Friday, December 29, 2023

What is in your medicine cabinet? 2023

 

My grandson Sawyer is starting daycare next week. His mommy is getting prepared and asked me about what things she should have in the medicine cabinet.This was a good incentive to update this old post.




Take stock of what’s in your medicine cabinet.



What medications should you have on hand?

If you or your child becomes ill in the middle of the night, that 3 am visit to the local pharmacy may furnish you with some interesting anecdotes about the odd folks lurking in the aisles, but generally it is something you want to avoid. Try to have some basic medications on hand ahead of time. A little preparation goes a long way.


Fever reducers/Pain relief

Acetaminophen and Ibuprofen are the most common medications used for this.


Remember that you never want to give actual aspirin to a child.


Acetaminophen/Tylenol Infant and Children's Liquid are the same

concentration so they are actually interchangeable, but the infant bottle comes with a nifty little measuring system and a spill proof bottle which is safer.  


Acetaminophen also comes as a suppository, which is great for a child who is vomiting or resisting medication by mouth. Suppositories are best kept in the fridge or someplace cool. If they get warm and mushy they are much harder to insert.


Ibuprofen is also known as Advil or Motrin. This medicine also comes in a more concentrated infant form. The infant and child dose are not the same. Make sure you understand your child's proper dose. The above link has a dosage chart



Antihistamines

Benadryl, Zyrtec and Claritin tend to be the most commonly used for pediatrics. These antihistamines would be given for general allergic reactions, itchy skin rashes or insect bites.


The generic name for Benadryl is Diphenhydramine HCL. There is no formulation specifically for infants. The directions on the bottle usually have a caution not to use it for children under 4. Most pediatric offices ignore that and are fine giving to younger patients if indicated. It is always a good idea to check with your doctor to see if they are comfortable with it.


While Benadryl will make most kids (and adults) very sleepy. Sometimes that sleepiness is a good thing!!! But be warned, it also can cause a few patients to be jittery.


Zyrtec (Cetirizine) typically has a more level response, with less likelihood of either sedation or the jitters. There is a dosage chart in the insect bite link above.


Claritin is fine for sneezy allergies, but perhaps not quite as effective for itchy rashes.


All of these come with the option for liquid or chewables.


Tummy issues

If your child is vomiting, you will be glad to have an oral rehydration solution in the house. Poplular options include:

Pedialyte and/or Drip Drop . Breast milk is also great for that, but not everyone is lucky enough to always have it on hand. Pedialyte also comes in popsicle form, which is great for older kids. 


These both come in little packets of powder that you can mix with water. As well as keeping these in your medicine cabinet, they are worth taking along with you on any trips.


Pedialax or glycerin suppositories are worth having on hand If your child is prone to constipation. If days have gone by without a poop, and diet enough hasn't helped to get things moving, these are often the next step. If it is the wee hours of the morning and you have a miserable, grunting and straining kid, getting the poop out is a good strategy.


Eye issues

For young babies, breastmilk in the eye can cure a variety of issues. For older kids and adults, it is worth having Zaditor. It is an over-the-counter treatment for allergic conjunctivitis. It works quickly if allergies are the culprit. I also find that the homeopathic brand Similason is very soothing.


If eye irritation or discharge continues, it might be viral or bacterialIt is time to check-in with your doctor. Most offices will want you seen. Gooey eyes can be a signal of an ear infection, so a visit is the best way to make sure you are getting the care you need.


Stuffy nose

XLEAR nose spray!!!



Mouth sores

If you child is prone to mouth sores or irritations, I find Glyoxide very helpful and seems to help things heal up pretty quickly


You can also do a combo/1 teaspoon Maalox/1 teaspoon of Benadry...apply topically



Respiratory

If your child has a history of wheezing, now is the time to make sure you have asthma medications available. Many of those are light sensitive so you should always mark the package when you open them. If your child uses a nebulizer, the tubing should be replaced every 6 months. If you or your child use an inhaler, the mouthpiece should be rinsed out at least once a week.

Check the directions on your specific medication to see if it needs to be primed. Some need an extra spritz into the air if they haven’t been used in more than a week.



Topical creams/ointments

  • Triple antibiotic ointment for cuts or scratches
  • Antifungal cream for yeasty rashes or fungal infections
  • Arnica for bruises
  • hydrocortisone cream for mild itchy irritations


HC cream comes in a variety of strengths. You can get the weakest ones over the counter.



Please pay attention to this rather disgusting factoid:

It is easy for tubes of ointments to get contaminated. If the tip comes in contact with bacteria from a finger or directly from the body...there you go. Yuck! One study that I read suggested that more than half of the tubes of creams and ointments that people have laying around are contaminated with Staph. The best way to avoid this is to make sure that you don't directly touch the tip to anything. Try to keep it sterile. Squeeze the desired amount onto a spoon and then use whatever applicator you want (clean fingers are usually fine.)


BASIC FIRST AID products

Consider getting some self adhesive bandage like Coban/Co-flex. They come in lots of colors and are fairly inexpensive. The advantage of these is that not only do they not hurt when you take them off and your child can’t pull them off without help. Also, your little one can’t eat the band-aid!


Ice packs/warm packs

I suggest that you invest in a child friendly ice pack that you can keep in your freezer. There are loads of adorable ones on Amazon. Holding a soft little penguin or bunny against the booboo might elicit a bit more cooperation.


Having a microwavable hot pack can also be useful. If you don’t want to buy one, you can fill an athletic sock with rice, and that warms up nicely. Another option for a warm pack is to pour some water in a disposable diaper and heat it in the microwave for a few seconds at a time until it is a good temperature.


Keep a bag of Epsom salts on hand. They come in handy for all sorts of things.



Useful Equipment

  • Have a working thermometer that you have tested for accuracy before someone actually has a fever. As long as your baby is over 2 months, I am not one who is going to focus too much on the exact degree of the fever, but we do want to get a sense of how high it is.
  • Have a syringe or dropper on hand for much more accurate measuring.
  • Pulse oximeters have gotten very inexpensive. If you or your child is congested, you can easily check the oxygen level.
  • Have a good set of tweezers for removing splinters.
  • If you are a hiker, I also suggest having a special tick removal tool.


  • Nebulizer if you have asthma in the family
  • Humidifier



Storage

Make sure that all your medications are stored in a safe, dry, childproof location (a steamy bathroom is not the best place.) Don't underestimate the ability of a climbing child who knows where the gummy vitamins or yummy medicine is stashed.


Pro Tip: With any of your medications, put a strip of masking tape on the side of the open bottle and sign and date your doses. This will avoid the common incident of parents double dosing their babies. This also will help you keep track of doses when you are sleep deprived. I get plenty of frantic calls from parents who have inadvertently overdosed their kids by giving the medications too often. If there is a concern your first call should be to Poison Control: 1-888-222-1222 


Here is my blog post on poison action and prevention



Boost your Immune system

With the cold and flu season in full throttle I would have the following on hand for the first sign of congestion or a throat tickle


Sambuccol/elderberry

Zinc

Manuka Honey (Not for babies under 1 year)

Make sure you are already getting routine Vitamin D (all year round)


Equipment

Humidifier

Nebulizer if you have asthma in the family


Do a routine check for expired medications. 

Even though I try to stay on top of this I can be occasionally stunned by the old stuff that I find lurking in the back of my own medicine cabinet (it runs in my family.) We sometimes do a contest to see who can find the oldest thing in there. (Without knowing what the topic for this weeks post was, Sandy told me earlier that he cleaned out our medicine chest today and found medicines that had expired in 2018. BTW, 5 years is not even close to things we have found in the past!)


How to get rid of expired medications that you find?

Please don't randomly toss expired medication down the drain or flush it in the toilet. Medicine can pollute the bay and ocean, or be accidentally misused or abused. Wastewater treatment plants are not designed to remove medications or other chemicals in waste-water, so after traveling down your drain, medicine may affect our environment. If you go online, you can easily find a list of places where you can drop off expired meds. If you live in SF, I did it for you.


http://sfenvironment.org/article/safe-medicine-disposal-for-residents



What does that expiration date mean anyway?

In 1979, the FDA required that manufacturers include an expiration date on prescription as well as OTC products. This is the date at which full potency and safety is guaranteed, Usually, that date is roughly 1 to 5 years from the time of manufacture. 


The US military, which maintains large stockpiles of medications for both military and civilian populations for use during an emergency, became very interested in this issue following the 2001 anthrax scare. The cost implications were obvious. Throwing out large numbers of expensive drugs simply because they were past their expiration date was an enormous expense that could potentially be avoided if it was determined that the drugs were effective beyond that date.


To explore this, the FDA analyzed the potency of 122 common medications. The was called the The Shelf-Life Extension Program (SLEP). After vigorous testing of more than 3000 different lots of these drugs, almost 9 out of 10 lots were determined to have more than 90% potency at 1 year past the expiration date. The average extension of this degree of potency was 5 years.


So, while obviously if your child is ill, we don't want to take chances with medications that may be out of date, the bottom line is that in an emergency, expired medications are likely not dangerous (always double check); they may simply have lost a bit of their potency.


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