Home Pharmacy

So you or someone you are caring for is beginning to feel a little ill. What should you do? The best advice is to notify the doctor if any condition is concerning to you. For routine illness, you may want to try some over-the-counter medicines, available without a doctor's prescription, that you can get at your drug store to relieve certain symptoms.

Here are some helpful hints on what you can keep at home for minor illness and take before going to see the doctor. You may even get lucky and fix the problem altogether with your very own home pharmacy.

The medicines listed here are made by various companies. Most of these medicines are also made by large pharmacy and grocery store chains, whose house brands have the advantage of being less expensive. Read the label to see which medicines are the active ingredients. There you will find the generic ingredients that are referred to here. Acetaminophen, for example, is the generic name for medicine sold under the brand name of Tylenol, among others.

These generic medicines are the key ingredients that will act in your body. The inactive ingredients are usually preservatives and stabilizers that do not affect your body very much at all.

As always, it is important to follow the directions listed for each medicine. Sometimes you can take these medicines differently but only under the advice of the doctor. If the over-the-counter medicine does not seem to give the results you expect, you should see your doctor.

Acetaminophen is a general pain medication that is extremely safe and effective for almost everyone, except someone who has a liver disease such as cirrhosis. It comes in tablets, gel caps, and liquids so that just about everyone can take one form or another. It is also used as a treatment for fever.

• Unlike some other pain relievers, acetaminophen does not treat the inflammation that occurs when there is injury or trauma. Acetaminophen is also usually one of several ingredients in many other over-the-counter remedies, especially cold remedies that you can buy.



• Common brand names are as follows: Aspirin Free Anacin, Children’s Silapap, Feverall, Genapap, Liquiprin, Panadol, Ridenol, Tempra, Tylenol.

Aspirin is an anti-inflammatory pain medication that may also be found as an ingredient in some other remedies as well. Like acetaminophen, aspirin is safe and effective for most people. But those who have stomach problems, especially ulcers, should not take it. Many aspirin products are coated to protect against stomach upset, but this does not protect against ulcers. Some elderly people can get life-threatening internal bleeding as a result of taking aspirin, so be sure to use aspirin with caution.

• Aspirin is also a treatment for fever, as well as inflammation caused by trauma or arthritis. However, because many fevers are caused by viruses, it is not recommended to take aspirin for fever. This is because some children can develop a life-threatening illness called Reye syndrome.



• Aspirin is also used to treat heart attacks because it prevents the formation of blood clots. Doctors recommend that you chew an aspirin as soon as possible if you are having a heart attack. You should probably take an aspirin if you experience chest pain that you think is a heart attack. Some heart patients, and other people at increased risk of developing a heart attack, are instructed to take 1 aspirin every day to prevent heart attacks.



• Common brand names are these: Anacin, Arthritis Foundation Pain Reliever, Ascriptin, Aspergum, Bayer Aspirin, Bayer Buffered Aspirin, Bufferin, Empirin, Enteric 500 Aspirin, Excedrin, Halfprin, St. Joseph Adult Chewable Aspirin, ZORprin.

Nonsteroidal anti-inflammatory pain relievers (NSAIDs) also treat inflammation and pain. Common NSAIDs are ibuprofen, naproxen, and ketoprofen. They are very similar to aspirin and do an excellent job of treating fevers, and there is no danger of life-threatening Reye syndrome. These medicines do not treat or prevent heart attacks like aspirin does.

• Common brand names are as follows: Ibuprofen (Advil, Excedrin IB, Genpril, Midol 200, Motrin, Nuprin, Pamprin); naproxen (Aleve, Anaprox, Naprelan, Naprosyn); and ketoprofen (Actron, Orudis KT, Oruvail).

Home care: Be sure not to overlook the usefulness of other treatments for pain such as ice packs, heating pads, whirlpools, and massage.

A multitude of products can help relieve some of the symptoms of the common cold. The best advice is to try to find a product that gives the most relief with the least number of side effects. Many times, trial and error is necessary in order to find the right medicine for you. These remedies can be found in many cough syrups for children, adults, and people with diabetes. They also come in pills or gel caps and even in powders that you can mix into hot liquids.

Ingredients such as vitamins, zinc, echinacea, sage, ginger, lemongrass, and other herbs have been used for centuries to help relieve the common cold. No scientific studies show that these really work, and that is why they have not been recommended by most doctors. However, if any of these kinds of remedies work for you, you should be able to continue using them as long as you do not take too much. If you have any chronic medical illness, be sure to consult a doctor before taking any of them.

Here is a list of major cold symptoms and the most common medicine to take to relieve the symptom:

• Cough
  • Menthol is the active ingredient in cough drops. They relieve cough as long as they are still in the mouth. When the cough drop is gone, the cough tends to return.

  • Dextromethorphan is the strongest over-the-counter product for cough. It is usually found as an ingredient in cough syrups (those that have the DM in their names such as Robitussin DM or house brands). It is generally regarded as safe, but if you have other medical problems, especially heart disease or lung disease, be sure to ask your doctor's advice before taking it.

  • Guaifenesin (found in Robitussin and many house brands) is an expectorant, which means it loosens mucus from your lung's air tubes. This will make you want to cough more, but when you do cough, you will cough out more mucus. Then later you will cough less. It is generally regarded as safe. It can be found in many cough syrups for children, adults, and people with diabetes, and it also comes in pills or gel tablets.

• Fever: Acetaminophen, ibuprofen, naproxen, and ketoprofen are all good to treat fevers. Acetaminophen is safer, and the others are stronger. When taking medicine for fever, be sure to drink extra fluids because the fever makes you dehydrated. Aspirin is usually not recommended to take for fever any more but can be used if your doctor recommends it.

• Head and sinus congestion: Oral medications come in either pill or liquid form and act by shrinking engorged blood vessels in the nasal and sinus passages. They work well because the medication is distributed in the bloodstream. Oral decongestants are often associated with stimulant side effects such as increased heart rate, increased blood pressure, and insomnia.
  • Pseudoephedrine (Sudafed) is the most common decongestant and is considered to be the most effective. It is the main ingredient in most major cold remedies you can buy.

  • Nasal spray decongestants act similarly to oral decongestants but have the advantage of acting only in the area applied, usually without the stimulant side effects. The most common active ingredient in nasal sprays is oxymetazoline (Afrin, Dristan Nasal Spray, Neo-Synephrine, Vicks Sinex). Nasal sprays do have side effects, however. Excessive use of nasal decongestants has been associated with dependency. Additionally, a "rebound" effect may occur in which nasal symptoms come back after you abruptly stop the medication. Use these no longer than the package instructions indicate—usually 3 days.

  • IMPORTANT! The Food and Drug Administration recently issued a public health advisory concerning the medication ingredient phenylpropanolamine (PPA), which has been used for many years in over-the-counter nasal decongestants. A recent study reported that PPA increases the risk of a bleeding stroke, primarily in women. Although the risk of a bleeding stroke is low, the FDA recommends that PPA be discontinued and removed from all medications. Although most pharmacies have removed this product from their shelves, it is prudent to carefully examine the label to be sure that the medication you buy (or have at home) does not contain PPA.

• Sore throat, headache, earache, and body ache: Acetaminophen is the safest, and it works very well. Ibuprofen and naproxen are more effective and are safe unless you have ulcers. They are more effective because they also relieve inflammation associated with tonsillitis, pharyngitis, sinusitis, and bronchitis. Aspirin is effective, too, but it is generally not recommended because it can possibly cause Reye syndrome.
  • Benzocaine (Cepacol) is the active ingredient in cough drops and sprays that helps to get rid of sore throat. It is also used as a topical anesthetic in eardrops and oral gels. It is safe, but the effect is only temporary.

• Sneezing, runny nose, watery eyes: Diphenhydramine (found in Benadryl) is an effective antihistamine to fight these symptoms. It is safe but usually causes drowsiness. (It is the same medicine found in sleeping pills.) Chlorpheniramine (Chlor-Trimeton), brompheniramine (Dimetapp), and dexbrompheniramine (Drixoral) are other antihistamines that you can buy over-the-counter. They are safe and do not cause as much drowsiness.

People who are at risk of heart attacks, such as smokers, those with diabetes, and anyone with very high cholesterol, should be sure to see a doctor before treating heartburn at home because heartburn can be a symptom of a heart attack in some people.

• Bismuth subsalicylate (Pepto-Bismol) is a liquid that is a good treatment for intestinal problems. It is a safe and effective treatment for mild abdominal pains, nausea, and diarrhea. It can sometimes make the stools turn black, but this is not a problem. Like aspirin, taking this when you have certain viral infections can cause Reye syndrome. It is therefore recommended that you not take this if you have fever or chickenpox.
  
  
• Bicarbonate tablets (Alka-Seltzer, Bromo-Seltzer) are put into a glass of water. They fizzle, and then you drink the fizz to relieve acid indigestion. Alka-Seltzer also contains aspirin, which reduces pain but can make indigestion worse.
  
  
• Simethicone (Gas-X, Phazyme) is an ingredient in many stomach remedies that reduces gas and the feeling of stomach bloating. It is safe and effective.
  
  
• Dimenhydrinate (Dramamine) alleviates nausea and vomiting as well as motion sickness and dizziness. It is generally safe, but if you have other medical problems, you should ask your doctor before taking it.
  
  
• Emetrol works to alleviate nausea and vomiting. It is a mixture of carbohydrate-rich sugars that is safe for just about anyone except those with diabetes, including children and even pregnant women, but it is not all that effective. If nausea and vomiting continue, consult a doctor.
  
  
• Ranitidine (Zantac), famotidine (Mylanta AR, Pepcid, Pepcid AC), cimetidine (Tagamet HB, Tagamet), and nizatidine (Axid, Axid AR) are good treatments for acid indigestion as well as heartburn, which is a burning pain in the chest and upper abdomen caused by the reflux of stomach acid into the esophagus or throat.
  
  
• Calcium carbonate (Caltrate 600, Os-Cal 500, Rolaids, Tums), aluminum hydroxide (ALternaGEL, Dialume), and magnesium hydroxide (Phillips Milk of Magnesia) are antacids that work immediately to relieve acid indigestion and heartburn. They come in chewable tablets or liquids. They are very safe. Additionally, calcium is good for maintaining strong bones, and taking extra calcium is important, especially for pregnant women and older women.

People normally have bowel movements once a day, more than once a day, or only every few days. So what may be constipation for one person may not be a concern to another person. If you feel discomfort from not having a normal bowel movement for you, then there are many ways to try to relieve the constipation.

• Adding fiber to your diet or taking a fiber supplement is the preferred method. This will increase the amount of water in your stools. You can also take a bacterial supplement, which will add "healthy" bacteria into your intestines to soften the stool. If this does not solve the problem, it is recommended to use enemas. Glycerin suppositories and mineral oil are also effective and safe.
  
  
• If the problem persists, you may want to try some medicines that can help. Bisacodyl (Correctol, Dulcolax), calcium docusate (Colace, Surfak), and the sennosides (Ex-lax, Senokot) are the most commonly available medicines that are considered safe and effective. If you do not have a bowel movement after taking them, if the stool is bloody or black, or if you have abdominal pain or fever, you should see a doctor.

• Attapulgite (Kaopectate) helps to control diarrhea. You should not use it for more than 2 days unless directed by a doctor.
  
  
• Loperamide (Imodium A-D) is a good medicine for diarrhea. It does not treat upset stomach, though. If used too much, it can cause constipation, and even dependency, so be careful. But a few days of treatment are basically harmless.
  
  
• Bismuth subsalicylate (Pepto-Bismol) is a good first-line treatment for intestinal problems. It is a safe and effective treatment for mild diarrhea. It also helps for nausea and indigestion. Like aspirin, taking this when you have certain viral infections can cause Reye syndrome. You should not take this if you have fever or chickenpox.

Diphenhydramine (Benadryl, Sominex, Compoz) is a sedating antihistamine. Its primary effect is to reduce histamine release in the body, which occurs when you have an immune or allergic response to something such as poison ivy or shellfish. Its secondary effect is sedation, which causes you to feel sleepy.

• Do not take any sleeping pills for several nights in a row because they can cause other problems. If you have trouble sleeping, you should see your doctor for advice.



• Health food stores sell sleep aids such as valerian root extract and melatonin. They are not regulated by the FDA, so there is not much information about their safety and efficacy. However, they do provide some relief to many people who have problems sleeping. It is important not to take too much of any of these sleep aids.

• Diphenhydramine (Benadryl) is an antihistamine that treats allergic reactions and itch. It is safe and effective, although it also causes drowsiness.
  
  
• Cromolyn sodium (Nasalcrom) is a nasal spray that is used to prevent nasal allergies. It is useful if you have repeated problems with nasal allergies.

|Web Links|

MayoClinic, Over-the-counter pain reliever guide: Compare before choosing

familydoctor.org, Types of OTC Medicines and How They Work

MedlinePlus, Home Pharmacy

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Author: Kenneth Ahonen, MD, FACEP, Consulting Staff, Department of Emergency Medicine, Baptist Hospital of Miami.

Editors: James E Keany, MD, FACEP, Director of Emergency Medical Education, Department of Emergency Medicine, Mission Hospital Regional Medical Center and Children's Hospital at Miss; Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, ; Ron Fuerst, MD, Clinical Assistant Professor, Department of Pediatrics, University of South Carolina College of Medicine; Director, Children's Emergency Center, Children's Hospital of Richland Memorial Hospital.