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Dr. Curbside

Dr. Curbside

Verified How doctors think about decisions — and what real-world experiences add
Emergency Medicine
Emergency physician and founder of Curbside.bio. I’ve seen how much medical care can vary in real life — and how different doctors can recommend very different approaches. Sharing a clinician perspective here, alongside real-world experiences about what has actually worked for others.
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Curbside.bio requires contributors to disclose relevant professional and financial relationships from the previous three (3) years. Older relationships may be listed voluntarily.

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GSK, Galvani

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June 2024

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Dr. Curbside's Reviews

Duloxetine

For Long COVID

1 day ago
Duloxetine (Cymbalta) is sometimes used in Long COVID patients with neuropathic pain, depression, or autonomic symptoms such as dizziness or orthostatic intolerance. Support for duloxetine is based on expert guidance and its proven benefit in related conditions like fibromyalgia and nerve pain rather than Long COVID-specific clinical trials. Its strongest role may be in patients with burning pain, tingling, or suspected small fiber neuropathy. Some clinicians also use it when depression, chronic pain, and fatigue overlap. However, duloxetine can occasionally worsen dizziness or orthostatic symptoms in some patients.

Buproprion

For Long COVID

1 day ago
Bupropion (Wellbutrin) is sometimes used in Long COVID patients with brain fog, fatigue, low motivation, or depression. Its stimulating dopamine and norepinephrine effects may help improve energy, focus, and cognitive symptoms in some individuals. Current support comes mainly from expert guidance, case reports, and related ME/CFS research rather than large Long COVID trials. Some patients report meaningful improvement, though anxiety and insomnia can worsen in others.

Fluvoxamine

For Long COVID

1 day ago
Fluvoxamine has some of the stronger emerging evidence for Long COVID fatigue. A 2026 randomized trial found that fluvoxamine 100 mg twice daily modestly improved fatigue and quality of life compared with placebo, with benefits still present at 90 days. This was the first adequately powered study to directly evaluate fluvoxamine for established Long COVID rather than acute COVID infection. Current Long COVID guidance also lists fluvoxamine as a medication under investigation for brain fog and cognitive symptoms.

Fluoxetine

For Long COVID

1 day ago
Fluoxetine (Prozac) is one of the more commonly recommended medications in the Long COVID literature when anxiety is a major symptom. It may help reduce persistent anxiety, panic, and mood symptoms, especially in patients also dealing with fatigue or brain fog. Benefits are usually gradual and can take several weeks. Long COVID guidance statements often favor SSRIs like fluoxetine over benzodiazepines, which may worsen memory problems, brain fog, or PTSD-related symptoms.

Ibuprofen

For Barometric Pressure Headache

3 weeks ago
Ibuprofen is often a first-line option because it is over-the-counter, widely available, and has a well-established safety profile when used as directed. It is effective for relieving mild to moderate headache pain by reducing inflammation and pain signaling. Many people find it works quickly, especially when taken early. Overall, it offers a reliable and accessible starting point for symptom relief.

Doxycyline

For Sea Urchin Spine Injury

4 weeks ago
Doxycycline isn’t usually needed for most sea urchin injuries, but may be considered in higher-risk situations, such as significant exposure or underlying comorbidities. It provides coverage against marine bacteria, including Vibrio species, which can be a concern with seawater wounds. When used appropriately, it can help treat developing infections or prevent progression in higher-risk cases. For uncomplicated injuries, though, antibiotics are typically not necessary.

Hot water

For Sea Urchin Spine Injury

4 weeks ago
Hot water is easy to access and often gives pretty quick relief—it likely helps by neutralizing some of the toxins and relaxing the area. Soaking the area in hot (not scalding) water for about 30–90 minutes is usually recommended and can make the pain much more manageable early on.

Acetaminophen and Hydrocodone

For Sciatica

1 month ago
I use acetaminophen and hydrocodone when Tylenol and ibuprofen aren’t enough to control the pain. It can be effective for short-term relief in more severe cases, helping patients stay comfortable and functional. That said, I’m mindful of the risks of dependence and misuse, so I counsel patients carefully. It’s something I use selectively and for a limited duration. Overall, it’s a balance between improving comfort and minimizing risk.

Prednisone

For Sciatica

1 month ago
Prednisone is something I’ll use for sciatica if symptoms aren’t improving with initial treatments, mainly to help calm down inflammation around the nerve. It can provide some short-term relief and improve function, though the results can be variable. It’s typically given as a short course rather than long-term therapy. Overall, it can be a helpful next step in select cases, but not a first-line option.

Epidural Glucortocoid Injection

For Sciatica

1 month ago
Epidural steroid injections for sciatica can provide significant relief, especially when symptoms are more severe or not improving with initial treatments. They work by delivering anti-inflammatory medication directly around the irritated nerve, which can help reduce pain fairly quickly. I’ve seen good benefit in many patients, particularly as a bridge to allow rehab and recovery. That said, they are more invasive and not usually a first step. Overall, a strong option to consider if symptoms persist despite conservative care.

Physical Therapy

For Sciatica

1 month ago
Flexeril (cyclobenzaprine) isn’t something I routinely prescribe for sciatica, unless there’s clear muscle spasm contributing to the symptoms. It doesn’t really address the underlying nerve irritation, so its role is fairly limited. In those cases with significant back tightness, it can help with comfort, especially at night. Otherwise, the benefit is modest and often outweighed by side effects like drowsiness. Overall, it’s not a primary treatment, but can be useful in select situations.

Cyclobenzaprine

For Sciatica

1 month ago
Flexeril (cyclobenzaprine) isn’t something I routinely prescribe for sciatica, unless there’s clear muscle spasm contributing to the symptoms. It doesn’t really address the underlying nerve irritation, so its role is fairly limited. In those cases with significant back tightness, it can help with comfort, especially at night. Otherwise, the benefit is modest and often outweighed by side effects like drowsiness. Overall, it’s not a primary treatment, but can be useful in select situations.

Acetaminophen

For Sciatica

1 month ago
Acetaminophen can be used for sciatica mainly to help with pain control, though it doesn’t reduce the underlying inflammation. It can take the edge off symptoms and is often a good option for people who can’t take NSAIDs. Relief is usually more modest compared to anti-inflammatory medications. It’s generally well tolerated when used at appropriate doses. Overall, it’s a simple, supportive option for pain, often used alongside other treatments.

Ibuprofen

For Sciatica

1 month ago
Ibuprofen is one of the first-line treatments for sciatica, mainly because it helps reduce inflammation around the irritated nerve. It can be effective at easing pain and improving mobility, especially early on. It’s easy to access over the counter and works well for many patients as an initial option.

Botulinum Toxin Type A

For Wrinkle

1 month ago
Botox is best for treating dynamic wrinkles—the kind that appear from repeated facial movements like frowning, smiling, or squinting. These include forehead lines, frown lines, and crow’s feet around the eyes.Unlike topical treatments (like retinoids) that work on the skin's surface to improve texture and fine lines over time, Botox works below the surface by relaxing the muscles that cause those expression lines.

Rest and proper nutrition

For Covid-19

1 month ago
Rest and good nutrition are probably the most important things you can do when you have COVID. Giving your body time to recover and staying hydrated helps your immune system do its job. It’s not a specific treatment, but for most mild cases, it’s really the foundation of getting better.

VItamin D

For Covid-19

1 month ago
Vitamin D has been studied quite a bit for COVID, mostly because it plays a role in the immune system. There’s some suggestion it might help a bit—especially if someone is deficient—but the data is mixed and the benefit is pretty modest at best. It’s not a main treatment for COVID. Overall, it’s reasonable to keep vitamin D levels up, but it’s more of a supportive measure than something that makes a big difference on its own.

Dexamethasone

For Covid-19

1 month ago
Steroids (like dexamethasone) are a go-to treatment for patients hospitalized with more severe COVID, especially if they need oxygen or breathing support. They help calm down the body’s inflammatory response, which is what often causes the most damage in advanced cases. In these patients, steroids have been shown to reduce mortality and improve outcomes. That said, they’re not helpful—and can even be harmful—in mild cases, so they’re really reserved for sicker, hospitalized patients.

Comirnaty

For Covid-19

1 month ago
COVID-19 vaccination is still a key way to lower the risk of serious illness and complications, even though COVID is generally not carrying the same level of threat it did earlier in the pandemic. For many people now, it is more of a risk-benefit decision, balancing side effects against protection from infection, severe disease, and Long COVID. The benefit is still most meaningful in older adults, higher-risk patients, and people with weaker immune systems. Overall, it is less of a universal urgency than before, but it remains a useful preventive tool.

Diphenhydramine

For Insomnia

1 month ago
Diphenhydramine can help with insomnia by causing drowsiness, but it’s generally not a first choice given the number of better OTC and prescription options available. Its effects can be inconsistent, and tolerance often develops quickly with repeated use. That said, if you happen to have it on hand, it can be a reasonable short-term backup and may be effective for occasional sleeplessness. Side effects like next-day grogginess and dry mouth can limit its usefulness. Overall, it’s more of a convenient fallback than a preferred sleep aid.

Zolpidem

For Insomnia

1 month ago
Zolpidem is a reliable option for insomnia and one I often use in the ER when patients need quick relief. It works fast and is effective, especially for helping patients fall asleep. Compared to older sedatives, it tends to be less habit-forming, though there’s still some risk with repeated use. It’s best used short-term, particularly in acute situations where immediate sleep is needed. Overall, it’s a practical go-to when non-medication or OTC options aren’t enough in the moment.

Melatonin

For Insomnia

1 month ago
Immediate-release melatonin can be helpful for insomnia, but it’s not usually the best option for typical, chronic insomnia—especially if the issue is staying asleep. It works quickly and is more useful for sleep onset, but its effects wear off relatively fast. Where it really shines is in circadian rhythm-related insomnia, like jet lag or delayed sleep phase, where it helps reset the body’s internal clock. It’s OTC, generally safe, and easy to try, but may be less effective than extended-release forms or other treatments for more persistent sleep issues.

Extended-release melatonin

For Insomnia

1 month ago
Extended-release melatonin is a great first option for insomnia, especially if the issue is waking up during the night. It lasts longer than regular (immediate-release) melatonin, so it better matches how the body naturally produces melatonin overnight. It’s OTC, generally safe, and easy to try without the downsides of prescription sleep meds. For many people, it works better than short-acting melatonin when staying asleep is the problem. It’s a simple, low-risk place to start before considering stronger treatments.

Cognitive behavioral therapy for Insomnia

For Insomnia

1 month ago
CBT-I is generally the best long-term treatment for insomnia because it fixes the underlying sleep habits and thoughts without needing medication. The downside is that it takes time—usually a few weeks to months—to really work. That makes it less practical in the moment if someone shows up to the ER unable to sleep and needing immediate relief. In those situations, short-term medications can help bridge the gap while CBT-I is getting started.

Aquaphor

For Eczema

1 month ago
Aquaphor is a great option for eczema—it does an excellent job locking in moisture and helping repair the skin barrier, especially during flare-ups or with very dry skin. I’ve found it especially helpful when lighter moisturizers aren’t enough. The downside is that it’s quite greasy, which makes it less practical during the day, so I usually save it for nighttime use—and honestly, that means I sometimes forget to use it consistently.

Tretinoin

For Wrinkle

1 month ago
Tretinoin is a highly effective treatment for wrinkles, helping improve fine lines and skin texture over time. It works by increasing collagen production and skin turnover, but results take a few months of consistent use. Early irritation is common, but it’s considered a gold-standard option for anti-aging.

Tazarotene

For Wrinkle

1 month ago
Tazarotene is a powerful prescription retinoid that works well for reducing fine lines, uneven skin tone, and sun damage, often delivering faster results than tretinoin or adapalene. However, it can cause more irritation, especially in the beginning. It's best suited for experienced users who want stronger results and can handle a more intense treatment.

Adapalene

For Wrinkle

1 month ago
Adapalene 0.1% is an over-the-counter (OTC) retinoid that’s a great starter option for improving fine lines and rough skin texture. It’s gentle enough for sensitive skin and can be used once daily at night after cleansing.

Imiquimod

For Wart

1 month ago
Aldara (imiquimod) can be used for warts when first-line treatments like salicylic acid or cryotherapy haven’t been effective. It works by stimulating the immune system to help clear the virus rather than directly destroying the wart. Best used for more persistent or difficult-to-treat cases, though it requires consistent application and can take several weeks to work.

Liquid Solution for Warts

For Wart

1 month ago
Liquid salicylic acid solutions are a first-line, over-the-counter treatment for warts that work by gradually breaking down the thickened skin. They’re inexpensive, widely available, and easy to use at home, making them a great initial option. While they take time and consistency, they’re preferred over more invasive treatments as a simple and low-risk starting point.

Cryotherapy

For Wart

1 month ago
Liquid nitrogen (cryotherapy) in the doctor’s office is very effective for treating warts, especially if OTC treatments haven’t worked. It can be more painful, but often leads to faster resolution. Typically a good next step when simpler options fail.

Tioconazole

For Vulvovaginal candidiasis

1 month ago
Tioconazole is a convenient option for vaginal yeast infections, typically used as a single-dose OTC treatment. It’s helpful for patients who prefer a one-time therapy rather than multi-day regimens like miconazole. While similarly effective for uncomplicated infections, it may be more irritating for some and is usually chosen for convenience rather than superior efficacy.

Terconazole

For Vulvovaginal candidiasis

1 month ago
Terconazole is a good option for vaginal yeast infections when patients don’t respond to OTC treatments like miconazole or clotrimazole. It’s a prescription azole with strong activity against Candida, including some strains that may be more resistant to standard OTC therapies. It can be used as a shorter, more effective course in moderate to severe cases, though it’s more expensive and requires a prescription.

Miconazole

For Vulvovaginal candidiasis

1 month ago
Miconazole is an effective over-the-counter treatment for vaginal yeast infections. It is available as creams or suppositories and is considered safe for use during pregnancy.

Butoconazole

For Vulvovaginal candidiasis

1 month ago
Butoconazole is a prescription antifungal that effectively treats vaginal yeast infections with a convenient single-dose cream formulation. It provides high cure rates and rapid symptom relief and considered safe during pregnancy.

Clotrimazole

For Vulvovaginal candidiasis

1 month ago
Clotrimazole is an effective over-the-counter antifungal treatment for vaginal yeast infections. It is available as a vaginal cream or tablet and is considered safe for use during pregnancy, especially for uncomplicated infections. Most women experience symptom relief within a few days of treatment.

Fluconazole

For Vulvovaginal candidiasis

1 month ago
Fluconazole is a convenient one-time oral treatment for vaginal yeast infections, providing quick and effective relief. It’s easy to use compared to creams or suppositories. However, it is not recommended during pregnancy, as oral fluconazole may pose risks to the fetus.

Desmopressin

For von Willebrand disease

1 month ago
Desmopressin is first-line therapy for type 1 VWD and some type 2 cases, if the patient is responsive. It requires refrigeration, and among administration routes, IV is most reliable, followed by subcutaneous injection and then nasal spray, which has more variable absorption.

Acyclovir

For Varicella

1 month ago
Acyclovir is used for chickenpox (varicella) mainly in patients at higher risk of complications. This includes older children and adults, those with chronic skin or lung conditions, or patients on steroids or long-term salicylates. When started early, oral acyclovir can help reduce how severe and how long the illness lasts. In more serious cases—such as pneumonia, encephalitis, or in immunocompromised patients—IV acyclovir is preferred. It’s not routinely needed for healthy children with mild disease, but it’s an important option for higher-risk patients.

Amoxicillin-clavulanate

For Urinary tract infection

1 month ago
Augmentin (amoxicillin/clavulanate) is a second-line option for UTIs, typically used if first-line treatments have failed or are not appropriate. It provides broader coverage, including beta-lactamase–producing bacteria. While effective, it’s generally not preferred as initial therapy compared to more targeted options.

Ciprofloxacin

For Urinary tract infection

1 month ago
Ciprofloxacin is generally a second-line option for UTIs due to potential side effects like tendon rupture and QT prolongation. It can be effective, especially in patients who have failed first-line therapies or have more resistant infections. Best reserved for situations where other safer options are not appropriate.

Trimethoprim-sulfamethoxazole

For Urinary tract infection

1 month ago
Bactrim is considered a first-line treatment for uncomplicated urinary tract infections and is effective against many common bacteria. It is convenient to take and often works quickly when local resistance rates are low. However, patients with a sulfa allergy should avoid this medication, as allergic reactions can be significant and alternatives may be safer.

Phenazopyridine

For Urinary tract infection

1 month ago
Phenazopyridine (Pyridium) is used for symptomatic relief in UTIs, helping reduce burning, urgency, and discomfort. It does not treat the underlying infection, so it should be used in conjunction with antibiotics. Best used short-term to improve comfort while waiting for antibiotics to take effect.

Nitrofurantoin

For Urinary tract infection

1 month ago
Nitrofurantoin is generally my first-line therapy for uncomplicated urinary tract infections due to its effectiveness and relatively minimal side effects. It has a low risk of allergic reactions compared with many other antibiotics and is well tolerated by most patients. Its targeted activity in the urinary tract makes it a reliable choice for straightforward bladder infections.

Cranberry

For Urinary tract infection

1 month ago
Cranberry juice is a low-cost option that may help prevent recurrent urinary tract infections by reducing bacterial adherence in the urinary tract. However, it does not treat active UTIs and should not be used as a substitute for antibiotics. Its benefits are mostly seen in prevention, particularly with regular use of unsweetened juice or concentrated supplements. While not guaranteed to work for everyone, it’s a safe and inexpensive addition to a broader prevention plan.

Cephalexin

For Urinary tract infection

1 month ago
Cephalexin is often considered a first-line option for uncomplicated urinary tract infections and is generally effective against common uropathogens but lately it has had developing resistance.. It’s usually well tolerated and easy to dose, making it a convenient choice for many patients. However, those with a known penicillin allergy should use caution, as there is potential cross-reactivity and an alternative antibiotic may be more appropriate.

Sound Generators

For Tinnitus

1 month ago
Research on sound generators for tinnitus shows mixed results, with modest improvements in perceived tinnitus distress, particularly when used alongside counseling or cognitive behavioral therapy. They are not proven to reduce the tinnitus sound itself but can help promote habituation and improve quality of life in some patients.

Sertraline

For Tinnitus

1 month ago
Sertraline is not a primary treatment for tinnitus, but it may be helpful in patients whose symptoms are worsened by anxiety or depression. By improving mood and reducing distress, it can make tinnitus more tolerable even if it doesn’t directly reduce the sound itself. It’s typically used as an adjunct rather than a first-line therapy specifically for tinnitus.

Cognitive Behavioral Therapy

For Tinnitus

1 month ago
Cognitive Behavioral Therapy is a first-line treatment for patients with bothersome chronic tinnitus, particularly when accompanied by anxiety, depression, or sleep issues. Strong research, including multiple randomized controlled trials, supports its effectiveness in reducing tinnitus-related distress and improving quality of life, even though it doesn’t reduce the sound itself. It is recommended by clinical guidelines as the most evidence-based behavioral intervention for tinnitus.

Nystatin Suspension

For Thrush

1 month ago
Nystatin suspension is a first-line treatment for oral thrush, especially in mild cases. It works locally by coating the mouth and is typically used multiple times a day as a swish-and-swallow (or swish-and-spit) medication. It’s safe and effective, though adherence can be challenging due to frequent dosing and taste.

Fluconazole

For Thrush

1 month ago
Fluconazole is a systemic antifungal used for oral thrush when topical treatments fail or aren’t tolerated. It’s taken orally and is effective, especially for more extensive or refractory cases. Convenient dosing helps with adherence, though it’s typically reserved for cases that don’t respond to first-line topical therapy.

Miconazole Mucoadhesive Buccal Tablet

For Thrush

1 month ago
Miconazole mucoadhesive buccal tablets are a convenient option for oral thrush, offering once-daily dosing compared to multiple doses with other treatments. The tablet adheres to the gum and slowly releases antifungal medication throughout the day. It’s effective and improves compliance, though cost and availability can sometimes be limiting.

Clotrimazole troches

For Thrush

1 month ago
Clotrimazole troches are a first-line treatment for oral thrush, especially in mild to moderate cases. They dissolve slowly in the mouth, delivering antifungal medication directly to the affected areas. With consistent use, they are effective and well tolerated, though require multiple doses per day for full benefit.

Prednisone

For Systemic Lupus Erythematosus

1 month ago
Prednisone is my first-line treatment for managing lupus flares because it works quickly to reduce inflammation and symptoms. However, it's not ideal for long-term use due to its side effects. As the disease stabilizes, the patient should be transitioned to steroid sparing medication.

Hydroxychloroquine

For Systemic Lupus Erythematosus

1 month ago
Hydroxychloroquine is a first-line, long-term treatment for chronic SLE and is recommended for nearly all patients. It helps reduce disease activity, prevent flares, and protect against long-term complications.

Doxycycline

For Syphilis

1 month ago
Doxycycline is an alternative option for syphilis in patients who cannot receive penicillin. The typical regimen is 100 mg orally twice daily for 14 days in early syphilis, and 28 days for late latent disease. While generally effective, it is considered less reliable than benzathine penicillin G, and it cannot be used during pregnancy because it does not prevent congenital syphilis. Since it requires a prolonged oral course, patient adherence is also a concern, so it is reserved for those with true penicillin allergy who cannot undergo desensitization.

Ceftriaxone

For Syphilis

1 month ago
Ceftriaxone can be considered a backup option for syphilis, but the supporting data are limited compared to penicillin. It may be used in cases of severe penicillin allergy, particularly when doxycycline is not suitable or when treating neurosyphilis or ocular disease.

Condom

For Syphilis

1 month ago
Condoms can lower the risk of syphilis by blocking contact with infected secretions, but they are less protective than for other STIs since sores may occur outside the covered area.

Benzathine Penicillin

For Syphilis

1 month ago
Benzathine penicillin G is the gold standard treatment for syphilis because it’s highly effective and provides long-lasting antibiotic levels. For early syphilis, it’s a single IM injection, which makes it much easier for patients to complete treatment and improves compliance. Later-stage disease requires weekly injections for three weeks, while neurosyphilis needs IV penicillin instead. It’s also the only treatment proven to prevent congenital syphilis in pregnancy, making it especially important in that setting.

Ciprofloxacin

For Swimmer’s ear

1 month ago
Ciprofloxacin is typically reserved for severe otitis externa in conjunction with topical therapy. It is indicated when there is concern for a perforated eardrum, extension of the infection beyond the ear canal, or failure to respond to topical treatment alone.

Aural toilet

For Swimmer’s ear

1 month ago
Aural toilet can be helpful in otitis externa by clearing debris and improving drop penetration, but in my experience, it's often too painful for patients. I usually start with topical treatments and prefer using a wick to aid delivery, referring to Otolaryngology if debridement is needed.

Wick

For Swimmer’s ear

1 month ago
I reserve the use of a wick for cases of otitis externa where the ear canal is significantly occluded and ear drops can't reach the affected area. In these situations, the wick helps deliver antibiotics deeper into the canal to ensure effective treatment. I find it especially helpful when there's marked swelling and topical therapy alone isn't sufficient without improved access.

Ofloxacin 0.3% otic solution

For Swimmer’s ear

1 month ago
Ofloxacin may be preferred when the eardrum is perforated or tubes are present, as it is non-ototoxic and safe for the middle ear. It also has a lower risk of allergic reactions compared to neomycin-containing drops and offers the convenience of once-daily dosing, though it may be more expensive.

Isopropyl alcohol

For Swimmer’s ear

1 month ago
Isopropyl alcohol ear drops are effective in preventing otitis externa, particularly in individuals who are frequently exposed to water, such as swimmers. By helping to dry out the ear canal and reduce moisture, they create an environment that's less favorable for bacterial and fungal growth.

Ear plugs

For Swimmer’s ear

1 month ago
Ear plugs are a simple and effective way to prevent swimmer’s ear, especially in individuals with a history of recurrent infections. By keeping the ear canal dry, they help reduce the risk of irritation and bacterial growth.

Ciprofloxacin 0.3% and Dexamethasone 0.1%.

For Swimmer’s ear

1 month ago
Although Ciprodex is more expensive than other treatments, it offers key benefits like safe use with a perforated eardrum, reduced dosing frequency, and low allergy risk. These advantages often make it a preferred option for otitis externa, especially when patient comfort and adherence are priorities.

Neomycin, polymyxin B, and hydrocortisone

For Swimmer’s ear

1 month ago
Cortisporin Otic is commonly used as a first-line treatment for bacterial otitis externa, especially in uncomplicated cases. Its combination of broad-spectrum antibiotics (neomycin and polymyxin B) and hydrocortisone makes it effective for reducing both infection and inflammation. It's been in use for decades and is generally inexpensive, especially in its generic form, making it a cost-effective option.

Acetic acid 2%

For Swimmer’s ear

1 month ago
Acetic acid 2% is considered a first-line treatment for mild otitis externa, especially when symptoms are minimal and there's no significant swelling or discharge. However, I generally opt for antibiotic ear drops as a more definitive treatment,

Incision and drainage

For Stye

1 month ago
Incision and drainage is a safe and effective option for persistent or severe styes that do not improve with warm compresses and topical antibiotics. It can provide rapid relief and promote faster healing. Proper aftercare and eyelid hygiene are important to help prevent recurrence.

Erythromycin Ophthalmic Ointment

For Stye

1 month ago
Erythromycin ophthalmic ointment can be used for a stye if it’s not improving with warm compresses. It helps reduce bacterial load and may speed resolution, though many cases still resolve with conservative care alone. Typically used as a next step rather than first-line treatment.

Cephalexin

For Stye

1 month ago
Keflex is an effective treatment for severe or complicated styes, especially when the infection spreads or does not improve with standard care.

Warm compresses

For Stye

1 month ago
Warm compresses are first-line treatment for a stye and are effective in the majority of cases. They help promote drainage and reduce inflammation when used consistently several times a day. Most styes will improve or resolve with this simple approach alone.

Clindamycin

For Strep Throat

1 month ago
Clindamycin is a good backup option for severe penicillin allergies or recurrent strep, but it’s not the preferred treatment due to its higher side effect risk and potential for antibiotic resistance.

Cephalexin

For Strep Throat

1 month ago
Cephalexin is a strong alternative to penicillin for mildly allergic patients, offering similar effectiveness with fewer side effects than macrolides (azithromycin) or clindamycin. However, it’s not safe for severe penicillin allergies and requires multiple daily doses for full effectiveness.

Azithromycin

For Strep Throat

1 month ago
Zithromax (Azithromycin) is an alternative treatment for strep throat, mainly used for patients allergic to penicillin or cephalosporins. While it offers a shorter 5-day course and once-daily dosing, it is less effective than first-line treatments (penicillin, amoxicillin) and has a higher risk of antibiotic resistance. It is useful if another bacterial infection (e.g., pneumonia, sinusitis) is present.

Benzanthine Penicillin G

For Strep Throat

1 month ago
Benzathine penicillin G is the go-to treatment for strep throat if you want a one-and-done solution. A single shot clears up the infection and prevents complications like rheumatic fever, so there’s no need to take pills for 10 days. The downside? The shot hurts, and it’s not an option for people with severe penicillin allergies.

Amoxicillin

For Strep Throat

1 month ago
Amoxicillin is the most effective and recommended antibiotic for treating strep throat, providing rapid symptom relief and preventing serious complications.

Surgical Release

For Stenosing Tenosynovitis

1 month ago
Surgical release is a highly effective treatment for trigger finger, especially when other therapies like splinting or steroid injections have failed.

Corticosteroid Injection

For Stenosing Tenosynovitis

1 month ago
Corticosteroid injection is an effective, minimally invasive treatment for trigger finger, especially when splinting or physical therapy hasn't worked. It offers fast relief by reducing inflammation at the A1 pulley and is often successful after just one dose. Consider it when symptoms persist or interfere with daily activities, particularly in non-diabetic patients.

Splint

For Stenosing Tenosynovitis

1 month ago
Splinting is considered a first-line therapy for trigger finger, especially in mild to moderate cases. It helps reduce tendon irritation by limiting movement and allowing inflammation to subside. Nighttime use is often effective, and many patients see symptom improvement within a few weeks. It's a non-invasive, low-risk option before considering steroid injections or surgery.

Physical Therapy

For Stenosing Tenosynovitis

1 month ago
Physical therapy is a good next step for stenosing tenosynovitis if symptoms aren’t improving with splinting. It focuses on stretching, strengthening, and improving tendon glide, but recovery can be gradual and may take several weeks. With consistency, it can help reduce pain and improve function over time.

Prednisone

For Sore Throat

1 month ago
Prednisone can be helpful for severe sore throat that isn’t improving with standard treatments, as it reduces inflammation and can provide more rapid symptom relief. It’s generally reserved for more significant symptoms rather than routine use. Given the potential for underlying infection, I often consider concurrent antibiotics if there is concern for a bacterial cause.

Honey and Tea

For Sore Throat

1 month ago
Honey and tea are effective natural remedies for pharyngitis, offering soothing relief, hydration, and mild antimicrobial effects. While they do not cure infections, they help ease throat discomfort and promote healing. I'll admit I don't usually use this, but it is natural remedy.

Benzocaine

For Sore Throat

1 month ago
Benzocaine is an effective, fast-acting numbing agent for sore throats caused by pharyngitis. It is best used for temporary relief but does not treat the underlying infection.

Ibuprofen

For Sore Throat

1 month ago
Ibuprofen is a good option for sore throat, helping relieve both pain and inflammation. It can provide more noticeable relief than acetaminophen for some people. Just be sure to take it with food to minimize stomach irritation.

Acetaminophen

For Sore Throat

1 month ago
Acetaminophen (Tylenol) is a great option for sore throat, helping relieve pain and reduce fever if present. It’s well tolerated and easy to use for symptomatic relief. However, it does not treat the underlying cause—so if the infection is bacterial, additional treatment may be needed.

Haloperidol

For Schizophrenia

1 month ago
In the emergency room, acute psychosis with severe agitation is often managed with rapid-acting medications to ensure safety and stabilization. A common approach is giving an antipsychotic, sometimes combined with a benzodiazepine such as lorazepam (Ativan), to quickly calm the patient and reduce agitation. This allows further evaluation and initiation of longer-term treatment once the immediate crisis is controlled.

Physical Therapy

For Sacroiliac joint pain

1 month ago
Physical therapy is my go-to if sacroiliac pain persists despite initial treatment. It focuses on strengthening, stability, and mobility, though it can take a few weeks—sometimes up to a month—to see significant improvement. With consistency, it often provides more durable, long-term relief.

Ibuprofen

For Sacroiliac joint pain

1 month ago
Ibuprofen is a first-line treatment for sacroiliac pain, helping reduce both pain and inflammation. It’s typically effective for mild to moderate symptoms and can improve mobility when taken appropriately. Overall, it’s a good initial option before considering more advanced therapies.

Humidified air

For RSV

1 month ago
Humidified air is often used for RSV, though the evidence supporting its benefit is limited. That said, it’s a simple, low-risk option that may help with comfort and congestion, so it’s reasonable to try. Overall, it won’t change the course of illness but can provide some symptomatic relief.

Deep nasal suction

For RSV

1 month ago
Deep nasal suction for RSV can offer noticeable relief in select severe cases, particularly in infants struggling with significant nasal congestion and respiratory distress. While the broader research does not show consistent, significant benefits across all populations, it does suggest that certain subgroups may experience improvements without adverse physiologic effects. Despite being more invasive than standard suctioning, it remains a reasonable option in targeted situations where other measures fall short.

Aerolized ribavirin

For RSV

1 month ago
Ribavirin is an antiviral that has been used for severe RSV infections in high-risk or critically ill children, typically as an aerosolized treatment. In practice, its use is limited due to logistical challenges, including specialized delivery systems, prolonged administration time, and concerns about exposure to healthcare staff. Given variable benefit and these barriers, it’s now used selectively rather than routinely.

Nirsevimab

For RSV

1 month ago
Nirsevimab reduces the risk of serious RSV illness by about 70–75% during their first RSV season. The protection lasts for around 5 months, which covers the typical RSV season.

RSVpreF vaccine

For RSV

1 month ago
RSVpreF (Abrysvo) is one of the most effective options to prevent severe RSV disease, particularly in older adults and in pregnancy to protect newborns. It works by generating antibodies against the RSV prefusion F protein, which helps reduce the risk of hospitalization and serious complications. Overall, it’s a key preventive tool, especially for higher-risk groups during RSV season.

Physical Therapy

For Rotator Cuff Injury

1 month ago
Physical therapy is one of the first-line treatments for rotator cuff injuries, helping to reduce pain, improve strength, and restore shoulder function. It focuses on gradually rebuilding stability and flexibility, allowing many patients to recover without the need for surgery. Early and consistent therapy is key to achieving the best outcomes.

Ice

For Rotator Cuff Injury

1 month ago
Ice is considered first-line treatment for a rotator cuff injury during the first 48 to 72 hours. It helps reduce swelling, numb pain, and limit inflammation early in the healing process. Regular ice application can make recovery more comfortable and support better outcomes when combined with other treatments.

Ibuprofen

For Rotator Cuff Injury

1 month ago
Ibuprofen is considered first-line therapy for managing pain and inflammation in rotator cuff injuries. It helps reduce swelling, ease discomfort, and support participation in physical therapy. While it does not heal the injury itself, it plays an important role in early symptom control and overall recovery.

Warfarin

For Pulmonary Embolism

1 month ago
Warfarin is an older treatment option for pulmonary embolism that has largely been replaced by factor Xa inhibitors such as apixaban and rivaroxaban. While effective, it is challenging to use because the dose must be carefully titrated to keep blood levels in the right range, and this is easily affected by certain foods, medications, and even illness. Frequent blood tests (INR checks) are required to make sure it is working safely. For these reasons, newer anticoagulants are generally preferred, though warfarin is still used in select cases.

Thrombectomy

For Pulmonary Embolism

1 month ago
Thrombectomy is a procedure used to remove blood clots in the lungs for patients with pulmonary embolism with with significant risk factors such as severe right heart strain, worsening instability, or a large clot burden.. Because it is invasive, it is generally recommended after thrombolysis has failed, but it may also be considered when clot-busting drugs are contraindicated—for example, in patients with a history of recent major surgery, active bleeding, prior hemorrhagic stroke, or very high bleeding risk. The decision depends on the patient’s situation and whether the hospital has the expertise and resources to safely perform the procedure.

Tenecteplase

For Pulmonary Embolism

1 month ago
Tenecteplase is a clot-busting medication sometimes used in severe pulmonary embolism. It is given as a single IV bolus, making it faster and easier to administer than alteplase. Because it carries a significant bleeding risk, it is reserved for life-threatening PE cases with hemodynamic instability.

Alteplase

For Pulmonary Embolism

1 month ago
Alteplase is a clot-busting drug used for very serious cases of pulmonary embolism (PE). It is mainly given when large clots block blood flow to major parts of the lungs or when the PE causes life-threatening problems, like dangerously low blood pressure that can’t be maintained without support. In these situations, alteplase can quickly break down the clot and restore circulation. Because it carries a high risk of severe bleeding, doctors reserve it only for patients who are unstable and at risk of dying without urgent treatment.

Heparin

For Pulmonary Embolism

1 month ago
Heparin is recommended in pulmonary embolism (PE) when immediate anticoagulation is required, including cases with confirmed PE or high clinical suspicion, even before diagnostic confirmation if the risk is high. Heparin is preferred in patients with severe renal impairment (CrCl <30 mL/min), high bleeding risk, clinical instability, or when rapid reversal is needed—for example, before procedures, during thrombolysis, or when aggressive interventions are planned. Its short half-life and ability to be quickly reversed make it especially valuable in these settings.

Enoxaparin

For Pulmonary Embolism

1 month ago
Enoxaparin (Lovenox) is an appropriate treatment for pulmonary embolism and is given as an injection, usually twice a day. It is effective and commonly used as a bridging therapy to transition patients to an oral anticoagulant.

Apixiban

For Pulmonary Embolism

1 month ago
Eliquis (apixaban) is recommended as a first-line treatment for pulmonary embolism because it offers strong protection against recurrent blood clots with a lower risk of major bleeding compared to rivaroxaban. It is often the preferred DOAC, especially in patients with moderate kidney problems, due to its lower renal clearance.

Trimethoprim-Sulfamethoxazole

For Prostatitis

1 month ago
Bactrim is a good alternative for prostatitis when fluoroquinolone resistance is high or contraindicated due to side effects. It penetrates prostate tissue well and is effective against many common gram-negative bacteria. Its oral dosing and low cost make it convenient for long-term outpatient treatment, though caution is needed in patients with sulfa allergy or kidney issues.

Doxycycline

For Prostatitis

1 month ago
Doxycycline is useful for prostatitis caused by atypical or sexually transmitted organisms like Chlamydia or Ureaplasma. It penetrates prostate tissue moderately well and is an effective oral option for chronic or low-grade infections.

Amoxicillin-clavulanate

For Prostatitis

1 month ago
Augmentin is used for prostatitis when cultures show infection with beta-lactamase–producing or gram-positive bacteria such as Enterococcus or Streptococcus. It offers a broad spectrum of activity and is useful when fluoroquinolones or Bactrim cannot be used. However, it’s generally reserved for mild or targeted cases due to limited prostate penetration.

Tamsulosin

For Prostatitis

1 month ago
Tamsulosin helps relieve prostatitis symptoms by relaxing smooth muscle in the prostate and bladder neck, improving urine flow and reducing discomfort. It is especially useful in chronic prostatitis or chronic pelvic pain syndrome to ease urinary obstruction and pelvic pressure. Although it doesn’t treat infection, it enhances symptom control when used alongside antibiotics or anti-inflammatories.

Levofloxacin

For Prostatitis

1 month ago
Levofloxacin is a first-line fluoroquinolone for bacterial prostatitis because of its broad-spectrum coverage and excellent penetration into prostate tissue. It can be initiated intravenously in severe cases and continued orally for outpatient treatment. Clinicians should monitor for potential side effects, including tendon rupture, QT prolongation, and CNS effects, especially in older adults.

Ciprofloxacin

For Prostatitis

1 month ago
Ciprofloxacin is considered a first-line antibiotic for bacterial prostatitis due to its strong activity against gram-negative organisms and excellent prostate tissue penetration. It can be started intravenously for severe infections and transitioned to oral therapy once the patient stabilizes. However, clinicians should be cautious of potential side effects such as tendon injury, neuropathy, and QT prolongation.

Ceftriaxone

For Prostatitis

1 month ago
Ceftriaxone is typically used for acute bacterial prostatitis in more severe cases requiring ER or hospital-level care. It provides broad coverage against common gram-negative pathogens and is given IV or IM for rapid effect in these settings. Once symptoms improve, patients are usually transitioned to an oral antibiotic to complete the course.

Labetalol

For Preeclampsia

1 month ago
Labetalol is a first-line treatment for managing hypertension in preeclampsia due to its safety and effectiveness in pregnancy. It’s commonly used for both acute and ongoing blood pressure control.

Hydralazine

For Preeclampsia

1 month ago
Hydralazine is typically used after labetalol or other beta-blockers in preeclampsia to manage severe hypertension while minimizing the risk of reflex tachycardia. It serves as a second-line agent when additional blood pressure control is needed.

Magnesium Sulfate

For Preeclampsia

1 month ago
Magnesium sulfate is the first-line treatment for seizure prevention in severe preeclampsia. It significantly reduces the risk of progression to eclampsia and is closely monitored to avoid toxicity, with deep tendon reflexes serving as an early indicator.

Delivery

For Preeclampsia

1 month ago
Delivery is the only definitive treatment for preeclampsia, as the condition typically resolves after the placenta is removed. However, the decision to deliver must carefully balance the risks of worsening maternal disease with the potential long-term complications of prematurity for the baby.

Clobetasol Propionate 0.05%

For Poison Ivy Dermatitis

1 month ago
Clobetasol is a very potent topical steroid that can be highly effective for localized poison ivy, especially in areas with significant inflammation or blistering. It works quickly to reduce redness, swelling, and itching, but should be used cautiously and for short durations given its strength. Best reserved for smaller areas or thicker skin, rather than widespread use.

Diphenhydramine

For Poison Ivy Dermatitis

1 month ago
I tend to prescribe Benadryl as another tool for managing itching from poison ivy, even though the evidence doesn’t strongly support its effectiveness. While it may not significantly reduce pruritus, it can help some patients sleep through the discomfort. I use it more as a supportive option rather than a primary treatment.

Prednisone

For Poison Ivy Dermatitis

1 month ago
Prednisone is very effective for more extensive poison ivy, especially when large areas are involved or symptoms are severe. I typically use a longer taper (2-3 weeks) rather than a short burst to help prevent rebound flare-ups, which are common with shorter courses. It works well to calm inflammation quickly and improve itching and rash.

Moxifloxacin

For Pneumonia, Outpatient Community Acquired

1 month ago
An option for outpatient pneumonia when there’s a higher level of concern or need for broader coverage, including atypicals. Convenient as monotherapy, but should be used selectively. Important to weigh risks, especially QT prolongation and tendon rupture, before choosing it.

Levofloxacin

For Pneumonia, Outpatient Community Acquired

1 month ago
Levofloxacin is a powerful, broad-spectrum antibiotic that provides excellent coverage for both typical and atypical pathogens in moderate to severe community-acquired pneumonia, making it a reliable option for patients with comorbidities or penicillin allergies. However, given potential side effects which include QT prolongation, tendon toxicity, C Diff. diarrhea, I consider the risk/benefit when prescribing.

Amoxicillin-clavulanate

For Pneumonia, Outpatient Community Acquired

1 month ago
A reliable option for community-acquired pneumonia with strong coverage for typical bacteria, including beta-lactamase–producing strains. I tend to use it when there’s more concern for a more significant infection. It can also be combined with azithromycin or doxycycline if atypical coverage is needed.

Doxycyline

For Pneumonia, Outpatient Community Acquired

1 month ago
Doxycycline is a reliable and cost-effective option for treating mild to moderate community-acquired pneumonia, offering broad-spectrum coverage against both typical and atypical pathogens. Its low resistance rates and twice-daily oral dosing make it a strong alternative to macrolides, especially in areas with high Streptococcus pneumoniae resistance.

Azithromycin

For Pneumonia, Outpatient Community Acquired

1 month ago
A common go-to for community-acquired pneumonia, especially when atypical coverage is needed. It’s a convenient 5-day course and generally well tolerated. Easy to use, though resistance patterns and local guidelines should be considered.

Amoxicillin

For Pneumonia, Outpatient Community Acquired

1 month ago
A good first-line option for mild community-acquired pneumonia, particularly when typical bacteria are suspected, and commonly used in children. It’s effective and well tolerated, but doesn’t cover atypical organisms, so another agent may be needed if that’s a concern or in cases of penicillin allergy.

Meropenem

For Pneumonia, Aspiration

1 month ago
Meropenem is selected for aspiration pneumonia when very broad coverage is needed, including resistant gram-negative organisms and anaerobes. It is particularly valuable in critically ill patients or when complications such as abscess, empyema, or necrotizing infection are suspected. Compared with imipenem, meropenem has a lower risk of seizures, making it safer in patients with renal impairment or CNS disease.

Ampicillin-sulbactam

For Pneumonia, Aspiration

1 month ago
Ampicillin-sulbactam (Unasyn) is a first-line IV antibiotic for aspiration pneumonia because it covers gram-positive, gram-negative, and anaerobic bacteria. It is especially useful in hospitalized patients, with the option to switch to oral amoxicillin-clavulanate (Augmentin) once stable.

Levofloxacin

For Pneumonia, Aspiration

1 month ago
Levofloxacin is a respiratory fluoroquinolone that can be used in aspiration pneumonia, particularly as an alternative for patients with penicillin allergy. It provides broad coverage against typical and atypical pathogens seen in community-acquired pneumonia, making it a reasonable choice when the distinction between aspiration and standard community acquired pneumonia is unclear.

Piperacillin-tazobactam

For Pneumonia, Aspiration

1 month ago
Zosyn (piperacillin-tazobactam) is often chosen for aspiration pneumonia because it provides broad coverage against gram-negative, gram-positive, and anaerobic organisms. It is especially useful in hospitalized or critically ill patients, or when there is concern for complications like abscess, empyema, or necrotizing infection.

Ibuprofen

For Partial A1 Pulley Injury

1 month ago
A good first-line option to help reduce inflammation and pain with A1 pulley irritation. Can ease discomfort and improve movement, especially during flare-ups. Easy to use short-term, but best combined with rest, splinting, or activity modification for better results.

Splinting

For Partial A1 Pulley Injury

1 month ago
Splinting is a conservative and effective first-line treatment for a partial A1 pulley injury. By limiting MCP joint flexion, it reduces strain on the injured pulley while allowing safe tendon gliding. It’s especially useful in early healing and for preventing symptom recurrence during activity.

Naproxen

For Pain

1 month ago
Naprosyn is a long-acting NSAID that effectively treats arthritis, muscle pain, migraines, and menstrual cramps. It lasts 8–12 hours, reducing the need for frequent dosing. However, it should be used cautiously in people with stomach, kidney, or heart conditions.

Ketorolac

For Pain

1 month ago
One of the go-to first-line non-narcotic NSAIDs for moderate to severe pain, especially in the ER. Can be given IV or IM, which makes it very useful when patients can’t take oral meds. Works well for a variety of pain (e.g., renal colic, musculoskeletal), often with great results. Typically used short-term due to GI, renal, and bleeding risks.

Naloxone

For Opiod Overdose

1 month ago
Naloxone is the best and most effective treatment for opioid overdose because it rapidly reverses life-threatening effects like slowed or stopped breathing. In some cases, especially with potent opioids such as fentanyl, multiple doses may be required to keep the overdose reversed until emergency care is provided. It is safe, fast-acting, and can be life-saving when used promptly.

Continuous Positive Airway Pressure

For Obstructive Sleep Apnea

1 month ago
First-line treatment for obstructive sleep apnea and very effective when used consistently. That said, it’s not always well tolerated, especially early on with the mask and pressure. Newer machines are much quieter and more comfortable, which has helped improve compliance.cc

Weight loss

For Obstructive Sleep Apnea

1 month ago
While weight loss can significantly reduce OSA severity and has been linked to a four-fold increase in the likelihood of remission in some studies, it is not always effective as a standalone treatment for all patients. As such, it should be included as part of a comprehensive treatment plan.

Laparoscopic sleeve gastrectomy

For Obesity

1 month ago
Laparoscopic sleeve gastrectomy is a powerful tool for long-term weight loss and health improvement. It’s not a quick fix — it works best when combined with lifelong changes in eating, exercise, and follow-up care. Most people who commit to those changes are happy with the results.

Tirzepatide

For Obesity

1 month ago
I’ve seen great results with tirzepatide, often with less side effects than semaglutide. Weight loss can be significant, and many patients tolerate it well. Starting low or “micro-dosing” can help the body adjust and minimize GI side effects. Overall, a very effective option when tolerated.

Semaglutide

For Obesity

1 month ago
Semaglutide can lead to significant weight loss, with studies showing ~15–20% body weight reduction over time. It can be expensive without insurance. Some patients use lower doses (“micro-dosing”) to reduce side effects like nausea and bloating, while still seeing meaningful benefit. Overall, effectiveness is dose-dependent, but careful titration can help balance results and tolerabili

Liraglutide

For Obesity

1 month ago
With daily dosing and 5-10% average weight loss, it is not as effective at semaglutide, but some may prefer with less side effects or better insurance coverage.

Exercise

For Obesity

1 month ago
First line treatment - Aim for 30 minutes, five to seven days a week. I prefer strength training, but also need to mix with cardio and flexibility. Also really hard until you develop a routine.

Dietary Therapy

For Obesity

1 month ago
First line in weight loss. Works well if you are able to monitor what you are eating to ensure as balanced diet, but really tough to follow.

Sodium citrate dihydrate

For Nausea

1 month ago
In general, I would not use this for nausea, unless it was due to acid reflux - this can help maintain electrolyte balance, though there are other solutions.

Droperidol

For Nausea

1 month ago
Droperidol is a potent antiemetic used in clinical settings to treat severe nausea and vomiting, including cases related to surgery, chemotherapy, and cannabinoid hyperemesis. It is fast-acting and often effective when other antiemetics fail. However, droperidol can prolong the QT interval and carries a risk of serious arrhythmias, so cardiac monitoring is recommended during use. While highly effective, it should be used cautiously, with alternatives such as ondansetron or metoclopramide considered for milder symptoms.

Doxylamine

For Nausea

1 month ago
An OTC option for nausea that I tend to use as a backup. Can be helpful, especially for mild symptoms, but not as strong as typical first-line antiemetics. Main downside is sedation, so best used when you can rest.

Ice

For Nasal Fracture

1 month ago
A simple first-line step for a nasal fracture that helps reduce swelling and pain early on. Best used in the first 24–48 hours, applied intermittently. Can make it easier to assess the injury once swelling comes down. Easy and effective, but supportive only—not a definitive treatment.

Closed Reduction

For Nasal Fracture

1 month ago
I find that if I can correct a significant nasal deviation immediately after the injury, it can sometimes improve both cosmetic and functional outcomes while also reducing the likelihood of needing future correction.

Nitroglycerin

For Myocardial Infarction

1 month ago
Nitroglycerin is commonly used in myocardial infarction to relax and widen blood vessels, which lowers blood pressure and reduces the heart’s workload. It also improves blood flow to the heart muscle and helps relieve chest pain. While it provides symptom relief, it does not reduce mortality and is used alongside other proven therapies.

Metoprolol

For Myocardial Infarction

1 month ago
Metoprolol is a beta-blocker given early in myocardial infarction to slow the heart rate, lower blood pressure, and reduce the heart’s oxygen demand. Randomized controlled trials have shown that it can shrink infarct size, improve heart function, and reduce mortality and reinfarction risk. It’s considered a standard treatment alongside reperfusion and other therapies.

Heparin

For Myocardial Infarction

1 month ago
Heparin is one of the main medications used to prevent new clots from forming and to stop existing ones from getting bigger. It is often given during percutaneous coronary intervention (PCI) to keep the artery open and reduce the risk of complications. Its fast onset of action and effectiveness make it a standard part of heart attack treatment protocols.

Percutaneous Coronary Intervention

For Myocardial Infarction

1 month ago
Percutaneous coronary intervention (PCI) is the main treatment for a heart attack if it can be done quickly. It allows doctors to see exactly where the artery is blocked and place a small stent to restore blood flow. In some people, however—such as those with severe or multiple blockages in the main heart artery, a coronary artery bypass surgery (CABG) may be a better option.

Aspirin

For Myocardial Infarction

1 month ago
Aspirin is one of the most important first-line treatments for myocardial infarction because it works quickly to inhibit platelet aggregation and limit clot growth. It has one of the fastest onset of benefits and provides the largest impact on reducing mortality . Its simplicity, low cost, and strong evidence base make it a cornerstone of acute heart attack management. and prevention.

Intravenous Valproate Sodium

For Migraine headache

1 month ago
Though not a first-line option in all settings, IV Depakote can be particularly useful in patients who cannot tolerate triptans or have contraindications to vasoconstrictive therapies. Given its efficacy and relatively low side effect profile, it remains a valuable tool in migraine management, particularly in hospital and emergency settings. It works better if boluses quickly.

Vaginal Estrogen Therapy

For Menopause

1 month ago
Vaginal estrogen is a safe and effective option for women seeking relief from genitourinary symptoms of menopause without the risks associated with systemic hormone therapy.

Estrogen and Progestin

For Menopause

1 month ago
Estrogen plus progestin therapy is used for menopausal symptom relief in women with an intact uterus, with progestin added to protect against estrogen-induced endometrial hyperplasia. This combination is effective for hot flashes, night sweats, and vaginal dryness, but should be used at the lowest effective dose and shortest duration due to risks like breast cancer, blood clots, and stroke.

Estrogen

For Menopause

1 month ago
Estrogen therapy is a first-line treatment for moderate to severe menopausal symptoms such as hot flashes and vaginal dryness, especially in women without a uterus. It is effective but should be used at the lowest dose for the shortest duration possible due to potential risks, including blood clots, stroke, and breast cancer. If a patient has a uterus, progesterone should be added to help prevent endometrial hyperplasia and reduce the risk of endometrial cancer.

Vitamin A

For Measles

1 month ago
Vitamin A can significantly reduce the severity of illness and lower mortality in measles, especially in more severe cases. It’s a simple, low-cost intervention with strong supporting evidence. While effective, its impact is less than immune globulin, which can prevent or markedly blunt the disease if given early. Best used as supportive treatment once infection is present.

Measles immunoglobulin

For Measles

1 month ago
Measles immunoglobulin is a critical intervention for preventing measles in high-risk individuals following exposure, significantly reducing the risk of disease and its complications but only provides temporary benefit.

MMR Vaccine

For Measles

1 month ago
The MMR vaccine is one of the best ways to prevent measles and can be given within 72 hours of exposure to reduce the risk of infection. It is a highly effective live attenuated vaccine that protects against measles, mumps, and rubella by stimulating the immune system without causing illness.

Scalp Micropigmentation

For Male Pattern Baldness

1 month ago
SMP doesn’t treat or slow hair loss, but instead uses tattooing to create the appearance of fuller hair or shaved follicles. It can make a remarkable cosmetic difference, especially for thinning areas or bald spots. It is expensive and requires skilled application, but results can look very natural when done well. Best thought of as a cosmetic solution rather than a medical treatment.

Platelet-rich plasma

For Male Pattern Baldness

1 month ago
An option for hair loss that involves drawing your blood, concentrating platelets, and injecting them into the scalp to stimulate follicles. It’s expensive, requires regular sessions, and results are usually modest and gradual. Best used as part of an overall strategy to improve hair density rather than a standalone solution, and is often continued even after a hair transplant to help maintain and support results.

Finasteride

For Male Pattern Baldness

1 month ago
While considered first line therapy for hair loss because it can be given topically or orally, I am less enthusiastic because it has a potential in reducing libido and erectile dysfunction. It's mechanism is to inhibit 5 alpha reductase that converts testosterone. Thus topically, it has less systemic side effects, than the oral pill. If I were to use this, I would recommend the topical agent more.

Minoxidil

For Male Pattern Baldness

1 month ago
A first-line treatment for hair loss that’s easy to use and widely available. The foam is easier to apply, while the liquid is cheaper. Results are usually modest, with some improvement in hair density over time, but it takes consistent use to maintain benefits.

Physical Therapy

For Long COVID

1 month ago
Physical therapy may benefit some people with Long COVID, but it needs to be carefully tailored to each patient’s tolerance. Studies show that structured rehab programs with breathing exercises, gentle strengthening, and gradual activity can improve fatigue, breathlessness, and quality of life. However, patients with post-exertional symptom exacerbation (PESE) require a cautious, pacing-first approach to avoid worsening their symptoms. When individualized, physical therapy can support recovery and help patients safely return to daily activities.

Energy Pacing & Rest

For Long COVID

1 month ago
Energy pacing is a commonly recommended strategy in the medical literature for managing Long COVID, though it does not treat the underlying illness. Similar to its use in ME/CFS (myalgic encephalomyelitis/chronic fatigue syndrome), pacing helps patients balance activity and rest to avoid post-exertional crashes, where symptoms worsen after overexertion. This approach typically involves breaking tasks into smaller steps, planning rest periods, and staying within personal limits. While the overall benefits are modest, pacing remains one of the more consistently supported ways to reduce flare-ups and maintain daily function.

Triple Antibiotic Ointment

For Laceration

1 month ago
Neosporin is a commonly used topical antibiotic ointment for lacerations, helping to prevent infection and promote healing. However, it can cause allergic reactions or skin irritation, particularly due to the neomycin component. For this reason, I prefer alternative topical antibiotics if infection is present, and petroleum jelly for clean wounds to protect the area with fewer side effects.

Tissue Adhesives

For Laceration

1 month ago
Tissue adhesives are ideal for low-tension lacerations less than 5 cm, particularly on the face and in pediatric patients, where a quick, painless closure is preferred. They form a protective, waterproof seal that holds wound edges together while eliminating the need for suture removal. This method provides excellent cosmetic outcomes and is well tolerated, especially in children.

Petroleum Jelly

For Laceration

1 month ago
Petroleum jelly is the preferred topical treatment for lacerations because it provides a protective, moisture-sealing barrier that promotes optimal healing. It helps prevent the wound from drying out or scabbing, which can reduce pain and scarring. Unlike some antibiotic ointments, petroleum jelly has a low risk of allergic reactions or skin irritation, making it safe for most patients. Its simplicity and effectiveness make it a first-line option for routine wound care.

Nonabsorbable sutures

For Laceration

1 month ago
Nonabsorbable sutures are the initial go-to treatment for most lacerations, particularly on the face and other areas under high tension, where precise wound edge approximation is essential for optimal healing and cosmetic results. They provide excellent tensile strength and control, allowing for accurate closure and reduced risk of wound separation. Because they do not dissolve, these sutures must be removed once adequate healing has occurred to minimize scarring and irritation. Typically, sutures on the face are removed in about 5 days, while those on the scalp, trunk, or extremities may remain for up to 10–14 days, depending on the site and depth of injury.

Absorbable sutures

For Laceration

1 month ago
Absorbable sutures are ideal for deep lacerations or wounds where follow-up removal may be difficult. They gradually dissolve in the body, maintaining closure strength during the early healing phase without needing removal. Because they are not removed, they can sometimes lead to more scarring, so they’re typically used for deeper layers, mucosal surfaces, or areas where cosmesis is less of a concern. They’re also useful in pediatric patients or situations where follow-up is uncertain. Overall, a practical choice when convenience and internal healing are the priority.

Staples

For Laceration

1 month ago
Staples are a fast and efficient method for closing lacerations, most commonly used on the scalp or other areas where cosmetic appearance is less critical. They provide strong wound closure and are ideal for high-tension or bleeding wounds. Because they can leave visible marks, staples are generally avoided on the face or cosmetic areas, and are typically removed within 7–14 days.

Ondansetron

For Kidney Stone

1 month ago
One of the more common treatments used to control nausea and vomiting from kidney stones, both in the ER and at home. Works well and is generally well tolerated. The ODT (dissolvable tablet) is especially convenient if you’re feeling too nauseated to swallow pills.

Ureteroscopy

For Kidney Stone

1 month ago
A minimally invasive and effective option for treating kidney or ureteral stones, especially when stones are stuck or not ideal for ESWL. It allows direct visualization and laser fragmentation without any external incisions, making it a precise and commonly used approach. Often chosen when quicker or more definitive treatment is needed. That said, it can require temporary tubes or stents afterward, which can be uncomfortable and inconvenient.

Urine Strainer

For Kidney Stone

1 month ago
Using a urine strainer is a key step in the treatment of kidney stones. It helps confirm whether the stone has passed, which is important for guiding further care and avoiding unnecessary tests or procedures. Catching the stone also allows for analysis of its type, which can help identify the cause and guide steps to prevent future stones.

Tamsulosin

For Kidney Stone

1 month ago
Tamsulosin is a safe and effective medication for helping pass ureteral stones, especially those larger than 5 mm. It works by relaxing the ureter, making it easier for stones to pass. Current urological guidelines support its use as part of medical management for kidney stones.

Ibuprofen

For Kidney Stone

1 month ago
Ibuprofen, a nonsteroidal anti-inflammatory drug (NSAID), is effective for managing the acute pain of renal colic. Its anti-inflammatory properties help reduce ureteral spasm and lower pressure in the renal pelvis, providing significant pain relief. It is a first line option for treating kidney stone-related discomfort.

Fluid intake

For Kidney Stone

1 month ago
Drinking enough fluids, especially water, helps prevent stone formation and can also aid in flushing out small stones. Staying well-hydrated is a simple and effective way to support kidney health.

Atorvastatin

For Ischemic Cerebrovascular Accident

1 month ago
Atorvastatin is one of the first-line treatments for preventing another stroke after an ischemic CVA. It lowers cholesterol, stabilizes artery plaques, and reduces the risk of future strokes and heart attacks. Because of its proven benefit, it is commonly prescribed long-term for secondary prevention.

Aspirin

For Ischemic Cerebrovascular Accident

1 month ago
Aspirin is the baseline antiplatelet therapy for ischemic stroke, with strong evidence supporting its role in preventing recurrent strokes. It has been well studied over decades and consistently improves outcomes in secondary prevention, but it is not used to treat the acute stroke itself. In addition, aspirin is widely available and inexpensive, making it a reliable and accessible cornerstone of long-term stroke care.

Mechanical thrombectomy

For Ischemic Cerebrovascular Accident

1 month ago
Mechanical thrombectomy is an effective treatment for acute ischemic stroke due to large-vessel occlusion, with a broader treatment window of up to 16–24 hours in selected patients. Its limitation is that it requires specialized resources and expertise, so availability depends on the hospital. When accessible and used appropriately, it can greatly improve outcomes by restoring blood flow and reducing long-term disability.

Tenecteplase

For Ischemic Cerebrovascular Accident

1 month ago
Tenecteplase (TNKase) is a clot-busting medication for acute ischemic stroke that’s given as a single IV bolus, making it simpler than alteplase. It’s used within 4.5 hours of symptom onset—with better outcomes the earlier it’s given—and onset is usually based on when the patient was last seen normal. In the ED, we always get a head CT first to rule out bleeding before giving it. I’m careful to confirm patients meet all criteria, since the main risk is intracranial hemorrhage. When used appropriately, it provides outcomes comparable to alteplase with easier administration.

Alteplase

For Ischemic Cerebrovascular Accident

1 month ago
Alteplase (tPA) is a clot-dissolving medication used for acute ischemic stroke that can significantly improve outcomes if given quickly. Timing is everything here—treatment is recommended within 4.5 hours of symptom onset, with the greatest benefit when it’s given as early as possible (ideally within 3 hours). When we talk about “time of onset,” it’s usually based on when the patient was last seen normal, especially if no one actually witnessed the stroke happen. I’m very careful to make sure patients meet all eligibility criteria, because while tPA can be very effective, there’s a real risk of serious bleeding, including intracranial hemorrhage. Careful patient selection is key to getting the benefit while minimizing harm.

Prednisolone 1% eye drops

For Iritis

1 month ago
Prednisolone 1% eye drops are a first-line treatment for iritis, helping to quickly reduce inflammation and prevent complications. They're effective but require close follow-up due to potential side effects like elevated intraocular pressure or cataract formation.

Atropine 1% ophthalmic

For Iritis

1 month ago
Atropine is a supportive, first-line adjunct treatment for iritis used to dilate the pupil, relieve pain from ciliary spasm, and prevent iris-lens adhesions (posterior synechiae). It is typically used alongside corticosteroid drops like prednisolone to manage inflammation and reduce complications. Though effective, it can cause blurred vision and light sensitivity.

Open toe or wide toed shoe

For Ingrown Toenail

1 month ago
A simple but effective option for ingrown toenails. Shoes with a wider toe box reduce pressure on the nail and surrounding skin, which can help relieve pain and prevent things from getting worse. Not a quick fix, but helpful both during recovery and for preventing recurrence.

Nail Avulsion

For Ingrown Toenail

1 month ago
Very effective for treating ingrown toenails, especially more severe or recurrent cases. Removing part (or all) of the nail relieves the pressure and addresses the root of the problem. That said, it does require some healing time with an open wound, so there’s a bit of downtime and wound care involved. Overall, a reliable option when more conservative treatments fail.

Cephalexin

For Ingrown Toenail

1 month ago
A good option if an ingrown toenail becomes more severe with signs of cellulitis. Helps treat the surrounding infection and can speed up recovery. Not needed for mild cases, but useful when there’s spreading redness, warmth, or drainage.

Warm water soaks

For Ingrown Toenail

1 month ago
I’ve had great success with warm soaks for ingrown toenails. They help reduce inflammation and discomfort and can make the area easier to manage. It does take time and consistency to see improvement, but it’s a simple and effective first step.

Dental Floss

For Ingrown Toenail

1 month ago
A commonly recommended technique where floss is placed under the nail edge to lift it and create a barrier from the skin. In theory (and in some literature), it can be effective for mild cases. Personally, I’ve had limited success getting it positioned well enough to make a difference. Worth trying early on, but can be tricky to do and not always reliable.

Oseltamivir

For Influenza

1 month ago
Tamiflu (oseltamivir) is an antiviral medication for treating and preventing influenza A and B. It is most effective when started within 48 hours of symptom onset and can reduce flu duration by 1–2 days.

Flu Vaccine

For Influenza

1 month ago
Prevention is key, and I’m a strong supporter of the flu vaccine. It’s designed ahead of time based on predicted strains, so it’s a bit of a moving target depending on how well the match turns out each season. Even when it’s not a perfect match, it still helps reduce severity, complications, and hospitalizations. Overall, still one of the most effective tools we have for preventing flu and protecting vulnerable populations.

Clonidine

For Hypertension

1 month ago
Clonidine is used for hypertension primarily in cases of resistant high blood pressure or for short-term outpatient control when rapid lowering is needed. It’s not a first-line choice due to side effects and risk of rebound hypertension, but it is effective when other options have failed.

Lisinopril

For Hypertension

1 month ago
A common first-line option for hypertension, especially in patients with diabetes, CKD, or heart failure, where it has added protective benefits. Generally effective and well tolerated. Should be avoided in pregnancy and used cautiously in patients with renal artery stenosis or a history of angioedema. Overall, a strong choice in the right population, but not for everyone.

Hydrochlorothiazide

For Hypertension

1 month ago
Hydrochlorothiazide (HCTZ) is included as a first-line option in most hypertension treatment algorithms, particularly in patients without compelling comorbidities. HCTZ is often used as monotherapy for stage 1 hypertension or in combination with other agents for better blood pressure control. It's especially favored in older adults and Black patients due to its effectiveness in salt-sensitive hypertension.

DASH Diet

For Hypertension

1 month ago
The DASH diet is a highly effective first-line therapy for managing hypertension through nutrition. By emphasizing fruits, vegetables, whole grains, and low sodium intake, it helps lower blood pressure naturally without medication. It’s a sustainable, evidence-based approach recommended in most clinical guidelines.

Amlodipine

For Hypertension

1 month ago
Amlodipine is a well-established first-line treatment for hypertension, particularly effective in older adults and Black patients, where it often outperforms ACE inhibitors. It’s also a good option for patients without compelling comorbidities who need long-term blood pressure control. Its once-daily dosing and low side effect profile make it a convenient and reliable choice.

Rosuvastatin

For Hypercholesterolemia

1 month ago
Rosuvastatin (Crestor) is my choice when stronger LDL reduction is needed or if atorvastatin isn’t tolerated. Its higher potency, longer half-life, and fewer drug interactions make it especially useful in high-risk patients.

Lifestyle Changes

For Hypercholesterolemia

1 month ago
The foundation of cholesterol management is making healthy lifestyle changes. Lifestyle changes like diet, exercise, weight management, and avoiding tobacco or excess alcohol are the most effective and proven ways to naturally improve cholesterol and lower heart risk. However, many people find these changes difficult to maintain consistently, which is why cholesterol-lowering medications are often needed as an additional tool.

Atorvastatin

For Hypercholesterolemia

1 month ago
Atorvastatin (Lipitor) is often my first choice for elevated cholesterol because it reliably lowers LDL and has strong evidence for reducing heart attack and stroke risk. It is well-studied, available as a low-cost generic, and offers flexible dosing for both moderate- and high-intensity therapy. For most patients at increased cardiovascular risk, it provides the best balance of potency, safety, and accessibility.

Topical Acyclovir 5%

For HSV-1

1 month ago
Topical Zovirax is convenient and well-tolerated for mild cold sores but not as effective as oral antivirals and needs to be started very early to have a meaningful effect.

Docosanol

For HSV-1

1 month ago
Abreva can help speed up recovery if applied early, and I use it alongside Valtrex or other antivirals for extra support. It’s a convenient, over-the-counter option that adds a layer of defense during outbreaks.

Valacyclovir

For HSV-1

1 month ago
Valacyclovir is my first-line treatment for cold sores—it works quickly when taken at the first sign of symptoms. It can also use be used as a preventive option to reduce the frequency of future outbreaks.

Acyclovir

For HSV-1

1 month ago
Acyclovir works similarly to Valtrex (valacyclovir) in treating HSV-1, but it requires more frequent dosing, which can make it less convenient. However, it's often more affordable and still effective when taken as prescribed. It's a good option for those looking for a lower-cost treatment.

Gamow Bag

For High Altitude Cerebral Edema

1 month ago
A Gamow bag is effective as a short-term measure, true descent remains the definitive treatment.

Dexamethasone

For High Altitude Cerebral Edema

1 month ago
Dexamethasone is an effective emergency medication for High-Altitude Cerebral Edema (HACE) that reduces brain swelling and improves symptoms like confusion and loss of coordination. It serves as a valuable temporizing measure when immediate descent is not possible. However, descent to a lower altitude remains the definitive treatment for full recovery.

Descending to a lower altitude

For High Altitude Cerebral Edema

1 month ago
Descending to a lower altitude is the single most effective treatment for High-Altitude Cerebral Edema. It rapidly increases oxygen availability, reduces brain swelling, and can be life-saving. Descent should begin immediately once HACE is suspected, even before other treatments are started.

Spironolactone

For Hidradenitis suppurativa

1 month ago
Spironolactone is a second-line or adjunct therapy for hidradenitis suppurativa (HS), particularly in women with hormonal or androgen-related flares. It works by blocking androgen receptors and reducing oil gland activity, which can lessen inflammation and lesion recurrence. It’s often used alongside antibiotics or biologics for better long-term control.

Adalimumab

For Hidradenitis suppurativa

1 month ago
Adalimumab is a first-line systemic therapy for moderate to severe hidradenitis suppurativa. It blocks tumor necrosis factor-alpha (TNF-α), a key driver of inflammation in HS, helping to reduce painful nodules, abscesses, and flare frequency.

Metformin

For Hidradenitis suppurativa

1 month ago
Rated 3 stars

Rifampin

For Hidradenitis suppurativa

1 month ago
Oral clindamycin plus rifampin is an effective combination for moderate or treatment-resistant mild hidradenitis suppurativa. This dual therapy targets both bacterial infection and inflammation, helping to reduce painful nodules, drainage, and recurrence. It is typically prescribed for 10–12 weeks, with monitoring for liver function and gastrointestinal side effects.

Intralesional Triamcinolone

For Hidradenitis suppurativa

1 month ago
Intralesional triamcinolone is used for large, isolated, painful hidradenitis suppurativa nodules to rapidly reduce inflammation, swelling, and tenderness. Injected directly into the lesion, it helps flatten nodules and speed healing within days. It is a targeted option for localized flares but should be used sparingly to avoid skin thinning or discoloration.

Doxycycline

For Hidradenitis suppurativa

1 month ago
Doxycycline is considered a first-line systemic therapy for mild to moderate hidradenitis suppurativa. It provides both anti-inflammatory and antimicrobial benefits, helping to reduce lesion count and prevent flares. It is often the initial oral antibiotic tried before escalating to combination or biologic therapy.

Benzoyl peroxide

For Hidradenitis suppurativa

1 month ago
Benzoyl peroxide is a first-line and adjunctive therapy for mild hidradenitis suppurativa due to its broad antibacterial and anti-inflammatory effects. Used as a wash or topical gel, it helps reduce bacterial colonization and prevent resistance when combined with topical or oral antibiotics. It is available over the counter and can be incorporated into daily skin care to decrease flare frequency.

Metoclopramide

For Hiccup

1 month ago
An off-label option for persistent hiccups that can be effective by acting on the central hiccup reflex and improving gastric motility. It tends to work fairly quickly—often within hours to a day. Generally well tolerated short-term, but can cause drowsiness, restlessness, or extrapyramidal symptoms. A reasonable option when simple measures don’t work.

Gabapentin

For Hiccup

1 month ago
Gabapentin is an off-label option for persistent hiccups and can work well, especially when other treatments fail. It helps calm the nerve pathways involved in the hiccup reflex. Generally better tolerated than some alternatives, though it can cause drowsiness and dizziness. A reasonable option for more stubborn cases.

Chlorpromazine

For Hiccup

1 month ago
Chlorpromazine is one of the more effective meds for stubborn hiccups and is actually the only FDA-approved option for this. It works well, but isn’t first-line because of side effects. Can cause drowsiness, dizziness, and low blood pressure, so it’s usually saved for more persistent cases when simple fixes don’t work.

Drinking water with a pencil

For Hiccup

1 month ago
One of those tricks I learned when I was younger that actually works pretty well. Biting on a pencil while drinking water helps change breathing and diaphragm movement, which can stop hiccups. There are plenty of other techniques out there, but this one is simple and worth trying.

Accupuncture – PC6

For Hiccup

1 month ago
I learned this from an anesthesiologist as a treatment for hiccups which works well if you can find the proper point.

Shingrix

For Herpes Zoster

1 month ago
Shingrix is a highly effective shingles vaccine, reducing the risk of herpes zoster and postherpetic neuralgia by over 90%. It is recommended for adults 50 and older, with a strong safety profile despite some short-term side effects like injection site pain and fatigue. Its long-lasting protection makes it the preferred vaccine for shingles prevention.

Prednisone

For Herpes Zoster

1 month ago
Corticosteroids can help speed up healing and reduce pain in acute herpes zoster when used with antivirals. However, they don't prevent postherpetic neuralgia and come with potential risks, so I use them selectively. The decision to prescribe them should always weigh the short-term benefits against the risk of side effects.

Valacyclovir

For Herpes Zoster

1 month ago
Valacyclovir is a first-line antiviral treatment for herpes zoster, recommended for reducing rash duration, pain severity, and risk of postherpetic neuralgia. It is best initiated within 72 hours of rash onset and is generally well tolerated. Its convenient dosing and effectiveness make it a preferred option over acyclovir in many cases.

Acyclovir

For Herpes Zoster

1 month ago
Acyclovir is a first-line antiviral option for shingles, especially when cost is a concern. It effectively reduces rash duration and complications like postherpetic neuralgia. However, it requires more frequent dosing (800 mg five times daily) compared to alternatives like valacyclovir, which may affect adherence.

Preparation H Hemorrhoidal Ointment

For Hemorrhoids

1 month ago
Preparation H is a good first-line therapy for relieving the symptoms of hemorrhoids, such as itching, burning, and swelling. It offers quick, over-the-counter relief and is available in multiple formulations to suit individual needs. While it doesn’t treat the underlying cause, it can significantly improve comfort during flare-ups.

Lidocaine

For Hemorrhoids

1 month ago
Lidocaine provides fast and effective relief from the pain, burning, and itching associated with hemorrhoids. It works by numbing the area, making it easier to sit, walk, or go to the bathroom during flare-ups. However, it does not reduce swelling or heal the hemorrhoids themselves, so it's best used for short-term symptom management alongside other treatments.

Sitz bath

For Hemorrhoids

1 month ago
A sitz bath is a simple and effective way to relieve hemorrhoid pain, swelling, and discomfort. Whether using a bathtub or a sitz bath basin, regular soaking (2–3 times daily) can significantly improve symptoms and promote healing.

Hydrocortisone 1%

For Hemorrhoids

1 month ago
Hydrocortisone is an effective short-term treatment for relieving hemorrhoid symptoms, including itching, swelling, and pain. However, it should not be used long-term due to potential skin thinning and irritation.

FIber

For Hemorrhoids

1 month ago
First line treatment to reduce hemorrhoids and prevent in the future. Consider fiber supplements like psyllium and methylcellulose.

Docusate

For Hemorrhoids

1 month ago
Colace helps ease bowel movements and reduces the discomfort from hemorrhoids. It doesn't treat the hemorrhoids directly, but makes going to the bathroom less painful.

RICE Treatment

For Groin Strain

1 month ago
First-line approach for a groin strain, helping reduce pain and inflammation early on. Rest, ice, compression, and elevation can calm things down in the initial phase. Simple and effective, but usually just the starting point before progressing to rehab.

Physical Therapy

For Groin Strain

1 month ago
A key part of recovery for groin strain, helping restore strength, flexibility, and prevent reinjury. It’s effective, but not quick—you’ll usually need a few weeks of consistent work to see real improvement. Best for long-term recovery rather than just short-term pain relief.

Ibuprofen

For Groin Strain

1 month ago
Ibuprofen is a first-line option for groin strain, helping reduce both inflammation and pain. It works well for acute injuries and can make movement more comfortable early on. Easy to use as needed, but best taken with food and with usual NSAID precautions.

Pegloticase

For

1 month ago
Pegloticase is a third-line treatment for chronic, refractory gout, used when standard urate-lowering therapies like allopurinol or febuxostat fail or are not tolerated. It is highly effective but can cause serious side effects such as infusion reactions and anaphylaxis, requiring close monitoring and premedication. The treatment is expensive, with costs exceeding $30,000 per month, though financial assistance programs may help offset the price for eligible patients.

Probenicid

For

1 month ago
Probenecid is effective for lowering uric acid in under-excreters but is considered a second-line agent after xanthine oxidase inhibitors like allopurinol or febuxostat. It's mainly used when first-line therapies are contraindicated or not tolerated.

Prednisone

For

1 month ago
I use prednisone when NSAIDs or colchicine are contraindicated or poorly tolerated. It is often used in patients with kidney disease, gastrointestinal issues, or those who cannot take other anti-inflammatory medications. However, it is not used for long-term urate-lowering therapy.

Indomethacin

For

1 month ago
Indomethacin is often my go-to for acute gout flares, largely due to medical tradition and its strong track record in crystal-induced arthritis. That said, other NSAIDs like naproxen or ibuprofen are generally just as effective. I continue to prescribe indomethacin in many cases, but I’m mindful of its higher risk of side effects, including GI irritation, CNS effects, and kidney strain. Safer alternatives may be preferred depending on the patient's overall health.

Hydration

For

1 month ago
Staying well-hydrated helps lower uric acid levels and can reduce the frequency of gout attacks. Drinking plenty of water supports kidney function and promotes the excretion of uric acid. It’s a simple but effective lifestyle measure in managing gout.

Avoiding Sugary Beverages

For

1 month ago
Sugary beverages, especially those with high-fructose corn syrup, raise uric acid levels by increasing purine metabolism, contributing to hyperuricemia and gout flares. Studies show a strong association, with a 35% higher risk of hyperuricemia among high consumers. While the exact benefit of eliminating these drinks isn't precisely quantified, reducing intake is recommended to help lower uric acid and prevent gout attacks.

Loperamide

For Gastroenteritis

1 month ago
Loperamide can reduce diarrhea in gastroenteritis, but I’m cautious about using it unless there is low suspicion for a bacterial cause. In cases with fever, bloody stools, or suspected infections like E. coli or C. difficile, it can actually make things worse by trapping the bacteria or toxins. For mild, non-bloody diarrhea in otherwise healthy adults, it may provide short-term relief.

Prochlorperazine

For Gastroenteritis

1 month ago
Prochlorperazine is a backup option for treating nausea and vomiting in gastroenteritis when ondansetron (Zofran) is not effective or available. It can help with symptoms but carries a higher risk of side effects like drowsiness or movement-related problems.

Metoclopramide

For Gastroenteritis

1 month ago
Metoclopramide (Reglan) is a backup option for treating nausea and vomiting from gastroenteritis when ondansetron (Zofran) is not available or suitable. It is less effective and less well tolerated but can still provide relief, especially by promoting stomach emptying.

Ondansetron

For Gastroenteritis

1 month ago
Zofran (ondansetron) is the preferred medication for nausea and vomiting caused by gastroenteritis. It works quickly, is well tolerated, and helps patients keep fluids down to prevent dehydration. Compared to other antiemetics, it has fewer side effects and stronger evidence supporting its use. Also, ask for the ODT version which will dissolve underneath the tongue.

Intravenous Hydration

For Gastroenteritis

1 month ago
IV hydration is used in severe gastroenteritis when dehydration is significant and oral fluids aren’t enough. It restores fluids and electrolytes more quickly than drinking alone, helping patients feel better faster and relieving symptoms like dizziness, weakness, and low blood pressure.

BRAT diet

For Gastroenteritis

1 month ago
The BRAT diet is not specifically recommended by the Infectious Diseases Society of America, but it can provide a gentle starting point for people recovering from vomiting. Its bland foods are less likely to trigger nausea, making it helpful for patients who are hesitant to eat. However, it should be used only until patients can advance their diet to include more balanced nutrition for full recovery.

Gentamicin plus azithromycin

For Gonorrhea

1 month ago
A backup option for gonorrhea if ceftriaxone can’t be used (like with a severe allergy). It’s a one-time IM shot plus a single oral dose, so still convenient. Works reasonably well for urogenital infections, but not as reliable—especially for throat infections—and tends to have more GI side effects from the azithromycin. Overall, useful when needed, but not a first-line choice.

Condom

For Gonorrhea

1 month ago
Condoms are strongly recommended for gonorrhea prevention because they provide a reliable barrier to infected secretions during sexual activity. While not perfect, they significantly lower transmission risk when used consistently and correctly

Ceftriaxone

For Gonorrhea

1 month ago
Ceftriaxone is generally preferred for treating gonorrhea because it is given as a single injection, eliminating concerns about patient adherence to oral regimens. It also achieves higher and more reliable cure rates across genital, rectal, and pharyngeal infections compared to alternatives. This makes it the most effective and convenient first-line option in current guidelines.

Cefixime

For Gonorrhea

1 month ago
Cefixime is an oral option for gonorrhea, which can be convenient compared to an injection, but I use it less often because of its lower efficacy. It does not achieve as high or sustained drug levels as ceftriaxone, making it less reliable, especially for pharyngeal infections. Because of these concerns, it is considered only an alternative when ceftriaxone is not available.

Pantoprazole

For Gastritis

1 month ago
A prescription “bigger gun” PPI that I use if symptoms aren’t improving with omeprazole. Very effective at reducing acid and helping the stomach lining heal. Also commonly used in the ER for upper GI bleeds. Not for immediate relief, but strong and reliable for more severe cases.

Famotidine

For Gastritis

1 month ago
A good first-line option for gastritis, with OTC doses around 10–20 mg and prescription dosing up to 40 mg daily. Not as strong as omeprazole, but often better tolerated with fewer long-term side effects. A nice middle-ground for symptom control without going straight to a PPI.

Aluminum Hydroxide, Magnesium hydroxide and Simethicone

For Gastritis

1 month ago
Mylanta works quickly to neutralize stomach acid and can help relieve gastritis symptoms. Personally, I’m not a fan of the taste, so I usually try options like Rolaids first, though some people I know prefer this first.

Omeprazole

For Gastritis

1 month ago
Prilosec is very effective for gastritis by reducing stomach acid and allowing the lining to heal. It doesn’t work immediately—usually takes 1–3 days to start helping, with full effect over several days. Best for more persistent symptoms rather than quick, on-the-spot relief.

Calcium Carbonate and Magnesium Hydroxide

For Gastritis

1 month ago
Rolaids work quickly and can give fast relief for gastritis-related discomfort by neutralizing stomach acid. They’re easy to use and, depending on the flavor, actually pretty pleasant to take. Best for short-term, on-the-spot relief rather than ongoing treatment. Helpful for mild symptoms, but doesn't address the underlying cause if symptoms persist.

Calcium Carbonate

For Gastritis

1 month ago
Tums work quickly and can give fast relief for gastritis-related discomfort by neutralizing stomach acid. Best for short-term, on-the-spot relief rather than ongoing treatment. Helpful for mild symptoms, but doesn't address the underlying cause if symptoms persist.

Cholecystectomy

For Gallstones

1 month ago
Cholecystectomy is the definitive treatment for symptomatic gallstones, preventing future attacks and complications. Laparoscopic surgery is preferred due to its quick recovery, while open surgery is reserved for complex cases. Most patients return to normal life with minimal dietary restrictions after surgery.

Reduce high-fat, high-cholesterol foods

For Gallstones

1 month ago
A low-fat diet is a good first-line approach to help manage symptoms from gallstones. By reducing fat intake, it decreases gallbladder stimulation and can help prevent pain episodes. It’s simple and safe, and many patients notice fewer attacks when they stick with it. That said, it doesn’t get rid of the stones—just helps control symptoms. Often used as a bridge or for milder cases, especially if avoiding or delaying surgery.

Doxycyline

For Folliculitis

1 month ago
Doxycycline is a good option for covering MRSA-related folliculitis due to its effectiveness against resistant Staphylococcus aureus and its added anti-inflammatory benefits. To ensure broader bacterial coverage, I often pair it with another antibiotic like cephalexin , which targets non-MRSA pathogens.

Clindamycin

For Folliculitis

1 month ago
Clindamycin is effective for severe folliculitis and offers coverage against MRSA, making it useful for resistant infections. However, it carries a higher risk of side effects, including potential C. difficile infection.

Cephalexin

For Folliculitis

1 month ago
A good broad spectrum antibiotic for moderate to severe bacterial folliculitis, though it doesn't cover MRSA. I'll double cover with something that does cover MRSA like bactrim or doxycyline.

Mupirocin

For Folliculitis

1 month ago
Mupirocin can be an effective treatment for bacterial folliculitis when used appropriately. It provides targeted action against Staphylococcus aureus, including MRSA, making it a useful topical treatment for superficial cases.

Benzoyl peroxide

For Folliculitis

1 month ago
Benzoyl peroxide is considered a first-line topical therapy for mild bacterial folliculitis, particularly when caused by Staphylococcus aureus. It is often used alone for initial treatment or in combination with topical or oral antibiotics in more persistent cases. Its broad antibacterial activity and low risk of bacterial resistance make it a useful early option, especially for superficial, non-severe folliculitis.

Cyclobenzaprine

For Fibromyalgia

1 month ago
Cyclobenzaprine is used off-label for fibromyalgia to improve sleep quality and reduce muscle tension, particularly in patients with prominent sleep disturbances. While not a first-line treatment, it can be a helpful adjunct for nighttime symptom relief. Its benefits are mainly due to its sedating and muscle-relaxing effects.

Pregalbin

For Fibromyalgia

1 month ago
Pregabalin (Lyrica) is an FDA-approved, first-line treatment for fibromyalgia that helps reduce nerve-related pain and improve sleep quality. It is especially useful for patients with prominent neuropathic symptoms, though side effects like dizziness and weight gain can limit its use. It’s typically considered when non-pharmacologic strategies or other medications are not sufficient.

Milnacipran

For Fibromyalgia

1 month ago
Milnacipran is a first-line pharmacologic treatment for fibromyalgia, particularly effective in reducing pain and fatigue. As an SNRI, it modulates pain processing in the central nervous system and is typically used when non-drug therapies are insufficient. Approved specifically for fibromyalgia, milnacipran may be more energizing than other SNRIs, making it a good option for patients with prominent fatigue but without major mood symptoms.

Duloxetine

For Fibromyalgia

1 month ago
Duloxetine is a first-line pharmacologic treatment for fibromyalgia, particularly effective for patients with both pain and mood symptoms. As an SNRI, it helps reduce central pain sensitization and has shown benefit in improving function and quality of life. It’s commonly used when non-drug approaches like exercise or CBT are not enough.

Cognitive Behavioral Therapy

For Fibromyalgia

1 month ago
CBT is a well-supported treatment for fibromyalgia, with evidence from studies and clinical guidelines showing it can help reduce pain, improve coping, and improve overall function. Benefits aren’t immediate—it typically takes several weeks to start noticing changes, with more meaningful improvement over 6–12 weeks as skills build over time. It’s less about eliminating pain and more about changing how pain is processed and managed. Works best when done consistently and often combined with exercise and other treatments.

Aerobic Exercise

For Fibromyalgia

1 month ago
Aerobic exercise is effective in reducing pain and improving quality of life in fibromyalgia patients, with optimal benefits achieved at 90 minutes per week. This intervention is well-supported by systematic reviews and meta-analyses, as well as clinical practice guidelines but may take weeks to months before you can see the benefit.

Prednisone

For Fever

1 month ago
Prednisone is not a first-line treatment for fever but may be used if the fever is due to an inflammatory or autoimmune condition. It helps by suppressing the immune response and reducing inflammation. Use should be reserved for specific cases under medical guidance because it can suppress the immune condition, which is not good, especially for bacterial infections.

Physical cooling methods

For Fever

1 month ago
I usually prefer medications, as physical cooling can be uncomfortable for patients. That said, it’s a reasonable option if the fever isn’t responding to meds. Can help bring the temperature down, but mainly as a backup rather than first-line.

Hydration

For Fever

1 month ago
Hydration is an important supportive step during a fever. It doesn’t treat the fever itself, but helps prevent and correct dehydration from increased fluid loss. Staying well hydrated can improve how you feel overall and support recovery. Simple but essential alongside other treatments.

Ibuprofen

For Fever

1 month ago
Motrin (ibuprofen) is a very effective fever reducer and has the added benefit of reducing inflammation, which can help with body aches and overall discomfort. I usually alternate it with Tylenol to keep fevers better controlled. It’s best taken with food to avoid stomach irritation. Like Tylenol, it helps with symptoms but doesn’t treat the underlying infection.

Acetaminophen

For Fever

1 month ago
Tylenol (acetaminophen) is a safe and effective fever reducer, commonly used for both adults and children. It works by lowering body temperature without reducing inflammation. Proper dosing is important to avoid liver toxicity. I often alternate it with ibuprofen for better fever control. It helps treat the fever, but not the underlying infection—especially if it’s bacterial.

Staying at bedside

For Family Member in the Hospital

1 month ago
One of the best ways to stay informed and advocate for your loved one. Hospitals are complex, and things can get missed, so having someone present helps catch issues early. It does take endurance since there’s often no clear schedule—consults can happen throughout the day or even after hours depending on clinic schedules. Being there consistently helps you stay on top of updates and communicate more effectively with the care team.

Bringing candy to the nurses

For Family Member in the Hospital

1 month ago
I do this during my ER shifts, and especially with longer hospital stays, it really helps build rapport. Healthcare workers are overworked, and even a small gesture goes a long way in showing appreciation. It doesn’t change care, but it definitely improves communication and the overall experience.

Accessing your family member electronic health records

For Family Member in the Hospital

1 month ago
Excellent option during prolonged hospital stays, especially if your family member isn’t medically savvy. Helps keep you updated in real time so you’re not relying solely on brief doctor updates. You can review results, follow along with the plan, and double check important details. In many cases, you’ll see updates faster than waiting to hear from the care team. Overall, a great way to stay informed and involved in their care.

Corticosteroid injection

For Extensor Carpi Ulnaris Tendonitis

1 month ago
Consider if PT, RICE, and NSAIDs haven’t worked. Can help calm inflammation and improve pain, but used selectively given risks—mainly tendon weakening/possible rupture and infection. Not something to repeat often.

RICE Treatment

For Extensor Carpi Ulnaris Tendonitis

1 month ago
First-line approach for ECU tendonitis that helps reduce inflammation and support recovery. Rest, ice, compression, and elevation can calm things down early, especially during flare-ups. Simple and effective.

Physical Therapy

For Extensor Carpi Ulnaris Tendonitis

1 month ago
Great option with high success for ECU tendonitis, but it takes time and consistency. Improvement isn’t immediate—often takes a few weeks to notice progress—but the long-term benefits can be very solid. Best for actually fixing the underlying issue rather than just masking symptoms.

Ibuprofen

For Extensor Carpi Ulnaris Tendonitis

1 month ago
A good first-line option to help with pain and inflammation from ECU issues. Works well for overuse or flare-ups and is easy to take as needed. Usually effective and well tolerated short-term, just keep in mind typical NSAID cautions (GI, kidney, bleeding risks).

Toynbee Manuever

For Eustachian Tube Dysfunction

1 month ago
A simple first-line option that can also help gauge how severe the eustachian tube dysfunction is. It involves pinching the nose and swallowing to equalize pressure. If symptoms improve, it suggests a milder, more responsive issue; if not, it may point toward more persistent dysfunction. Easy, safe, and a good starting point before moving to other treatments.

Valsalva Maneuver

For Eustachian Tube Dysfunction

1 month ago
The Valsalva maneuver as a simple first step to clear ear pressure and assess Eustachian tube function. If a patient is unable to successfully equalize pressure using this technique, it serves as a useful clinical indicator of Eustachian Tube Dysfunction (ETD), suggesting obstruction or inflammation that will require further evaluation and treatment.

Oxymetalozone

For Eustachian Tube Dysfunction

1 month ago
Oxymetazoline nasal spray provides quick relief for Eustachian Tube Dysfunction (ETD) by reducing nasal congestion and helping open the Eustachian tubes, making it especially useful for short-term use during colds, allergies, or air travel. However, prolonged use beyond three days can lead to rebound congestion, dryness, nasal irritation, and may not be suitable for individuals with high blood pressure or heart conditions.

Fluticasone Propionate

For Eustachian Tube Dysfunction

1 month ago
As adjunct treatment that won’t provide immediate relief but effectively reduces inflammation and nasal congestion, helping improve Eustachian Tube Dysfunction (ETD) over time. Best used consistently, it works to decrease swelling and mucus buildup, making it a valuable option for chronic or allergy-related ETD when combined with other treatments.

Cetirizine

For Eustachian Tube Dysfunction

1 month ago
A non-sedating antihistamine that effectively reduces mucus production, making it a useful adjunct treatment for Eustachian Tube Dysfunction (ETD) caused by allergies. While it doesn’t provide immediate relief or directly open the Eustachian tubes, it can help prevent congestion-related blockages when used consistently.

Vardenafil

For Erectile Dysfunction

1 month ago
Vardenafil (Levitra, Staxyn) is a PDE-5 inhibitor used for erectile dysfunction that works similarly to sildenafil but may be slightly more potent in some men. It is taken about 30–60 minutes before sexual activity and lasts around 4–6 hours. It may be prescribed when sildenafil is ineffective or not well tolerated, offering another short-acting option with a reliable safety profile.

Avanafil

For Erectile Dysfunction

1 month ago
Avanafil (Stendra) is a newer PDE-5 inhibitor for erectile dysfunction that is known for its fast onset of action, sometimes working in as little as 15 minutes. Its effects last about 4–6 hours, and it has fewer interactions with food and alcohol than older agents. It may be prescribed for men who value rapid, on-demand use or who did not tolerate other PDE-5 inhibitors well.

Tadalafil

For Erectile Dysfunction

1 month ago
Tadalafil (Cialis) is an effective treatment for erectile dysfunction that lasts up to 36 hours, earning it the nickname “the weekend pill.” It can be prescribed as needed or as a daily low dose, making it a good option for men who prefer more spontaneity or who also have urinary symptoms from benign prostatic hyperplasia (BPH). It is often chosen when patients want longer duration or more flexible dosing than sildenafil.

Sildenafil

For Erectile Dysfunction

1 month ago
Sildenafil is usually the go-to first-line treatment for erectile dysfunction. It’s been around the longest, so we have a strong track record for both safety and effectiveness. With cheap generics available, it’s often the most affordable option too. Overall, it works well, is generally well tolerated, and is easy to access—though other PDE-5 inhibitors might be a better fit depending on how long you want it to last or how you respond.

Rhino Rocket

For Epistaxis

1 month ago
While the Rhino Rocket can be effective for controlling epistaxis, I do have concerns about patient comfort during its use. The device is initially rigid for placement, which can cause discomfort for patients. Only after it absorbs moisture does it soften and expand to tamponade the bleeding. This makes it reliable but less comfortable compared to balloon devices like the Rapid Rhino.

Silver nitrate cautery

For Epistaxis

1 month ago
A good next step if pressure and topical meds aren’t enough and you can still localize the bleeding site. Silver nitrate works by chemically cauterizing the vessel to stop bleeding. It’s generally effective, though can be uncomfortable—topical lidocaine beforehand helps a lot with tolerability. Best used when you can clearly see the source, and avoid overuse to prevent tissue damage or septal injury.

Tranexamic acid

For Epistaxis

1 month ago
Tranexamic acid (TXA) can be safely combined with oxymetazoline, to help control nosebleeds. The oxymetazoline works by constricting blood vessels, while TXA helps stabilize the clot, and together they may improve bleeding control.

Rapid Rhino

For Epistaxis

1 month ago
Rapid Rhino is an effective option for stopping nosebleeds by applying direct pressure inside the nasal cavity. It works well for tamponade, especially in moderate to more persistent bleeds when simple measures fail. However, placement can be uncomfortable and is often not well tolerated without anesthesia or lubrication. Overall, it’s a reliable tool, but not the most pleasant experience for patients.

Oxymetazoline

For Epistaxis

1 month ago
Oxymetazoline is my second-line treatment for epistaxis after direct pressure. It works as a topical vasoconstrictor to shrink the nasal blood vessels and often helps stop bleeding when pressure alone is not enough. I usually combine it with lidocaine to provide anesthesia so that If the bleeding continues I proceed to cauterization with silver nitrate to directly seal the bleeding vessel.

Direct pressure

For Epistaxis

1 month ago
Direct pressure is first line treatment for epistaxis and will stop most nosebleeds. The soft part of the nose should be pinched continuously for 10–15 minutes, which allows clotting to occur. If the bleeding recurs, the maneuver can be repeated. Persistent or heavy bleeding lasting longer than 20-30 minutes should prompt medical evaluation for further treatment.

Roflumilast topical

For Eczema

1 month ago
Topical roflumilast is a non-steroidal medication used to treat mild-to-moderate eczema. It works as a PDE4 inhibitor and can be a good option for patients who want to avoid steroids or who have had side effects from them. I often think of it as an alternative to topical steroids or calcineurin inhibitors for longer-term control. It can also be used along with systemic biologics as another topical therapy when needed, including when documenting adequate topical treatment for insurance approval. One downside is that it can be quite expensive depending on insurance coverage.

Lukewarm baths

For Eczema

1 month ago
Switching to lukewarm baths or showers instead of hot ones can help reduce skin dryness and itching. Hot water tends to strip the skin of its natural oils, which can worsen irritation. Keeping showers or baths short and lukewarm helps preserve the skin’s natural barrier. That said, this can sometimes be a compliance and preference issue, since many patients simply prefer hotter showers.

Triamcinolone

For Eczema

1 month ago
Triamcinolone is a stronger topical steroid that I often use when over-the-counter options like hydrocortisone aren’t enough. It works well to calm down inflammation, redness, and itching in things like eczema or other irritated skin. I usually step up to this if OTC treatments aren’t getting things under control. When used appropriately, it can make a noticeable difference pretty quickly.

Q-tip

For Ear wax

1 month ago
Q-tips are commonly used to clean the ears, but they’re usually not a great option for removing earwax. Since it’s essentially a blind procedure, they often end up pushing the wax deeper into the canal rather than removing it. They can help clean some superficial wax near the opening of the ear, but they frequently contribute to cerumen impactions. For deeper wax buildup, other treatments tend to work much better.

Manual Removal

For Ear wax

1 month ago
Manual removal of earwax can be very effective, depending on the provider’s experience and the equipment available. When done well, it can clear the impaction quickly and provide immediate relief. That said, the success really depends on the technique and tools being used. There’s also a small risk of irritation or minor trauma to the ear canal if the wax is difficult to remove.

Ear Irrigation

For Ear wax

1 month ago
Ear irrigation is one of the most effective and reliable methods for removing stubborn ear wax, especially when the buildup is deep in the ear canal, close to the eardrum. One of the biggest advantages of ear irrigation is that it is widely accessible, both as a professional treatment and an at-home solution. Many over-the-counter ear irrigation kits and devices allow users to safely and effectively remove ear wax in the comfort of their own homes, saving time and money on doctor visits.

Debrox

For Ear wax

1 month ago
Debrox is one of the most common things I recommend for earwax buildup since it’s easy to get over the counter. It helps soften and break up the wax so it can come out more easily on its own. I usually suggest trying this first before needing ear irrigation or having the wax removed in the office. It’s simple, inexpensive, and works well for a lot of mild earwax impactions.

Ibuprofen

For Ear infection, Inner

1 month ago
Ibuprofen is one of the first things I recommend to help with the pain and discomfort from an ear infection. It works well to reduce ear pain, inflammation, and fever, making patients much more comfortable while things improve.

Cefdinir

For Ear infection, Inner

1 month ago
Cefdinir is an effective treatment for acute otitis media, especially against beta-lactamase-producing bacteria. It is recommended by the American Academy of Pediatrics as an alternative initial antibiotic. However, it may be less effective than amoxicillin/clavulanate for treating penicillin-resistant Streptococcus pneumoniae.

Medroxyprogesterone acetate

For Dysmenorrhea

1 month ago
Depo-Provera can be an alternative option for treating Dysmenorrhea by suppressing ovulation and the normal menstrual cycle. By reducing or stopping periods, many patients experience less cramping and lighter bleeding. It is given as an injection every three months, which can be convenient for some patients who prefer not to take daily medication.

Magnesium glycinate

For Dysmenorrhea

1 month ago
An over-the-counter treatment that can be an adjunct treatment for dysmenorrhea.

Estrogen and Progestin

For Dysmenorrhea

1 month ago
Hormonal birth control can help treat Dysmenorrhea, especially if NSAIDs aren’t enough. It works by suppressing the normal menstrual cycle, which often leads to lighter periods and less severe cramping. Because of this, it’s commonly used as a second-line option when basic pain medications don’t provide enough relief.

Heat Therapy

For Dysmenorrhea

1 month ago
Applying a heating pad or warm compress to the lower abdomen can relax muscles and reduce pain as a first line, though effectiveness will vary from person to person.

Exercise

For Dysmenorrhea

1 month ago
There is some evidence that regular exercise may reduce the severity of dysmenorrhea, and given the overall benefit of exercise and low risk of adverse events, this modality should be added to other treatments.

Acetaminophen

For Dysmenorrhea

1 month ago
Acetaminophen is a safe option for treating pain from Dysmenorrhea when used at appropriate doses. It can be combined with or alternated with NSAIDs like ibuprofen to provide better overall pain control. Because it is widely available and generally well tolerated, it’s a practical option for managing menstrual pain.

Ibuprofen

For Dysmenorrhea

1 month ago
Ibuprofen is a first-line option for Dysmenorrhea. It helps relieve pain while also reducing the inflammation and prostaglandins that drive menstrual cramps, so it treats more than just the discomfort. It tends to work best when taken early when cramps start. Since it’s over the counter, inexpensive, and widely available, it’s an easy first option for many people dealing with menstrual pain.

Mineral Oil

For Dry Eyes Disease

1 month ago
Mineral oil is commonly used in lubricating eye drops and ointments to help treat Dry eye syndrome. It works by forming a protective oily layer over the tear film, which helps reduce evaporation and keep the eyes moist longer. Because it is thicker than many artificial tears, it is often found in gel drops or nighttime ointments for longer-lasting relief. While very effective for dryness, it can temporarily blur vision, so it’s commonly used before bed or when sustained lubrication is needed.

Carboxymethylcellulose

For Dry Eyes Disease

1 month ago
Carboxymethylcellulose is a common ingredient in artificial tears used to treat Dry eye syndrome. It works by increasing the thickness and stability of the tear film, helping keep the surface of the eye lubricated and reducing irritation or burning. These drops are widely available over the counter and generally very well tolerated, making them a good first option for mild dry eye symptoms.

Polyethylene Glycol (PEG) & Propylene Glycol (PG)

For Dry Eyes Disease

1 month ago
Polyethylene glycol (PEG) and propylene glycol (PG) are common ingredients in lubricating eye drops used as a first-line treatment for Dry eye syndrome. They help moisturize the eye and stabilize the tear film, which can relieve dryness, burning, and irritation. These drops are widely available over the counter, easy to use, and generally very well tolerated, making them a good starting option for mild dry eye symptoms.

BRAT Diet

For Diarrhea

1 month ago
BRAT diet is commonly recommended during episodes of Diarrhea, though it likely doesn’t directly stop the diarrhea itself. Instead, it provides bland, easy-to-digest foods that are helpful when patients are recovering from nausea or vomiting and beginning to eat again. The diet can support hydration and basic nutrition while being gentle on the stomach. In practice, it works best as a simple transition diet while the gut recovers, rather than a treatment that actually resolves diarrhea.

Loperamide

For Diarrhea

1 month ago
Loperamide can be helpful for managing Diarrhea by slowing down the gut and helping stools become more formed. It usually starts working within about an hour, so it can provide fairly quick relief when symptoms are bothersome. That said, it’s not a great choice if the diarrhea is likely infectious, since slowing the intestines can make it harder for the body to clear the infection. Used appropriately, it’s a simple and effective option for short-term symptom control.

Novolin R

For Diabetes, Type 1

1 month ago
Novolin R is a short-acting insulin that works relatively quickly to help lower blood sugar in patients with Diabetes mellitus. It is widely available and inexpensive, making it a practical option for many patients who need insulin therapy. However, it must usually be taken about 30 minutes before meals and often requires multiple injections per day, which can make it less convenient than some newer rapid-acting insulin options. Despite this, it remains a reliable and accessible treatment for blood sugar control.

Novolin R

For Diabetes, Type 2

1 month ago
Novolin R is an effective option for patients with Type 2 diabetes whose blood sugars remain poorly controlled despite oral medications or other treatments. It can reliably lower glucose levels and is sometimes necessary when the pancreas is no longer producing enough insulin. However, insulin therapy is more labor-intensive, since it requires injections and regular blood glucose monitoring to adjust dosing and avoid low blood sugar. Because of this, many patients and clinicians try other medications first before transitioning to insulin. When used appropriately, though, it remains one of the most powerful tools for controlling blood sugar.

Liraglutide

For Diabetes, Type 2

1 month ago
Liraglutide is a helpful option for lowering blood sugar in Type 2 diabetes and can also lead to some weight loss. That said, the weight loss tends to be less than what many patients see with semaglutide. It requires a daily injection, which is a bit less convenient than the newer weekly options. Some patients experience nausea or vomiting, especially when starting the medication.

Dulaglutide

For Diabetes, Type 2

1 month ago
Dulaglutide is a once-weekly GLP-1 receptor agonist that lowers blood sugar, supports weight loss, and provides cardiovascular protection in type 2 diabetes. It is often chosen over other GLP-1s for its simple, easy-to-use pen and minimal dose adjustments, making it ideal for patients who prefer convenience. However, weight loss is lower than some of the other GLP-1 drugs and its function is more for blood sugar control.

Semaglutide

For Diabetes, Type 2

1 month ago
Semaglutide is a highly effective treatment for Type 2 diabetes that not only improves blood sugar control but also leads to substantial weight loss in many patients. The degree of weight reduction can be so significant that some patients experience near remission of their diabetes and meaningful reductions in cardiovascular risk. It has also shown benefit in lowering the risk of heart disease and major cardiovascular events in high-risk patients. However, the medication can cause notable gastrointestinal side effects, particularly nausea and vomiting, especially when first starting or increasing the dose. Despite this, many patients find the metabolic and weight benefits substantial when the medication is tolerated well.

Metformin

For Diabetes, Type 2

1 month ago
Metformin is an affordable, first-line treatment for type 2 diabetes that effectively lowers blood sugar with a low risk of hypoglycemia. It may also promote weight loss and offer cardiovascular benefits, though side effects like nausea, diarrhea, and rare lactic acidosis can occur.

Tympanostomy tubes

For Ear infection, Inner

1 month ago
Tympanostomy tubes can be a very effective preventative treatment for recurrent Otitis media, helping ventilate the middle ear and reduce the frequency of infections. They are typically recommended for children with recurrent infections or persistent fluid affecting hearing. While generally well tolerated, patients should be cautious with water exposure, as activities like swimming or water sports can increase the risk of water entering the middle ear through the tube.

Azithromycin

For Ear infection, Inner

1 month ago
Azithromycin can be used to treat Otitis media, particularly in patients with a penicillin allergy who cannot take first-line therapies like amoxicillin. It provides coverage against several common respiratory pathogens and also has activity against atypical organisms, which can occasionally contribute to ear and respiratory infections. Azithromycin is convenient because it is typically taken once daily for a short course, improving adherence. It is generally well tolerated, with mild gastrointestinal upset being the most common side effect. Because of increasing bacterial resistance, it is usually reserved for patients who cannot take first-line penicillin-based antibiotics.

Amoxicillin-clavulanate

For Ear infection, Inner

1 month ago
Amoxicillin-clavulanate is indicated for the treatment of acute otitis media in cases where there is failure of initial therapy with amoxicillin alone. According to AAP guidelines, it is the preferred second-line agent when symptoms persist or worsen after 48–72 hours of appropriate first-line treatment.

Lidocaine 4% Otic

For Ear infection, Inner

1 month ago
Topical anesthetic ear drops were previously available by prescription for pain relief but are now available over the counter, making them a convenient option for symptom control with ear infections such as Otitis media. These drops can provide quick local pain relief and are a great adjunct while the infection itself runs its course or is treated with antibiotics when appropriate. Because many ear infections are viral, antibiotics are not always needed, and topical pain relief can help manage symptoms in either bacterial or viral cases. These products are especially helpful for children who are experiencing significant ear discomfort. As with any ear drops, they should only be used if the eardrum is intact.

Amoxicillin

For Ear infection, Inner

1 month ago
Amoxicillin is a first-line treatment for Otitis media, commonly used for children with acute ear infections. It has a broad spectrum against the most common bacterial causes, making it an effective and reliable initial therapy. The medication is generally well tolerated with a low side-effect profile, with mild gastrointestinal upset being the most common issue. Amoxicillin is also inexpensive and widely available, making it an accessible option for most families. It comes in liquid suspension formulations, which makes dosing easier for young children who cannot swallow pills.

Tranexamic acid

For von Willebrand disease

1 month ago
Tranexamic acid is a useful first-line treatment for bleeding episodes in patients with Von Willebrand disease, particularly for mucosal bleeding such as nosebleeds, dental procedures, or heavy menstrual bleeding. It works by inhibiting fibrinolysis, helping stabilize clots and prevent premature breakdown of clots. The medication can be taken in several forms, including oral tablets, intravenous (IV) formulations, and topical preparations such as mouthwash or soaked gauze for dental or surgical bleeding. Because it is relatively inexpensive, easy to use, and generally well tolerated, it is often used early before considering factor replacement therapy. Overall, tranexamic acid is a practical and effective option for managing mild bleeding episodes in patients with von Willebrand disease.

Ursodeoxycholic Acid

For Gallstones

1 month ago
Ursodeoxycholic acid is a non-surgical option for dissolving small cholesterol gallstones in patients who are unable or unwilling to undergo surgery. This method works gradually by altering bile composition, and typically requires several months of daily treatment to see results. It is best suited for non-calcified stones and is generally well tolerated. While not a quick fix, it offers a useful alternative when surgery isn’t feasible.

Enoxaparin

For Deep Venous Thrombosis

2 months ago
Enoxaparin (Lovenox) is an appropriate treatment for DVT and is given as an injection, usually twice a day. It is effective but because it is a twce daily injection, it is commonly used as a bridging therapy to transition patients to an oral anticoagulant.

Warfarin

For Deep Venous Thrombosis

2 months ago
Coumadin is one of the older options for treating DVT, but it can be challenging to manage because blood levels must be checked regularly to ensure it is therapeutic. Patients often need bridging with Lovenox until the INR reaches the target range, which makes it less convenient than newer agents.

Rivaroxaban

For Deep Venous Thrombosis

2 months ago
Xarelto (rivaroxaban) is a Factor Xa inhibitor used to treat and prevent DVT and PE by blocking part of the clotting cascade. Like other newer anticoagulants, it doesn’t require routine blood monitoring. One reason I’ll choose it over other Factor Xa inhibitors is the simpler dosing, since after the initial period it can be taken once daily, which is easier for many patients.

Apixiban

For Deep Venous Thrombosis

2 months ago
Apixaban is a Factor Xa inhibitor and is now commonly used as a standard treatment for anticoagulation. It has been shown to have strong efficacy for preventing and treating blood clots with a lower bleeding risk compared with older options like warfarin. It’s widely used for conditions such as DVT and pulmonary embolism. For DVT treatment, it is typically taken twice daily, which provides steady anticoagulation without the need for routine blood monitoring.

Hydroxychloroquine

For Covid-19

2 months ago
The current consensus in the medical literature, as well as the American College of Physicians advises against the use of hydroxychloroquine for the treatment of COVID-19 because of the lack of benefit and the risk of cardiac toxicity (QT prolongation).

Molnupiravir

For Covid-19

2 months ago
Molnupiravir is an oral antiviral for COVID-19, used when Paxlovid isn’t appropriate due to drug interactions or kidney/liver issues. While less effective than Paxlovid, it’s a valuable alternative when other treatments aren’t suitable.

Nirmatrelvir-Ritonavir

For Covid-19

2 months ago
Paxlovid is an effective treatment for COVID-19 that should be started within 5 days of symptom onset. It helps reduce the risk of severe illness, especially in high-risk patients. Some people may experience a rebound of symptoms after completing the treatment, but it still offers strong protection overall.

Spikevax

For Covid-19

2 months ago
The COVID-19 vaccine remains a key tool in protecting against severe illness, especially for those at higher risk. Over time, the overall severity of COVID-19 has decreased—thanks to widespread vaccination, improved treatments, and the emergence of less harmful variants. However, since protection from the Moderna vaccine typically wanes after about six months, continuing with updated doses becomes a personal risk-benefit decision based on individual health, exposure risk, and evolving public health guidance.

Remdesivir

For Covid-19

2 months ago
Remdesivir is the first-line antiviral treatment for hospitalized patients with COVID-19 who are not yet on mechanical ventilation. Administered intravenously over 5 days, it works by inhibiting viral replication and has been shown to shorten recovery time in clinical trials. It is most effective when initiated within 7 days of symptom onset. While generally well tolerated, patients may experience side effects such as nausea or elevated liver enzymes.

Guaifenesin and Dextromethorphan

For Cough

2 months ago
Combination OTC cough medications can help maximize symptom relief by using more than one approach. These products often combine a non-opioid cough suppressant with an expectorant to both reduce coughing and help loosen mucus. While results can vary, this can be a reasonable option when trying to get the most benefit from over-the-counter treatments before moving on to prescription medications.

Promethazine with codeine

For Cough

2 months ago
Promethazine with codeine is a commonly prescribed cough syrup that combines an antihistamine with an opioid cough suppressant. It can be effective for reducing cough and helping with symptoms like irritation and post-nasal drip. However, given current concerns about opioid use and dependence, I’m much less likely to prescribe it and usually reserve it if other treatments have failed.

Prednisone

For Cough

2 months ago
Prednisone can sometimes help with cough when there is a strong inflammatory component, such as with asthma, COPD exacerbations, or significant airway inflammation. It works by reducing inflammation in the airways, which can improve breathing and decrease coughing. However, because it has more potential side effects, it is not usually a first-line treatment for a typical cough. It’s generally reserved for situations where inflammation is clearly contributing to the symptoms.

Albuterol

For Cough

2 months ago
Albuterol can help with cough when the cause is bronchospasm, such as in asthma or COPD. It works by relaxing the muscles in the airways, which opens them up and can reduce coughing related to airway tightening. However, it doesn’t help every type of cough, especially those caused by post-nasal drip or throat irritation. It’s most useful when the cough is coming from airway constriction or wheezing.

Guaifenesin

For Cough

2 months ago
Guaifenesin is an expectorant that is supposed to help thin mucus and make it easier to cough up phlegm. While that’s the idea, research studies haven’t consistently shown a significant benefit. Some people feel like it really helps them loosen mucus, but in my experience the results are pretty mixed. Because of that, I don’t typically recommend it, though it’s generally safe and available over the counter.

Fluticasone nasal spray

For Cough

2 months ago
Flonase can help with cough when it’s caused by post-nasal drip, which is often the underlying issue. By reducing nasal inflammation and mucus production, it helps dry up drainage that can irritate the throat and trigger coughing. It usually takes a couple of days to start working, but once the nasal symptoms improve, the cough often improves as well. It’s a helpful option when the cough seems to be coming from sinus or allergy-related drainage rather than the lungs.

Dextromethorphan

For Cough

2 months ago
Dextromethorphan is an inexpensive over-the-counter option for cough. It works as a cough suppressant and can help reduce coughing for some people with upper respiratory infections. I also find many of the formulations taste fairly good, which makes them easier to take. It doesn’t work for everyone, but it can provide modest relief with generally minimal side effects.

Benzonatate

For Cough

2 months ago
Benzonatate is an effective option for treating dry, irritating coughs by numbing the cough reflex at its source. It is a non-narcotic alternative to other cough suppressants, providing relief with minimal central nervous system effects. Proper use is essential to avoid potential side effects. Always follow the prescribing physician’s directions.

Ciprofloxacin 0.3%

For Corneal Abrasion

2 months ago
I’ll prescribe ciprofloxacin eye drops for higher-risk corneal abrasions, especially if the injury is related to contact lens use. These cases have a higher risk of infection, particularly from Pseudomonas bacteria. The drops help protect the eye from infection while the cornea heals. It’s a simple precaution when the risk of infection is higher.

Eye patch

For Corneal Abrasion

2 months ago
Routine eye patching is no longer recommended for corneal abrasions as it does not improve healing and covering prevents casual observation if the infection gets worse. Modern management focuses on lubrication, pain control, and infection prevention.

Erythromycin 0.5 % Eye Ointment

For Corneal Abrasion

2 months ago
I often prescribe erythromycin eye ointment for corneal abrasions to help prevent infection, especially since follow-up from the ER can sometimes be difficult. Most simple corneal abrasions will heal on their own and probably don’t require antibiotics, but using an ointment can add a layer of protection while the surface of the eye heals. The ointment also provides some lubrication, which can make the eye feel a bit more comfortable. Overall, it’s a low-risk precaution that can help reduce the chance of complications.

Diclofenac 0.1%

For Corneal Abrasion

2 months ago
Overall, both topical diclofenac 0.1% and oral NSAIDs are viable options for managing pain in corneal abrasions. The choice between them may depend on patient preference, the need for rapid pain relief, and the consideration of potential side effects. Topical diclofenac 0.1% is particularly beneficial for patients who require immediate pain relief and wish to avoid systemic side effects associated with oral NSAIDs.

Orthotics Insert

For Corn

2 months ago
Orthotic inserts are often a first-line treatment for corns because they help reduce the pressure and friction that cause them in the first place. By redistributing weight across the foot and cushioning high-pressure areas, they can take stress off the spot where the corn is forming. This can make walking more comfortable and give the skin a chance to heal. For many people, simple over-the-counter inserts are enough, though custom orthotics can help if foot structure or gait is contributing to the problem.

Salicylic Acid Gel

For Corn

2 months ago
Over-the-counter salicylic acid treatments can help soften and gradually break down the thick skin that forms a corn, which can give some short-term relief. Corn pads are also helpful because they take pressure off the area, making it more comfortable to walk while the skin heals. These options can work well for mild corns, especially if you also switch to better-fitting shoes to stop the rubbing that caused the problem. Just be careful with salicylic acid, since it can irritate the surrounding skin, particularly in people with diabetes or poor circulation.

Properly Fitting Shoes

For Corn

2 months ago
One of the first things to address with corns is wearing better-fitting shoes. Corns usually develop from constant pressure or rubbing, often from tight or narrow shoes. Switching to shoes with a wider toe box and better cushioning can relieve that pressure and give the skin a chance to heal. In many cases, simply changing footwear can make a big difference and is the most important first step before trying other treatments.

RICE Protocol

For Contusion

2 months ago
RICE—Rest, Ice, Compression, and Elevation—is usually one of the first treatments recommended for a contusion. Resting the injured area helps prevent further damage, while ice can reduce swelling and pain, especially in the first 24–48 hours. Compression with a wrap and elevating the injured area can also help limit swelling and promote healing. It’s a simple and effective approach that can often make a noticeable difference in comfort early after an injury.

Ibuprofen

For Contusion

2 months ago
Ibuprofen is often a first-line treatment for pain from contusions (bruises). It helps reduce both pain and inflammation, which can improve comfort and swelling after an injury. Because it is widely available over the counter and works well for mild to moderate pain, it is commonly used early after a soft tissue injury. One thing to be aware of is that ibuprofen can slightly increase bleeding or bruising since it affects platelet function, so it should be used cautiously if there is significant bleeding or a large hematoma.

Saline enema

For Constipation

2 months ago
A saline enema can provide quick relief for constipation, especially when stool is sitting in the rectal vault and needs direct stimulation to pass. It works by drawing fluid into the rectum and triggering a bowel movement fairly quickly. While it can be effective in this situation, I tend not to prefer it because it can be uncomfortable and awkward to use. For that reason, I usually try other treatments first unless it’s clear the stool is stuck low in the rectum.

Polyethylene glycol 3350

For Constipation

2 months ago
GoLYTELY is best known for being used as a bowel prep before colonoscopies, and it definitely lives up to the name—it will make you go a lot. It works by flushing large amounts of fluid through the intestines to clear everything out. Because of how strong and reliable it is, I sometimes think of it as a backup option for severe constipation when other medications haven’t worked. The main downside is that you have to drink a fairly large volume of the solution, and it can be a bit unpleasant, but it’s usually very effective at getting things moving.

Magnesium citrate

For Constipation

2 months ago
Magnesium citrate is a stronger laxative that works much faster than many other options and is available over the counter. It pulls water into the intestines, which stimulates a bowel movement and can help clear more significant constipation. It typically works within about 30 minutes to 6 hours, making it quicker than medications like lactulose. Because of this stronger effect, it can be more disruptive, often causing urgent bowel movements and sometimes cramping, so it’s usually best used for short-term relief rather than regular use.

Lactulose

For Constipation

2 months ago
Lactulose is an effective second-line treatment for constipation, especially for individuals who have not had success with first-line options like fiber supplements or stool softeners. It works by drawing water into the colon, which softens stool and makes it easier to pass. Lactulose typically takes about 6–24 hours to work, so it acts more slowly than stronger laxatives like magnesium citrate. Because of this gentler effect, it is often a good option when a more gradual treatment is preferred. Some people do experience bloating or gas, but these side effects are usually mild and manageable.

Psyllium

For Constipation

2 months ago
Psyllium is a natural fiber supplement commonly used to help treat constipation. It works as a bulk-forming fiber, absorbing water in the intestines and helping soften and bulk up stool so it’s easier to pass. Because it works in a gentle, more natural way, it’s often a good option for regular or long-term use. Just make sure to drink plenty of water with it, since psyllium needs fluid to work properly and to avoid worsening constipation.

Fiber

For Constipation

2 months ago
Increasing dietary fiber is usually the first thing I recommend for constipation. Fiber helps add bulk to stool and keeps things moving through the intestines more regularly. This can come from foods like fruits, vegetables, whole grains, or fiber supplements if needed. It’s a simple, natural approach that works well for many people, though it’s important to increase fiber gradually and drink enough water to avoid bloating or discomfort.

Docusate

For Constipation

2 months ago
Colace (docusate) is a stool softener that can be helpful for mild constipation or for preventing constipation before it becomes a problem. I often recommend it when starting medications that commonly cause constipation, such as opioids or iron supplements. It works by drawing water into the stool, making it softer and easier to pass. It’s generally well tolerated and gentle, though it may not be strong enough for more severe constipation.

Nitroprusside

For Congestive Heart Failure

2 months ago
Nitroprusside is a potent, titratable IV vasodilator for acute decompensated CHF, providing rapid relief by reducing both preload and afterload. However, because it requires ICU-level monitoring due to risks like hypotension and cyanide toxicity, I often prefer other vasodilators such as IV nitroglycerin. In many cases, patients can be effectively stabilized with alternative medications without needing ICU admission.

Sublingual Nitroglycerin

For Congestive Heart Failure

2 months ago
Sublingual nitroglycerin can be very helpful in acute congestive heart failure, especially when the patient is hypertensive. It works by causing vasodilation, which lowers blood pressure and reduces the workload on the heart, often helping symptoms like shortness of breath fairly quickly. Because it acts rapidly and is easy to give under the tongue, it can serve as a quick bridge while more definitive treatments for heart failure are started. However, clinicians need to be cautious because it can drop blood pressure too much, leading to hypotension in some patients.

Furosemide

For Congestive Heart Failure

2 months ago
Furosemide is one of the first medications used in acute heart failure to help remove excess fluid from the body. It works by acting on the kidneys, causing them to make more urine and helping relieve symptoms like shortness of breath and swelling. When given IV, it can start working within about 5 minutes, which makes it very useful in urgent situations when fluid needs to be removed quickly. It can also be used long-term to help control fluid buildup in chronic heart failure. Because it works through the kidneys, however, it can sometimes strain or worsen kidney function, so doctors usually monitor kidney labs while patients are taking it. Patients also commonly notice a lot of urination, which can be inconvenient but is part of how the medication removes excess fluid.

Sling

For Clavicle Fracture

2 months ago
A sling is often what I have readily available for treating a clavicle fracture. It helps support the arm and stabilizes the shoulder, which can reduce pain and allow the bone to start healing. While it doesn’t restrict movement as well as a shoulder immobilizer, it still works well for many uncomplicated fractures. It’s a simple and practical option, especially early on or when a shoulder immobilizer isn’t available.

Shoulder Immobilizer

For Clavicle Fracture

2 months ago
A shoulder immobilizer is usually the go-to treatment for most clavicle fractures. It keeps the arm and shoulder still, which helps reduce pain and allows the bone to heal in the right position. Most broken collarbones heal well with this simple approach and don’t require surgery. It’s typically worn for a few weeks until the pain improves and the bone starts to heal.

Fluticasone/Salmeterol

For Chronic Obstructive Pulmonary Disease

2 months ago
Fluticasone/Salmeterol can be a practical way to reach triple therapy in COPD at a lower cost. Because generic versions are available, it can be added to a long-acting muscarinic antagonist (LAMA) to provide steroid, LABA, and LAMA coverage without needing a brand-name triple inhaler. This approach can help improve symptoms and reduce exacerbations in patients who are not well controlled on dual therapy. While it does require using more than one inhaler, it is often a more affordable path to triple therapy.

Oxygen

For Chronic Obstructive Pulmonary Disease

2 months ago
Oxygen can be used for severe COPD when oxygen levels are chronically low. It helps improve oxygenation and can reduce strain on the heart and other organs. Because it’s a more intensive therapy, it’s generally reserved for patients with significant hypoxemia, rather than mild or moderate COPD.

Fluticasone Propionate

For Chronic Obstructive Pulmonary Disease

2 months ago
Fluticasone propionate is an inhaled corticosteroid that can help reduce airway inflammation, but inhaled steroids alone are generally not recommended for COPD according to current guidelines. However, because fluticasone is available as a low-cost generic, it can sometimes be added to existing LABA/LAMA therapy to create a triple-therapy regimen when symptoms remain uncontrolled. This approach may help reduce exacerbations in selected patients, particularly those with frequent flare-ups or higher eosinophil counts. Using a separate generic steroid inhaler can also be a more affordable alternative to brand-name triple inhalers.

Aclidinium/Formoterol

For Chronic Obstructive Pulmonary Disease

2 months ago
Aclidinium/Formoterol is a combination inhaler used for COPD that contains a long-acting muscarinic antagonist and a long-acting beta-agonist, helping relax airway muscles and improve airflow. I typically consider it a second-line option when symptoms aren’t adequately controlled with a single long-acting inhaler. The dual mechanism can provide better symptom control and reduce shortness of breath for many patients. One downside is that there is no generic version available, and similar medication combinations can often be prescribed using other inhalers at a lower cost.

Trelegy

For Chronic Obstructive Pulmonary Disease

2 months ago
Trelegy is a convenient inhaler that combines three medications in one device: an inhaled corticosteroid, a long-acting beta agonist, and a long-acting muscarinic antagonist. This triple therapy can be very effective for patients with COPD or more severe asthma who need multiple mechanisms of treatment. The main advantage is simplicity—one inhaler once daily instead of juggling several medications. The downside is potentially cost, as Trelegy can be expensive, and similar treatment combinations can often be achieved using two separate inhalers at a lower price.

Tiotropium

For Chronic Obstructive Pulmonary Disease

2 months ago
Tiotropium, a long-acting muscarinic antagonist, is recommended by GOLD guidelines as a first-line maintenance therapy for patients with moderate to severe COPD. It can be used alone or combined with a LABA or ICS, depending on disease severity and exacerbation risk.

Influenza Vaccination

For Chronic Obstructive Pulmonary Disease

2 months ago
Influenza vaccine is one of the best ways to help prevent influenza and its complications, especially in patients with COPD. Respiratory infections like the flu can trigger COPD exacerbations, so vaccination can play an important role in reducing illness and hospitalizations. It’s generally recommended annually, particularly for patients with chronic lung disease.

Water intake

For Chronic Kidney Disease

2 months ago
Water intake is an important factor in managing chronic kidney disease, but there’s no one-size-fits-all recommendation. It should be personalized based on kidney function, symptoms, and other health conditions—and always discussed with a physician.

Dietary Modifications

For Chronic Kidney Disease

2 months ago
Dietary modification is a cornerstone of CKD management—reducing sodium, processed foods, and excess animal protein helps minimize kidney stress and slow disease progression. Simply put, less junk in means less damage to the kidneys over time.

Avoiding nephrotoxins

For Chronic Kidney Disease

2 months ago
Avoiding further kidney damage in CKD involves recognizing and minimizing the use of commonly used nephrotoxic medications, such as NSAIDs, certain antibiotics, and over-the-counter supplements. Even everyday drugs like metformin, PPIs, and gabapentin can accumulate or cause harm if not properly adjusted for kidney function.

Amoxicllin

For Chlamydia

2 months ago
Amoxicillin can be an option for treating chlamydia, particularly if someone is unable to take Doxycycline or Azithromycin due to allergies or other contraindications. It’s generally well tolerated and has a long safety record, especially in pregnancy. While it’s not usually a first choice, it can still be a reasonable alternative in the right situation.

Levofloxacin

For Chlamydia

2 months ago
Levofloxacin works for chlamydia, but I don’t reach for it very often. It tends to be more expensive and fluoroquinolones come with a list of potential side effects, so I usually prefer other options first. That said, it can still be a reasonable backup if someone can’t take the typical first-line treatments or covering other types of infection.

Azthromycin

For Chlamydia

2 months ago
Azithromycin used to be a preferred treatment for chlamydia because it could be given as a single dose, which made adherence easy. However, with increasing concerns about lower effectiveness compared with Doxycycline, doxycycline is now generally preferred as first-line therapy. That said, azithromycin can still be a reasonable alternative for patients who can’t take doxycycline or when medication adherence is a concern.

Condoms

For Chlamydia

2 months ago
Condom are one of the best ways to help prevent chlamydia transmission. When used correctly and consistently, they significantly reduce the risk of spreading sexually transmitted infections. They’re inexpensive, widely available, and an important part of safer sex practices.

Doxycycline

For Chlamydia

2 months ago
Doxycycline is the recommended first-line treatment for chlamydia. It works very well against Chlamydia trachomatis and is usually taken for 7 days, with high cure rates when the full course is completed. I tend to prefer it because studies show it’s a bit more effective than some alternatives, especially for rectal infections. Side effects can include stomach upset and sun sensitivity, so it’s a good idea to take it with plenty of water and be mindful of sun exposure.

Bilevel Positive Airway Pressure with Backup Rate

For Central Sleep Apnea

2 months ago
Bilevel Positive Airway Pressure can be used for central sleep apnea when Continuous Positive Airway Pressure doesn’t adequately control symptoms. It delivers different pressures for inhalation and exhalation, which can help support breathing and improve ventilation during sleep. In practice, it’s often considered a step up from CPAP, particularly when additional ventilatory support is needed. While helpful for some patients, more advanced options like ASV may be considered if events persist.

Adaptive Servo-Ventilation

For Central Sleep Apnea

2 months ago
Adaptive Servo-Ventilation is a next-line therapy for central sleep apnea, typically used when treatments like Continuous Positive Airway Pressure or Bilevel Positive Airway Pressure don’t adequately control symptoms. It works by providing dynamic, breath-by-breath pressure support to stabilize breathing patterns during sleep and reduce central apnea events. Compared with standard positive airway pressure therapies, it has better evidence for improving sleep quality and overall quality of life in appropriate patients. However, it is contraindicated in patients with heart failure and reduced ejection fraction (≤45%), where studies have shown potential harm.

Continuous Positive Airway Pressure

For Central Sleep Apnea

2 months ago
Continuous Positive Airway Pressure is typically the initial treatment for central sleep apnea (CSA). It provides continuous airway pressure that can help stabilize breathing patterns during sleep and reduce apnea events in some patients. While it tends to work more consistently for obstructive sleep apnea, it’s often tried first for CSA before moving to other options if needed. When effective, it can improve sleep quality and reduce daytime fatigue.

Amoxicillin-Clavulanate

For Cellulitis

2 months ago
Amoxicillin/clavulanate can be a reasonable option for cellulitis, and I sometimes use it when I want broader coverage than Cephalexin. It covers common skin bacteria like streptococci and MSSA while also adding some additional gram-negative and anaerobic coverage. That said, it’s important to remember that it does not cover MRSA, so another antibiotic may be needed if that’s a concern. Overall, it can be a useful option when a little broader coverage makes sense clinically.

Trimethoprim Sulfamethoxazole

For Cellulitis

2 months ago
Bactrim is a great option for resistant staph cellulitis when resistant staph because it provides strong MRSA coverage. Be aware of sulfa allergies, which can range from mild rashes to more serious reactions.

Doxycycline

For Bronchitis

2 months ago
Doxycycline is a good substitute for azithromycin when there's concern for a bacterial component in bronchitis, especially since it also covers atypical pathogens. I’ll consider it in patients with COPD, prolonged symptoms, or when azithromycin isn’t a good option. It’s generally well tolerated and effective in the right clinical context.

Azithromycin

For Bronchitis

2 months ago
I’ll consider prescribing azithromycin for bronchitis if the patient is very symptomatic and I’m concerned about a possible bacterial component. It’s also appropriate in patients with risk factors like COPD or a significant smoking history. While not routinely needed, it can be helpful in select high-risk cases.

Honey

For Bronchitis

2 months ago
Honey is a natural first-line option for symptomatic relief of cough in bronchitis, particularly in children over age one and adults. It soothes the throat and may reduce cough frequency and severity, especially at night. While it doesn’t treat the underlying infection, it is a safe and inexpensive remedy for mild cases. That said, It's not something that I usually use.

Dextromethorphan

For Bronchitis

2 months ago
Dextromethorphan is a common first-line OTC therapy for symptomatic relief of dry, non-productive cough in acute bronchitis. It helps suppress the cough reflex, providing short-term relief, particularly useful for improving sleep and comfort. While it doesn't treat the underlying cause, it can ease symptoms during the recovery period.

Benzonatate

For Bronchitis

2 months ago
Benzonatate is an effective option for treating dry, irritating coughs by numbing the cough reflex at its source. It is a non-narcotic alternative to other cough suppressants, providing relief with minimal central nervous system effects. Proper use is essential to avoid potential side effects. Always follow the prescribing physician’s directions.

Albuterol

For Bronchitis

2 months ago
Albuterol is a helpful first-line therapy for bronchitis when bronchospasm is present. I typically use it if the patient has a history of asthma, reactive airway disease, or demonstrates improvement with a test dose in the emergency department. It works quickly to relieve wheezing and shortness of breath, and can significantly improve comfort and airflow in the right patients. While not needed for all cases, it's an effective option when bronchospasm is contributing to symptoms.

Applied Behavior Analysis

For Autism Spectrum Disorder

2 months ago
Early, intensive ABA-based therapy (20–40 hours per week) is first-line and has the strongest evidence for improving language, cognition, and adaptive skills. The American Academy of Pediatrics recommends behavioral and educational interventions as the primary treatment for autism spectrum disorder, with medications reserved for specific symptoms or comorbidities.

Synchronized Cardioversion

For Atrial Fibrillation

2 months ago
Synchronized cardioversion can be very effective at restoring normal rhythm in atrial fibrillation. I usually reserve it for patients who are unstable or whose heart rate can’t be controlled with medications, partly because it requires procedural time and sedation for patient comfort. It’s also important to keep the risk of embolic stroke in mind, so anticoagulation status and timing of the arrhythmia should be considered before cardioversion whenever possible.

Metoprolol

For Atrial Fibrillation

2 months ago
Metoprolol is commonly used to help control heart rate in atrial fibrillation and can be used both acutely and for long-term management. It works by slowing AV node conduction through beta-blockade, helping bring the heart rate down and keep it controlled. In the acute setting it can be given IV or orally, and many patients stay on it chronically for ongoing rate control. It’s a practical option since it’s widely available, familiar to clinicians, and generally well tolerated.

Diltiazem

For Atrial Fibrillation

2 months ago
Diltiazem is a medication commonly used to control heart rate in atrial fibrillation. In practice, I tend to reach for it because it usually brings the heart rate down fairly quickly and reliably. It slows conduction through the AV node and helps keep the ventricular rate under control. Anecdotally, in the ER I’ve often found it works a bit more consistently for rate control than some other options.

Apixiban

For Atrial Fibrillation

2 months ago
Apixaban is commonly used as a first-line anticoagulant for atrial fibrillation to reduce the risk of stroke. Among the factor Xa inhibitors, it’s often favored because studies suggest lower rates of major bleeding, particularly gastrointestinal bleeding, compared with some alternatives like Rivaroxaban. It’s also generally well tolerated and effective, which makes it a common go-to option when starting anticoagulation for non-valvular atrial fibrillation. For many patients, it strikes a good balance between strong stroke prevention and a relatively favorable bleeding risk profile compared with other medications in the same class.

Pregabalin

For Anxiety

2 months ago
Pregabalin can be a useful option for anxiety, especially when the symptoms are more physical—things like restlessness, muscle tension, or feeling constantly on edge. It often works faster than SSRIs, and some people notice improvement within a few days to a week. It’s approved for anxiety in some countries, but in the U.S. it’s not FDA-approved for anxiety and is usually used off-label. It can make more sense if someone also has a condition it is approved for, like neuropathic pain, fibromyalgia, or seizures. Side effects like dizziness, sedation, and weight gain can happen, so those are worth keeping in mind when considering it.

Buspirone

For Anxiety

2 months ago
Buspirone is an option for anxiety that I often consider when patients want to avoid some of the downsides of other medications. It doesn’t cause sedation, sexual side effects, or dependence, which makes it appealing compared with benzodiazepines or sometimes even SSRIs. It tends to work best for generalized anxiety and builds effect gradually over a few weeks. It may not be quite as strong as SSRIs for severe anxiety, but it’s usually well tolerated and a reasonable long-term option for many patients.

Fluoxetine

For Anxiety

2 months ago
Fluoxetine is an SSRI that can work well for anxiety, especially when anxiety overlaps with depression. One advantage over some other SSRIs is its long half-life, which makes it a bit more forgiving if someone misses a dose and tends to cause less withdrawal when stopping. It’s also a little more energizing than other SSRIs, which can be helpful for people dealing with low energy or motivation, though it may feel too activating for very jittery anxiety. Like most SSRIs, it takes a few weeks to really kick in, but it can provide steady improvement in anxiety over time.

Escitalopram

For Anxiety

2 months ago
Escitalopram is a common first-line medication for anxiety and one I often reach for when therapy like Cognitive Behavioral Therapy isn’t enough on its own. Among the SSRIs, it’s generally very well tolerated, with fewer medication interactions and often less GI upset or activation than some alternatives. Many patients also find it less sedating and easier to stay on compared with other SSRIs. It still takes a few weeks to reach full effect, but when it works, it tends to provide steady, consistent anxiety relief with a relatively manageable side-effect profile.

Lorazepam

For Anxiety

2 months ago
Lorazepam can work very quickly for anxiety and is one of the few medications that can calm symptoms almost immediately during a panic episode. That said, I’m usually cautious about prescribing it because benzodiazepines carry a real risk of dependence and addiction with regular use. For that reason, I tend to reserve it for only occasional or short-term situations rather than as a daily treatment. It can be very effective in the moment, but people do better long term with therapies or medications that don’t carry the same risks.

Sertraline

For Anxiety

2 months ago
Sertraline is a common first-line medication for anxiety when symptoms persist despite therapy such as Cognitive Behavioral Therapy. It works by increasing serotonin levels in the brain and has strong evidence across several anxiety disorders. Compared with some other options, sertraline tends to cause less sedation and less weight gain, making it a good choice for patients who want to stay alert and maintain energy during the day. It may take several weeks to reach full effect, but many patients experience meaningful improvement with continued use.

Cognitive Behavioral Therapy

For Anxiety

2 months ago
Cognitive Behavioral Therapy is a first-line treatment for anxiety that helps people recognize and change the thought patterns and behaviors that fuel worry. Over time, it teaches practical tools—like reframing anxious thoughts and gradually facing triggers—that can have lasting benefits even after therapy ends. That said, it’s not an overnight fix; it usually takes weeks to months of practice for the skills to really stick. For many people, though, the long-term payoff can be significant.

Honey

For Cough

2 months ago
Overall, honey may be a useful alternative for mild cough relief, especially in children, but I admit that I don't use it that much.

Cetirizine

For Allergic Conjunctivitis

2 months ago
Cetirizine can help with symptoms of Allergic Conjunctivitis, though it’s usually not as effective eye drops that work directly in the eye. That said, it’s cheap, over-the-counter, and easy to take once a day, so it’s a convenient option for many people. It can also be taken ahead of allergy season to help prevent symptoms, especially if you’re also dealing with sneezing or a runny nose.

Ketotifen

For Allergic Conjunctivitis

2 months ago
For mild to moderate allergy symptoms, ketotifen is a great OTC, cost-effective option.

Fluticasone Propionate Ointment 0.005%

For Eczema

2 months ago
Fluticasone propionate is a mid-potency topical steroid available as a cream or ointment, commonly used for inflammatory skin conditions such as eczema and dermatitis. It is stronger than low-potency steroids like Desonide, so it can be helpful when milder treatments aren’t controlling symptoms. I often use it for moderate inflammation, but as with all topical steroids, it should be used carefully on sensitive areas like the face or groin and generally for limited durations.

Doxycyline

For Acne

2 months ago
Doxycycline is an oral antibiotic commonly prescribed for moderate to severe inflammatory acne (red pimples, pustules, and cystic acne). It works by reducing acne-causing bacteria and inflammation.

Oral isotretinoin

For Acne

2 months ago
Isotretinoin is the go-to treatment for severe acne that doesn’t improve with standard oral or topical therapies. It’s extremely effective, but it does require close monitoring — including labs, psychiatric screening, and pregnancy precautions — because of its potential side effects. When used appropriately, though, it can provide long-term, life-changing improvement for tough, resistant acne.

Doxycyline

For Cellulitis

2 months ago
Doxycycline is one of my go-to antibiotics for cellulitis when MRSA is a concern, since it covers MRSA well and tends to have fewer side effects than many alternatives. The main limitation is that its strep coverage isn’t always reliable, so I’ll sometimes combine it with cephalexin to make sure both bacteria are covered. Overall it’s an easy oral option that most patients tolerate well, though you should watch for sun sensitivity and mild stomach upset.

Doxycyline

For Abscess

2 months ago
Doxycycline is a good treatment option for suspected MRSA skin infections and is often used along with incision and drainage when there is surrounding cellulitis. It provides strong MRSA coverage but has a narrower spectrum for other common skin bacteria, so clinicians may combine it with another antibiotic if broader coverage is needed. Overall, it’s a useful adjunct with minimal side effects when abscesses show signs of spreading infection or if it’s an early infection that is developing into an abscess

Honey

For Upper Respiratory Infection

2 months ago
Honey is a well-supported, evidence-based option for symptomatic relief of upper respiratory infections, particularly cough and throat irritation. Its demulcent and antimicrobial properties help soothe inflamed mucosa and may reduce cough frequency, especially at night. It is a safe, effective first-line option for adults and children over one year of age.

Guaifenesin and Dextromethorphan

For Upper Respiratory Infection

2 months ago
Guaifenesin and dextromethorphan is an over-the-counter combination that works through two different mechanisms: guaifenesin helps thin and loosen mucus, while dextromethorphan suppresses the cough reflex. While I’m generally not a big fan of combination cough medications, this can be a reasonable option when a persistent cough is the main symptom you’re trying to control. It can be helpful for short-term relief, especially when coughing is interfering with sleep or daily activities. Plus I do enjoy the taste.

Dexamethasone

For Nausea

2 months ago
Dexamethasone can be highly effective for specific types of severe or persistent nausea, especially due to chemotherapy. There is some benefit as prophylaxis for postoperative nausea and vomiting. However, due to their potential side effects, they are typically used for short periods and in targeted cases.

Isopropyl alcohol

For Nausea

2 months ago
DO NOT DRINK - intended for inhalation only. In some trials, it provided some benefit, though not as good as prescribe medications. Inhalation of isopropyl alcohol can be a fast-acting and effective method for temporary relief of nausea and vomiting, especially in acute settings. However, it should be used cautiously and for short periods. I'll admit that I haven't had success with this approach.

Meclizine

For Nausea

2 months ago
Meclizine is commonly used for motion sickness and vertigo, and it can also help with nausea and vomiting related to dizziness. It works well for many people, but it may cause drowsiness, so avoid driving until you know how it affects you. It also has anticholinergic side effects, so use with caution, especially in older adults.

Acetaminophen

For Upper Respiratory Infection

2 months ago
Acetaminophen (Tylenol) is a first-line treatment for fever, sore throat, muscle aches, and general pain from upper respiratory illnesses. When used at regular, recommended doses, it has one of the lowest side-effect profiles of common pain relievers and is gentle on the stomach. It’s an effective, reliable option for symptom relief, especially for people who cannot tolerate NSAIDs.
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Pimecrolimus Cream 1%

For Eczema

2 months ago
Pimecrolimus works well for controlling mild to moderate eczema, especially in sensitive areas like the face and skin folds where steroids aren’t ideal. It reduces redness and itching without causing skin thinning, making it useful for longer-term or maintenance treatment.

Topical diphenhydramine

For Poison Ivy Dermatitis

2 months ago
Topical Benadryl is not recommended for poison ivy dermatitis and is discouraged by the American Academy of Dermatology. It has limited benefit for itching and can actually cause allergic contact dermatitis, potentially worsening the rash. Because of this risk and lack of clear effectiveness, I do not recommend or prescribe topical diphenhydramine for poison ivy.

Calamine lotion

For Poison Ivy Dermatitis

2 months ago
While many people find calamine lotion helpful, I find topical steroids to be far more effective and easier to use without leaving residue on the skin. Calamine can help dry oozing or weeping lesions in acute contact dermatitis and may serve as an adjunct in those situations. However, given its limited anti-inflammatory effect, I generally reserve it for cases where other treatments are not available or not tolerated.

Hydrocortisone 1%

For Poison Ivy Dermatitis

2 months ago
Hydrocortisone 1% is a first-line treatment for mild poison ivy because it is over-the-counter, inexpensive, and easy to start right away. It can reduce itching, redness, and inflammation when used early in the course of symptoms. If the rash is not well controlled, stronger prescription topical steroids or oral steroids are often needed for adequate relief.

Calamine Lotion

For Contact dermatitis

2 months ago
While many people find calamine lotion helpful, I find topical steroids to be far more effective and easier to use without leaving residue on the skin. Calamine can help dry oozing or weeping lesions in acute contact dermatitis and may serve as an adjunct in those situations. However, given its limited anti-inflammatory effect, I generally reserve it for cases where other treatments are not available or not tolerated.

Tacrolimus topical

For Contact dermatitis

2 months ago
Topical tacrolimus can be a useful option for contact dermatitis despite not being FDA-approved for this indication, particularly when symptoms are resistant to OTC topical steroids. It is especially helpful in sensitive locations such as the face, eyelids, or skin folds where steroids are less desirable. If accessible, it offers an effective non-steroidal alternative for difficult or recurrent cases.

Prednisone

For Contact dermatitis

2 months ago
Prednisone is a second-line option for severe contact dermatitis and can be very effective when started at a high dose and properly tapered. It often provides rapid and significant symptom relief when topical treatments are insufficient. However, it is not an ideal therapy due to the systemic side effects associated with oral steroids. Careful dosing and a gradual taper are necessary to avoid rebound symptoms and minimize risks.

Mometasone furoate

For Contact dermatitis

2 months ago
Mometasone furoate is a solid second-line option for contact dermatitis when OTC hydrocortisone fails or symptoms are more severe. It provides stronger anti-inflammatory control while still being appropriate for short-term use. As with all topical steroids, it should be used cautiously on thin skin areas and avoided with prolonged use.

Betamethasone dipropionate

For Contact dermatitis

2 months ago
Betamethasone dipropionate is a strong treatment option for contact dermatitis when OTC hydrocortisone is not effective. It is available in different strengths and formulations, allowing treatment to be tailored if a lower potency is not strong enough. It can rapidly reduce inflammation, redness, and itching in more severe flares. Caution is needed when using it around the eyes and with chronic or prolonged use due to the risk of skin thinning and other side effects.

Hydrocortisone 1%

For Contact dermatitis

2 months ago
Hydrocortisone 1% is a great first-line treatment for mild contact dermatitis because it is available over the counter and easy to start right away. It helps calm inflammation, redness, and itching while the skin heals after allergen exposure. Early use can shorten symptom duration and reduce discomfort without needing a prescription. While not strong enough for severe reactions, its accessibility and safety profile make it an excellent initial option for most mild flares.

Avoidance to allergen

For Contact dermatitis

2 months ago
Avoiding exposure to the triggering allergen is the most effective way to prevent contact dermatitis and stop reactions before they start. Once exposure occurs, all other treatments—such as topical steroids, antihistamines, or moisturizers—are aimed at reducing inflammation and relieving symptoms rather than preventing the reaction itself. Identifying and strictly avoiding the culprit (whether a metal, plant, fragrance, or chemical) remains the cornerstone of long-term control and prevention.

Acetaminophen and Hydrocodone

For Back Pain

2 months ago
Hydrocodone-Acetaminophen may be considered only after other treatments have failed to provide adequate pain control. As a narcotic, it can offer short-term relief for more severe pain but carries risks of sedation, dependence, and misuse. When used, it should be prescribed at the lowest effective dose for the shortest possible duration, typically during the initial phase of pain management.

Transcutaneous Electrical Nerve Stimulation

For Back Pain

2 months ago
TENS units are widely available over the counter and are commonly used for back pain. While research does not consistently support a clear benefit for most patients, some individuals report meaningful symptom relief. Given their low risk and noninvasive nature, TENS may be a reasonable option to try as an adjunct or alternative therapy for back pain.

Lidocaine Patch

For Back Pain

2 months ago
Lidocaine patches are available over the counter or by prescription and are sometimes used for localized back pain. While research shows limited overall benefit for musculoskeletal back pain, some individuals do experience meaningful relief, particularly with focal or nerve-related pain. Given their good safety profile and minimal systemic side effects, lidocaine patches can be a reasonable alternative or adjunct to consider.

Heat Therapy

For Back Pain

2 months ago
Heat therapy is a strongly recommended first-line treatment for acute and subacute musculoskeletal low back pain, with moderate-quality evidence showing meaningful improvement in pain and function and minimal side effects. After an acute injury, patients may benefit from cold therapy during the first 24–48 hours to help reduce inflammation and pain, then transition to heat therapy as muscle stiffness and spasm become more prominent. When combined with gentle activity or exercise, heat can further enhance short-term pain relief and functional recovery.

Cold Therapy

For Back Pain

2 months ago
Cold therapy can be a helpful first-line treatment after an acute back injury, as it may reduce inflammation, swelling, and pain while supporting the early healing process. Ice is typically applied for 15–20 minutes at a time, every 2–3 hours, especially during the first 24–72 hours after injury, with a barrier between the ice and skin to prevent irritation. For chronic back pain, however, cold tends to be less effective, and heat therapy often provides greater relief by easing muscle tension and stiffness.

Acupuncture

For Back Pain

2 months ago
Research shows some improvement in back pain with massage, particularly for short-term pain relief and muscle relaxation. While it’s not a cure, it’s a useful alternative or add-on to other treatments and often leaves patients feeling noticeably better after sessions.

Massage

For Back Pain

2 months ago
Massage provided noticeable short-term improvement—less tightness, better mobility, and overall relief right after the session. While the benefits weren’t long-lasting, it definitely felt better and was a helpful adjunct to other treatments.

Physical Therapy

For Back Pain

2 months ago
Physical therapy is one of the most effective treatments for back pain, focusing on strengthening muscles, improving flexibility, and correcting movement patterns to prevent recurrence. While it often takes 4–6 weeks to notice meaningful improvement, the benefits tend to be longer lasting. Because progress is gradual, it is generally not a short-term solution for immediate pain relief but plays a key role in long-term recovery.

Cyclobenzaprine

For Back Pain

2 months ago
Flexeril is a useful short-term treatment for back pain associated with muscle spasms. It provides significant relief when used as part of a broader treatment plan that includes physical therapy and other supportive measures. While effective, its sedative effects and potential side effects require caution and adherence to the prescribed regimen.

Stretching

For Back Pain

2 months ago
Stretching is a low-risk, effective way to relieve back pain, especially when symptoms are related to muscle tightness or prolonged sitting. There are several recommended stretches that can help improve flexibility and reduce stiffness, but I personally find back extension stretches to be the most helpful. These movements often provide quick relief by counteracting forward-bending posture and easing pressure on the lower back. When done gently and consistently, stretching can be a great adjunct to other treatments and part of a long-term back care routine.

Ibuprofen

For Back Pain

2 months ago
Ibuprofen is my go-to treatment for back pain because it helps reduce inflammation while also providing effective pain relief. Its every-6-hour dosing allows flexibility to titrate based on symptom severity. In adults, lower doses (200–400 mg) can help with pain, while higher doses (around 600 mg) provide more anti-inflammatory benefit. To reduce gastrointestinal side effects, it’s best taken with food, and patients should remain mindful of potential GI and kidney risks, especially with prolonged use.

Acetaminophen

For Back Pain

2 months ago
Acetaminophen is a non-narcotic pain reliever commonly used for back pain and is generally well tolerated when taken at appropriate doses. It helps reduce pain but does not treat inflammation, which can limit its effectiveness for certain causes of back pain. Because it works through a different pathway than NSAIDs, it can be used as a complementary option without the same gastrointestinal or bleeding risks. Acetaminophen is often combined with narcotic medications for enhanced pain control, and care should be taken to avoid exceeding the total daily acetaminophen dose when using combination products.

Budesonide

For Asthma

2 months ago
Budesonide is a reliable inhaled corticosteroid for controlling persistent asthma, often preferred for its availability in nebulized form and lower risk of throat irritation. Compared to fluticasone, it has a slightly faster onset and may be better tolerated in some patients, though both are similarly effective.

Levalbuterol

For Asthma

2 months ago
Levalbuterol has similar effectiveness to albuterol but is typically reserved for patients who experience side effects like tachycardia or jitteriness from albuterol. Due to its higher cost, it’s not usually used as a first-line option unless better tolerated.

Albuterol

For Asthma

2 months ago
Albuterol is a reliable, fast-acting inhaler that quickly eases asthma symptoms like wheezing, chest tightness, and shortness of breath. It’s especially helpful during sudden flare-ups and works within minutes to open the airways. Many people with mild asthma use it only when needed and get good relief. It’s widely available, affordable, and has a long track record of safety, making it a trusted first-line option for asthma symptom control.

Semont Maneuver

For Benign Paroxysmal Positional Vertigo

3 months ago
The Semont maneuver is reported to be an effective treatment for posterior canal BPPV, working by rapidly moving the patient between positions to reposition displaced inner ear crystals. Based on my review of the medical literature, it can provide meaningful symptom relief when performed correctly. However, it is not commonly performed in my emergency department.

Diazepam

For Benign Paroxysmal Positional Vertigo

3 months ago
Diazepam is generally not recommended by otolaryngologists for treating BPPV, but it can help control symptoms in patients who do not respond to meclizine. It works by calming the vestibular system and reducing intense vertigo and associated anxiety. Because it can cause sedation, increase fall risk, and lead to dependence, it is usually reserved for short-term use in more difficult or refractory cases. It should be used cautiously and as a temporary measure rather than a primary treatment.

Lampert Maneuver

For Benign Paroxysmal Positional Vertigo

3 months ago
The Lempert maneuver, also known as the barbecue roll, is reported to be an effective treatment for horizontal canal BPPV. It involves slowly rotating the patient a full 360 degrees to help move displaced inner ear crystals out of the horizontal semicircular canal. Based on my review of the medical literature, this maneuver can significantly reduce vertigo symptoms in appropriately selected patients.

Meclizine

For Benign Paroxysmal Positional Vertigo

3 months ago
Meclizine is often not recommended by otolaryngologists for BPPV, but many ER physicians—including myself—consider it a useful first-line option for controlling dizziness, nausea, and vomiting. While it does not treat the underlying cause, it can significantly improve comfort during acute symptoms. Meclizine works best as a short-term aid and should be used alongside repositioning maneuvers, not as a replacement for them. When used appropriately, it can make BPPV episodes much more tolerable.

Tapinarof

For Eczema

3 months ago
Vtama has worked well for my eczema and is especially helpful because it can be safely used on sensitive areas. It’s a good non-steroid option and doesn’t come with the same long-term skin-thinning concerns. The main downside is that the copay can be high depending on insurance. That said, I’ve had good luck using compounding pharmacies to bring the cost down and make it more affordable.

Dupilimab

For Eczema

3 months ago
Dupilumab was a game changer for me and allowed me to come off steroids and even the topical biologics. It’s a self-injection given every two weeks, which takes a little getting used to but is manageable once you’re comfortable with it. Cost can be a real barrier even with insurance, depending on your plan and deductible. That said, the manufacturer often offers copay assistance or rebate programs that can significantly lower out-of-pocket costs and make treatment much more affordable.

Bleach baths

For Eczema

3 months ago
While bleach baths have been reported to provide some benefit for eczema, I found the improvement to be minimal. The process can be inconvenient and difficult to maintain regularly. Given the limited benefit I experienced compared with the effort involved, I was not a fan of this treatment.

Tacrolismus topical

For Eczema

3 months ago
Tacrolimus is a good non-steroid option for treating eczema and can help reduce redness, itching, and inflammation. It is especially useful for sensitive areas like the face or skin folds where steroids are best avoided. Tacrolimus does not cause skin thinning, which makes it helpful for longer-term use. The main downside is cost, which can be high depending on insurance coverage. Overall, it’s an effective alternative when topical steroids aren’t ideal or haven’t worked well.

Fexofenadine

For Eczema

3 months ago
Allegra can be used as a backup option to cetirizine for antihistamine therapy. While antihistamines are not routinely recommended by dermatologists for eczema, they may help reduce itching and inflammation in some patients. Allegra is non-sedating and can be helpful for comorbid allergic conditions such as allergic rhinitis or urticaria, which can worsen skin symptoms. Its benefit for eczema itself is limited, but it may improve overall comfort by controlling associated allergies.

Betamethasone

For Eczema

3 months ago
Betamethasone is a strong prescription corticosteroid that's more potent than over-the-counter hydrocortisone. It's highly effective at reducing inflammation, redness, and itching during eczema flares. However, due to its strength, it should be used short-term and only on affected areas, as long-term use can lead to side effects like skin thinning. It's best reserved for more severe or stubborn eczema that doesn't respond to milder treatments.

Hydrocortisone 1%

For Eczema

3 months ago
Hydrocortisone 1% is a mild steroid cream you can buy over the counter to help treat mild eczema. It works by reducing redness, swelling, and itching. It’s generally safe for short-term use and can be used on sensitive areas like the face, but it should be used carefully and sparingly around the eyes. Using it too often or for long periods can thin the skin and cause other side effects, so it’s best for brief flare-ups only.

Cetirizine

For Eczema

3 months ago
Cetirizine can be used as a helpful add-on for eczema, even though it is not a primary treatment recommended by dermatology guidelines. As a non-drowsy antihistamine, it may reduce itching, which can make flares easier to tolerate. It is easy to take, widely available, and generally safe. Cetirizine can be especially useful if a patient also has other allergic conditions like hay fever or asthma. While it may not treat the skin inflammation itself, it can improve comfort when used alongside standard eczema treatments.

Amoxicillin-clavulanate

For Sinusitis

3 months ago
Augmentin (amoxicillin–clavulanate) is my go-to antibiotic for more severe sinusitis or when amoxicillin alone has failed. The addition of clavulanate provides broader bacterial coverage, particularly against organisms that produce beta-lactamase. This makes it a strong choice for patients with more intense symptoms or prolonged illness. While effective, it should still be used thoughtfully given the risk of gastrointestinal side effects. In the right clinical setting, Augmentin is a reliable and commonly used option.

Levofloxacin

For Sinusitis

3 months ago
Levofloxacin is a potent antibiotic that can be effective for acute bacterial sinusitis, particularly in severe or complicated cases. I tend to use it reluctantly because of the potential for serious side effects, including tendon rupture and heart rhythm disturbances. For this reason, it is not a first-line choice and should be used only when clearly indicated. It is most often reserved for patients who cannot tolerate standard therapies or who have failed prior treatments. In the right patient, and with careful consideration of risks, it can be an appropriate option.

Doxycyline

For Sinusitis

3 months ago
Doxycycline is an effective and generally well-tolerated alternative for treating sinusitis in patients who cannot take first-line antibiotics. It is particularly useful for individuals with penicillin allergies or those at risk for antibiotic-resistant infections. Doxycycline offers broad coverage and is convenient to take. However, because of its side effect profile, it should be used with caution in certain groups, including pregnant patients and young children.

Pseudoephedrine

For Sinusitis

3 months ago
Pseudoephedrine helps relieve sinus congestion by acting as an alpha-adrenergic agonist, which shrinks swollen nasal blood vessels and improves airflow. It can be effective for pressure and congestion related to sinusitis. However, because it can cause side effects such as elevated blood pressure, insomnia, and jitteriness, I tend to use it less often. These effects make it a poorer choice for patients with hypertension, heart disease, or sleep issues.

Oxymetalozone

For Sinusitis

3 months ago
While the literature is mixed on oxymetazoline for sinusitis, I find it can provide very rapid symptomatic relief, especially for severe congestion and pressure. It works by quickly shrinking swollen nasal tissues, which can dramatically improve airflow and drainage. The key risk is overuse—using it for more than 3 days can lead to rebound congestion and worsening sinus symptoms. For this reason, it’s best used in the short term only. When used appropriately, it can be a very effective tool for quick relief for patients.

Fluticasone Propionate

For Sinusitis

3 months ago
Fluticasone propionate is a useful adjunct treatment for sinusitis, often added alongside antibiotics to help reduce nasal and sinus inflammation. Evidence shows particular benefit in chronic sinusitis, where ongoing inflammation plays a major role in symptoms. In cases that are more likely viral rather than bacterial, fluticasone may provide more benefit than antibiotics by decreasing swelling, congestion, and pressure. It can improve drainage and symptom control even when infection is not the primary issue. Overall, it is an option that addresses inflammation, which is a key driver of sinus symptoms.

Amoxicillin

For Sinusitis

3 months ago
Amoxicillin is a first-line antibiotic that I commonly use for uncomplicated bacterial sinusitis. It’s effective, well tolerated, and has a long track record when true bacterial infection is suspected. While there are formal diagnostic criteria and imaging findings that can help distinguish bacterial from viral sinusitis, in the ER setting I tend to prescribe more aggressively, especially when symptoms are prolonged, severe, or clearly worsening. The goal is to reduce symptom burden and prevent complications rather than wait out borderline cases.

Lidocaine Patch

For Meralgia Paresthetica

3 months ago
Lidocaine patches can be a simple, short-term option to help relieve pain from meralgia paresthetica. The research behind them is limited, but they may help numb the irritated nerve and reduce burning or tingling. Because lidocaine patches are available over the counter and by prescription, they are easy and low-risk to try. They are often used before moving to more invasive treatments like injections. Lidocaine patches work best when combined with lifestyle changes, such as avoiding tight clothing and reducing pressure on the hip and groin area.

Corticosteroid Injection

For Meralgia Paresthetica

3 months ago
Corticosteroid injection is typically the next step when conservative treatment fails for meralgia paresthetica. Studies report a broad success range (approximately 22%–85%), reflecting differences in technique and patient selection. The treatment involves an injection near the affected nerve at the hip, close to the groin. Outcomes are generally better when the injection is performed with ultrasound guidance. If combined with a local anesthetic, such as lidocaine, there is at least short term relief.

Ibuprofen

For Meralgia Paresthetica

3 months ago
Ibuprofen may be helpful for meralgia paresthetica as an adjunct treatment, particularly during periods of worsening pain or irritation. By reducing inflammation, it can lessen discomfort related to local nerve irritation, though it does not address the underlying nerve compression. Because it is over-the-counter and widely available, ibuprofen is an easy first step for symptom relief. It is best used alongside lifestyle measures such as weight reduction, avoiding tight clothing, and activity modification. Ibuprofen can also be useful for breakthrough pain when symptoms flare.

Ondansetron

For Nausea

3 months ago
Ondansetron is a first-line treatment for nausea and is especially useful when the underlying cause is unclear. It is highly effective and has one of the safest side effect profiles among antiemetic medications. Most patients tolerate it well, with constipation being one of the more commonly reported but generally mild side effects. Ondansetron is also available as an orally disintegrating tablet (ODT) that dissolves on the tongue, making it an excellent option for patients who are actively nauseated or unable to tolerate pills. Overall, it is a reliable and well-tolerated choice for acute nausea across a wide range of clinical settings.

Olopatadine

For Allergic Conjunctivitis

3 months ago
Olopatadine is ideal for severe allergic conjunctivitis, offering stronger and longer-lasting relief compared to other options. However, its higher efficacy comes at a greater cost, making it a premium choice for those seeking sustained symptom control.

Azelastine HCL 0.05%

For Allergic Conjunctivitis

3 months ago
Azelastine hydrochloride is a prescription, option for allergic conjunctivitis that works quickly and reliably. With combined antihistamine and mast cell–stabilizing effects, it provides rapid relief of itching, redness, and tearing—often within minutes—with symptom control lasting up to 8–10 hours. It is generally well tolerated and approved for use in adults and children over age 3, typically dosed as one drop in each eye twice daily. Some users may notice mild, short-lived side effects such as a bitter taste or brief eye irritation, but these are usually transient. Overall, azelastine is a solid choice when first-line OTC options are insufficient or when faster symptom relief is needed.

Vitamin C

For Upper Respiratory Infection

3 months ago
The evidence for vitamin C in upper respiratory infections is mixed, with most studies showing minimal overall benefit, particularly when started after symptoms begin. That said, it is low cost, widely available, and has a strong safety profile at typical doses. For patients looking for a low-risk option that may provide a small reduction in symptom duration or severity, vitamin C is reasonable to consider as an adjunct during a URI, with appropriate expectations.

Acetaminophen and codeine

For Pain

3 months ago
Tylenol with codeine can be a reasonable option when stronger pain control is needed than Tylenol alone, such as in children or adults who find hydrocodone too strong. It offers added analgesia from the opioid component while remaining a step below stronger narcotics. However, it still carries risks of opioid-related side effects, dependence, and misuse, so it should be prescribed cautiously.

Tramadol

For Pain

3 months ago
I prescribe tramadol for patients who need more pain relief than Tylenol alone but for whom hydrocodone/acetaminophen feels too strong. It often serves as a middle-ground option and is commonly requested by patients familiar with its effects. While generally milder than traditional opioids, it still requires caution due to risks of sedation, dependence, and drug interactions.

Gabapentin

For Pain

3 months ago
Gabapentin can be a useful option for certain types of pain, especially neuropathic pain such as nerve injury, radiculopathy, or postherpetic neuralgia. It works through a different mechanism than traditional pain relievers and does not carry the same gastrointestinal or kidney risks as NSAIDs. Common downsides include dizziness, sedation, and the need for gradual dose titration to balance effectiveness with tolerability.

Acetaminophen and Oxycodone

For Pain

3 months ago
Acetaminophen and oxycodone can be an effective tool for severe acute pain, particularly when symptoms are not controlled with ibuprofen, Tylenol, or even hydrocodone. It provides potent pain relief but carries a significantly higher risk of dependence, misuse, and other opioid-related side effects. It should be used cautiously, and care should be taken not to combine it with additional Tylenol-containing products, as this can increase the risk of liver damage.

Acetaminophen and hydrocodone

For Pain

3 months ago
Hydrocodone combined with Tylenol provides stronger pain relief by adding an opioid component to acetaminophen, making it effective when pain is not adequately controlled with Tylenol and ibuprofen alone. While it can be very helpful for acute, moderate to severe pain, it carries risks of sedation, dependence, and abuse. Given the ongoing opioid crisis, its use is closely scrutinized, but it remains a valuable short-term option when used appropriately and cautiously.

Ibuprofen

For Pain

3 months ago
Ibuprofen is one of the first-line treatments for pain, muscle aches, and arthritis, with the added benefit of reducing inflammation. It is effective for both pain relief and swelling, making it especially useful for inflammatory conditions. However, it can have gastrointestinal and kidney side effects, so it should be used cautiously and at the lowest effective dose.

Acetaminophen

For Pain

3 months ago
Acetaminophen is often one of my first go-to options for pain relief, especially since it doesn’t carry the gastrointestinal side effects commonly seen with NSAIDs like ibuprofen. It works well for fever, headaches, and mild to moderate pain from arthritis, and can be used in conjunction with ibuprofen since they work through different pathways. However, it does not reduce inflammation, and it’s important to be mindful of dosing, as exceeding recommended amounts can increase the risk of liver injury.

Vicks NyQuil Cold & Flu

For Upper Respiratory Infection

3 months ago
NyQuil offers convenient symptom coverage by combining medications for fever and pain, cough, and runny nose into a single product. The antihistamine component can be sedating, which may be helpful at night but can also cause next-day drowsiness for some people. Personally, I prefer to take the individual components separately so I can better target specific symptoms. If using NyQuil, it’s important to be aware of the acetaminophen (Tylenol) content and avoid combining it with other products that contain acetaminophen.

Dextromethorphan

For Upper Respiratory Infection

3 months ago
Dextromethorphan works by acting on the brain’s cough center to reduce the urge to cough and is widely available over the counter in many cold and cough products. It can be helpful for suppressing a dry, irritating cough, especially when coughing is disruptive. Personally, I don’t find it very effective for my own symptoms, but it can be supportive for some people, particularly at night. As with combination products, it’s important to check labels to avoid duplicating ingredients.

Guaifenesin

For Upper Respiratory Infection

3 months ago
Guaifenesin is commonly used for cough and chest congestion, but the evidence supporting its effectiveness is limited. While it’s intended to thin mucus and make coughs more productive, research doesn't show a clear benefit. I typically don’t routinely recommend it, especially when other supportive measures are available. That said, if a patient feels it helps them or swears by it, it can be reasonable to use, as it is generally well tolerated.

Vicks DayQuil Severe® Cold & Flu Relief Liquid

For Upper Respiratory Infection

3 months ago
DayQuil Severe adds an expectorant to help with coughing, making it a solid all-in-one option for treating multiple cold symptoms. It can be convenient when you want a single medication to address fever, pain, congestion, and cough at the same time. That said, I personally prefer to treat symptoms individually so dosing can be tailored more precisely. If using this product, it’s important to be aware of the acetaminophen content and avoid taking other acetaminophen-containing medications.

Vicks Dayquil®

For Upper Respiratory Infection

3 months ago
DayQuil is a convenient combination option since it includes acetaminophen (Tylenol) for fever and pain, dextromethorphan for cough, and phenylephrine for nasal congestion. Some formulations such as severe also have guaifenesin which helps with coughing. While it can simplify dosing, I personally prefer treating each symptom separately so I can better tailor medications to specific symptoms. If using DayQuil, it’s important to be aware of the acetaminophen content and avoid taking additional Tylenol-containing products to prevent exceeding safe dosing limits.

Nasal irrigation

For Upper Respiratory Infection

3 months ago
Nasal irrigation is a great adjunct treatment when nasal congestion is a significant complaint, as it helps flush out thick mucus and irritants and can improve breathing. That said, it does take some time to perform, and many people don’t enjoy the sensation. When tolerated, it can be a helpful addition to other cold treatments to improve overall comfort.

Zinc

For Upper Respiratory Infection

3 months ago
Zinc is one of the few treatments for the common cold that may provide benefit beyond symptom relief. When taken early in the course of illness, it may help support the immune response and reduce the duration and severity of symptoms for some people. While it doesn’t cure the cold, it can be a helpful addition to other supportive treatments.

Oxymetazoline

For Upper Respiratory Infection

3 months ago
This is my main treatment for nasal congestion from the common cold. Oxymetazoline provides rapid, often immediate relief, which makes it especially helpful when congestion is severe or disrupting sleep. It is very effective when used short term, but should not be used for more than 3 days to avoid rebound congestion.

Ibuprofen

For Upper Respiratory Infection

3 months ago
For fever, pain, headache and sore throat from the common cold, ibuprofen is the go-to option that works well to reduce discomfort. I prescribe ibuprofen every 8 hours and alternate it with acetaminophen (Tylenol), so a medication can be taken about every 4 hours to keep symptoms under control. Ibuprofen is available over the counter in 200 mg tablets, and higher, prescription-level doses can be reached by taking more than one tablet at a time—but do not take more than 600 mg per dose. When used as directed, this approach can provide steady relief while staying within safe limits.

Promethazine

For Nausea

3 months ago
Works well, but a second line treatment for nausea, because of potential side effects, especially extra-pyramidal ones.

Metoclopramide

For Nausea

3 months ago
My 2nd line treatment for nausea because it has more side effects, especially the potential for extra-pyramidal side effects.

Intravenous hydration

For Migraine headache

3 months ago
Although evidence is mixed regarding the benefit of IV hydration for migraine headaches, it is commonly included as part of the emergency department migraine “cocktail.” When combined with NSAIDs and anti-nausea medications, IV fluids can support symptom relief, particularly in patients who are dehydrated from vomiting or poor oral intake. Hydration may also improve medication tolerance and overall patient comfort during acute migraine treatment.

Rizatriptan

For Migraine headache

3 months ago
Rizatriptan is a first-line abortive treatment for acute migraine headaches and is particularly effective when taken early in the attack. It is often preferred over sumatriptan due to its faster onset of action and, for some patients, better early pain relief with fewer chest or pressure-type side effects. Rizatriptan’s rapid absorption and orally disintegrating tablet option make it easier to use during migraines with nausea, while overall efficacy remains comparable to other triptans.

Sumatriptan

For Migraine headache

3 months ago
Sumatriptan is a cornerstone of acute migraine therapy, best taken at onset. Available in oral, nasal, and injectable forms, with subcutaneous injection offering the fastest relief (10-15 min). It reduces headache severity and symptoms like nausea, photophobia, and phonophobia.

Ketorolac

For Migraine headache

3 months ago
Toradol is often used as a first-line treatment (combined with anti-nausea medication and IV fluids) for acute migraine headaches in the emergency department. This combination effectively targets pain, inflammation, and associated symptoms such as nausea and dehydration, leading to rapid symptom relief for many patients. It provides a non-opioid, evidence-based approach to migraine management in the ER setting.

Metoclopramide

For Migraine headache

3 months ago
Metoclopramide is a great treatment for nausea and vomiting, commonly used in migraine management. I often combine it with diphenhydramine to reduce the risk of side effects such as akathisia and to promote drowsiness, which can aid in migraine relief.

Prochlorperazine

For Migraine headache

3 months ago
Prochlorperazine is a highly effective option for acute migraine attacks, especially in emergency settings or when nausea and vomiting are prominent symptoms. I often combine with benadryl to reduce side effects and causing sleepiness.

Ibuprofen

For Migraine headache

3 months ago
Ibuprofen is one of my first-line treatments for mild to moderate migraines. As a widely available NSAID, it helps reduce pain and inflammation, especially when taken early in an attack. A standard dose of 200–400 mg can provide significant relief, sometimes even eliminating the migraine when combined with rest and hydration.

Stretching

For Muscle Cramps

3 months ago
Stretching can help relax tight muscles and is often effective for relieving active muscle cramps. It can also be used preventively before physical activity to reduce muscle tension and improve flexibility. Stretching after physical activity may help decrease muscle tightness and support recovery. When done regularly, stretching may lower the risk of recurrent cramps. It is a low-risk, accessible approach that can be combined with other preventive strategies.

Dupilimab

For Asthma

3 months ago
Dupilimab is an effective add-on biologic therapy for patients with moderate to severe asthma, particularly those with an eosinophilic phenotype or oral steroid dependence. It reduces exacerbation frequency and the need for systemic steroids in patients who remain poorly controlled on standard inhaler therapy, with added value when other Dupilimab-approved indications are also present.

Ibuprofen

For Muscle Cramps

3 months ago
NSAIDs, such as ibuprofen, can help with muscle cramps that are not relieved by initial stretching and rest by reducing pain and inflammation. While they do not directly stop the muscle contraction, they may ease discomfort once the cramp has passed. NSAIDs are most helpful when muscle cramps are associated with overuse or muscle strain.

Rest

For Muscle Cramps

3 months ago
Rest is often a first-line approach for managing muscle cramps, allowing the affected muscles time to recover and reducing further strain. Taking a break from triggering activities can help prevent recurrent cramps and limit ongoing irritation. Adequate rest also provides an opportunity to observe whether symptoms improve, which can help clarify the underlying cause. If cramps resolve with rest, they are more likely related to overuse or fatigue. Persistent cramps despite rest may suggest an alternative etiology that warrants further evaluation.

Avoid Alcohol

For

3 months ago
Reducing or discontinuing alcohol intake can lead to modest decreases in serum uric acid levels, particularly in individuals with hyperuricemia. Episodic drinking significantly increases the risk of recurrent gout attacks, prompting clinical guidelines to recommend limiting alcohol as part of gout management.

Allopurinol

For

3 months ago
Allopurinol is considered first-line therapy for long-term management of gout by lowering uric acid levels and preventing flares. However, I’ve had a family member who developed Stevens-Johnson syndrome from this medication, so I’m cautious about its risks despite its effectiveness.

Lifestyle Changes

For Meralgia Paresthetica

4 months ago
Lifestyle modification is a key first-line treatment for meralgia paresthetica, aimed at reducing compression of the lateral femoral cutaneous nerve. Studies suggest that up to 69% of patients improve with conservative measures alone, such as weight loss, avoiding tight clothing, and activity modification, without the need for further intervention. Because of its safety and effectiveness, this approach is recommended before medications or procedures.

Darbepoetin Alfa

For Anemia

4 months ago
Darbepoetin alfa is used for anemia because it stimulates the bone marrow to produce more red blood cells, similar to epoetin alfa, but with a longer half-life. This means it can be given less frequently, which is more convenient for patients. It is commonly used in anemia from chronic kidney disease or chemotherapy to reduce the need for blood transfusions.

Vitamin B12

For Anemia

4 months ago
Vitamin B12 supplementation will improve anemia if the cause is a true B12 deficiency. It helps the body make healthy red blood cells and can also prevent nerve damage linked to low B12. Treatment may be given as pills or injections, depending on how well the body absorbs it.

Iron Supplements

For Anemia

4 months ago
Iron supplementation is a basic and widely used treatment for anemia caused by iron deficiency. It works by replenishing the body’s iron stores, which are needed for the bone marrow to make more red blood cells. Many forms are available over the counter, making it easy to access. While effective, improvement takes time since the body must build new red cells, and side effects like constipation or stomach upset can occur.

Synchronized Cardioversion

For Paroxysmal Supraventricular Tachycardia

4 months ago
Synchronized cardioversion is reserved for PSVT patients who are unstable or do not respond to medication therapy. It delivers a timed electrical shock to quickly restore normal rhythm and is highly effective in urgent situations.

Metoprolol

For Paroxysmal Supraventricular Tachycardia

4 months ago
Metoprolol IV is an alternative to diltiazem for treating PSVT, helping to slow AV node conduction and restore normal rhythm. I usually select it based on the patient’s prior experience or if they are already on a beta blocker.

Diltiazem

For Paroxysmal Supraventricular Tachycardia

4 months ago
Diltiazem IV is one of the treatment options for PSVT if adenosine does not work. It slows conduction through the AV node and can help restore normal rhythm, though it must be used carefully in patients with low blood pressure. I generally choose this if the patient is already on a calcium channel blocker.

Vagal maneuvers

For Paroxysmal Supraventricular Tachycardia

4 months ago
Vagal maneuvers can sometimes stop PSVT episodes at home by slowing the heart’s rhythm. If they don’t work or symptoms persist, patients usually need to come to the ER for further treatment.

Adenosine

For Paroxysmal Supraventricular Tachycardia

4 months ago
Adenosine is a first-line treatment for stopping PSVT, given as a rapid IV push to reset the heart’s rhythm. If the initial dose does not work, a larger dose may be needed. It is very effective, though patients may briefly feel flushing or chest pressure.

Bilevel Positive Airway Pressure

For Asthma

4 months ago
BiPAP can be a very helpful tool in severe asthma when there’s concern about airway compromise and you need to bridge the patient until medications start taking effect. It can improve ventilation, reduce work of breathing, and often helps avoid the need for intubation. I prefer using BiPAP over intubation whenever possible, but it’s only appropriate if the patient is awake, cooperative, and able to protect their airway. When used in the right setting, it’s a great stabilizing option for tough asthma flares.

Albuterol

For Chronic Obstructive Pulmonary Disease

5 months ago
Albuterol is a first-line bronchodilator for COPD and provides rapid relief of symptoms by relaxing airway muscles. In cases of mild COPD with infrequent symptoms, it may be sufficient as the sole treatment.

Azelastine

For Allergic Rhinitis

5 months ago
Azelastine is ideal for people with moderate to severe allergic rhinitis who need fast, effective relief. It’s a good option for those who don’t get enough benefit from oral antihistamines or prefer a non-steroid treatment, and it can also be used as an add-on therapy for better symptom control. The only downside is that it tastes awful, which some people find hard to tolerate.

Fluticasone Propionate

For Allergic Rhinitis

5 months ago
Flonase works well for allergic rhinitis, especially for reducing congestion, sneezing, and irritation. It usually takes a couple of days to reach full effect, but once it kicks in, it provides steady, reliable relief with minimal side effects.

Montelukast

For Allergic Rhinitis

5 months ago
Singulair is a second-line or add-on therapy for allergic rhinitis. Because of the risk of neuropsychiatric side effects, Singulair should be used with caution, especially in children and teenagers.

Loratadine

For Allergic Rhinitis

5 months ago
Claritin is a popular choice for allergic rhinitis because it provides effective symptom relief with minimal drowsiness, unlike first-generation antihistamines like Benadryl. It’s taken once daily and is well tolerated, making it a convenient, non-sedating option for long-term allergy management. Compared to alternatives like Zyrtec or Allegra, Claritin is less likely to cause fatigue but may have a slightly slower onset.

Cetirizine

For Allergic Rhinitis

5 months ago
Cetirizine (Zyrtec) is a highly effective antihistamine for treating rhinorrhea caused by allergies and a good first line drug. It works within an hour and provides 24-hour relief with minimal drowsiness compared to first-generation antihistamines (e.g., Benadryl).

Loteprednol etabonate ophthalmic suspension 0.5%

For Allergic Conjunctivitis

5 months ago
Loteprednol etabonate ophthalmic suspension 0.5% serves as an effective second-line therapy for allergic conjunctivitis, providing rapid relief with a lower risk of steroid-associated complications compared to traditional corticosteroids, but more expensive.

Phenobarbital

For Alcohol Withdrawal

5 months ago
Phenobarbital can be used in severe alcohol withdrawal, particularly when seizures are present or hard to control. Its long half-life provides steady protection against recurrent withdrawal seizures, but close monitoring is required due to the risk of oversedation or breathing problems.

Midazolam

For Alcohol Withdrawal

5 months ago
Versed (midazolam) is often used in severe alcohol withdrawal, especially when seizures occur. Its rapid onset makes it highly effective for quickly calming agitation and stopping seizures. Due to its short duration, it is typically followed by longer-acting benzodiazepines to maintain control. Overall, Versed is best suited for acute stabilization, with other agents providing ongoing management.

Lorazepam

For Alcohol Withdrawal

5 months ago
Ativan is an effective option for alcohol withdrawal, providing reliable symptom control with a calmer onset. It’s shorter-acting than drugs like diazepam, which can be useful if you don’t want prolonged sedation or lingering effects. Works fine overall, especially when a tighter dosing window is preferred.

Chlordiazepoxide

For Alcohol Withdrawal

5 months ago
Chlordiazepoxide (Librium) works well as an outpatient option after withdrawal is stabilized in the ER. Its long half-life gives steady coverage and allows for a taper at home, reducing rebound symptoms.

Diazepam

For Alcohol Withdrawal

5 months ago
Valium (diazepam) is often preferred in alcohol withdrawal because its long half-life allows for smoother coverage — I can load up a patient in the ER and sometimes carry them through the withdrawal period without frequent redosing. This makes it convenient in acute settings and reduces the risk of breakthrough seizures or agitation. However, caution is needed in patients with advanced liver disease, since impaired metabolism can lead to accumulation and oversedation. In those cases, shorter-acting benzodiazepines like lorazepam are often safer.

Banana Bag

For Alcohol Withdrawal

5 months ago
The banana bag is a standard ER treatment for patients in alcohol withdrawal, especially those who are vomiting, confused, or unable to take medications by mouth. It provides thiamine, folate, multivitamins, and fluids to prevent serious complications like Wernicke’s encephalopathy and correct common deficiencies. However, if a patient is stable, not vomiting, and mentally clear, I usually skip the IV and give the pill equivalents with oral fluids instead. This approach is easier, just as effective in those cases, and avoids unnecessary IV use.

Descending to a lower altitude

For Acute Mountain Sickness

5 months ago
Descending to a lower altitude is the fastest and most effective treatment for acute mountain sickness (AMS). Even a descent of 500–1,000 meters can quickly relieve symptoms by increasing oxygen availability and reducing brain and lung swelling. Rapid descent should be initiated at the first sign of worsening symptoms to prevent progression to severe altitude illness. Affordability depends on travel flexibility.

Dexamethasone

For Acute Mountain Sickness

5 months ago
Dexamethasone is a corticosteroid used to prevent or treat moderate to severe acute mountain sickness, especially when rapid ascent or descent is unavoidable. It reduces brain swelling and inflammation caused by low oxygen, quickly relieving symptoms such as headache, confusion, and loss of coordination. Unlike acetazolamide, it does not aid acclimatization but provides potent short-term symptom control.

Acetazolamide

For Acute Mountain Sickness

5 months ago
Acetazolamide is most effective as a preventive medication for acute mountain sickness rather than as a treatment once symptoms are severe. It works by stimulating breathing and helping the body acclimatize faster to low oxygen levels. When started a day before ascent and continued during climbing, it significantly reduces the risk and severity of acute mountain sickness

Estrogen and Progestin

For Acne

5 months ago
Estrogen and progestin (combined oral contraceptives) are prescribed for women with moderate to severe or hormonally driven acne, especially when topical treatments are insufficient or acne flares with menstrual cycles. They carry risks such as blood clots, stroke, and hypertension—particularly in smokers or women over 35—and should be used with caution in those with cardiovascular risk factors.

Salicylic acid

For Acne

5 months ago
Salicylic acid is an excellent, versatile treatment for mild to moderate acne, particularly for those with oily or combination skin. While it may not be sufficient for severe acne or cysts, it is a highly effective preventive and maintenance option when used consistently. Pairing it with benzoyl peroxide, good moisturizer and sunscreen can optimize its benefits and minimize potential irritation.

Warm Compresses

For Abscess

5 months ago
A warm compress is an alternative option that may take more time and isn’t as definitive as an I&D, but it’s certainly less painful. It can help small abscesses drain on their own with consistent use over several days. In combination with antibiotics may successfully treat the abscess.

Heliox

For Asthma

5 months ago
Heliox can be useful in severe, near–end-stage asthma when airflow is critically limited and other treatments haven’t taken effect yet. It’s not always available, but when it is, the lighter gas mixture can improve airflow enough to buy time for medications to work and potentially avoid intubation. It’s a niche option, but sometimes a valuable one in the right setting.

Paper bag

For Asthma

5 months ago
Using a paper bag during an asthma attack is dangerous and should be avoided. Asthma is an airflow problem, not hyperventilation, and rebreathing CO₂ can worsen breathing and delay proper treatment. It’s harmful, not helpful.

Mepolizumab

For Asthma

5 months ago
Mepolizumab is an add-on treatment for severe eosinophilic asthma, used when high-dose inhaled corticosteroids and other controllers fail to control symptoms. It reduces exacerbations, improves lung function, and may decrease oral steroid dependence by targeting IL-5 to lower eosinophil-driven inflammation.

Prednisone

For Asthma

5 months ago
Prednisone is my go-to treatment for moderate to severe asthma exacerbations, especially when symptoms aren’t fully responding to albuterol. It rapidly reduces airway inflammation and can turn around a flare that isn’t improving with standard rescue therapy. I prefer using a 5-day burst, which is usually enough to get symptoms under control without unnecessary prolonged steroid exposure. While it’s not something to use frequently because of systemic side effects, for a true exacerbation, prednisone is highly effective and often prevents the need for hospitalization.

Medrol Dosepak

For Asthma

5 months ago
Medrol Dosepak is a convenient, pre-packaged oral steroid taper that helps patients gradually reduce their corticosteroid dose over several days. It's commonly used in asthma exacerbations when a controlled steroid taper is needed to prevent rebound symptoms. The built-in schedule improves adherence and reduces confusion around dosing.

Montelukast

For Asthma

5 months ago
Singulair is a solid second-line or add-on option for asthma, especially if symptoms are triggered by allergies or if exercise-induced bronchospasm is a big issue. It can help smooth out those flare-ups, but inhaled corticosteroids are still the first-line controller therapy for most patients. One thing to watch for is the potential for side effects like vivid or unusual dreams, which some people experience. Overall, it’s a helpful add-on when asthma isn’t fully controlled with standard treatments.

Magnesium Sulfate

For Asthma

5 months ago
Magnesium is typically reserved for more severe asthma attacks when standard treatments aren’t working well enough. It’s used as an adjunct therapy, often given intravenously, to help relax the airways and reduce the intensity of an exacerbation. While it’s not a routine part of everyday asthma management, it can be a useful add-on in tough cases to help improve breathing and prevent further deterioration.

Ipratropium Bromide

For Asthma

5 months ago
Atrovent is used as an adjunctive bronchodilator in acute asthma exacerbations, particularly in the emergency department alongside albuterol. It is not a first-line maintenance therapy for asthma but can be beneficial for patients who have intolerances to beta-agonists or need additional relief during severe attacks.

Fluticasone furoate

For Asthma

5 months ago
Arnuity is a great once-a-day option for inhaled steroid therapy, which makes it really convenient compared to twice-daily controllers. It’s a newer formulation, but it’s been around long enough to be well-tested and is generally covered nicely under most insurance plans. For patients who need consistent inflammation control without the hassle of multiple daily doses, Arnuity is a solid and easy-to-use choice.

Fluticasone Propionate and Salmeterol Inhalation Powder

For Asthma

5 months ago
Advair is a solid second-line option for moderate to severe asthma prevention. It combines a long-acting beta agonist with an inhaled corticosteroid, giving both bronchodilation and inflammation control in one inhaler. It’s typically taken twice a day, and for many patients it does a good job of reducing flare-ups and keeping symptoms under control.

Budesonide/formoterol

For Asthma

5 months ago
The latest asthma guidelines recommend using a combination of a long-acting beta agonist with an inhaled corticosteroid for both acute flares and ongoing prevention. It’s an efficient, evidence-backed approach that works well for most people. Personally, I still prefer to keep those components separate during acute use — mostly to avoid the hassle of having to rinse my mouth after using a steroid inhaler — but the combined therapy is effective and convenient for the general population.

Fluticasone Propionate

For Asthma

5 months ago
Fluticasone is a solid inhaled steroid for controlling asthma symptoms, especially if you want treatment without a beta-agonist. It’s effective, easy to use, and a good option for mild to moderate asthma, though many patients now use combination inhalers like Symbicort. Be sure to rinse your mouth after each use to prevent thrush and hoarseness.

Cephalexin

For Cellulitis

5 months ago
Cephalexin is a good first-line antibiotic for simple skin infections caused by regular staph and strep. It’s affordable, generally easy to take, and works well for typical cellulitis. However, it does not treat resistant staph infections, so I’ll generally add coverage preemptively—using a second medication such as Bactrim or doxycycline.

Benzoyl Peroxide

For Acne

5 months ago
Benzoyl peroxide is a first-line, over-the-counter topical treatment for acne and better for inflammatory acne. It works by killing acne-causing bacteria and reducing inflammation, making it effective for both inflammatory and non-inflammatory acne. Common side effects include dryness or irritation, especially at higher strengths.

Adapalene

For Acne

5 months ago
Adapalene is a topical retinoid that treats acne by speeding up skin cell turnover, unclogging pores, and reducing inflammation. It's better for comedonal acne (blackheads/whiteheads). One of the first line treatments for acne. Available in otc and prescription strength.

Clindamycin

For Abscess

5 months ago
Clindamycin is a good option for abscesses when MRSA coverage is needed, especially if there’s concurrent cellulitis. It offers broader gram-positive and anaerobic coverage, but I mainly reserve it for patients who can’t take penicillins or Bactrim, given its higher risk of C. difficile diarrhea.

Trimethoprim-Sulfamethoxazole

For Abscess

5 months ago
While incision and drainage is the standard treatment for abscesses, I often add antibiotics to reduce cellulitis and prevent recurrence. Bactrim is particularly useful because it covers MRSA and can be an alternative for early abscesses or in patients who decline I&D. Allergies to the medication is common and I do worry that a small percentage of people have a strong reaction.

Incision and Drainage

For Abscess

5 months ago
Incision and drainage is considered the first-line treatment for abscesses, as it provides the quickest resolution of infection and symptoms. By releasing the collection of pus, patients often experience rapid relief of pain and swelling. Antibiotics alone are usually insufficient because they cannot penetrate the walled-off cavity effectively.

Epley maneuver

For Benign Paroxysmal Positional Vertigo

5 months ago
The Epley maneuver is a highly effective, first-line treatment for benign paroxysmal positional vertigo (BPPV). It works by repositioning dislodged inner ear crystals to relieve dizziness and vertigo. Most patients experience significant improvement after just one or two treatments.

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