http://en.wikipedia.org/wiki/Paracetamol

Just read this blog postabout an overdose on the UK equivalent of Tylenol (they call it Paracetamol).

While the story is very sad, in the comments, I tool note of the fact that there's Acetaminophen in many, many other products.

In looking over some of my med supplies, I did not find Acetaminophen in any of the stuff I stock (we tend to use aspirin and occasionally sodium naproxin) but I do know that it's in many cold remedies.

Well, I reckon there's better ways to commit suicide than destroying your liver, but it fits the 14 year old mentality.

Acetaminophen (aka Paracetamol, Tylenol) is dose sensitive, in that the body can only fully metabolize a limited dose at one time. When someone overdoses, the body partially metabolizes it into a hepatoxin (liver poison). It does much the same as eating a toadstool or other similarly poisonous fungus.

I still prefer to use Acetaminophen over aspirin or other Nsaid based products for pain relief. In the right dose it is much safer, especially taken on a regular basis. Ibuprofren is a better anti-inflammatory and fever reducer, and aspirin has it's cardio benefits, but there are inherent risks with those that seem a bit more common than any from Tylenol, at least from my experience.

It is nonetheless prudent to know what is in the OTC meds you take, lest you end up overdosing yourself unwittingly.

I think the current recommended adult dose for Tylenol is 1/4 the LD 50/50 for acetaminophen, IIRC. That is a pretty good margin.

My first EMS instructor told us that "if aspirin were introduced today, it would be a prescription-only medication".

Aspirin is in a lot of other over the counter products as well. I once had a bad experience with some back pain medication mixed with herbal ginseng pills. Both were high dose and both aspirin and ginseng are blood thinners. My nose started to bleed and run like water. Took me hours to stop it...lesson learned the hard way. I'll never take herbal stuff for granted as harmless again.

Actually, it might not even get through FDA tests at all if introduced today. I work for a metabolomics researcher, which is the study of what happens chemically at the cellular level in various circumstances (e.g. while a cancer cell is dying). He said that while they have a theory about how aspirin works (at the cell level), no one knows for sure.

We also had an interesting talk the other day about caffeine and nicotine. Both are alkyloids, used by the plants to ward off disease and insects. So, we are getting high off smoking and ingesting insect repellant and anti-fungals.

"Well, I reckon there's better ways to commit suicide than destroying your liver, but it fits the 14 year old mentality."
when I was working at King's College Hospital in London we had a person in there final year of med school try to commit suicide this way, notice TRY. He did not die and was alive a year later but had no functional liver etc... and was bed ridden in the hospital.

There are trade off for all medications, if it can kill you it probable is no good.

cheers

Probably any OTC med can kill if overdosed. The tylenol lethal dose is about 10 grams (20 extra-strength tablets) and it causes centrilobular necrosis of the liver.

Do you remember the recent story of the cross-country runner in high school that died of salicylate poisoning from rubbing sports cream on her body? She probably had also taken salicylates from other sources (aspirin) and didn't realize the additive effect.

I was surprised to read once that a significant percentage--more than half in that particular survey--of unintentional overdoses were from combination drugs of Vicodin and Percocet which also contain acetominophen. People in chronic pain often develop resistance to the narcotics, so they increase the dosage, not realizing or not being that concerned that they're also upping the acetominophen dosage, too. I guess we're all brainwashed with TV ads that make us think that acetominophen is so safe.

I don't know the exact number, but tens of thousands ER visits are attributed to acetominophen overdoses each year.

Another advantage is that there's a 'antidote' to Acethaminophen: http://en.wikipedia.org/wiki/Acetylcysteine


Tylenol is the prefered pain-killer over Aspirin, if used according to the instructions/doctor and WITHOUT ALCOHOL!

This is called EVOLUTION. Plants produce what they do to survive.
cheers

You might want to reconsider buying "Extra-Strength" Tylenol, acetaminophen, products and stick to the regular strength pills.

The standard dosage is two 325mg tablets giving you a total of 650mg. Extra-strength versions typically contain 500mg in each tablet for a total of 1000mg, one gram. The difference of 350mg is significant.

Most people get the same effect from the regular strength products that they get from the extra-strength version. By using the lowest effective dosage your reducing the risk of toxicity and adverse reactions. I realize this goes against a couple of generations of 'more is better' commercial programming but sometimes less is, in fact, better.

If and when you have tried the regular dose and found it to be ineffective you can safely take a third regular strength tablet and still be below what you get in a single extra-strength two-pill dose.

There is one other thing to keep in mind. Keep a running written log of all the drugs given to a person. This should include the person's name, the drug given, the dose and both the date and time of administration. I find simple 3by5 cards to be handy.

A good number of people who have ODed on Tylenol have done so simply because it is easy lose track of when they took their last dose. Even otherwise healthy people can too casually toss back a couple of tablets and then forget they took them. Or go asleep and lose track of the time or day. This is even more true when your sick or for the elderly. I have lost days at a time when I was really sick.

In some cases people have accidentally taken twice or three times the recommended dose. Even worse if they are using an extra-strength version. An accurate written log of what was taken and when can largely eliminate these situations.

In the case professional medical care is needed be sure to bring the written drug log with you. It can go a long way in helping tell the doctors what is, and what is not, going on.

Aspirin works for me for headaches, also it is recommended for reduced chance of heart attacks. And I did have one a few months ago and am now taking them every day.

I also have and take Percocet for several broken bones and damaged knees & shoulder from a motorcycle accident. But I never take more then the prescription says to. My prescription says I can take 2 if needed, But I have found that if I take one with 2 aspirin it does just as well as taking 2 of the Percocet. And it doesn’t put me to sleep.

I have a relative that is on Vicodin and he gave me well over 100 of them, but I have never taken one of them. I never did any research on them and am very reluctant to just take something I know nothing about.


I think the issue is to not take any medication excessively, or to mix & match without a doctors recommendation.

I don't know as I would count on 50mg of acetaminophen to take the place of 650mg, two 325mg tablets, but I don't see any harm in giving it a try and seeing if it works. If 50mg works for you so much the better. Why take more than you need.

Of course I wonder how much of the observed drugs effect at very low dosage can be attributed to a placebo effect.

It is an old medics trick when the morphine runs out to substitute an M&M or a vitamin, sometimes blackened with a magic marker, and to talk it up as an extra-special pain pill before solemnly administering it. Of course, in that case, you have a captive audience that is highly motivated to suspend dis-believe and feel it working.

Not that that is a bad thing. Placebos generally don't cause overdoses or dangerous drug interactions. As one writer pointed out: 'Any method that works well without causing harm is, by definition, good'.

I have a nasty leg ulcer, and my MD warned me about this. For instance, Vicodan HP is a 10/660 tablet - that 660 is meant to prevent you from taking more than 1 at a time

What my MD said "if you need more pain killer, you can add advil - up to 3, and if that doesn't work, you are off to a pain control specialist, which I'd like you to go to anyway"

Today (knock on wood) is thge lowest pain day I've had in a LONG time - JUST the Advil is working. Feels good to NOT have a narcotic running around in my system

I seem to recall that the ratio of a toxic and an effective dose of acetominophen is somewhat low; the ratio of a toxic and an effective dose of ibuprofin is significantly higher. Is that correct?

I have no idea about any actual ratios, but in my mind, it's sort of an apples to oranges comparison. An acute ibuprofen overdose doesn't produce the kind of really toxic by-products like acetominophen does. Actually, I believe that people who deliberately, massively overdose on ibuprofen often don't really show any symptoms of it.