Indication: Herpes Simplex Labialis (cold sore)

Classification: Antiviral

How it works: Prevents virus from replicating; reduces duration and severity of symptoms (less pain, burning, itching, and tingling)

Dosing: Apply 5 times per day until lesion is healed, no more than 10 days. Wash hands before and after application.

Side effects: Headache, reaction on application site

Treatment expectations: Should see improvement in 1-2 days

Medical intervention: Follow up in 14 days, see doctor if: Present > 14 days, increased frequency of outbreaks, infection symptoms

Nonpharm: Wash with mild soap solution, wash hands frequently, keep moist to prevent cracking (cracking makes susceptible to bacterial infection)

Indication: Sinus headache/congestion

Classification: NSAID and decongestant

How it works: Ibuprofen provides pain relief, and pseudoephrine will relieve nasal congestion

Dosing: See box

Side effects: Pseudoephrine can sometimes cause nervousness, insomnia, and increased blood pressure.  Ibuprofen occasionally can cause GI bleeding.

Treatment expectations: Pain relief in 30-60 minutes, maximum of 1 week

Medical intervention: If symptoms do not improve in one week, if signs of cardiac arrhythmia occur, signs of GI bleed, allergic reaction

Interactions: Pseudoephedrine- MAOIs; Ibuprofen- corticosteroids, smoking and alcohol use, aspirin

Nonpharm: Maintain good sleep/eat patterns, stay hydrated, wash hands, saline nasal sprays for sinuses

Indication: Nasal decongestion (Cold)

Classification: Topical decongestant

How it works: Shrinks blood vessels in nose and decreases swelling

Dosing: 2-3 sprays q12h, max 3-5 days; insert tip into nostril using criss cross method, sniff deeply while squeezing the bottle

Side effects: Rebound congestion if use for more than 3-5 days, elevated blood pressure, tachycardia, insomnia, anxiety

Treatment expectations:  Starts within a few minutes, works for 12 hours

Medical intervention:  Fever >101.5, SOB, chest pain, symptoms last longer than 7-14 days

Interactions: MAOIs- contraindicated

Nonpharm: Drink plenty of fluids, rest, nutritious diet, humidifier, raise head of bed

Indication: Minor skin irritation (poison ivy, poison oak, poison sumac)

Classification: Antipruritic

How it works: Unknown mechanism, but it is a skin protectant and antipruritic

Dosing:  Shake bottle, put lotion onto a piece of cotton, apply to skin, allow to dry on skin (will leave a pink film)

Side effects:  Rash/irritation

Treatment expectations:  Reduced itching within a few days (?)

Medical intervention: >20% of body area affected, does not help at all within 7 days (full healing will take 10-21 days), signs of infection, swelling of eyes, involvement of mucous membranes

Interactions: None known

Nonpharm: Cold/tepid soapless showers, trim fingernails to avoid scratching, use hypoallergenic cleansers and do not scrub vigorously

Indication:  Pain (arthritis, neuropathic, or musculoskeletal)

Classification: Substance P depleter; analgesic

How it works: It depletes substance P, a chemical in your body that causes you to feel pain.  So, capsaicin intially will increase pain as it's releasing all the substance P, but it can help alleviate pain with repeated use.

Dosing: Apply thin film to affected area 3-4 x/day

Side effects: Most people experience redness and pain upon application of this product, and some may also have rash or itching.

Treatment expectations: Must use 2-6 weeks for maximum benefit (usually start noticing relief after 14 days)

Medical intervention: Not known to cause any overdose, but see your doctor if you feel nausea, vomiting, fever, or pelvic and abdominal pain.

Interactions: If you are taking an ACE inhibitor, capsaicin can increase the risk of ACE inhibitor cough.

Nonpharm: Good posture, shoes that fit well, RICE therapy for injuries, good mattress, heat therapy (15-20 min 3-4x/day) for non-inflammatory injuries

Indication:  Wart removal

Classification: Keratolytic

How it works: It helps break down the tough, hard skin called keratin on the wart. It also is a little bit of an antiseptic, so it can help keep the area clean.

Dosing: Liquid: 1-2x/day up to 12 weeks, Pad: apply for 48 hours, repeat up to 12 weeks, Plaster: apply at bedtime and leave on overnight every day up to 12 weeks

Side effects: Burning, redness, itching

Treatment expectations: Improvement within 1-2 weeks, complete healing in 6-12 weeks

Medical intervention:  Still there after 12 weeks, painful plantar wart, or if warts are on face, nails, or genitals

Nonpharm: Wash hands after touching the wart, use a separate towel to dry that area, do not poke at or cut the wart, can use shoe inserts to help with pain of warts on feet, don't walk barefoot if the wart is on the foot

Indication:  Removal of ear wax

Classification: Ceruminolytic (ear wax softening agent)

How it works: The carbamide peroxide bubbles inside the ear, helping break up and loosen the ear wax.  The glycerin softens the ear wax.

Dosing: BID up to 4 days; remove wax with gentle warm watter irrigation or rubber bulb syringe.  To insert drops, wash hands, warm the drops in hands for a few minutes, pull ear up and back, and gently insert drops without letting the dropper touch the inside of the ear.

Side effects:  Irritation, tenderness, redness, discharge

Treatment expectations: Some wax will probably come out right away, but it should be fully resolved within 4 days of use

Medical intervention: Symptoms persist for more than 4 days or adverse effects develop

Interactions: None, avoid contact with eyes and do not use in children under 3 years old

Nonpharm: Only remove ear wax when it is in the outermost portion of the ear, and use a wet, wrung out wash cloth draped over the finger.

Indication:  Treatment and prevention of motion sickness

Classification: Antihistamine

How it works:  Decrease histamine levels in the brain. Increases in histamine are associated with the nausea and vomiting experienced during motion sickness.

Dosing: See package; Take 30-60 minutes before travel and then for duration of  travel

Side effects:  Sedation, dry mouth

Treatment expectations: Should help prevent motion sickness if taken 30-60 minutes before travel

Medical intervention:  Nausea/vomiting from motion sickness associated with severe dehydration, severe side effects from medication (cardiac arrhythmia, seizure)

Interactions: Alcohol, TCAs

Nonpharm: Avoid reading during travel, keep vision straight ahead, avoid excess food and alcohol before travel, sit in front of car, near wings of airplane, or midship on boat, avoid strong odors

Indication:  Headache (tension and migraine type)

Classification: analgesic, stimulant (caffeine)

How it works: Acetaminophen- reduces pain,  Aspirin- inhibit prostaglandin synthesis (COX inhibitor), Caffeine- stimulant, helps reduce pain

Dosing: Each pill: 250/250/65 mg

Side effects: nausea, vomiting, ulcer, insomnia

Treatment expectations:

Medical intervention: Migraine symptoms without diagnosis, persists for longer than 10 days

Interactions: Warfarin (aspirin), alcohol use, liver dysfunction, history of ulcers, ketorolac, SSRIs

Nonpharm:  Avoid dietary triggers, adequate hydration, good sleep/eat patterns, strengthening and relaxation of muscles in tension headache

Indication:  Fever reduction

Classification: Antipyretic

How it works:  Inhibits COX in CNS

Dosing:  See box; 6-11 mos: 80 mg q6, 12-36 mos: 80 mg q4, 3-6 y: 120 mg q4-6, 6-12 y: 325 mg q4-6

Side effects: Constipation, n/v

Treatment expectations: Onset in 2 hours

Medical intervention:  <6 mos >101, >6 mos >104, Fever persisting for greater than 3 days

Interactions: Warfarin, alcohol

Nonpharm: Sponge bath with tepid water, light clothes, hydration

Indication:  Constipation

Classification: Bulk-forming laxative

How it works: Swells in your colon to stimulate bowel movement

Dosing: 2 625 mg tabs orally, chew and swallow 1-4 times per day as needed

Side effects:  Abdominal cramping and gas

Treatment expectations: Onset 12-24 hours, may be up to 72 hours

Medical intervention: Changes in BM- especially with weight loss, fever, abdominal pain, symptoms >2 weeks or recur over 3 mos, blood in stool or change in caliber of stool

Interactions: Not recommended in children or opiate-induced constipation, salicylates, anticoagulants

Nonpharm: Increase fiber, fluid, and exercise

Indication:  Constipation

Classification: Laxative, hyperosmotic

How it works:  Pulls water into rectum to stimulate bowel movement

Dosing: 1 suppository (2 grams)

Side effects: Rectal irritation

Treatment expectations: Onset 30 min

Medical intervention: Blood in stool, constipation persists for >2 weeks or recurs over 3 months, change in BM especially with weight loss

Interactions: Poorly absorbed, little interaction

Nonpharm: Fluid, exercise, high fiber diet

Indication:  Diarrhea and gas

Classification: antidiarrheal, surfactant

How it works:  Slows down gastric motility, simethicone breaks up gas bubbles

Dosing: See box

Side effects:  Dizziness, constipation

Treatment expectations:  Should reduce frequency of loose  stools and help make more formed stools

Medical intervention:  Symptoms get worse or last for more than 2 days, abdomen swells

Interactions: liver failure, allergy to loperamide

Nonpharm: oral rehydration, avoid fatty, sugary, and spicy foods

Indication:  Prevention of allergic contact dermatitis

Classification: protectant

How it works:  Forms barrier and prevents rash from poison ivy, poison oak, and poison sumac

Dosing: Apply generously 15 minutes before anticipated exposure, reapply every four hours; should leave a film

Side effects: redness

Treatment expectations: Should prevent outbreak of skin reactions, will not work if used after exposure

Medical intervention: Poison ivy on more than 25% of the body or if present on face or genitals

Interactions: Allergy to product

Nonpharm: Avoidance, protective clothing

Indication: Athlete's foot

Classification: Antifungal

How it works: Kills the fungi responsible for athelete's foot

Dosing: See box

Side effects:  Rare: burning, irritation, itching/dryness

Treatment expectations:  Massage product into affected area twice daily; Some relief in 1 week, but treatment will take at least 2-4 weeks, possibly up to 6 weeks for full healing

Medical intervention: Worsens, fever/malaise, oozing pus, unsuccessful treatment

Interactions: None

Nonpharm: Wear protective footwear, discard old shoes, add antifungal powder to shoes every week, keep foot dry, use a separate towel for the affected area, do not share towels or clothing with other people, cleanse daily with soap and water and pat dry, wash clothes on hot and dry on a heated cycle

Indication: Vulvovaginal candidiasis (yeast infection)

Classification: Imidazole antifungal

How it works: Kills the fungi, relief of irritation and itching

Dosing: Insert cream into vagina daily for three days; apply to vulva twice daily as needed for itching

Side effects: Burning, itching, and irritation in 3 to 7% of patients

Treatment expectations: Relief depends on how many days of therapy; should improve within three days

Medical intervention: Symptoms do not improve within three days or are still present after 1 week, if vaginal discharge changes, or if you get another VVC within two months

Interactions: Unlikely since absorption is low

Nonpharm: Decrease sucrose and refined carbs, eat yogurt

Indication:  non-effective productive cough

Classification: expectorant

How it works: Thins secretions so you can cough them up more easily

Dosing: 200-400 mg q 4 h, take with full glass of water

Side effects: Nausea, vomiting, dizziness, headache, rash, diarrhea, drowsiness, stomach pain

Treatment expectations:  May make mucus in chest easier to cough up

Medical intervention:  Cough lasting for longer than 7 days or that keeps coming back, high fever, rash, or headache that will not go away

Interactions: Allergy to guaifenesin

Nonpharm:  Nonmedicated lozenges, humidifiers, hydration

Indication: Lice

Classification: pyrethrums

How it works: Paralyzes and kills the lice

Dosing: One treatment usually enough, retreat in 7-10 days if you see active lice

Treatment expectations: Do not use conditioner, leave on for at least 10 minutes, comb with lice comb

Side effects: Itching, edema, redness

Medical intervention: Lice persist 3-5 days after 2nd treatment

Interactions: Hypersensitivity

Nonpharm: Avoid direct physical contact, do not share combs, etc., wash clothing and bedding on hot, place pillows on quarantine in plastic bag for 2 weeks, boil plastic brushes for a couple minutes

Indication: Dandruff, especially refractory cases

Classification: antifungal

How it works: Kills the fungus that causes/aggravates dandruff

Dosing: See box

Treatment expectations: Leave shampoo on hair for at least 5 minutes

Medical intervention: Persistent dandruff after 4-8 weeks

Interactions: Few since not systemically absorbed

Nonpharm: Washing hair daily with non-medicated shampoo can also help control dandruff

Indication: Heartburn

Classification: H2 receptor antagonist

How it works: Prevents some, but not all, gastric acid secretion

Dosing: See box

Treatment expectations: Will start working 1 hour after you take it and will last 6-12 h

Side Effects: Constipation, diarrhea, headache, dizziness

Medical intervention: >2x/week or lasting for >1 month, chest pain, signs of GI bleed

Interactions: Pregnant women usually just stick with antacids, interacts with cranberry juice, also interacts with drugs that require more stomach acidity to be absorbed (iron, some antibiotics, digoxin, vitamin B12)

Nonpharm: Elevate head of bed, do not eat before bed, avoid chocolate, mint, fatty foods, citrus, spicy foods, tomatoes, and coffee, limit alcohol and do not smoke, reduce size of meals

Indication: Heartburn

Classification: Antacids

How it works: Neutralizes stomach acid

Dosing: See box; chew tablets 2-4 hours as needed

Treatment expectations: Should work within a few minutes and last for half an hour; if you need something stronger, consider H2 antagonist or PPI.

Side Effects: Diarrhea- magnesium; Calcium overdose if take with other foods that are fortified with calcium

Medical intervention: >2x/week or >1 month

Interactions: Many drugs due to altering pH; especially digoxin, tetracycline, iron, and fluoroquinolones

Nonpharm: Elevate head of bed, do not eat right before bed, avoid chocolate, mint, fat, spicy foods, citrus foods, eat smaller meals

Indication: Cough and cold; sleeplessness associated with cold symptoms

Classification: analgesic, cough suppressant, and sedating antihistamine

How it works: Acetaminophen helps alleviate pain, dextromethorphan can help suppress cough

Dosing: See box

Treatment expectations: DM: 15-30 minutes

Side Effects: Drowsiness, n/v,

Medical intervention:

Interactions: Alcohol, APAP products

Nonpharm: Lozenges, humidifiers,