Looting the post-apocalyptic pharmacy: How do they find anything?

Cafe Society
1

You can picture it: The world has gone to shit (again), supply chains have crumbled (again), zombies and mean people are everywhere (per usual). Someone had an oopsie and needed something stronger than a band-aid. So the hero(ine) goes out in search of pharmaceuticals, shotgun, backpack, and sacrificial extra in tow.

They arrive at some pharmacy, grocery store, vet clinic, whatever, and rummage through scattered pill bottles on the shelves. Twenty seconds later they magically find piles of the exact things they needed, usually some painkiller or antibiotic. Examples: World War Z, Walking Dead, The Mist. (See also: No Healthcare in the Apocalypse - TV Tropes and Disaster Scavengers - TV Tropes)

How realistic is this? Even in these slightly pre-apocalyptic times, in well-stocked grocery stores with clear aisles and labels, I have trouble finding something as common as ibuprofen. And whenever I pick up prescription medication, I look behind the counter and think to myself, I have no idea what any of those drugs do or how they’re organized. I also have no idea whether similar-sounding drugs are close enough – methamphetamine is the same as dextroamphetamine, right?

So, does regular ol’ Postapocalyptic Joe stand a chance at finding the right medications for any given (non-exotic) injury or disease? Presumably Wikipedia is offline and he probably doesn’t have a pharma degree. But hey, maybe he’s learned a thing or two from other survivors (but then presumably all the common drugs would’ve been looted or hoarded already, no?).

What are the chances an average person can actually find the correct medications (and dosages?) to treat likely zombie bites, gunshot wounds, runaway STIs, whatever happens after 2025?

2

Depending on how long it’s been since collapse, I would think the drugs have spoiled in the heat when the AC goes out. But yeah, dosage would be hard to gauge.

The Stand should be remembered for the ghost of Nick Andros instructing Tom Cullen to give the proper drug (M-O-O-N, that spells “drug”) and dosage to Stu recovering from regular flu. Barely believable.

3

For what it’s worth, in the Last of Us video games, there are a couple of different scenes where people go into pharmacies and hospitals, looking for specific things, and they don’t find what they’re searching for right away. The games are zombie survival horror, so this delay is used to stretch out the narrative and build suspense, but it also feels realistic that if you’re going into a drug store hoping to find (say) a suture kit, you’re going to need to root through a lot of junk because the easy pickings are long gone.

4

This looks like it could fit pretty well into this long-running thread:

Although to be fair, you’re asking the question from the opposite POV.

Trying to answer the narrow question of “how do they find anything?”, that starts with knowing what they are looking for. You can’t find “aspirin” in the OTC section if you don’t know that’s what it’s called. You also can’t find “ampicillin” in the pharmacy part if you don’t know that’s what you want.

Within any pharmacy, there is some organization to “all those pills on all those shelves”. Any post-apocalyptic scavenger only needs to learn that once. Maybe it’s alpha by drug name. Maybe it’s categorical. Heck, there may be section tags we just don’t see from our usual spot on the opposite side of the counter. I know I don’t know how pharmacies are arranged, but I’m darn confident there is a logical arrangement that even a layman could learn to follow. Once they know the name and general category of what they are looking for.

Setting aside of course the giant artificiality that every pharmacy in the land will have been turned inside out by looters and drug-seekers in the opening hours of the apocalypse. Finding an unstaffed but nonetheless nearly virginal pharmacy simply isn’t going to happen. Which is another way this scene fits the thread I cited.

Which thread could have been titled “Hollywood’s unreal but omnipresent tropes”

5

Costco. Home Depot. Lowes. And Walmart for the guns and ammo.

6

:man_facepalming:

Missed a word there. It should be “…goes out in search of pharmaceuticals, with shotgun, backpack, and sacrificial extra in tow.”

7

Yeah, I really do wonder this. I am not sure if I could suss that out without external reference. A bunch of drug names, generic or brand, isn’t going to help much =/ Even if they were alphabetical, I wouldn’t know what an “ampicillin” is… a lotion? Brand name? Sounds like some sort of fungal remedy possibly related to penicillin…? I dunno.

Heh, exactly. What’s worse is that in many of the scenes, the pharmacy isn’t virginal… more like, er, well-loved… and the character is seeking drugs to treat the super-common condition that everyone else is dealing with too. But lo and behold, there it is, miraculously! How convenient that there was just enough of this in stock to treat all the major characters.

Cool! I loved the TV show, and supposedly Weston’s [pharmacy] is making in appearance in Season 2 due out next year. Looking forward to see how that plays out and hopefully breaks the trope.

8

That’s a different issue altogether.

If you don’t know what you’re looking for, it could be in your hand and you wouldn’t / couldn’t recognize it.

Conversely if you do know what you’re looking for now it’s just a matter of finding it, whether by an organized search (e.g. neat labeled categories on neat shelves) or by a brute force search: pick up each bottle in turn and yep/nope each one.

Now if your real question is how is it that the major characters have enough medical / pharma knowledge to a) diagnose their problem, b) identify a treatment regimen with suitable substitutes if the ideal med isn’t available, c) find it at the first store they go to within the first 4 things they pick up, and d) pronounce all that correctly?

The answer to that is as always: they have better scriptwriters than we here in reality do. Plot armor is the best armor by far. Unless you’re the one wearing the red shirt.


OTOH, if you’re actually curious about how anyone in the medical / pharma biz keeps all that straight it’s useful to know there are established formal patterns to drug naming. Knowing just the name tells you a bunch about what it does / how it works. Although not necessarily much about which conditions it can treat. See here for more:

9

Huh? You just go to the aisle with the painkillers, and Ibuprofen is going to have dark blue trade dress (acetaminophen is typically red, naproxen is light blue/yellow, aspirin is typically orange or yellow, and blends like Excedrin are typically green)

Typically the game designers do one of two things, and either abstract it away where you just find “antibiotics” and they’re good for some number of HP, resolve common problems, etc… or they make it part of a quest, where old Dr. Krustovsky sends you out to find some specific dosage of an antibiotic, and it’s a quest item that you’re guaranteed to find if you do things right.

I’d personally love to see a game where the Dr. sends you on a quest, but there isn’t a guaranteed quest item and your party member/NPC dies of the infection, because the random spawns of available drugs in the pharmacy created a whole bunch of hemmorhoid cream, and no amoxicillin. That would give players more choices- do you go to the next town over and rummage through their stuff? Do you ransack every vacant house in town? And so forth. And as a player, you aren’t guaranteed the story path you want either.

10

This is awesome! I was wondering about this just yesterday at the pharmacy, when trying to describe something by its… uh, I wanted to call it by its “scientific name”, which it isn’t… maybe a “generic” name? But apparently that’s different from its INN. For example what we call “acetaminophen” is “paracetamol” in INN?

I mean, is it just me? I never know if something like ibuprofen is under “First Aid” or “Cold and Flu” or something else. There isn’t a “Painkillers” aisle, is there?

And trade dress…? What the heck is that? Are you saying the packages are color-coded? :exploding_head: I never noticed that, and even if they were, it doesn’t seem easy to look for… I never would’ve realized there was a system for this, given that:

Examples of drug packages

At Costco, the pills I buy look like this:
Screenshot

I remember that as “clear bottle with red pills”, never noticing the blue (which doesn’t really seem “dark” to me). Their acetaminophen is much bluer, both in packaging and pill colors:

Screenshot

And the “IB” version is orangy/gold, though I’m not sure what the difference is:
Screenshot

Which looks like one of the CVS versions:
Screenshot

Which looks nothing like this turquoise:
Screenshot

I guess they all have some blue in them, but that never stood out to me as the “dominant” color.

11

I should have linked you to this instead:

Bringing up international differences just makes things more confusing.

There are US official “generic” names for every drug. e.g. acetaminophen. Then there are trade names for products containing that drug. e.g. Tylenol or Wal-phen.

As a separate matter there is an IUPAC chemical nomenclature for the active molecule in acetaminophen, but nobody other than chemists cares about that. It’s N‑(4‑hydroxyphenyl)acetamide. And it has a chemical formula too: C8H9NO2. which again is chemist-only trivia.

The thing you want is the “generic” USAN name.

12

In The Day After Tomorrow, the pharmacy comes to them, with scarcely a minute to spare. It’s onboard a Russian ship that runs aground. On the NYC Public Library HQ. Where the heros are holed up. Dying for lack of medicine. Brink of death, meet movie magic!

13

There are some easy rules you would learn pretty fast. With this example, almost anything ending in “cillin” will be some variant on penicillin, and be an effective anti-biotic.

14

At least in the pharmacy sections of the stores I frequent, there are a few aisles and there are usually the following sections arranged in those aisles- cold/flu, stomach/constipation, first aid/wound care, painkillers, foot/fungus, supplements, and eye/ear. The order varies by store/location though.

But yeah, the painkillers are all together, the bandaids/neosporin/gauze/antiseptics are all together, the cold/flu/congestion stuff is all together, and so forth.

Well yeah. Typically the brand names have distinctive color schemes- Tylenol(acetaminophen) is typically red, Advil(ibuprofen) is typically blue, Aleve(naproxen) is blue/yellow, Motrin(ibuprofen) is orange, Bayer aspirin is yellow/brown, and Excedrin is green/red. And the PM versions which have sleep-fostering ingredients are usually a blue/purple.

Typically (but not always), the house-brand generic versions follow the same color coding so that consumers aren’t confused. Here are the name-brand versions of the ones you linked:

Advil
Generic ibuprofen 1
Generic ibuprofen 2

Motrin (compeitor of Advil)
Generic ibuprofen 3
Generic Ibuprofen 4

Aleve (naproxen)
Generic Naproxen 1
Generic Naproxen 2

Tylenol (acetaminophen)
Generic Acetaminophen 1
Generic Acetaminophen 2

After looking these up, it turns out that the generic manufacturers track even closer- the red cap on some is an indicator of arthritis-friendly cap (not child safe). And that follows in the generics as well.

It’s super-obvious. I’m a little bit surprised you never noticed that they’re all together and that the brand names have distinctive color schemes that the generics mimic.

This isn’t even limited to pharmaceuticals; Pine-Sol, for example has an amber liquid with green/yellow labeling. And so do nearly all their generic knock-offs. Same thing with laundry detergents. Tide is bright orange/blue, and so are Costco’s Kirkland knock-off, and Sam’s knock-off.

15

I am not a doctor, but i know lots of generic names of drugs, I’m familiar with the layout of drug stores, and i know some of the naming conventions. If you need an antibiotic or a painkiller, I’m confident i could find it moderately efficiently in an un-looted drug store. If you are looking for an anti-seizure medicine, i would struggle, although that old doorstop (the physician’s desk reference) my father gave me years ago might be good enough to find something suitable. Or not, i might strike out or accidentally give you a heart medication for that.

But i managed my mother’s ever-shifting array of drugs (every time she was hospitalized they would change something to a similar drug, so i learned a lot of drug equivalents) for a few years, and i could find a lot of the basics.

16

Okay, it’s a stupid movie but I have to quibble with this. The ship doesn’t show up last second. It was there pretty much immediately when it started to flood. It was only when one of them was getting really sick from an infection that they decide to search the ship.

17

I’m sure you’re right and I think the flooding of NYC are the best scenes. It’s one of those movies that they show on tv a lot and with many, many skippable dialog parts.

I knew they were urgently racing for the meds but forgot they were being hotly pursued. By wolves. On the Russian freighter. I’d have been in the group sets off from the library and freezes to death days earlier, probably in some state of hypothermia paradoxical undress.

18

At least you got that far. I’d apparently just have starved to death looking for the ibuprofen.

Well, TIL. Thanks for the tip! I never knew. Always just looked for the red pills, and I never buy brand name drugs if I can help it, so never thought to compare them. Mostly I just look for the logo of the house brand, not any particular label color. But this should make it easier in the future.

By the way, what IS the difference between regular ibuprofen and the IB or USP versions?

19

USP just means “United States Pharmacopoeia” (or however that’s spelled), which is basically a big compendium of drug specifications as compiled and maintained by the USP non-profit.

IB just specifies “Ibuprofen”. In the case of Motrin, it’s because it’s a brand-name used for multiple products that can contain other drugs. They make an acetaminophen/ibuprofen blend, they sell branded diclofenac gel, and they sell a night-time version with diphenhydramine to help you sleep.

20

Ah, thank you!

Wut? So this is just a bottle of… ibuprofen ibuprofen? https://www.costco.com/kirkland-signature-ibuprofen-ib%2C-200-mg%2C-1%2C000-caplets.product.100376939.html

It’s the exact same thing as the regular ibuprofen, just with a redundant name and “trade dress” to look more similar to the Motrin kind?