What to have in your medicine cabinet?

Senior Matters
By Lesley Fernow

    I am often called by patients experiencing an acute health problem who don’t have access to common remedies which are available over the counter. I will discuss 10 easily available and inexpensive drugs and treatments which are safe when used carefully. While there are some warnings for people as they age, for most people cautious use of these medications for short-term use is safe and effective, and may prevent an unnecessary doctor’s visit.

    Basic guidelines for seniors are: the older you are the smaller the starting dose you should use and the less frequently you should take the medicine. When in doubt about interactions with your prescription medications, speak to your pharmacist or medical practitioner.
    This week we will discuss management of the most common acute problems: pain, fever, cuts, heartburn and colds.
1) Pain relievers and fever reducers: The two you need are acetaminophen (Tylenol) and any NSAID (non steroidal anti-inflammatory drug) which includes aspirin, ibuprofen, Advil, Motrin or Aleve. 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. All NSAIDs have the potential to irritate stomach lining or cause bleeding, especially if taken often. They should not be used by people with ulcers, GERD, bleeding problems or on blood thinners. When in doubt, consult your medical practitioner. Tylenol has very important dose limits: no more than 3,000mg in 24 hours. It is safe with proper usage, but it is deadly when overdosed.
2) Antibiotic ointment: For cuts and scrapes you should have Polysporin, Bacitracin or Neosporin (triple antibiotic ointment). Don’t skip cleaning simple wounds with soap and water, and then apply one of the above topical ointments 2-3 times a day for a couple of days with a loose band aid. These should not be used longer than 1 week at a time. Tea tree oil can also be effective to treat minor skin infections.
3) Antacids for heartburn, upset stomach and bloating: Maalox and Mylanta or TUMS are good for quick relief. One of the H2 blockers like ranitidine (Zantac), or famotidine (Pepcid) are also a must have, and you can take those along with Mylanta or Maalox. A stronger alternative is omeprazole (Prilosec). As with any over the counter medication, prolonged use should be avoided and if symptoms persist you should check with your medical practitioner.
4) Cold and cough: For a productive cough where you are bringing up “junk” an expectorant like guaifenesin (Robitussin [syrup] or Mucinex [tablet]) can help to relieve congestion. If you need a cough suppressant, one of these with -DM on the end will usually suffice. For seniors I discourage the other endings -AC, -E, -PCE due to potential cardiac side effects. Cough drops often also work well-choose sugar free if you are diabetic. Acetaminophen (Tylenol) can be used for a fever or aches and pains as described above. The most important advice is rest, drink fluids.
    This is the first part of a two-part series. We invite readers to offer feedback about this column and to suggest topics for future articles. You may do so by contacting Meg Callaway of the Charlotte White Center at (207) 947-1410 and mcallaway@charlottewhite.org or Lesley Fernow at (207) 992-6822 and lmfernow@rcn.com.