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Managing Your Medicine Cabinet

Chances are you don't think about your medicine cabinet until you have a cold or a nasty cut.

Keeping a well-stocked medicine cabinet isn't difficult and doesn't take much time. You'll first want the essentials for first aid and symptom relief, rounded out with a few items that meet the special needs of you and other adults in your family.

Keep in mind that even a well-stocked medicine cabinet isn't a substitute for professional medical attention. If what you are doing at home isn't making you feel better, be sure to see your health care provider. Do not give any over-the-counter (OTC) medicines to infants or children without first checking with your child's health care provider.

The following recommendations are for adults only.

Pain relief

Two types of OTC pain relievers are available: acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs). Both types effectively reduce pain and fever; NSAIDs also reduce inflammation. OTC NSAIDs include aspirin, ibuprofen, ketoprofen, and naproxen.

NSAIDs reduce pain, inflammation, and fever by decreasing substances called prostaglandins, which are made by your body in response to irritation, injury, or infection. These drugs help relieve pain from conditions such as menstrual cramps, joint and muscle soreness, and headaches.

Aspirin, unlike other NSAIDS, also helps prevent a second heart attack and strokes caused by blood clot formation. Aspirin should not be taken by those under 19 years of age as it may cause Reye syndrome.

Acetaminophen relieves fever and pain by working in the brain centers that control body temperature and sense pain.

In the average healthy adult who uses these pain medications occasionally, side effects from these medicines are uncommon. Taking higher than prescribed doses or taking NSAIDs too frequently can cause upset stomach, bleeding from the stomach, or kidney damage. It can also make high blood pressure worse. Acetaminophen can cause liver damage if taken in doses larger than prescribed, so care should be taken not to exceed the maximum allowable dose. Acetaminophen should not be taken if you drink alcohol, because this increases the risk of liver damage. 

Many products, such as OTC cold remedies, also contain combinations of acetaminophen or NSAIDs. If you take an NSAID for 1 symptom and also take a cold medicine that contains the same NSAID, you may be getting too high a dose. Read OTC drug labels so you know the active ingredients and their doses in all the OTC medicines you are taking.

Cough/cold remedies

Cough medicines called cough suppressants help suppress nagging coughs. Cough medicines with expectorants help loosen mucus so that it can be cleared from airways. Coughs from smoking and certain chronic diseases such as emphysema, asthma, or chronic bronchitis should not be treated with cough medicines.

Decongestants can make breathing easier by shrinking swollen nasal passages. They work by reducing the amount of blood flow through the area to reduce congestion in swollen tissue inside the nose and allow air to pass through more easily. They may be taken along with other medicines, such as aspirin, to relieve cold symptoms. Both pseudoephedrine and phenylephrine are available OTC, but you must ask the pharmacist and sign a registry for medicines containing pseudoephedrine. Decongestants can interact with many other medicines you take, so talk with your doctor before starting any OTC decongestants. Do not use decongestant nose sprays and drops for more than 3 days because your body can become dependent on them and make you feel even more stopped-up when you do stop using them.

Antihistamines

These medicines block histamine, the substance that tries to attach to the cells in your body and irritate them when you have allergies. Antihistamines can be used for allergies, hives, insect bites, bee stings, and as a sleeping aid. Antihistamines are often combined with decongestants and pain relievers. Be sure you know what ingredients are in each OTC medication you are taking. Most antihistamines cause drowsiness and you should not drive or drink alcohol if you take an antihistamine. 

Corticosteroids

OTC corticosteroids, like hydrocortisone, can relieve itching and swelling. They are available as a topical medication in some ointments or creams. Inhaled or oral forms of cortisone require a prescription. Topical corticosteroids may be used to treat eczema, atopic dermatitis, insect stings, and bites. They are also used to treat rashes caused by stinging nettle, poison ivy and oak, psoriasis, and neurodermatitis.

Antifungal medications

Antifungals treat athlete's foot, jock itch, and ringworm. They are available as ointments, creams, powders, or solutions. Fungal infections of the fingernail and toenail must be treated with prescription antifungal agents. OTC laquers and lotions are not proven to work for nail fungus. 

Antacids

Antacids may relieve heartburn, acid reflux, or a sour stomach. Three classes of antacids are available:

  • Antacids. These commonly contain calcium, aluminum or magnesium, or a combination of the 2. These drugs neutralize acid in the stomach and provide immediate but short-lasting relief from heartburn.

  • Histamine 2 blockers. These receptor antagonists like cimetidine, famotidine, nizatidine, or ranitidine reduce the production of stomach acid.

  • Proton pump inhibitors, like omeprazole. This class of antacids blocks the production of stomach acid. These drugs need from 1 to 4 days to completely shut off acid production.

Antacids may mask the symptoms of serious disease such as ulcers, stomach cancer, and cancer of the esophagus. If you don't have relief of symptoms after two weeks of use, you should talk to your health care provider.

Diarrhea medications

Anti-diarrheal remedies include loperamide, bismuth substlicylate, and attapugite. Loperamide and bismuth subsalicylate help slow down bowel activity. Attapulgite may help to absorb extra water and fluids in the bowel. Most diarrhea does not need to be treated with medication and usually gets better without treatment, other than replacing lost fluids. You should not take bismuth subsalicylate if you are allergic to aspirin or other salicylates, or you are under 19 years old (see comments above for aspirin).

Wound care

To promote healing, you should cleanse, treat, and protect wounds:

  • Wash the cut area well with soap and water, but do not scrub the wound. Remove any dirt particles from the area and let the water from the faucet run over it for several minutes. A dirty cut or scrape that is not thoroughly cleaned can cause infection and scarring.

  • Apply an antiseptic lotion or cream, such as povidone ointment 10%. Caution when using an ointment since it can be difficult to remove causing more trauma to the wound.

  • Cover the area with an adhesive bandage or gauze pad if the area is on the hands or feet, or if it is likely to drain onto clothing. Change the dressing often.

Don't forget these

Other items essential for your medicine cabinet are:

  • Adhesive bandages

  • Adhesive tape

  • Gauze pads

  • Tweezers

  • Thermometer

  • Calibrated measuring spoon

  • Alcohol wipes

  • Disinfectant, such as rubbing alcohol or hydrogen peroxide 

Safety first

The FDA says to be sure to go through your medicine and first-aid supplies once a year to discard items that are outdated or damaged. Replenish supplies that are missing or low. Also, to avoid accidental poisoning or overdoses, never store medicines in anything other than their original containers.

To safely get rid of old or unwanted medicines, the FDA suggests either mixing them with coffee grounds or another substance that's unappetizing, and sealing them in a container. That container can then be put in the trash. Some communities also offer drug take-back programs to help with disposal. 

Some medicines should be flushed down the sink or toilet to eliminate any chance that they might be taken by someone. For more information on which medicines to flush, visit the FDA website.