The home medicine cabinet: appropriate management of the family medicine cabinet is mostly just good, common sense.

Appropriate management of the family medicine cabinet is mostly just good, common sense.

Mom, I feel miserable. I have a headache, my nose is all stopped up, my throat feels scratchy, and I'm sure I have a fever. Do you think I need some medicine?"

Jessica has just started back to school following vacation and has caught a cold, the first viral upper respiratory infection to make the rounds of the schools this year. She doesn't feel well at all, and her malady prompts a brief search of our medicine box.

Where is our medicine box?

Under the sink in the bathroom (Uh-oh!) is a white plastic box about the size of a small tool chest or sewing kit. It contains most of our home medicines. But there are some in the kitchen cabinet above the sink (Uh-oh again!) and even two or three bottles in the refrigerator door.

So, let's lay this stuff out on the kitchen table and see what we have. In no particular order (which is the way it was found), we have the following:

Antihistamines (allergy remedies), prescription and OTC (over-the-counter)

Antibiotics, three unfinished bottles, one beyond its expiration date (This is getting embarrassing!)

Nose drops

Eardrops 

Antibiotic ointments, several

Cortisone cream, one old, scrunched-up, dried-out tube

Antacids, liquid and tablet form

Decongestants and expectorants (cold medicines), a variety

Analgesics, including aspirin, and acetaminophen (Tylenol)

Vitamins, an assortment

Liniment, several brands and formulations

Surgical tape

Band-aids

Cotton ball, one, dirty

Plastic medication spoon, one, grungy 

Medication bottle, one, empty

This is all true, and it is really embarrassing!

I wonder what your medicine box looks like. Is it anything like mine? Maybe it's time we did something about it.

First, what really belongs in the home medicine cabinet?

Medication prescribed by a physician for chronic disease, infection, or other illness belongs there. And it is wise and appropriate to keep on hand medications for minor injuries (cuts and scrapes) and common illnesses (such as cold, flu, headache, and indigestion). The American College of Emergency Physicians recommends ipecac syrup and activated charcoal to treat poisoning. Although not medications per se, a thermometer, scissors and tweezers, and bandaging materials should be available as well.

But some of the items in my medicine box (and probably yours too) clearly do not belong there.

Out-of-date medications should be discarded. It is important to finish taking all medications as prescribed, but when, as happens occasionally, a small amount remains following medical treatment, it should not be kept for any reason. Safe disposal of unused medications means flushing them down the toilet rather than putting them in the garbage can.

Unlabeled medications--or any drugs without clearly printed indications and instructions for use--and medications originally prescribed for a neighbor, friend, or relative have no place here either.

The Guide to Prescription and Over-the-Counter Drugs, by the American Medical Association, recommends regular, routine inspection of the home medicine cabinet and prompt disposal of the following:

* Aspirin and acetaminophen tablets that smell like vinegar.

* Tablets that are chipped, cracked, or discolored, and capsules that have softened, cracked, or stuck together.

* Liquids that have thickened or discolored, or that taste or smell different in any way from the original products.

* Tubes that are cracked, leaky, or hard.

* Ointments and creams that have changed odor, or changed appearance by discoloring, hardening, or separating.

* Any liquid needing refrigeration that has been kept for more than two weeks.

* Tablets or capsules more than two years old.

All medications are best stored in the original containers in which they were purchased. Cotton should be discarded after opening. Caps and lids should be replaced each time after medication is removed, to avoid spillage or accelerated deterioration.

Most drugs are best stored in a cool, dry place (not a warm, humid bathroom) out of direct sunlight. Some medications require refrigeration, although room temperature is suitable for most. Storage information for individual drugs is generally on the label or may be obtained from your pharmacist. All medications, including vitamins, cough medications, and headache preparations, should be kept in a secure place out of the reach of children.

Appropriate management of the family medicine cabinet is mostly just good, common sense. But it's easy to overlook potential problems, particularly when we are usually well and have little reason to use its contents. However, when we go to the medicine cabinet on the occasion of a minor accident or illness, it's good to know that the remedy we seek is available, fresh, safe, and effective.

Why not take a few minutes right now to inspect your supply of home medications? It may be surprising, even a bit embarrassing, to learn what has accumulated there. Some things may need to be replaced, and others discarded. Place a sticker on the inside of the door or lid with the date of your inspection, and plan to repeat the process every 6 to 12 months. Someday you may be very glad you did.

Ted Hamilton, M.D., in addition to serving as a senior editor for VIBRANT LIFE, is an associate professor at Loma Linda University and handles a private medical practice.