I have to admit, if I need to convince myself that I made a good career choice or I need to feel like the training was worth it, all I need to do is visit the pharmacy aisles. It's hard enough to wade through all the options with medical training: it was even more overwhelming before that.
This guide is meant to help your confidence when it comes to basic over-the-counter medications. If it's helpful, keep it in the medicine cabinet.
Medications have a brand name and generic name. The brand name helps with recognition, but the active molecular structure is the same. You don't have to worry about sacrificing quality when saving money on generic versions.
I've found that some people believe that a medication past its expiration date could be harmful. That likely comes from mistakes we've had drinking milk past the magic printed date.
Medications are different. They don't spoil or become harmful. Time may just make them less effective.
A recent ProPublica investigation showed how arbitrary the printed expiration dates can be. If the stores are all closed when you have a headache, an expired med is better than none at all. In general, storage in a cool, dark place will keep medications effective longer.
Over-the-counter pain medications
Tylenol (acetaminophen): Interestingly, we're still not sure how it works. It is known as a safe pain option because it doesn't increase cardiac risk. It is digested by the liver and safe for the kidneys. Of course, all medications should be used as directed. It's notable that with Tylenol, it doesn't take much above the recommended daily amount (4 grams) before the liver is overwhelmed and can get damaged. Be careful with combining cold meds because many have acetaminophen as an ingredient.
NSAIDs (Non-Steroid Anti-Inflammatory Drugs) are a group of medications including Motrin/Advil (ibuprofen) and Aleve (naproxen) plus some other prescription medications. They work by intervening on a chemical pathway to reduce pain and inflammation. They are digested by the kidneys, so those with kidney disease should avoid this group of medications.
They have a slight effect on bleeding, making it take longer to clot. That's why surgeons will ask you not to take these medications before an operation. This is also the reason they should be avoided with other prescribed blood thinners. If you've ever had a stomach ulcer, you should avoid this type of medication. They can slightly raise blood pressure while active and can present some risk of cardiac disease. Aleve (naproxen), however, has been shown as an exception to the cardiac risk.
When the body has an allergic response, the immune system is reacting to something it perceives as foreign. Chemicals called histamines are part of the reaction that brings on the symptoms of runny nose and eyes, sneezing, or skin symptoms like itching and redness.
Benadryl (diphenhydramine) is known as a "first generation antihistamine," meaning it's been around forever. It's only active 4-6 hours. It can be sedating and even disorienting. For those over 60, it's advised against because of the confusion it can cause. If diphenhydramine is used to treat emergency allergic reactions, it should be used at the smallest dose possible. Many over-the-counter sleep aids will use diphenhydraine as the active ingredient. Elderly folks should consult with a doctor for a safer sleep aid.
Because of the side effects with Benadryl, the newer "second-generation antihistamines" were developed. They include Zyrtec (cetirizine), Claritin (loratidine), and Allegra (fexofenadine). These have the same effect on allergic reactions for skin rash and seasonal allergies without the typical sedation of Benadryl. They are active longer (usually just taken daily or twice a day). These are generally safe for children and the elderly.
It's great to have meds on hand for headaches, bug bites and other ailments. But the medicine cabinet holds great risk when used improperly. When taken in large amounts, even seemingly safe meds, such as Tylenol and ibuprofen, can have a dangerous effect.
With teenagers in the house, it's worth taking stock of what medications are around. If you or a loved one has experienced feelings of suicide or even mood swings, depression or anxiety, take the medications in your house seriously.
Acknowledging the reality of overdose doesn't mean you don't trust those around you. It means you care about them. With the basic medication listed, keep small amounts. Prescription medications for pain, mood and sleep should be discarded when you're not using them.
Discarding old medications can be as simple as throwing them out in the trash. Some will even combine the pills with kitty litter or coffee grounds as an extra step to ensure they don't get used by another.
Flushing is not recommended since it may become part of the water supply. Sometimes the county sheriff's departments will have events to discard old medications safely.
Erika Lucero is a physician assistant working at Taos Urgent Care for the past three years after previously working in Española. She lives in Embudo with her husband and twins, enjoying life on the river.