FDA to dump the most toxic of drugs.....(Tylenol and stuff combined with it)

  • Posted by a hidden member.
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    Jul 01, 2009 7:14 AM GMT
    http://www.cnn.com/2009/HEALTH/06/30/acetaminophen.fda.hearing/index.html

    About time we used some common sense on some stuff.
  • MikePhilPerez

    Posts: 4357

    Jul 01, 2009 10:54 AM GMT
    http://www.cnn.com/2009/HEALTH/06/30/acetaminophen.fda.hearing/index.html
  • MikePhilPerez

    Posts: 4357

    Jul 01, 2009 11:03 AM GMT
    I can't believe I just done that for someone who claims to be a computer techie.

    Anyway, where is AMT.
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    Jul 01, 2009 2:20 PM GMT
    Acetaminophen (Tylenol) if used in the recommended amounts is safe. It is far safer than the only product that could be substituted for it, and that is aspirin. Aspirin can cause bleeding and ulcers. Aspirin is contraindicated in young children because of its association with the potentially fatal illness Reye's syndrome.

    The problem with acetaminophen occurs when people don't realize that it is in many combination cold medicines and is also combined with narcotics such as Percocet, Vicodin and Lortabs. People are using large doses of extra strength Tylenol along with the combination drugs and end up with liver damage. Not mentioned in the article is the problem with alcoholics. Alcoholics have preexisting liver disease. The large amounts of Tylenol used for their hangovers pushes the damaged liver into failure. I have witnessed this several times. I have never seen anyone die from a Tylenol suicide attempt. They were given the antidote acetylcysteine. If the victim would have stayed home rather than seek treatment, death could have occurred. I have seen a death from an intentional aspirin overdose. There is no antidote for aspirin; only supportive treatment is available.

    I think it is a good idea to get rid of the combination drugs. The stand alone product would not be removed. The maximum recommended does has already been lowered or will soon be lowered
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    Jul 01, 2009 2:49 PM GMT
    The same drugs are still going to be available...

    Acetaminophen provides the most calls to poison control. That said in Europe the most you can buy in a supermarket in a single transaction is 12 pills, you can buy up to 36 under the supervision of a pharmacist

    In the US in CVS/Rite-aid I've bought two 100 pack bottles of acetaminophen over the counter without issue.

    But then try and buy a pack of any cold medicine containing codiene and they need to see your ID. icon_rolleyes.gif

    So you can see where the priorities lie.... feel free to kill yourself but if your buying anything that could be converted into an amphetamine they'll stop you

    As for alcohol it generally has nothing to do with preexisting liver damage, larger alcohol doses that can be dealt with by the alcohol dehdhydrogenase pathway ramps up a secondary alcohol metabolism pathway that shares enzymes with the acetaminophen pathway. It's metabolized too fast dumping it's toxic product called NAPQ into your blood stream.

    So a single large dose of alcohol and acetomenophin can cause liver failure even with no preexisting liver damage
  • creature

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    Jul 01, 2009 2:58 PM GMT
    What I don't understand is why advisory panel elected not to vote on pulling over-the-counter drugs that use acetaminophen in combination with other ingredients, or at least lower the maximum dosage.

    I read in the link provided (thanks chuckystud and MikePhilPerez) that it's because less than 10% of over-the-counter drugs account for overdoses, but still allowing the combination to exist, especially as over-the-counter, is still dangerous. They should at least lower the maximum daily dosage for over-the-counter drugs since they are within easy reach.
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    Jul 01, 2009 3:20 PM GMT
    MsclDrew said
    So a single large dose of alcohol and acetomenophin can cause liver failure even with no preexisting liver damage


    Thanks for the information I was not aware of this fact.
    I always assumed there had to be preexisting liver disease for alcohol and Tylenol to cause liver failure. The patients we saw had alcoholic cirrhosis and continued to drink inspite of warnings.

  • MSUBioNerd

    Posts: 1813

    Jul 01, 2009 3:23 PM GMT
    Genuine curiosity, kneedraggen: You say that the only available substitute for acetaminophen is aspirin. Why is ibuprofen not an option? It's processed through the kidneys, rather than the liver, so my doctor's told me that there's no danger in taking one even if you've already taken the other given the lack of interaction in the detoxification systems -- quite useful when I get a sinus infection and my primary symptom is incapacitating jaw pain.
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    Jul 01, 2009 3:25 PM GMT
    creature saidWhat I don't understand is why advisory panel elected not to vote on pulling over-the-counter drugs that use acetaminophen in combination with other ingredients, or at least lower the maximum dosage.

    I read in the link provided (thanks chuckystud and MikePhilPerez) that it's because less than 10% of over-the-counter drugs account for overdoses, but still allowing the combination to exist, especially as over-the-counter, is still dangerous. They should at least lower the maximum daily dosage for over-the-counter drugs since they are within easy reach.


    Two reasons

    1. The world needs Tylenol, it's the most common analgesic, safest for use in kids at the recommended dose, Just imagine telling half a billion menopausal cramping women it's being taken off the market. icon_lol.gif

    2. Big Pharm basically is Johnson and Johnson, Just outside the fortune 100 and employing more than it's two closet competitors (Pfizer or GSK) combined.

    Makes for one hell of a powerful lobby, no government agency will touch anything which might be seen as a threat to that company

    Of course so the patent on acetaminophen is long expired so they continue to sell on branding alone, removing it or limiting it in prescription drugs doesn't hurt the parent company
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    Jul 01, 2009 3:50 PM GMT
    MSUBioNerd said Why is ibuprofen not an option?


    I forgot to mention the NSAIDS icon_redface.gif In my mind I just lumped them in with aspirin because of the shared GI side effects. Tylenol is safe to take if you have ulcer disease or gastritis. Asprin and NSAIDS can worsen these problems. NSAIDS are definitely an option as you pointed out.
    NSAIDS have problems that aspirin and Tylenol don't have. NSAIDS are problematic in individuals with pre exsiting kidney disease and can cause deterioration of renal function. Small dose of aspirin can be cardiac protective. NSAIDS have been linked to heart disease. Vioxx was removed from the market for this association. Fluid retention and hypertension are side effects. NSAIDS have been reported to cause liver disease (uncommon)
    http://www.medicinenet.com/drug_induced_liver_disease/page8.htm

    The three classes Aspirin, Acetaminophen and NSAIDS each have side effects and may not be appropriate for all individuals depending on existing medical conditions.

    Acetaminophen and NSAIDS can be combined for some problems
    http://findarticles.com/p/articles/mi_m0689/is_6_53/ai_n6121272/
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    Jul 01, 2009 4:07 PM GMT
    It's all about the COX (cycloxygenase) lol

    Enzyme which converts arcadonic acid to prostagaldins that cause inflammation

    Aspirin is a COX1 inhibitor, prevents the formation of prostaglandins involved in pain, over-riding the hypothalamus and platelet aggregation

    Ibuprofen is a COX2 inhibitor, prevents formation of prostaglandins involved in the local inflammatory response, more for swelling and muscle and joint pain

    Tylenol....we don't actually know how it works, It's a COX 3 inhibitor although COX3 products don't seem to play a large roll in inflammation and pain...but and interesting fact no.45 for the day, I know it hits a cannabis receptor involved in pain signals in neurons

    All three are NSAIDs Non steroid anti-inflamatory drugs

    Cortisone is the steroid alternitive to NSAIDs

    I like pharmacology, it's phun icon_lol.gif

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    Jul 01, 2009 4:35 PM GMT
    MsclDrew said
    I like pharmacology, it's phun icon_lol.gif



    You sound like my good friend that is the program director of a PharmD residency. On teaching rounds he could continuously spit out metabolic pathways and minutiae about medications. He easily overwhelmed the medical students and residents. I was usually lost myself.icon_lol.gif
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    Jul 01, 2009 4:39 PM GMT
    I am all fairness I suck at all the names, structures and pedantic details, and tend to only remember the relevant stuff

    So I expect a real professional would bury me
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    Jul 01, 2009 4:40 PM GMT
    I've got 250 pack.. Costco of course..
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    Jul 01, 2009 4:55 PM GMT
    I can only take tylenol.

    If i take asprin, advil, ANY other type of over the counter pain killer, I stop breathing and will be in the emergancy room within an hour
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    Jul 01, 2009 5:32 PM GMT
    There is yet another issue with the tylenol component in narcotic painkillers such as Percoset. Abuse of the Percoset. I treat some clients who have comorbid opioid addiction with other mental health issues and the tylenol is killing them a lot faster than the opiate.

    I have seen clients who were crushing up 4-5 percs at a time (10mg) and snorting them ala Nurse Jackie. They have considerable live damage naturally since they do this multiple times per day.

    I would have to agree the combined drug is problematic in that it is present in many things and people do mix and match meds with the best of intentions. Regardless of itent, it can still result in toxicity. The average person isn't aware of the impact of overdosing from doses from mujltiple sources.
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    Jul 01, 2009 5:49 PM GMT
    Tylenol also has the side effect of stripping the body of glutathione which is the final receptor of the electric charge from free radicals. The charge from free radicals goes to anti-oxidants like vitamins A, C and E and is then passed on to glutathione. Without glutathione, the elimination of the charge from free radicals is disrupted.
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    Jul 01, 2009 6:11 PM GMT
    kneedraggen saidAcetaminophen (Tylenol) if used in the recommended amounts is safe. It is far safer than the only product that could be substituted for it, and that is aspirin. Aspirin can cause bleeding and ulcers. Aspirin is contraindicated in young children because of its association with the potentially fatal illness Reye's syndrome.

    The problem with acetaminophen occurs when people don't realize that it is in many combination cold medicines and is also combined with narcotics such as Percocet, Vicodin and Lortabs. People are using large doses of extra strength Tylenol along with the combination drugs and end up with liver damage. Not mentioned in the article is the problem with alcoholics. Alcoholics have preexisting liver disease. The large amounts of Tylenol used for their hangovers pushes the damaged liver into failure. I have witnessed this several times. I have never seen anyone die from a Tylenol suicide attempt. They were given the antidote acetylcysteine. If the victim would have stayed home rather than seek treatment, death could have occurred. I have seen a death from an intentional aspirin overdose. There is no antidote for aspirin; only supportive treatment is available.

    I think it is a good idea to get rid of the combination drugs. The stand alone product would not be removed. The maximum recommended does has already been lowered or will soon be lowered


    Yeah.

    I think the whole mentality of poisoning the narcotics with Tylenol is kinda silly.