Medication Expiration Dates

As I was on vacation at my in-laws house and needed to take something for an allergy attack caused by their terrible cat (she's actually very sweet, just danderful), I checked the expiration date and was wondering if Sudafed (pseudoephedrine) that was 3 years past its expiration date was still going to work.

And it did. Because the expiration date doesn't actually mean when the medication stops working. It's just the amount of time the FDA will guarantee that the medication will work for and is usually somewhere between 1-3 years, but most medications in pill and capsule form are stable for much much longer than that. The catch is that there's no financial reason for the manufacturers to check and see how long they are effective for because that's just money out of their pockets.

There are some caveats to this - any liquid medications can be easily contaminated by bacteria as can medications that need to be refrigerated so you should heed their expiration dates. Similarly for prescription medications when it can be potentially dangerous if they're not working at 100%, when in doubt, throw it out.

I'd recommend sorting through your medicine cabinet about once a year and disposing of old medications through the Drug Take Back program at one of the many locations in San Mateo County (check them out here)

For a little bit more info on this, go here

And you can read much much more about all this here

NSAIDs

Advil and Motrin are ibuprofen, then you have Aleve (naproxen). Those are the over-the-counter ones. Prescriptions are Mobic (meloxicam), nabumetone, indomethacin, Toradol (ketorolac), diclofenac, Lodine, and the list goes on. All of these medications are in a class called non-steroidal anti-inflammatory drugs (NSAIDs). I'm giving you this list because there is mounting evidence that these medications a) don't work as well as we'd thought and b) have some very serious long term side effects we're finding out more about. NSAID's act by reducing the amount of prostaglandins you make in order to reduce inflammation. However, prostaglandins have a ton of other effects and are involved in the maintenance of just about AIDs and also stronger if they are taken every day and/or around-the-clock. every other organ system that you have. The effect is stronger with higher doses of NS NSAID's work best and are best indicated for times when something is r...

Kidney Stones

I've written about this previously , but it's often hard to explain to people what a 10 is on the "1-10" pain scale if they haven't been in that spot before. For women who have had children, they generally know what a 10 is, but for men it's a little harder. When I was a medical student on my psychiatry rotation, we had a patient calmly sitting there saying his pain level was at a 10 and our resident, who was an ex-military sniper with a large skull tattoo on his forearm and a crosshair through the eye, calmly leaned forward and asked, "so if I lit you on fire and ran you over with my truck, you could not be in more pain than you are now, correct?" The patient changed his answer. Getting to the point, a kidney stone is about the close I can come to describing a 10/10 pain to people who haven't gone through childbirth. The fundamental issue is similar - your body is trying to move a big solid thing through an opening that was not really desig...

Pain

Sorry to be a pain I would say about 90% of the comments I hear from people about their pain threshold is that they think they have a high pain tolerance. Which is statistically impossible unless I just attract people who have a high pain tolerance. We traditionally ask people to rate their pain on a 1-10/10 scale and while we hear a lot of 9's and 10's, I would say that, having been present for a number of them, a 10/10 would be giving birth to a first child. For those who haven't experienced that, my old psychiatry resident described it as "so if I lit you on fire and ran you over with my truck, you would not be in any more pain than you are now" (he was also a former Marine sniper which might explain that). But this is pretty pervasive throughout the medical system and got me wondering as to how people's understanding of what their pain threshold was matched up to what it really was. Fortunately, there were researchers who had a yen to poke peopl...

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