Trying to get together an emergency medical kit to take with me while traveling to unimproved countries.  What medicines (both script and non script) should I take?  The places will be quite the shitholes of the globe.  I've got all my shots as do the people I'll travel with.  Are antibiotics a good idea to have on hand?  I've heard that taking your own needles/syringes may be a good idea.

Penicciline is ALWAYS good to have around the house or while traveling.

Since I'll visit my doc prior to going wheels up and brief him on the situation, what scripts should I request?  Are there any good anti malarial drugs available in the US?  I was thinking along the lines of :

some broad spectrum anti biotics such as Levofloxacin or Cipro
a good anti diarrheal
some sleeping pills (won't be staying in one place long and have to function when I get new places)
a prescription pain pill


Any thoughts?

I'm not the kind to take anitibiotics at the first sniffle and I rarely get sick but I want to be prepared for the distintly crappy medical systems outside the US.  I know that basically its not a matter of IF but WHEN and WHERE I'm gonna get sick.

IM sent

Make sure to keep the prescriptions with you as Customs in some places look dimly on people entering with needles and syringes. Even diabetics get hassled often. Particularly if you're taking painkillers and sleeping pills.

Quoted: Make sure to keep the prescriptions with you as Customs in some places look dimly on people entering with needles and syringes. Even diabetics get hassled often. Particularly if you're taking painkillers and sleeping pills.

Definintely. I was gonna keep a copy of them on me and leave the originals with my support guys in the states.  We utilize a service that can also have our scripts and drug descriptions translated in many languages to make it easier to travel.

Get one of those temp filling kits for your teeth. Along with some superglue!, bandaids assortment, ointment for jock ich and other.

where specifically? In my experience, you can get the meds you need where you are, even in Central Africa. They also tend to be much cheaper there, especially for antibiotics... the only thing you might want to bring is mefloquine, and if you are going to take it you need to start a week or so before you go.

Quoted: Quoted: Make sure to keep the prescriptions with you as Customs in some places look dimly on people entering with needles and syringes. Even diabetics get hassled often. Particularly if you're taking painkillers and sleeping pills. Definintely. I was gonna keep a copy of them on me and leave the originals with my support guys in the states.  We utilize a service that can also have our scripts and drug descriptions translated in many languages to make it easier to travel.

I'd be very careful taking narcotics into other countries. Personally don't think it worth the risk. You can live with pain.

Overall you made good choices, I think.

Immodium AD for diarrhea
Phenergan for Nausea/vomiting
Levaquin or Cipro as you said, or other fluoroqunolone
Zithromax and /or Augmentin. Cephalexin is a useful alternative.

If you are prone to allergic reactions or other health problems you should consider taking an anithistamine and prednisone.
Other meds are you need.

It also depends on where you are going somewhat.

FWIW, most forms of bacterial dysentery are resistant to Cipro now due to widespread use but it can be used for other things. Zithromax will work for dysentery if bacterial in most cases.

Amoebic dysentery such as Giardia should respond to metronidazole and I would think about that depending on where you are going but remember you cannot mix with alcohol.
That would also be useful if you develop C. difficile colitis as an opportunistic infection after taking other antibiotics.

Also, with things going as they are you might want to bring some Tamiflu if you can get a hold of some.

If your wife has problems with vaginal yeast infections when she takes antibiotics(v. common with Augmentin or other penicillins) you should bring something along for that.

My better half will have to wait this one out.

Mostly travelling to Eastern Europe (no worries there)
all the -stan's
subsaharan africa

I know that most of the drugs can be obtained overseas and cheaper however I want to ensure I have scripts for all of them.   If I have to take a sleeping pill or even a narcotic, I want to have a script because I am subject to drug testing.   And, I know some places have problems with knock off drugs, here in the US, I know I am getting the real stuff.

Also, as an afterthought, if I have something and finally get back to the states, anyone know of a doc in the atl area familiar with tropical diseases.  The general family doc probably doesn't deal with amoebic dysentary very often

Get your shots before you go.  Flu, updated tetanus, Hep-B, and anything your doc recomends for the country(ies) you may be traveling to.  Then I'd pack a decent first aid kit, take aspirin and another pain killer like Tylenol or Advil, lots of vitamins or a product called "Airborne" which is a Alka Seltzer type tablet but is vitamin based designed to help boost the imune system.  Anythng you normally take obviuosly, even allergy stuff if you have seasonal ones.  Some hand sanitizer and/or your own atibacterial soap you can pack into a fanny pack or your carryon bag. Maybe even some disenfecting wipes to hit the seatback tray and arm rests on the plane if your are so inclined.

visit the state department website, and enter the country you want to visit. very informative.
It lists innoculations you should get before going, and a ton of other info. if I can find the link again, I'll post it.
www.state.gov/r/pa/ei/bgn/

bump for continued medical advice.

Quoted: My better half will have to wait this one out. Mostly travelling to Eastern Europe (no worries there) all the -stan's subsaharan africa I know that most of the drugs can be obtained overseas and cheaper however I want to ensure I have scripts for all of them.   If I have to take a sleeping pill or even a narcotic, I want to have a script because I am subject to drug testing.   And, I know some places have problems with knock off drugs, here in the US, I know I am getting the real stuff. Also, as an afterthought, if I have something and finally get back to the states, anyone know of a doc in the atl area familiar with tropical diseases.  The general family doc probably doesn't deal with amoebic dysentary very often

I wouldn't worry about prescriptions too much, most places in the 3rd world don't require them to buy antibiotics and even narcotics.

Evening doctors care to chime in?

Anti-worms pills!!!

Levofloxacin didn't work for me. doc had to cut it out. talk about giving the devil his pound of flesh.

so make sure the girl washes her feet beofre she walks on your back.

seriously. get a twinrex hep a and b shot series, expect dysentery if you do not boil all water that goes into your mouth or eyes, and take some methyl-prednisone.

check the CDC website for the areas you are going, or get your doc to do it. take your own life into your hands with foreign working girls. 80% of africa has aids, herpes, or syphillis. the hep c sub type varies by country, and few are treatable. keep your blood from mixing with others, no matter what.

don't wash or swim in african streams/rivers. the liver flukes kill slow, but they still kill. watch out for scorpions and stinging ants in africa. be glad for the mongoose. africa would be uninhabitable if not for them. do not believe anybody who tells you tse-tse fly is down in east africa. anti malarial prophylactic is available as an oral, and should be taken as directed.

don't call africans "darkie", "nigger", "boy" or some such. call them "african". learn a little swahili.

"jambo" is how are you, or hello
"missouri" is fine, thanks
"tumia maji ya moto" is use hot water
"ashante" is thank you
"hapana hij, nataka bunduki kubwa" is not this one, i want the big rifle

Botfly larva.

Has anyone experienced that?

Quoted: Penicciline is ALWAYS good to have around the house or while traveling.

What is that?  Is that like a super-strong version of Penicillin?

+1 for my the opinion of my esteemed collegue, DrJarhead.  

I gto to some real not nice places. Augmentin and Cipro are a must.  Get it in the USA.  I do not trust the meds in Africa and other place. I am in that field.    

Tequin may be a good idea, but it is after the other stuff does not work.  The Cipro is for the runs and the augmentin will do well if you have a sinus issue. I would take some alergy meds too.  Some places are real dusty.  

BTW did you get your Typhod shot?

Quoted: I gto to some real not nice places. Augmentin and Cipro are a must.  Get it in the USA.  I do not trust the meds in Africa and other place. I am in that field.     Tequin may be a good idea, but it is after the other stuff does not work.  The Cipro is for the runs and the augmentin will do well if you have a sinus issue. I would take some alergy meds too.  Some places are real dusty.   BTW did you get your Typhod shot?

Typhoid, yellow fever, Hep A & B and everything else that makes up a full .mil deployment series

Thanks for all the info guys.

Please verify with a physician before acting on this: I've read that doxycycline works as a malaria preventative (take 100mg daily) as well as an antibiotic (main use).  I don't know whether it works as well as the other drugs;  this may depend on which area you're in anyway.  I've read that some strains of malaria are now resistant to the other antimalarials (region-dependent), so you may need to switch among them depending on where you are.

I'd avoid Cipro and Levaquin and go with some other fluoroquinolone antibiotic.  No idea if it's a class effect or limited to those two, but they have been found to cause "persistence" (failure to kill) in chlamydia, and presumably in other mycoplasma infections.  In the U.S., there's currently a diarrhea-causing infection running (heh) around which is now highly resistant to them (mentioned in the news a few weeks ago, sorry no linky no more).

As some other folks have mentioned, medication is often pretty widely (and cheaply) available over-the-counter in other countries, anyway.  In Taiwan, the Augmentin prescription that cost me US$105 in the U.S. (US$250 or so if you include the doctor's visit fees ) cost around US$20.

And please be aware that you can f*ck yourself up quite badly by taking the wrong antibiotic for a given disease.  Self-medicating should be a last resort.  If you're going on "official business", surely you'll have some sort of medical care available?

So, are you going to get the Wandering Duck site up before you leave?

My boss, who has done this type of travel frequently, recommended prophilactic 10mg Doxycyline before during and after deploying what do you docs have to say on that?

I always take Cipro and Flagyl with me. They will cover >90% of bacteria infections.

Okay, so far I have

Phenergan for Nausea/vomiting
Levaquin or Cipro or other fluoroqunolone
Zithromax and /or Augmentin. Cephalexin is a useful alternative.
metronidazole (Flagyl)- ameobic dysentary
800mg Ibuprofen-aches and pains
Lomotil- diarrhea OR Immodium AD

Which would be preferrable? Immodium or Lomotil?

And for sleep regulation:
Modafinil (Provigil®; Vigicer®; Alertec®) stimulant
Temazepam (Restoril) sleep


I don't take any medicines at all and generally hate doing so.  This seems like a lot of dope.  One concern is becoming dependent on the sleep regulators even though it would be short term usage.  From what I have been briefed though, I'll be expected to hit the ground in a potentially hazardous location and be able to function so I've been told that it is probably a good idea to have sleep regulators.

Stick with the Levaquin (once a day dosing--less pills to carry), ditto on the Z-pak.  Take some vitamins (multi-vitamins).  Drink only bottled stuff (avoid ice in your drinks, water, etc.).  Use sealed bottles of water to brush your teeth with.  

AFARR

Quoted: My boss, who has done this type of travel frequently, recommended prophilactic 10mg Doxycyline before during and after deploying what do you docs have to say on that?

this works well for malaria and other bad bugs but has the unfortunate effect of making your skin very photo-sensitive to the point of pain, something to be avoided in hot sunny places.

Quoted: Quoted: My boss, who has done this type of travel frequently, recommended prophilactic 10mg Doxycyline before during and after deploying what do you docs have to say on that? this works well for malaria and other bad bugs but has the unfortunate effect of making your skin very photo-sensitive to the point of pain, something to be avoided in hot sunny places.

Are you sure that wasn't 100mg (one hundred milligrams), not ten?  AFAIK, the usual dosage range is between 100mg - 300mg per day depending on the infection.  I'm not even sure they make 10mg capsules.

Oh yeah, the photosensitivity is a listed side effect;  personally, I've never had a problem with it, and I'm extremely pale and sunburn easily already.  YMMV.

Quoted: Quoted: Quoted: Make sure to keep the prescriptions with you as Customs in some places look dimly on people entering with needles and syringes. Even diabetics get hassled often. Particularly if you're taking painkillers and sleeping pills. Definintely. I was gonna keep a copy of them on me and leave the originals with my support guys in the states.  We utilize a service that can also have our scripts and drug descriptions translated in many languages to make it easier to travel. I'd be very careful taking narcotics into other countries. Personally don't think it worth the risk. You can live with pain. Overall you made good choices, I think. Immodium AD for diarrhea Phenergan for Nausea/vomiting Levaquin or Cipro as you said, or other fluoroqunolone Zithromax and /or Augmentin. Cephalexin is a useful alternative. If you are prone to allergic reactions or other health problems you should consider taking an anithistamine and prednisone. Other meds are you need. It also depends on where you are going somewhat. FWIW, most forms of bacterial dysentery are resistant to Cipro now due to widespread use but it can be used for other things. Zithromax will work for dysentery if bacterial in most cases. Amoebic dysentery such as Giardia should respond to metronidazole and I would think about that depending on where you are going but remember you cannot mix with alcohol. That would also be useful if you develop C. difficile colitis as an opportunistic infection after taking other antibiotics. Also, with things going as they are you might want to bring some Tamiflu if you can get a hold of some. If your wife has problems with vaginal yeast infections when she takes antibiotics(v. common with Augmentin or other penicillins) you should bring something along for that.

I agree with the above. Neurontin 300 to 600 mg at night is great for sleep. I use it for jet lag. It helps you get to sleep and keeps you in REM longer than usual, so the sleep is much more restful than other, more "traditional" sleep aids.
Something to purify water would be a must as much of the water may be "questionable" and bottled water may not always be available.