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Zanshin 02-05-2007 09:59 AM

Prescription medicines for first aid kit
I'm off to see an amenable doctor later this week and will discuss what medicines above and beyond the contents of a prepackaged offshore first-aid kit I should bring. This will be for myself on transoceanic passages (I have no known allergies) and have only come up with:

Cipro(flaxin) - in case of severe infection
Antihistamine - in case of allergic reaction
Penicillin - general emergency antibiotic
Scopolamine patch - Seasickness, I hate suppositories, and normal medicine taken orally won't work after symptoms have started.

Does anyone have other recommendations for contents that might (or do) require a prescription?

PBzeer 02-05-2007 10:17 AM

Not sure what they have pre-packaged, but here are some of the things I always have on hand.

Since I became allergic to insect stings, I have been using Benedryl as an anti-histamine. As worked quite well for me to reduce the swelling, which is my reaction to the stings.

Neosporin for topical application. As well as hydrogen peroxide.

Ora-gel for temporary relief of dental pain. Also Bayer asprin for placing on a bad tooth directly.

Persripction-wise, I think you have it pretty well covered, unless you were to get some type of pain killer.

Zanshin 02-05-2007 10:27 AM

I have Benadryl, Aspirin, Neosporin and 1l of Hydrogen peroxide and alcohol in my kit already (those didn't require a prescription) - wow, you really hit on exactly what I'd envisioned needing. {so far I used only the peroxide and bandages for a cut-to-the-bone on my hand}. I forgot all about a powerful general painkiller!

sailingdog 02-05-2007 10:36 AM

You would probably want to have some narcotic-based pain medication on-board in case of serious injuries. Tylenol-3, which contains codiene, Percocet, Dilaudid or morphine sulphate, are possible choices. I'd stay away from Oxycodone or oxycontin, as that drug is flagged more by DEA due to it being "hill-billy heroin".

It would also be good to get another broad-spectrum antibiotic, since many diseases are now fairly resistant to pennicillin.

If you're going to get any of the medications in tablet form, make sure that you can get them in smaller containers. That way, if you do have to use the tablets, you can keep some of them sealed. Tablets tend to degrade in high-heat/high-humidity conditions, fairly rapidly.

Also, Silvadene creme is another thing you'd probably want to have on-board. It is used for burn treatment.

Prescriptions for antihistamines don't really make much sense... Benadryl, Claritin, and Sudafed are available over the counter...and all three are quite effective. Benadryl also works partially to counter motion sickness, but can make many people drowsy.

One other prescription medication that may be of interest, which I believe is available transdermally, is Zofran... it is a very potent anti-naseau drug... can be of great use in combating the effects of seasickness.

You may also want to get, depending on where you're planning on going, some form of anti-malarial medication. Be aware that in many areas, the older standard treatments for malaria are no longer effective.

Another medication you may want to carry is an anti-parasitical medication... Tapeworms and other intestinal parasites are fairly common in third world countries... you may want to discuss this with your doctor.

A few other things I'd pack in the Medical Kit, and I call it a medical kit rather than a first aid kit, since you will probably be further than 10 hours from medical it really is a medical kit...

1) Eye wash of some sort
2) Boric acid powder, which is both a good insecticide and topical antiseptic.
3) splinting equipment—SAM splints are excellent, and fairly easy to use
4) Antifungal lotion or creme—Tinactin, Lotromin or something like that.
5) Electrolyte solution powder for rehydration
6) Multi-vitamins for daily use. Prevents scurvy, etc.. and easier than carrying lemons and lime juice. :D

One other piece of advice.... I would take the bottles of medication and then individually vacuum seal each bottle, using a food vacuum sealing machine. This will protect the medications for oxygen degradation as well as humidity degradation... Then you can store the medications in the bilge, where it is coolest... without worrying about the effects of any bilge water on them. Don't do this for any transdermal patches, as the vacuum sealing process may damage the transdermal gelatin matrix. It should be fine for any tablets or caplets though.

One last thing I'd carry is some Cyanocrylate-based "crazy glue" type adhesive. It can work to seal larger lacerations fairly well. Medically, it is sold under the name Dermabond, but I've found that the regular, hardware store supplied stuff works just as well. It is more effective and less prone to problems than either sutures or surgical staples, at least under the conditions you'll be using them.

hellosailor 02-05-2007 12:38 PM

Zanshin, look for products like "Quik-Clot". These are available either as powders, or as impregnated bandages. The special ingredients cause rapid blood clotting, so blood loss is stopped and wounds sealed very rapidly.

A product of combat medicine, they've been on the civilian market for only a few years now but many pharmacies are starting to carry them. Much more effective than pouring granulated sugar on a wound--which is an alternative if you have nothing else. (The sugar promotes clotting by absorbing the fluid, it is reasonably sterile and water-washable.)

sailingdog 02-05-2007 10:25 PM

One other medication that might be worth looking at getting is Provigil, aka Modafinil. It has definite uses if you're single handing... :D

Zanshin 02-13-2007 07:17 AM

I've finally spoken with a UK doctor and now have a prescription for the following things for the 1st aid kit:
1. Dicloflex - anti-inflammatory and analgesic
2. Scopoderm TTS - transdermal patch for seasickness relief (intended to be used in case of sickness, not as a prophylaxis)
3. Co-dydramol - paracetamol and dihydrocodeine tartrate based analgesic and anti-inflammatory
4. Flamazine - topical burn treatment and other skin infections
5. Amoxicillin - antibiotic. Penicillin based. The only drug with a limited shelf-life of < 1 year.
6. Malarone and Doxycycline - Antimalarial medicines. These two medicines are meant to be used separately (if at all) depending upon which malaria region I am in - since many strains are now resistant to one or the other drug. Not intended as a prophylaxis.

The medicine case contains a lot more elements that are OTC, but I won't list them all here since the subject has been covered in detail in other threads. The prescription drugs were chosen to cover as many possible conditions as possible while ensuring that their shelf-life in tropical conditions was sufficient for a lengthy voyage. All but the antibiotics have 3 year + shelf lives.

That covers the prescription drugs for the moment; but I don't feel that this is quite sufficient and am going to try to find a physician here who either sails or understands the issues involved when out to sea. Since England is so heavily populated I think that most doctors assume that help will be available within hours and not the days or even weeks that one might have to wait at sea.

hellosailor 02-13-2007 01:39 PM

Amoxicillin could be a bad choice. First, because a LOT of people have allergies to penicillin-type antibiotics, and this could kill them. Second, from the limited shelf life, there should be other alternatives that have a more reasonable shelf life.

And if you are not familiar with the Scopoderm, read the data sheet with it. Scop is very effective a lot of the time, but also has major side effects with many people. It can also be very dangerous. I wouldn't use it on someone unless it was medically necesary, i.e., if this person isn't able to function they're going to die, unless they'd tried it ashore first. Among the complications, violent delusional pyschosis, heart problems, eye pressure problems. Or, as some of us say, "I'm on meds now. I may become an axe murderer but you don't have to worry about me being seasick, just to let you know."

Zanshin 02-13-2007 02:06 PM

Hellosailor - you've added 2 negatives without a positive; it would be helpful if you were to offer alternatives.

I researched the alternatives to Amoxicillin and all have a short shelf life. The kit is mainly for me, and as I'm not allergic to penicillin I went for the amoxicillin. I asked for Azactam but they stated that I could only get one type of antibiotic; perhaps I can find that OTC somewhere else and have an antibiotic for those allergic to penicillin based pills.

Regarding Scop - I do not intend to use, or have any passenger use, the Scop as a prophylaxis; just as an emergency measure to reduce symptoms. The usual anti-seasickness medications are pills and are therefore useless by the time symptoms are bad enough to require medication. I don't like suppositories so the only alternative is transdermal which limits the choice to Scop. In addition, all the other active seasickness medications have as many and as severe reactions plus they induce more drowsiness than Scop. Also, if you actually read the clinical observations, the cases of psychotic behaviour are very, very rare and the symptoms all go away quickly after removal of the patch, unlike ingested medications where symptoms can last a long time. I don't see any alternative to the (very pricey) patches in this case, do you?

hellosailor 02-13-2007 02:38 PM

For me, Scop counts as "GOOD DRUGS!" and when our FDA took the oral caps off the otc market in the 80's, I actually placed a curse on the man who did that. Don't misread me as being negative about Scop, I would just say to be extremely careful about it under uncontrolled circumstances.
It is on the market as oral pills, brand name Scopace in the US. Much cheaper than the patches, much faster action. Easier to control the dosage. And, like most similar drugs, it works best as a prophylaxis, rather than after the fact. If you take it when someone says "I'm not feeling too good" it kicks in way better than after someone says "Ohhhh, I'm siiiiccckkk".
Most of the effective drugs for seasickness have some range of counterindications and IIRC none of them work for more than 1 in 3 customers. Sturgeron (cina-somethingorother) is supposed to be very effective, didn't work for me at all. Easily available in the UK I'm told. Ontologists often know more about these meds than anyone else, they are also used for the naseau produced in chemotherapy. There are a couple of other orals and suppositories (Compozine) as well. (And given the choice of being seasick or using a suppository, I think most of us would be glad to eagerly shove them in our ears and noses as well.<G>)
I don't not to use Scop, just beware that it is a very serious drug, and that like Penecillin, it can save--or kill--equally effectively.

Antibiotics in the US and UK often have different brand names, I've no idea what you have available to you over there, or what your doctor would be familiar with. Azithromycin (Zithromax) is one of the more common ones in the US supposedly with a 3-year shelf life, also a bit expensive. Shelf life is one of the things no one wants to talk about, especially when you are supposed to only get what you need, when you need it, and then consume the full course. If you asked your doc for a short list of what he'd recommend as being broad-spectrum, strong, and relatively safe, and then researched the shelf lifes, that would probably give you a better way to start.
Or, the one-year shelf life you were quoted may be incorrect--apparently many pharmacies in the US simply use one year as the "throw away" time for anything they have in stock.

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