Posted by Dr. Marc Mickiewicz at December 4, 2019 2:23 pm Blogs, News, urgent care
What This ER Doc Keeps in His Medicine Cabinet

What This ER Doc Keeps in His Medicine Cabinet

Ever wonder if your medicine cabinet is properly stocked?  Do you have everything you need for most everyday injuries and illnesses?  Wish you could take a peak inside the medicine cabinet of a physician to see what they have?  This month one of our favorite Nashville urgent care physicians, Dr. Marc Mickiewicz – a board certified emergency medicine physician, discusses what he keeps in his medicine cabinet for himself and his family.  Read on to take a peak inside his medicine cabinet!

This month’s blog post is all about the medicines and supplies I use at home for my family and myself. I’ve broken it down into 3 categories: pain remedies, allergic symptoms, and trauma. We are not paid endorsers or sponsored by any products. Most of our over-the-counter medicines are bought at a warehouse store (there is a large one located right by our West Nashville urgent care clinic). It’s just cheaper for us to buy them in bulk since we use them fairly often. This information simply reflects what I and my family use and should not be considered medical advice or a replacement for consulting a physician.

Category 1: Aches and Pains

By far the most commonly utilized medication in our medicine cabinet is ibuprofen (Motrin). As I head into the latter half of my 40s I don’t feel old at all but definitely am more prone to the occasional backache, stress headache, muscle pull, or neck strain. Generally after a couple of ibuprofen tablets I feel right as rain after about an hour or two. It also works great for the kids when they have a cold or the flu, or are sore after band camp or swim practice.

However, ibuprofen can cause some significant side effects, namely stomach irritation/bleeding and kidney failure. For this reason it is best used only occasionally and under the direction of your primary care provider if you have a history of or are at risk for those conditions. Also, please note that ibuprofen is not FDA approved for over the counter use in children less than 6 months of age.

For more stubborn fevers or those times when ibuprofen just doesn’t quite get the job done, we will alternate acetaminophen (Tylenol) with ibuprofen. Both can be taken 4X/day so it is nice to be able to give something every 3 hours when those kids keep spiking high temperatures. It is also a great medicine for pain and is safe for babies if dosed correctly. Here is a good pediatric dosing chart for both acetaminophen and ibuprofen for your reference.  However, too much acetaminophen can lead to liver toxicity or even be fatal in overdose situations. Always follow the recommended dosing guidelines and don’t exceed the limit when using this medicine.

Category 2: Allergies

Living in Middle Tennessee, seasonal allergies are just a part of life for our family (along with millions of others in this region). You probably know whether or not you have fall or spring allergies or both (if you have none, I am envious). I am definitely a spring (flowering pollen) allergy kind of guy. Come March when my eyes start itching I reach for our trusty bottle of cetirizine (Zyretc). Fortunately my allergies are mild enough that this generally gets the job done and leaves me seeing and breathing better within a day or so.

Although no one in my family has a history of anaphylaxis I also always have a dose of epinephrine (EpiPen) handy just in case. Anaphylaxis is a severe allergic reaction to a food or medicine or something in the environment that may cause difficulty breathing, swelling of the lips/tongue/throat, vomiting, hives, low blood pressure, or any combination of those terrible symptoms. The only real treatment for this is a shot of epinephrine into a muscle. Diphenhydramine (Benadryl) can help some of these symptoms, and is generally given in addition to epinephrine but it is not strong enough by itself to treat a severe allergic reaction.

If you or anyone in your family has a history of anaphylaxis make sure you always have an EpiPen or EpiPen Jr (for pediatric patients) available at home as well as for your car/school/handbag/desk at work etc. These are available with a prescription from a primary care provider or allergist, and often after severe reactions we will prescribe from the emergency department as we understand it can take time to get those appointments made. If you do end up needing to use your EpiPen, don’t hesitate to do so but always go to the emergency department immediately afterwards. Sometimes repeat dosing and/or other medications are needed, and some severe reactions will require hospitalization.

Category 3: Injuries

Life happens, and sometimes you just slice your finger while opening up a can of tomato paste, or notice that one of your toenails is just becoming the slightest bit ingrown/infected. For these little mishaps, we always have a variety of bandages in different sizes, gauze, ACE wraps, tweezers, small scissors and over-the-counter antibiotic ointment handy. My grandfather always kept a big bottle of iodine handy and any scrape or cut we sustained as kids was treated with a liberal pour directly into the wound (ouch, the burn!) He meant well, but these days we understand that’s toxic to the cells that help heal you as well as bacteria. So, skip that and just go with gentle soap and water instead.

If these just don’t work, or you are concerned you may need an x-ray or stitches, we are always happy to see you at Complete Urgent Care (but for life threatening bleeding, call 911 and hold direct pressure until help arrives).  Our Nashville urgent care clinic is open from 9am to 7pm 7 days a week for injuries or illnesses.  Our urgent care is unique in that care is directed by board certified emergency medicine physicians – to help you avoid the emergency room for non-lifethreatening injuries or illnesses.

Have a happy and healthy holiday season,

Dr. Marc

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