I didn't see Modafinil (Provigil/Alertec et al.) in the list. For those who have never heard of it, it's a drug which is used in the treatment of fatigue and narcolepsy. The military uses it to help pilots who need to fly 30hr+ missions maintain alertness, forgo sleep, and still function at near peak capacity.
It would be an extremely valuable post-disaster aid (e.g. you have to spend 18-24 hours in your car driving), and is safe for most people to use. It has vague enough indications for use that it shouldn't be a problem to obtain; especially if, like me, you have a job which requires you to work extremely long and irregular hours for weeks at a time. It's not an amphetamine, and has low potential for addiction.
Good thoughts.
Indeed this one is used in the military. While it is not addictive, there is potential for abuse (as is the case with many medications). With that said, if you are a person who would need to stay awake, this one may not be a bad one to add to your pharmaceutical arsenal. For a general survival concept though, it is best to travel in numbers. It is best to let your body sleep when it is tired. Lack of sleep will lead to bad decisions and a poor outlook when you need a positive attitude the most.
Modafinil (Provigil)
Fatigue / Narcolepsy
200-400 mg by mouth one time per day (max 400 mg per 24 hrs)
(Maybe Archer can work his magic and add this to the sleep section???
)
I have one med to add to the GI section, and forgive me if I overlooked it on your list: Dicyclomine 20 mg po four times daily as needed for GI cramping. Since many wilderness ailments include diarrhea/cramping, this can be very useful. I've seen many people faint from severe cramping, and this can make them more able to self-rescue and walk to a higher level of care.
Great addition!
Dicyclomine (Bentyl)
Abdominal Cramping / Irritable Bowel Syndrome
20-40 mg by mouth every 6 hours as needed for cramping (max 160 mg per 24 hours)
(Maybe Archer can work his magic AGAIN and add this to the GI section!)
And...one thing to add to the discussion about Doxycycline and prolonged storage, since it's so handy to keep around for tickborne rickettsial diseases. As tempting as it is to hang onto Doxycycline, it can degrade with prolonged storage, and can cause acute renal failure (laypeople read as: general kidney BADness) if it is used too long after the expiration date.
Really important point here. As I said in earlier posts, some medicines can last well for years, and other medicines won’t be safe long term. We don’t know which is which unfortunately, as that information is not made public.
However, we do know that any medicine that ends with “–cyline” will be UNSAFE for long term storage.
Doc K, what do you think of people storing/using antibiotics that are made for animals?
I'll be real honest and say I don't know. The two sides of the issue are 1) if these are the exact same medicines, it should be no problem (the dosing may be different based on concentrations however) and 2) since these are not "made for human use" are there preservatives or other ingredients that would be harmful to humans?
I may try to make a few phone calls and track this one down a bit more...
Thanks, Doc. Hope to buy you a beer someday.
One quick question. The major problem faced by diabetics is their inability to store sufficient quantities of insulin long term. Would reverting to oral meds such as Metformin (because they are easier to store) be of any benefit? In other words, would they lower BS at all?
Forget the karma points… I’ll take the beer!
Good question. Insulin does not store well long term.
Unfortunately, Metformin (Glucophage) does have the potential to cause a deadly lactic acidosis. I left this one off the list on purpose, because without a lab to watch for kidney function this medicine would potentially be very unsafe. But if the alternative is death from diabetic ketoacidosis, then I may risk it. Metformin also has the unfortunate side effect of causing severe GI upset, nausea, vomiting, and diarrhea in some people when they first start taking it. When I prescribe this medicine, I always start at a low dose and work up to the treatment dose needed.
If you had a lab (or no other options) here is the dosing:
Metformin (Glucophage) - Immediate Release Form
Start with 500 mg by mouth daily for a week;
Then increase to 500 mg by mouth twice daily for a week;
Then increase to 500 mg by mouth in the a.m. and 1,000 mg by mouth in the p.m.
You can work your way up to 850-1,000 mg by mouth twice a day (I wouldn’t go any higher without a laboratory available).
Metformin (Glucophage) – Extended Release (ER) Form
Start with 500 mg ER by mouth one time daily for a week;
Increase by 500 mg ER daily every week to an final dose of 1,000-2,000 mg total ER daily.
Check out this link to another thread where homemade insulin is talked about quite a bit.Hope this helps,
Doc K
