Zombie apocalypse: pharmacy must-grab items

[confettiflyer]

Okay, maybe not a zombie apocalypse (kind of overplayed), but let's say you're at work (hospital, retail...doesn't matter) and some sort of natural disaster occurs. Mayhem, chaos, martial law ensues...

With 10 minutes and a regular sized backpack, what items from your pharmacy would you grab?

Be realistic, and nothing from your front store area/grocery store either.

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[PharmerC]

Although you say not zombie based, from watching the walking dead I'd go for antibiotics and antivirals. Since I'm young and healthy with no comorbidities, don't really need anything else, but you never know when that there flesh eating disease may get you. Maybe some flintstone chewables for when food gets scarce lol. (This would be from an inpatient pharmacy). Maybe some 1L sterile water bags to drink in a bind.

 

[Its Z]

I would post some videos of "arsenal" but I better not.... could get many of us in a lot of trouble.. but omg, fun as heck.

Let's just say AR10 full auto and propane tank.

 

[StellargalS]

Amoxicillin, IBU 400, SMX/TMP, levaquin, ultram, oxycodone, tylenol, morphine ampules, toradol ampules, medrol dose pack, NTG, TAC, ASA, diaz 5, NS, D5W, portable autoclave, metronidazole, diflucan, bacitracin, mupirocin, prozac, effexor xr 37.5 and 150, lidocain, 3cc syringes, 25G1inch needle, 25G 1.5 needle, 25G 5/8inch needle, dexamethasone tabs, lomotil and loperamide, potassium tabs, lasix, lantus, humalog, cocaine powder, a couple of admin sets, and toilet paper. 10 minutes time.

 

[BeLikeBueller]

Antibiotics (including topical), pain meds, and possibly some anti-anxiety meds, depending on the magnitude of the disaster.

 

[trailerpark]

XANAX 🤣

 

[Jibby321]

Atripla anyone? Oh and sudafed and why not some adderall or any other stimulant. Need to stay on watch for the possible attacks.

 

[297point1]

Martial law doesn't scare me.
A breakdown of social order? Zombie apocalypse? The second coming of you know who, and I'm (likely) left behind? In those instances...I'm loading up on the stuff with the highest resale value. I can buy/barter whatever else I'll need later.

 

[DAW2]

nothing. im fat and i wont be able to outrun anything so ill be the first to get bit. but watch out because once im infected im coming after you guys

 

[SpirivaSunrise]

I would respond. But fear that Homeland Security and the Nuclear Regulatory Comm would be knocking on my door tomorrow.

 

[Sparda29]

I would respond. But fear that Homeland Security and the Nuclear Regulatory Comm would be knocking on my door tomorrow.

Why would they be monitoring your internet posts?

 

[SpirivaSunrise]

Why would they be monitoring your internet posts?

Not that they are now...but they would be if I posted what I'd grab.

Read Z's post.

 

[Jibby321]

They watch EVERYTHING!

 

[nnguyenc]

Amoxicillin, IBU 400, SMX/TMP, levaquin, ultram, oxycodone, tylenol, morphine ampules, toradol ampules, medrol dose pack, NTG, TAC, ASA, diaz 5, NS, D5W, portable autoclave, metronidazole, diflucan, bacitracin, mupirocin, prozac, effexor xr 37.5 and 150, lidocain, 3cc syringes, 25G1inch needle, 25G 1.5 needle, 25G 5/8inch needle, dexamethasone tabs, lomotil and loperamide, potassium tabs, lasix, lantus, humalog, cocaine powder, a couple of admin sets, and toilet paper. 10 minutes time.

i love this thread, often thought about this

ibu 400 = why not i800?
ultram = redundant
tyenol = redundant
bacitracin = why not triple abx?
lidocain = misspelled
lasix = why?

+1 to person who said stimulant
no one said proair, epi, or glucagon

zombie bits leg, you need to make tourniquet and anesthetic for numbing to amp the leg

 

[nnguyenc]

for the love of god....TWINKIES!

 

[kvl1027]

Oral Antibiotics, IV antibiotics, IV supplies, and OXY. I should be able to trade the oxy for food or ammo, whatever I need really. A couple Rescue MDI's and some epi. I would also grab some lomotil, getting a major case of diarrhea in a survival situation with limited resources could be fatal.

 

[kvl1027]

The truth is I think most of us would have more than 10 minutes. As soon as I heard all hell was breaking loose, the store would get locked up and most of the lights turned off. I would grab everything I need and then some. Whatever I couldn't carry I would hide above the roof tiles so that I may come back once things cool off and re-supply.

It actually might not be a bad idea to come up with a list of items and "must-haves" and keep it on you, so that in the event that something occurs you don't have to depend on a clear mind.

 

[nnguyenc]

should swap out all the pills (e.g. put furosemide tablets in hydromorphone bottle, or senna-plus tablets in loperamide bottle)

if people try to rob a pharmacy, jokes on them

only the retail pharmacist will recognize the pill and what it is used for

 

[npage148]

Oh, Grab some iodine (either betadine, iodine tincture or lugol's) to sterilize water. I think about it a lot too. You really don't need that much. A broad range of ABXs (don't forget flagyl for GIT stuff and doxy for that weird bug), pain meds (one NSAID and then all the opiates you could grab to barter and to ease your way out of life at the end), all the stimulants, benzos, a bunch of prednisone, and albuterols, maybe some . I'd skip epi (it's exp date is so short anyways)

I see no point of antidepressants, glucagon, potassium, insulin.

 

[StellargalS]

i love this thread, often thought about this

ibu 400 = why not i800?
ultram = redundant
tyenol = redundant
bacitracin = why not triple abx?
lidocain = misspelled
lasix = why?

+1 to person who said stimulant
no one said proair, epi, or glucagon

zombie bits leg, you need to make tourniquet and anesthetic for numbing to amp the leg

oh fun fun.
I have 10 minutes and a back pack. Thinking about the potential populations I could encounter and practicality i.e. running from zombies. Ibu 400 to split in to 200 in case smaller kids and then titrate up prn to 800mg? Thought about orabase after the buzzer went off for pediatric suspensions.

The "setting" indicates a likelihood for lots of acute pain cases where true incidence of opiate allergy is unknown (and I forgot the epi )

Ultram has a following these days and may offer an acceptable alternative to those who are worrying about being stoned on opiates.

Tylenol actually has a proposed NMDA moa (anecdotal = apap with oxy kills the oxy HA) and helps to lower the narcotic requirements and offset the undesirable narc effects. Also antipyretic where NSAID intolerant.​

Bacitracin because of the the higher incidence of allergy to the neomycin component in the triple (forgot the benadryl )

Lidocaine - spelling correction appreciated and noted. That I threw in the bag without really having a solid plan for it. Pharmacist intuition, which whenever I ignore I regret . Thinking of wounds and possible morphine lidocaine topical concoctions. Did not want to limit the delivery to the patch. Thinking perhaps a McGuiver doc might find it useful in some way.

Lasix because I have a soft spot for old folks. I mean food is scarce and they can't really be picky about sodium content. Would hate to watch them blow up gratuitously.

So after the fact on the proair, epi and glucagon. I rethought that next time I would have a right hand tech to get my back for such oversights.

Touniquet for the zombie bit legs. I thought about kling but then ditched it due to my version of zombie = 28 weeks later zombies and the bite kills fast. Retrospectively I think your are right. If they were dawn of the dead type then first aid and quarantine would be in order (although not in the best interest of the group).

Yes very good on the stimulant. I missed that too. The cocaine I included was just for the unique vasoconstriction properties in case the Dr McGuiver could make good use. Also they used to make a palliative concoction with morphine and cocaine that sounded kind of great. I am all for easing the end of life suffering.

 

[StellargalS]

Oh, Grab some iodine (either betadine, iodine tincture or lugol's) to sterilize water. I think about it a lot too. You really don't need that much. A broad range of ABXs (don't forget flagyl for GIT stuff and doxy for that weird bug), pain meds (one NSAID and then all the opiates you could grab to barter and to ease your way out of life at the end), all the stimulants, benzos, a bunch of prednisone, and albuterols, maybe some . I'd skip epi (it's exp date is so short anyways)

I see no point of antidepressants, glucagon, potassium, insulin.

I like the antidepressants for the placebo effect. I was thinking of anxiety over the longer term.

Insulin/glucagon : That would suck if one of the core members of the group was type 1. They can get pretty wild.

The potassium we need intuitively. Thinking of hypokalemia that occurs upon correcting hyperglycemia (glucagon). Then of course the old folks. 😳

Got the metronidazole but not the doxy. Doxy good call.

 

[type b pharmD]

First off, I am going to make the assumption that I am a very healthy young adult .. so in this case no chronic meds or preventative meds

First things first. . .. the entire control safe if it would fit (the stock) , for barter value

Then essentials

Definitely:
Ibuprofen or naproxen (voltaren would be nice but its off the list due to bulk and being able to make your own topical anti inflammatories)

Cephs and tetracyclines (sulfa is too big to carry for sure)

Dexamethasone/prednisone

Epi or other stimulant if you didn't grab c2 stimulants

Testosterone, for the resale value , and I'm gonna need some more muscle, fast.

Sterile syringes.. no room for alcohol or sterile water plus both of those can easily be made at home if needed.

Antibiotic eye drops and steroid eye drops .. these things are not going to resurface soon and if you need them, you REALLY need them.



Probably/if possible:

Diphenhydramine .. you just never know.

Benzos.. you may need it to live peacefully and also to come off the stimulants lol.

Ondansetron / lomotil

Potassium and sodium for potential dehydration scenarios

Azole topical



I think we should pose another question.. what would you take if you had a large duffel, 30 minutes and were planning to open up shop as a post apocalyptic independent pharmacist?

1. Anything anyone is dependent on:
Hormones of any kind, inhalers, antidepressants, all benzos, all opioids including suboxone.. all steroids

2. Best bang for your buck preventatives.. crestor, lisinopril, maybe metformin?

3. topicals that can't be compounded at home

4. All eye drops

Any other ideas? I know my list is probanly woefully inadequate, but I admit I haven't really thought long and hard about it .. but this thread is outrageously awesome

 

[rxlea]

All the antbiotics i can grab with preference for broad spectrum and that cover MRSA, some azoles, Tylenol and ibuprofen, all the opioids and stimulants i can grab, benzos, benadryl, albuterol, prednisone, topical abx like triple or mupirocin, zofran, multivitamin, syringes/needles, cipro eye drops, epi, senna, lomotil, and some ziplocks for tablets so i don't take up room with the bottles.

Then if i still have room, bottle of alcohol.

I'd give myself a tdap, zoster, and flu.

And I'd have my ruger p345 and colt.22 strapped to my side and ankle.

I don't like the rule of not running through the store- I'd throw some protein bars in the mix.

Ten minutes is a long time when you're functioning at 100mph.

 

[confettiflyer]

I'm impressed with the replies, good job all. You guys keep guns in the pharmacy? Closest thing to a weapon I can finagle is a 60cc syringe with an 18G needle attached to it.

I agree with opioids for barter. Didn't even think of Lugol's or iodine.

What spurred this was the fact that I've been put in charge of reviewing our earthquake/disaster planning. Trying to figure out what would be most useful if we have to set up an emergency pharmacy in a parking lot.

 

[pharmerjohn]

Hmm... No mentioning of ED meds? For err... bartering and repopulation (you could be the last man/woman on earth). 😀

 

[trailerpark]

I love how everyone says "barter and trade". You know if someone wanted your meds they'd shoot you dead without hesitation.

 

[DrWrong]

I love how everyone says "barter and trade". You know if someone wanted your meds they'd shoot you dead without hesitation.

Governor style.


Vanc/Cefepime/flagyl.

 

[DrWrong]

I think we should pose another question.. what would you take if you had a large duffel, 30 minutes and were planning to open up shop as a post apocalyptic independent pharmacist?

1. Anything anyone is dependent on:
Hormones of any kind, inhalers, antidepressants, all benzos, all opioids including suboxone.. all steroids

2. Best bang for your buck preventatives.. crestor, lisinopril, maybe metformin?

3. topicals that can't be compounded at home

4. All eye drops

Any other ideas? I know my list is probanly woefully inadequate, but I admit I haven't really thought long and hard about it .. but this thread is outrageously awesome

I'd imagine that A1c is the least of someone's worries in the post-apocalyptic world haha. Plus, I doubt McDonalds will make it past the apocalypse.

 

[npage148]

Seriously, no one will know about my stash of narcotics

The issue with insulin is that after like 2 months it's all gonna be garbage, type Is are screwed.

I could maybe see taking a statin as preventative. Having a stroke/MI would be a death sentence and they are pretty benign overall

 

[pharmerjohn]

I love how everyone says "barter and trade". You know if someone wanted your meds they'd shoot you dead without hesitation.

That's why it's a good idea to be armed as well! Never come alone when you barter... Meet in an open area and have a buddy or two wait in a building or a nearby hill with a scoped SA m1a or a similar rifle. Tell the person you're bartering with that they're being watched and if they value their life, then they won't pull anything stupid.

 

[pharmerjohn]

Seriously, no one will know about my stash of narcotics

The issue with insulin is that after like 2 months it's all gonna be garbage, type Is are screwed.

I could maybe see taking a statin as preventative. Having a stroke/MI would be a death sentence and they are pretty benign overall

You'll be running for your life half the time, so I think you can skip the statins.

 

[confettiflyer]

Yeah I would imagine the first priority is water - so lugol's/iodine would be most useful, followed by broad spectrum abx + loperamide/lomotil for sx's.

 

[Jibby321]

This thread is very entertaining.

 

[MackandBlues]

I'd also be running to central supply in the hospital (down the hall from the pharmacy) and grabbing suture kits, IV start kits with some IV fluids, lidocaine for numbing, all the antibiotics/antinfectives I can carry both po and iv, opoids, nsaids, benzos, iodine, syringes and needles, etc

 

[confettiflyer]

I'd also be running to central supply in the hospital (down the hall from the pharmacy) and grabbing suture kits, IV start kits with some IV fluids, lidocaine for numbing, all the antibiotics/antinfectives I can carry both po and iv, opoids, nsaids, benzos, iodine, syringes and needles, etc

Stop cheating. Haha...but I'd do the same and grab suture kits. But IV's? I don't know, IVF gets bulky and would crowd out other valuable items in my backpack.

 

[confettiflyer]

Follow-up question (for those who answered the first one already):

What's your first destination after loading up said backpack with your selected pharmacy supplies?

 

[MackandBlues]

Stop cheating. Haha...but I'd do the same and grab suture kits. But IV's? I don't know, IVF gets bulky and would crowd out other valuable items in my backpack.

True on the bulkiness issue but fluids are used to treat alot of things so that's why I'd grab at least a couple NS to save for my self or family members.

 

[owlegrad]

My first destination is not very original, but a place with high fences and thick walls. A nice old fashioned prison.

Even better, a place with a mote, draw bridge, and high walls, like the old fort at St Augustine or any of the centuries old forts in Europe. A military base may also do, but I am not sure how properly fortified they really are now-a-days. An underground bunker may work also.

 

[rxlea]

First stop, my parents to get an arsenal of weapons and ammo, camping and fishing gear, propane tank, food, and the quad which will go in the back of the truck to drive into the mountains in northern Arizona where I'll be able to hunt and fish and build a tree fort. I'll probably stop at my uncle's on the way to grab his arsenal of weapons and ammo and food. Of course I'll bring my family and gf with me.

 

[slimcutt]

Don't forget a bunch of cotton balls to stuff those bottles with. It's going to be hard to sneak around with a backpack that sounds like it's filled with maracas.

 

[confettiflyer]

True on the bulkiness issue but fluids are used to treat alot of things so that's why I'd grab at least a couple NS to save for my self or family members.

If I had room I would, but here...what's going to be your big culprit for fluid losses? If you're running from zombies, PO intake will do just fine, so a little vial of iodine or bleach will go a long way; if you get cholera or something, you're gonna need a hell of a lot more than a few bags of NS and you'll be dead after that anyway, so the biggest punch you'll get from that is some doxy or other abx.

Plus if you're running from zombies, the heft of NS or LR in your backpack could increase your chances of death (depending on whether you're in 28 Days Later vs. Night of the Living Dead).

 

[xiphoid2010]

Showing my chinese origin, iodine water puriftion tablets (eg. Military issued ones) would be far more portable and as a bartering goods. Glass syringe and stainless steel needles can be reused indefinitely as you boil/steam it. Which bring us to fire starters + canteen as priority items.

Antibiotics wise, if you can only pick one, either doxy or minocycline wld be my pick. Can be taken orally, cover g+/g-, atypicals, paracitic illnesses, even ca-mrsa and acinetobascter. I don't expect mutidrug resistant super bugs since hosts won't likely live long enough to transmit them.

 

[confettiflyer]

First stop: car dealer, I'd pick up a 4 wheel drive of some sort.

Then my gut tells me to drive to Costco and hole up in there... At the very least, I can have a hot dog and a churro....and I can probably drive my car IN to costco somehow, assuming zombies haven't taken over the place.

 

[Jibby321]

My first destination is not very original, but a place with high fences and thick walls. A nice old fashioned prison.

Even better, a place with a mote, draw bridge, and high walls, like the old fort at St Augustine or any of the centuries old forts in Europe. A military base may also do, but I am not sure how properly fortified they really are now-a-days. An underground bunker may work also.

I'm with owl grad. There st Augustine here I come.

Or I'd go to the doomsday preppers castle you see on TV. 🙂

 

[StellargalS]

Seriously, no one will know about my stash of narcotics

The issue with insulin is that after like 2 months it's all gonna be garbage, type Is are screwed.

I could maybe see taking a statin as preventative. Having a stroke/MI would be a death sentence and they are pretty benign overall

I gotta keep going with the insulin. The incidence of type 1 is like 0.5% so the demand will be low. In an already horrifying situation moral is really going to take a kick from things like DKA, tonic clonic seizures, allergic rhinitis (kidding). The insulin will be trash but it buys us time and if we come across no further supply I am all for euthanasia in this new society if it empowers the group. No? Still no? Which reminds me midazolam.

 

[StellargalS]

I love how everyone says "barter and trade". You know if someone wanted your meds they'd shoot you dead without hesitation.

No that is why the pharmacists rule in the new land. Our boys are all on roids and are equipped to cover the graveyard shift.

 

[StellargalS]

Stop cheating. Haha...but I'd do the same and grab suture kits. But IV's? I don't know, IVF gets bulky and would crowd out other valuable items in my backpack.

Are SQ works less cumbersome? This suggestion is actually for your real world scenario in the parking lot. I am in way over my head on this topic but IMO it would be an above average addition to your armamentarium because of the lower risk of infection and the lower skill level required for site set up.

 

[StellargalS]

Follow-up question (for those who answered the first one already):

What's your first destination after loading up said backpack with your selected pharmacy supplies?

To the airport then to Fiji to take over the underwater hotel. Then we live on coconuts and go to bed when the sun goes down until all the zombies starve to death. Maybe they never even make it to Fiji. Also I think cannabis would be a great colonial economy booster. I would try my darnedest to score some seeds before boarding. And I would grab some succinyl choline to make poison darts if I can't find a gun.

 

[MackandBlues]

If I had room I would, but here...what's going to be your big culprit for fluid losses? If you're running from zombies, PO intake will do just fine, so a little vial of iodine or bleach will go a long way; if you get cholera or something, you're gonna need a hell of a lot more than a few bags of NS and you'll be dead after that anyway, so the biggest punch you'll get from that is some doxy or other abx.

Plus if you're running from zombies, the heft of NS or LR in your backpack could increase your chances of death (depending on whether you're in 28 Days Later vs. Night of the Living Dead).

true true. but it just makes me feel better if I have some. I was thinking more on the hypotension from a really bad infection (septic shock) so you can buy time for the abx to work before you die or kill off your organs... but probably need lots of fluid. Probably one I'd come back for if possible.

 

[MackandBlues]

To the airport then to Fiji to take over the underwater hotel. Then we live on coconuts and go to bed when the sun goes down until all the zombies starve to death. Maybe they never even make it to Fiji. Also I think cannabis would be a great colonial economy booster. I would try my darnedest to score some seeds before boarding. And I would grab some succinyl choline to make poison darts if I can't find a gun.

love the paralytics as potential weapons blow dart style. they need to come up with a "hal-dart" for haldol in the acutely psychotic patients we get in our ER...