Expanding the medications you stock in a stationery location or home base

By Jane-Alexandra Krehbiel BS ES RN

One of the questions I receive a great deal lately, is once a family establishes the emergency kit I have described here, what should be stocked and supplied next to refill or expand it. Most families benefit immensely from the first aid kit stocked as I have listed in a prior article, but many wish to expand it further.

Many people wonder if it is worth stocking medications that are over the counter (OTC) rather than prescription, because they think that nothing terribly effective is OTC. This is actually not true. Many of the drugs which are OTC now were prescription just a few years ago. Also many of the drugs we use in hospitals, or in the military are in fact, OTC medications. Assuming that you already have the first aid kit I outlined in the prior article, these are some ideas for expansion. Remember that these need to be behind lock and key for many reasons. Number one, you need to keep them from toddlers and young children, and number two, you need to keep them from visitors to your house, babysitters, relatives, people touring your house when it is up for sale, etc. I have had friends whose medications have been opened and used or even stolen by everyone from realtors, to cleaning ladies and even prospective home buyers.

WHENEVER POSSIBLE, PURCHASE THE TYPE NEEDED FOR EACH AGE GROUP IN YOUR FAMILY. For example, Adult dose Tylenol is not appropriate for a six year old, or an infant, so you would need, chewable tylenol for a six year old, and tylenol drops for an infant as well as the type you would use for your spouse.

In addition, try to purchase generic OTCs whenever possible. Generally, they are identical to name brands and save a great deal of money allowing you to stock a broader range of medications overall. The only time I would not use a generic is for certain prescription cardiac drugs, certain anti-seizure medications, and for thyroid hormone replacement, as the bio-availability of different generic brands of thyroid may shift brand to brand. In our home we use almost exclusively generic OTCs with the expiration date as far in the future as possible. Although it is not my intention to become a walking advertisement for Wal-Mart here, for many people, a Wal-Mart pharmacy may be their best source of OTC meds with expiration dates which are as far off in the future as possible. This is simply due to the volume of OTC meds, they, in fact, move.

With any and all drugs, one should use caution when driving or operating machinery as one cannot always predict ones reaction to any specific drug.

A listing of these drugs, and a supply of them does not free you to administer any and all of them to all family members of all ages. Having these meds in stock and available means that when you contact a licensed physician or nurse practitioner by phone, they have alternatives to provide to your family members, and so do you. This listing is not a substitute for competent physician care following your consultation with them. This is simply a primer so that you may ask the best questions and make intelligent suggestions when speaking with your medical provider. This is especially true when managing the episodic illnesses of children, pregnant or nursing women, patients over 70, or patients of any age with a chronic medical problem or patients with with dementia of any cause. Please contact your physicians prior to use and for appropriate follow up afterward.

Analgesics and Antipyretics:

These drugs reduce fever, and decrease pain, and some reduce inflammation .

Acetaminophen (also known as Tylenol in the US)

Ibuprofen (also known as Motrin IB in the US)

Use with caution in children. Make sure the child is hydrated before administering if possible. I don’t generally give ibuprofen to children unless physician ordered. It can cause gastrointestinal discomfort also.

ASA (Acetylsalicylic acid also known as aspirin)

Stock both enteric coated varieties and plain. Enteric aspirin dissolves farther down the gastrointestinal tract and so it is preferable for many people whose stomach is upset by ordinary, more rapidly absorbed aspirin preparations. Do not use aspirin in patients under 18 unless specifically ordered by a physician, as aspirin and other salicylate medications are implicated and somehow involved in the development of something called Reye’s Syndrome, a potentially fatal disorder which can afflict children and teens, usually during or immediately following a viral syndrome.

Do not exceed ordinary package dosage amounts without a specific phone order from a physician to do so. I have a friend who makes a fine living as a nephrologist because people have disregarded the normal package directions for ibuprofen, and ultimately destroyed their kidney function.

Antihistamines:

Diphenhydramine (Benadryl)

Stock in liquid form for children and the elderly and capsule AND tablet form for adult

Diphenhydramine is one of the best antihistamines for hives, mild to moderate allergic reactions of eyes, skin, etc. This is a key ingredient in a home medical kit. Have plenty of it.

It can be useful in diminishing some allergic reactions, diminishing itching from parasites, (tick and chigger bites) or other skin issues,and it can induce sleep in most people. (There are people, especially children with ADHD who have a paradoxical effect, and actually become more alert on it, but as a parent, you probably know for which of your children this may be true)

Loratadine (Claritin, Alavert)

Stock small tablets for adults, and dissolving tablets for children and the elderly.

This is an antihistamine which does not cross the blood brain barrier and therefore is said not to make people drowsy. It is useful for treating eye, nasal and mild respiratory allergies, and even during colds especially when you must drive or operate equipment afterward. Although it does not cross the blood brain barrier, I do notice that my reflexes are just tenths of a second slower while taking it, so be advised.

Cetrizine (Zyrtec)

Stock tablets and liquid for children and the elderly.

This is an additional antihistamine which crosses the blood brain barrier only slightly, and may produce slight drowsiness in some. It is valuable because it may be more effective for some than Loratadine.

It is being marketed as a drug for both “indoor and outdoor allergies” It adds something else to your arsenal. There is ongoing research on this drug being used for other purposes.

DON’T USE THIS DRUG IF YOU ARE ALLERGIC TO HYDROXYZINE, as there is cross allergy information. Hydroxyzine is also known as prescription drugs Vistaril or Atarax.

If you have known or documented anaphylactic reactions in members your family, or sticking insect allergy, then you need to develop a relationship with a physician who will provide you with prescriptions for Epipens, and who will renew these when they expire. Although they can be used past expiration, this is the one drug in the emergency kit that I am a stickler about having available unexpired. If your supply has turned brown, then do not use.

Others:

Melatonin

Available since 1994 OTC in our country, this is one of the reasons to be glad to be an American.

This drug is prohibited in Germany, and is prescription in many countries. Here in the US, it is considered a dietary supplement. I first began using Melatonin to avoid jet lag, to help to induce sleep following a long flight, when I would otherwise have been up all night due to a time difference. Since 1994, physicians have found that it can be helpful in inducing sleep in autistic children and those with ADHD as well as children without known medical issues. Normally, we secrete melatonin in darkness from our own pineal glands in the brain, but a tablet form is said to give us a small jump start. Certainly, you should ask your physician in advance before using especially if you plan to administer to a child. The starting dose for a child can be 0.3 mg. The starting dose for an adult can be 5 mg.

There are ongoing studies which study the effectiveness of this drug for those with Seasonal Affective Disorder and also for Bipolar Disorder.

Mucinex (Also known as Glyceryl Guaiacolate or formerly Guaifenesin)

Available in many different brands of generics.

This is a drug, originally of American Indian origin, which reduces the thickness or viscocity of mucus secretions. It is of obvious aid in respiratory infections where phlegm can be a barrier to a more rapid recovery, and is used occasionally in asthma, gout, fibromyalgia, and some arthritises. It has also been used recently to facilitate conception. This remarkable drug should be in everyones home kit.

It is available in liquid form, which you should have if you have children at home, and tablet form for adults. It should be used in caution for those for whom it makes drowsy, those who are at full term pregnancy (because it can disrupt a mucus plug), and for those with blood clotting disorders. I have also noticed that it can cause mucusy diarrhea for those who are predisposed or who have Crohn’s disease or other variants. It is essential to drink generous amounts of water with this drug.

Dextromethorphan Polystirex (Widely marketed as Delsym)

This drug is available in both liquid and gelcap form. Stock liquid for children and capsule for adults.

This is a good antitussive or anti-cough medication. Some patients do report euphoria with this drug, and so if this is your experience, you may wish to use something else. It should be used with caution in children as it may produce allergic reactions.

Meclizine

This drug is an antihistamine which is used most often as an anti-emetic. (Anti-nausea and anti-vomiting drug) It is especially effective for motion sickness, but is occasionally recommended as a drug for the nausea and vomiting of pregnancy when adjustments in prenatal vitamins and diet have not been successful. It should probably not be used in those who experience confusion from any cause,

Amassing these particular supplies and using them cautiously and appropriately will make a big difference in terms of your medical preparedness in emergencies.

Please also see my article: Hydration and Rehydration Solutions as medication is only one step to managing episodic illness.

Other references:

Melatonin

Mucinex

Dextromethorphan

Meclizine