What to keep in your medicine cabinet during the COVID-19 pandemic

TORONTO — With the ongoing spread of coronavirus, more emphasis is being placed on maintaining good health. While there is currently no treatment for COVID-19, there are a number of medications and devices that can be used at home to address some of the symptoms associated with the virus.

While new symptoms of COVID-19 continue to be identified, some of the most common ones are fever, dry cough and fatigue, according to the World Health Organization. Some of those infected with COVID-19 also experience body aches and pains, nasal congestion, sore throat and diarrhea.

The global body also states that in most cases, symptoms of COVID-19 are mild and about 80 per cent of those infected recover from the virus without requiring a visit to the hospital. That being said, the organization does warn that no one is immune to the novel coronavirus and anyone can become serious ill as a result of it.

CTVNews.ca reached out to various experts to find out what they recommend keeping stock of at home amid the COVID-19 pandemic.

TO START…

Aside from getting enough food, rest and exercise, Terry Dean, president and CEO of the Canadian Lung Association, reminds Canadians to continue taking any prescription medication they were using before the COVID-19 outbreak. He suggests making sure you have a minimum of 30 days’ worth of these medications at home.

“It is appropriate that people build sufficient inventories of the medications that they require,” he told CTVNews.ca over the phone on Tuesday. “Make sure you’re not waiting until you run out of your medication [to get more].” 

Dean also stressed the importance of maintaining good air quality at home through the use of air purifiers and other filtering devices if air pollution is an issue in your area.

“High levels of air pollution or poor air quality is something that people should monitor,” said Dean. “We encourage people to do that if they’re in an area where there’s a temporary or ongoing air quality issue.” 

HOW SHOULD I STORE MY MEDICATION?

The efficacy of a drug is very much impacted by where it is stored, explained Dr. Jamie Kellar, associate professor of teaching and acting director of the doctor of pharmacy program at the University of Toronto’s faculty of pharmacy. First and foremost, she recommends reading and following instructions on the label – certain medications must be kept away from sunlight while others must be refrigerated, for example.

For most oral solids or tablets, Kellar suggests storing them in something like a cupboard, where they can be kept dry and at room temperature. The goal is to keep them in a place where the temperature is constant and controlled, and where there is no moisture. 

“You want to replicate as best you can the place that you bought the medication,” Kellar told CTVNews.ca on Tuesday over the phone. “Being exposed to changing temperatures, humidity and moisture…causes the drugs to actually break down and changes their potency.”

As a result, Kellar recommends avoiding rooms like the kitchen or bathroom. She also stresses the importance of storing medication in a spot that is difficult for children and pets to reach.

 

Medicine Cabinet inforgraphic

 

SHOULD I STOCK UP ON PAINKILLERS AND FEVER REDUCERS?

Painkillers such as acetaminophen and ibuprofen both reduce fever and can help treat some of the symptoms that come along with it, including headaches, aching muscles and chills. With this in mind, Dr. Matthew Oughton, an infectious disease specialist and assistant professor at McGill University’s department of medicine, suggests that people keep drugs like Tylenol on hand.

“It’s wise to have these medicines within easy access such that if you need them…then you have them,” he told CTVNews.ca via telephone on Tuesday. 

The recommended daily dose for the average, healthy adult is 3,000 to 4,000 milligrams of acetaminophen. Experts say it is important to note that other medications can also contain acetaminophen, and this daily limit includes all forms of the drug across all types of medications. 

Oughton also points out that children and adults require different doses of the same medication, so it is important to read the label beforehand. The same goes for those with pre-existing medical conditions such as high blood pressure, heart and lung complications, and diabetes.

Ibuprofen is another drug that can help reduce the inflammation and fever caused by COVID-19, but Oughton warns that some of the side effects can be quite severe, especially for those with pre-existing kidney problems. There have been questions about whether the use of ibuprofen in COVID-19 patients can actually worsen symptoms, but the Government of Canada released a statement saying there is no evidence to support this. 

In terms of which painkillers are best, Kellar recommends turning to the same ones you would normally use if experiencing similar symptoms, whether they’re COVID-related or not.

“Our philosophies and our thoughts around health probably don’t need to shift or change that much because of the current situation in terms of medication,” she said. “Whatever someone has used to treat similar symptoms in their past with efficacy, you can still reach to those things.” 

Kellar also suggests reading the label on all medications and speaking to a doctor or pharmacist if you have any questions or concerns. Anyone experiencing severe symptoms – including shortness of breath or persistent coughing – should seek urgent medical attention.

WHAT ABOUT OTHER OVER-THE-COUNTER MEDICINES?

The above also applies to cough and cold medications. While Kellar warns that neither painkillers nor cough and cold medications help treat COVID-19 itself, they can certainly be helpful in managing its symptoms. If you use a particular type of drug to address these symptoms, she recommends using it in this case too.

“If you have a headache and you’re congested and you’re feeling overall unwell…and you’re not worried about your health at a level that you need to seek care…some of these over-the-counter products can reduce some of those symptoms,” she said.

Oughton also warns that it is important to be careful of mixing these types of medications with others that are already being taken, as certain drugs can either intensify or block the effects of other drugs. 

“The more medications you have on board, the more concerned you have to be with potential side effects and interactions between those medicines and other medicines you may have,” said Oughton. “You’ve got to go through your health care professional to figure out in your particular case what makes sense and what doesn’t.

“It’s all a question of balancing risks and benefits.”

Oughton also stresses the importance of staying hydrated for those suffering from COVID-19. Those who develop fevers often require extra hydration, he explained, due to increased body heat as well as loss of appetite. He recommends drinking not only water, but other liquids to help replenish lost electrolytes, such as Pedialyte, Gatorade or Powerade.

Dehydration is also linked to another symptom of COVID-19 – diarrhea. Although drugs like loperamide, or Imodium, are commonly used to treat the condition, Oughton suggests avoiding treatment in this case and simply letting things run their course. Diarrhea is one of the ways the body rids itself of infection, he said. Medications that prevent this help keep the virus inside.

“We know that COVID-19 can be detected in stool and increasing the amount of time for which the virus sits in the gastrointestinal tract may not necessarily be a good idea,” said Oughton. “I don’t think there’s any proof to say that [this medication] is beneficial in this setting and I would be cautious about its use.”

WHAT KIND OF THERMOMETER SHOULD I USE?

Fever is a common symptom of COVID-19, so it is important to monitor body temperature. Oughton recommends keeping a thermometer at home for general use, plus a backup just in case. Extra batteries wouldn’t hurt either.

While there are various kinds of thermometers, Kellar recommends reaching for whichever is easiest or most comfortable to use. For the most part, she said, it comes down to personal preference – just be sure to hold the thermometer in the correct position and for the appropriate amount of time.

“The instrument itself can be effective across the board, it’s more how you use the instrument,” said Kellar. “It’s important to make sure you read the instructions for the device that you have so that you’re using it properly because the answer you get is only dependent on if you’ve done it properly.” 

Oughton, however, advises against using some of the old style thermometers that use mercury, due to the health risks they pose if they break. Instead, he suggests opting for digital ones.

When it comes to getting the most accurate result, Oughten emphasizes the fact that body temperature can vary throughout the day. As a result, it’s important to measure it in fairly controlled circumstances. Avoid using a thermometer immediately after drinking something hot or cold, or coming in from outside.

One final reminder: only check your temperature when you feel it is absolutely necessary.

“If I felt sick, yes I would [use a thermometer] – at that point, it makes very good sense to measure temperature and see if there’s a real a fever or not,” said Oughton. “But I wouldn’t be checking just for the sake of checking.”

SHOULD I INVEST IN ANY OTHER DEVICES?

One device that may be useful in monitoring for symptoms of COVID-19 is a pulse oximeter. While Oughton insists it is not necessary for the average family to have this device at home, especially considering how expensive it can be – prices range from about $50 to several hundreds of dollars – it would be helpful for those showing signs of COVID-19.

This device is used to measure the level of oxygen in red blood cells. According to the WHO, about one in five people infected with coronavirus becomes seriously ill and has difficulty breathing. Using a pulse oximeter to monitor the amount of oxygen in your blood can give you a sense of how well it is being distributed throughout your body.

The tool attaches to your fingertip or earlobe to give you a reading. Typically, those with a respiratory virus will have lower levels of oxygen saturation. This is due to issues with gas exchange due to inflammation caused by the virus. 

“If someone has symptoms and checked their pulse ox [level] and it comes out as being low, that certainly would be another indicator that that person needs to have urgent medical attention,” he said.

The device would also be useful for those with pre-existing medical conditions, such as lung disease. It’s especially important that people with these types of issues have a way of reliably monitoring their oxygen saturation level, said Oughton. While normal pulse oximeter readings usually range from 95 to 100 per cent and results under 90 per cent are considered low, he recommends speaking with a health-care professional to determine target levels based on personal health.

“You have to individualize [treatment] based on all these other circumstances that might modify the benefits versus the risks.”

Infographic by Mahima Singh.


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