Risk for allergic reactions are high given the increased exposure to a new and different environment, including new foods, different air quality, increased pollution, and even different ingredients in cleaning products, soaps, and other hygiene products. For allergy prevention and treatment, a first-generation antihistamine, diphenhydramine (Benadryl), or a second- generation antihistamine, fexofenadine (Allegra), should be included in the travel kit. Diphenhydramine can also help treat motion sickness, another common ailment. First-generation antihistamines are highly lipophilic and cross the blood brain barrier, thus affecting the central nervous system (CNS) and causing CNS related adverse effects, including sedation and drowsiness. They also have short half-lives, leading to multiple daily doses. Second-generation antihistamines, on the other hand, are lipo-phobic and have poor penetration of the blood brain barrier and are thus less likely to be sedating. They also have longer half-lives, necessitating only once or twice daily dosing. As a result, diphenhydramine may be preferred if help with sleep is needed and fexofenadine may be preferred when wanting to avoid disruption of daytime activities.
Due to the changes in food intake and the difference in food and water hygiene, especially outside of the United States, infectious diarrhea, constipation, nausea, and GERD are common ailments. Bismuth subsalicylate (Pepto-Bismol) and/or loperamide (Imodium) should be included for diarrhea, along with oral rehydration salts to replace lost fluids. A stimulant laxative, senna (Senokot) should be included for constipation, antacid magnesium hydroxide and aluminum hydroxide (Mylanta) for symptoms of GERD, and acetaminophen (Tylenol) for pain/fever. However, if children are brought along, bismuth subsalicylate and senna should not be used; lots of fluids for either constipation or diarrhea should be given along with oral rehydration salts for diarrhea. For diarrhea, the Liquid form of loperamide is recommended for children under 5 years of age due to the risk of choking. It is also important to educate parents on the proper dosage of Mylanta for their children.
Travel-related skin conditions are also commonly encountered, such as bacterial or fungal infections and contact dermatitis from plant toxins. Neomycin + polymyxin B + bacitracin (Neosporin), an antibacterial, can help prevent infection of minor cuts, burns, and scrapes; terbinafine (Lamisil), an antifungal, can help with athlete’s foot or ringworm, and 1% hydrocortisone cream can help relieve itching from contact dermatitis. In addition, instant ice packs should be brought along to help decrease swelling or inflammation from any injuries or sores. An Insect repellant (DEET), especially when traveling to South America or Asia or other tropical areas, should be brought along as well because mosquitoes, ticks, and other insects may be vectors of a serious disease, such as the Zika virus. And never forget broad spectrum sunscreen, with an SPF of at least 30 that covers both UVA and UVB.
Do not forget to take along some 325mg chewable aspirin as well, as it can help relieve a heart attack while waiting for paramedics. Not only will a person save himself, but he may also save the life of someone else.
Appropriate medications for any medical conditions such as asthma should also be brought along. Again, these are the minimum that should be taken along when traveling. For more information on other medications, click on the first two links below.
- Traveler’s Health, Pack Smart. Centers for Disease Control and Prevention. https://wwwnc.cdc.gov/travel/page/pack-smart. Published October 21, 2016. Accessed March 3, 2017.
- Travel Medical Kit. Medical Clinics of North America: Vol 100, Issue 2. http://www.sciencedirect.com.proxy.westernu.edu/science/article/pii/S0025712515001649. Published March 2016. Accessed March 3, 2017.
- Hu Y, Sieck DE, Hsu WH. Why are second-generation H1-antihistamines minimally sedating? European Journal of Pharmacology. http://www.sciencedirect.com.proxy.westernu.edu/science/article/pii/S0014299915301904.
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