Choosing Appropriate Products
This month's patient leaflet briefly discusses some of the products that patients might wish to have on hand at home. When the patient approaches the pharmacist for additional help, the information below can be used to guide the patient in preparing for self-treatable conditions.
A well-maintained first aid kit or medicine cabinet allows patients to self-treat a variety of conditions.
Keeping the wound moist is the new philosophy for promoting healing in minor cuts and scrapes. Allowing a wound to dry and form a scab prolongs the time to healing and can lead to a scar. Patients should be urged to have a variety of self-adhesive bandages appropriate for wounds of different sizes. Some new products are hydrated to confer an inherent moisture to the wound. Others simply keep the wound moist through preventing evaporation of water from the wound after washing or bathing. In addition to assembling an assortment of bandages, the patient should be told to keep a first aid antiseptic on hand to prevent the risk of infection. Items such as alcohol (denatured ethyl [Lavacol] or isopropyl), hexylresorcinol (S.T. 37), hydrogen peroxide, iodine tincture, povidone-iodine (Betadine), or antibiotics are useful. However, neomycin can cause contact dermatitis and can sensitize patients to other aminoglycosides, so a neomycin-free antibiotic product is a better choice (e.g., Polysporin, Betadine First Aid Antibiotics + Moisturizer Ointment). If the cut/scrape is painful, a local anesthetic may also be helpful (e.g., Dermoplast Spray, Americaine Aerosol).
Gastrointestinal problems are quite common, and take various forms. For upset stomach, a simple antacid (e.g., Tums, Maalox, Mylanta, Wrigley's Surpass gum) may give rapid relief. If acid reflux is the problem, a foaming alginate (e.g., Gaviscon) might be beneficial. If the patient prefers longer-lasting relief from "acid stomach" or reflux, H2 antagonists are recommended.
Another common GI problem is constipation. To prevent this condition, the patient should be advised to keep psyllium, methylcellulose, or calcium polycarbophil handy, and to take them as directed. To treat an existing case of constipation, a mild agent such as docusate (available OTC) can ease elimination safely.
Although diarrhea often alarms the patient, it can usually be safely self-treated with bismuth subsalicylate (Pepto-Bismol), attapulgite (Kaopectate), calcium polycarbophil (Equalactin, Mitrolan), or loperamide (Imodium A-D). However, if it has lasted more than two days or the patient is under the age of 3 years, a physician should be consulted. Finally, if the patient has gas, simethicone can give relief.
The common cold is one of the most common conditions prompting patients to seek advice from a pharmacist. It can cause a host of symptoms, most commonly nasal congestion and/or rhinorrhea, sore throat, and a productive or nonproductive cough. Nasal congestion responds to several treatment modalities, including nasal sprays, oral pseudoephedrine, and nasal strips. Each provide relief, so patient preference is the guide, unless there are contraindications. For instance, nasal sprays and oral pseudoephedrine (Sudafed) are contraindicated in patients with diabetes mellitus, heart disease, hypertension, thyroid disease, or difficulty urinating due to an enlarged prostate gland. Nasal strips may be preferable since they have no contraindications. Sore throat can be treated either topically or systemically. The patient may take acetaminophen, naproxen, ibuprofen, or ketoprofen. Acetaminophen and ibuprofen are safe for use in patients 2 years of age and older. Aleve (naproxen) is not appropriate for patients under 12 years of age and Orudis KT (ketoprofen) is not to be used by those under 16 years of age. Aspirin is not the drug of choice in anyone under 19 years of age since its use has been linked to Reye's syndrome. Topical lozenges/sprays containing phenol, dyclonine, benzocaine, menthol, or hexylresorcinol (Vicks Chloraseptic, Halls, Sucrets) can relieve minor sore throat and allow the patient to rest. If the patient's cough is productive, exhibiting a great deal of mucus in the respiratory tract, a product containing guaifenesin (Robitussin) is the best choice. The patient should also be advised to increase fluid intake. If the cough is dry, with little mucus, a syrup containing dextromethorphan (Delsym) or codeine (in states that permit its sale as Schedule-V preparations) is indicated. Additionally, menthol lozenges (Halls), camphor/menthol ointments (Vicks VapoRub, Mentholatum) and steam inhalants can relieve cough.
Preventing poisoning is the optimal intervention, but children seem to be ingenious at finding ways to ingest various substances. For this reason, the pharmacist should recommend that all households with young children (even those with an occasional young visitor, such as a grandchild) keep an in-date bottle of syrup of ipecac. However, it is imperative that the parent, grandparent, etc., understand that a poison control center must be contacted before its administration since some potential ingestants (e.g., corrosives, petroleum distillates) can cause further tissue damage and/or risk of aspiration if they are vomited. The parent should also be urged to post the number of a poison control center by the cabinet or inside the first aid kit.
Several skin problems, other than the cuts/scrapes previously mentioned, fall into the realm of potential first aid situations. For instance, insect stings/bites are common from ants, wasps, bees, yellow jackets, ticks, fleas and chiggers. If they cause pruritus or minor pain, topical sprays or creams containing benzocaine, pramoxine, dibucaine or benzyl alcohol can help numb the area (e.g., Dermoplast, Itch-X, Caladryl Clear, Lanacane, Sting-Kill). Hydrocortisone (Cortaid, KeriCort) can reduce inflammation, shortening the period of discomfort. The local anesthetic sprays can also help the pain of first- or minor second-degree burns and sunburn. Poison ivy symptoms may be helped by local anesthetics and hydrocortisone.
For sprains or strains, it is vital to have some type of cryotherapy device. This may be a blue gel pack that is constantly kept cooled in the lower section of the refrigerator, or an instant cold pack that can be activated, giving off a therapeutic chill. If the person experiences weekend back strain, a low-level portable heat-producing device (e.g., ThermaCare) is a must for the medicine cabinet. The patient may also choose one of the many counter-irritant products available for strains and sprains. These products contain ingredients such as menthol, methyl salicylate or camphor (e.g., Ben Gay, Icy Hot, Mineral Ice).
Finally, oral analgesics such as acetaminophen (Tylenol), ibuprofen (Motrin IB), naproxen (Aleve) and ketoprofen (Orudis KT) are helpful for the pain associated with common cold, sore throat, headache, muscular aches, backache, premenstrual pain, minor arthritis pain and reduction of fever. The patient should be advised to keep adult forms of these products as well as dosage forms appropriate for children, if necessary.
US Pharmacist. 2001;26(6) © 2001 Jobson Publishing
Cite this: Preparing a First Aid Kit for Home or Travel - Medscape - Jun 01, 2001.