dermatitis (an allergic skin reaction from something that touched you).

8) Diarrhea: Immodium (Loperamide) is your best over the counter option. Period.

9) Nausea: There are many anti-emetics that require a prescription but Dramamine over the counter tablets will work well. As you know you can also use them for prevention of motion sickness so they are good to have on hand.

10) Let's call this one "special needs": The MUST HAVE for those of you who are sexually active is CONDOMS. Please people for sexually transmitted disease and pregnancy prevention these are still our BEST option.

Dr O.