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Tuesday, August 4, 2009

What's in my medicine cabinet?


Since I'm a pharmacist I get lots of questions about over the counter drugs to take for various conditions. I actually don't take a lot of medication myself - nothing prescription, and I use over the counter drugs very judiciously. But I still have a large assortment since I like to be prepared for anything!
Here's what is sitting upstairs expiring in my cabinet:
Pain killers:
Ibuprofen. It helps with pain, fever, and inflammation, plus it is the drug of choice for menstrual cramps.
Cough and Cold:
Antihistamine: Cetirazine. It's second generation, so does not cause drowsiness, but it's more potent than loratidine. I also keep diphenhydramine on hand in case of a major allergic reaction, which I get occasionally. It causes big time drowsiness but if I have a rash all over my body I'll take it.
Decongestant: Pseudoephedrine. Purchase in the United States requires your ID and signature thanks to its use in the production of methamphetamines, and in Louisiana it will soon become a controlled substance. However it is vastly superior to phenylephrine, the substitute many companies are using in cough and cold products. Phenylephrine is broken down in the gut so you don't get much of the drug to actually do its job, so purchase pseudoephedrine behind the counter.
Cough: I only buy cough products if I need them. If it's a wet cough buy plain Robitussin to help you cough it all up. If it's a dry cough buy Delsym to suppress it. I don't buy Mucinex although people swear by it - it is a long acting guaifenasin preparation to expel mucous but it can be very drying so I like the shorter acting drugs instead. Then you only use them when you need them.
Sore throat: Sucrets or Cepacol lozenges can numb the throat better than a throat spray, which washing away quickly.
Tummy troubles:
I rarely have GI complaints but here are my recommendations:
Nausea: nothing OTC works.
Diarrhea: loperamide; take it with fiber to soak up the liquid in the intestines.
Gsa: Pepcid complete helps with sour stomach with gas; for gas alone use simethicone by itself.
Acid reflux: If it is just occasional you can use an antacid. Gaviscon is best if you feel a burning in your throat because it floats so enters the esophagus before the reflux does and protects the esophagus.
Other:
Neosporin plus pain relief - kids love this; 1% hydrocortisone cream (again, I get allergic reactions! BTW the best thing to do for a bad reaction such as a large, swollen insect bite is diphenhydramine by mouth and a steroid like hydrocortizone topically - don't waste time applying Benadryl itch stick etc); black drawing salve (Ie ichthamol, to draw out deep splinters); clove oil for toothaches.

Well, that's my cabinet. Notice that I rarely use combination products. I'd rather treat only the specific problem I have, so I never buy cough and cold tablets with several ingredients. You're almost sure to take a drug you don't need. Don't forget to read doses and warnings, too. All drugs are toxic to some extent!

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