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Sun Nov 1, 2020, 01:56 PM

The most popular painkiller on the planet has been poisoning people

By Mike Wehner @MikeWehner
November 1st, 2020 at 10:13 AM

Got a headache? How about back pain? Maybe a fever? Donít worry, thereís a magical pill that will take care of all those thingsÖ if only for a short while. Itís acetaminophen (or paracetamol), and itís sold under various brand names like Tylenol and included in multi-drug combo pills like Excedrine. Itís long been considered the safest way to alleviate pain, but new research suggests it may not be quite as innocent as it seems.

The main issue with the drug, despite being a safe medication, is that people take its safety for granted and begin using it in higher and higher dosages and for extended periods of time. Overdose of the medication can result in poisoning that damages the liver and can even lead to death.

The research focuses on recent data showing a clear increase in the number of poisoning cases resulting from acetaminophen and the various pills that contain it. ďIt is a very safe drug, but only for short-term pain relief and as long as the daily dosage does not go above the recommended range,Ē Andrea Burden, co-author of the study, said in a statement.

The data the researchers used is specific to Switzerland, but the trend of increased poisonings appears to be much more widespread, and the cause is likely the same across the board. The medication is available easily over the counter, and while directions make it clear that those with pain of various types should be using only the lowest effective dosage, they tend to ignore those guidelines and take higher dosages. For patients that the drug doesnít work well for, that means taking quite a bit more than the safe dose.

More:
https://bgr.com/2020/11/01/acetaminophen-safety-tylenol-paracetamol/

20 replies, 2028 views

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Reply The most popular painkiller on the planet has been poisoning people (Original post)
Judi Lynn Nov 2020 OP
soothsayer Nov 2020 #1
WePurrsevere Nov 2020 #6
My Pet Orangutan Nov 2020 #2
mopinko Nov 2020 #12
Fiendish Thingy Nov 2020 #3
Liberty Belle Nov 2020 #4
soothsayer Nov 2020 #7
muriel_volestrangler Nov 2020 #20
Faux pas Nov 2020 #5
Doreen Nov 2020 #8
sweetloukillbot Nov 2020 #9
yonder Nov 2020 #10
OregonBlue Nov 2020 #11
csziggy Nov 2020 #15
OregonBlue Nov 2020 #18
Freelancer Nov 2020 #13
NNadir Nov 2020 #14
Judi Lynn Nov 2020 #16
hunter Nov 2020 #17
SCantiGOP Nov 2020 #19

Response to Judi Lynn (Original post)

Sun Nov 1, 2020, 01:58 PM

1. Only aspirin in this house

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Response to soothsayer (Reply #1)

Sun Nov 1, 2020, 02:19 PM

6. We only use buffered aspirin or white willow...

after reading some studies a year or so ago it's now very rare that we use ibuprofen and I think the only time we've ever used acetaminophen was when it was combined with codeine mostly because it just never worked well for us.

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Response to Judi Lynn (Original post)

Sun Nov 1, 2020, 02:02 PM

2. Acetaminophen is used as suicide pill

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Response to My Pet Orangutan (Reply #2)

Sun Nov 1, 2020, 02:48 PM

12. beat me to it.

easiest way to punch your own ticket.

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Response to Judi Lynn (Original post)

Sun Nov 1, 2020, 02:06 PM

3. So, used as directed for occasional pain relief, NOT POISONOUS. Nt

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Response to Judi Lynn (Original post)

Sun Nov 1, 2020, 02:06 PM

4. It's also dangerous to take with alcohol - liver damage can happen with even 1 or 2 drinks.

I take ibuprofen when needed, it's safer (found in Motrin, Advil, etc)

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Response to Liberty Belle (Reply #4)

Sun Nov 1, 2020, 02:21 PM

7. Yep

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Response to Liberty Belle (Reply #4)

Tue Nov 10, 2020, 07:47 PM

20. Not "even 1 or 2 drinks", it's only regular heavy drinking, when ibruprofen is also a problem

or just overdoses of paracetamol:

There are concerns that therapeutic doses of paracetamol may be hepatotoxic in patients who regularly drink moderate to large amounts of alcohol. Critical examination of case histories reveals that overdoses of paracetamol were responsible for the hepatotoxicity in many cases. Experimental studies in which paracetamol was taken for short periods also show no interaction. Paracetamol is therefore a suitable analgesic for patients who regularly drink moderate to large amounts of alcohol but, as with all patients, care should be taken to minimise the chances of overdose.
...
The non-selective non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen, are relatively contraindicated in heavy drinkers because of the gastrointestinal damage produced by these drugs and alcohol. Furthermore, NSAIDs may also cause bleeding from varices. The selective COX-2 inhibitors, such as celecoxib and rofecoxib, may decrease the likelihood of gastrointestinal bleeding although evidence for the safety of these drugs in alcoholics with liver disease is currently lacking. Narcotic analgesics may be used in severe pain, but care should be taken with their dosage because of possible decreased metabolic clearances and respiratory depression in alcoholics.

Hepatotoxicity from therapeutic doses of paracetamol is unlikely in patients who consume moderate to large amounts of alcohol daily. However, patients with severe alcoholism should be instructed or supervised about the correct dosage of paracetamol. The depression often associated with alcoholism may make them more likely to take an overdose of paracetamol. Furthermore, the memory loss often seen in severe alcoholism may make patients unaware of having taken more than the recommended dose.

https://www.nps.org.au/australian-prescriber/articles/alcohol-and-paracetamol

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Response to Judi Lynn (Original post)

Sun Nov 1, 2020, 02:12 PM

5. Thank you!

Most of the people I know who take acetaminophen have some type of liver problem . I consider myself lucky that I never liked it.

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Response to Judi Lynn (Original post)

Sun Nov 1, 2020, 02:24 PM

8. I have Tylenol extra strength but I take pain pills so rarely.

Despite the fact that I am a woos when it comes to pain I would still rather be in pain than take pain meds. If I am in a lot of pain I will take a couple but if my pain is more than just a lot I will use cannabis.

I cringe when I see people using pain meds every day and several times.

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Response to Judi Lynn (Original post)

Sun Nov 1, 2020, 02:28 PM

9. This is news?

Iíve been hearing about the dangers of Tylenol for over 20 years...

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Response to Judi Lynn (Original post)

Sun Nov 1, 2020, 02:33 PM

10. Here it's aspirin when necessary, Ibuprofen only rarely.

I think I read that ibuprofen is contraindicated with any kind of Covid issue and in that case, acetaminophen might actually be helpful.

Aspirin rules the roost otherwise.

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Response to Judi Lynn (Original post)

Sun Nov 1, 2020, 02:43 PM

11. I have serious arthritis in my hands and the only thing that works is naproxin. I know it's bad to

take it long term so I just put up with the pain as long as I can. Still, it's a miracle drug for some. The others don't work nearly as well.

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Response to OregonBlue (Reply #11)

Mon Nov 2, 2020, 02:03 AM

15. I really liked naproxin for my aches and pains

But the doctor who took out my left kidney advised me to avoid it and acetaminophen (Tylenol). Since I take low dose aspirin every day, he recommended Ibuprofen.

It was odd - while in the UK, Ibuprofen was hard to get over the counter. I could only find it in 24 dose blister packs and then only buy one pack at a time. Fortunately I don't need it that often, but like to keep it on hand.

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Response to csziggy (Reply #15)

Sat Nov 7, 2020, 12:07 AM

18. I know it's not the best for me but it is a miracle

For arthritis. Guess I'll have a shorter but less painful life

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Response to Judi Lynn (Original post)


Response to Judi Lynn (Original post)

Sun Nov 1, 2020, 04:10 PM

14. The toxicology of acetaminophen has been well understood for decades.

Here's a paper from 1985 describing the mechanism of the toxicology, which involves the oxidation product N-acetyl-p-benzoquinone imine: The toxicity of acetaminophen and N-acetyl-p-benzoquinone imine in isolated hepatocytes is associated with thiol depletion and increased cytosolic Ca2+.

Here's a picture of what is involved:



The toxicology is generally only very serious at very high doses, as p-450 oxidation to the quinoylimine is not the major metabolic pathway, and can be in many cases irreversible, although prompt treatment with S-acetylcysteine can ameliorate the toxicity.

I generally avoid acetaminophen, although under some circumstances I will take it, being careful to adhere to the recommended dose levels.

I generally like to take aspirin for pain and for inflammation, because taking aspirin makes me contemplate the chemistry of the eicosanoids, a marvelous cascade of the arachidonic inflammatory pathway. Targeting that pathway has provided some very problematic medicinal chemistry, specifically with the Vioxx and Celebrex cases of COX-2 inhibitors.

A lot of work around the world has been conducted to develop injectable aspirin to treat heart attacks. It is not a simple thing to do.

Aspirin, one of the world's first synthetic drugs, is still the world champion drug, even though it has well known anti-coagulation properties and can thus cause bleeding and in rare cases hemorrhaging. I take it fairly regularly, and I am always struck by its beauty and simplicity as well as its effectiveness.

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Response to NNadir (Reply #14)

Mon Nov 2, 2020, 07:27 AM

16. So good to see your comments. Thank you. n/t

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Response to Judi Lynn (Original post)

Mon Nov 2, 2020, 11:20 AM

17. My psychiatrist told me to avoid it.

Acetaminophen may have some unusual side effects.

For example:

IS TYLENOL DULLING OUR CAPACITY FOR EMPATHY?

It is frequently lamented that we have become a me-first society, in which people care little about the welfare of others. This ethos, arguably personified by our president, has been blamed in part on modern technology, and especially on social media.

But new research points to a very different and unexpected culprit: Tylenol.

In a follow-up to a startling 2016 study reporting that use of the popular painkiller acetaminophen dulls our response to others' suffering, Ohio State University psychologist Dominik Mischkowski reports that it also makes us more indifferent to their pleasure.

"Given that an estimated quarter of all U.S. adults consume a drug containing acetaminophen every week, this research really matters," Mischkowski said in announcing the findings. Amplifying his point, another new study finds that the ability and willingness to empathize with others promotes cooperative behavior.

--more--

https://psmag.com/news/is-tylenol-dulling-our-capacity-for-empathy


Maybe that explains how Donald Trump became president. That would be an interesting study. Where do all these mean stupid Republicans come from? Does exposure to things like acetaminophen or insecticides aggravate those forms of sociopathy?

Hmmmm....

I suffer severe arthritis and chronic pain from damage I did to myself when I was young and feeling immortal --- falling off of cliffs, jumping out of moving cars, running all night, experimenting with big rockets and explosives, etc.

It's possible I'd have the arthritis anyways as something inherited but I no doubt made it much worse.

When Celebrex came out my doctor believed the manufacture's hype and prescribed it for me. Yeah it worked, but it eventually screwed up my stomach, contradicting Pfizer/Pharmacia's false advertising and fabricated efficacy studies.

I'm allergic to aspirin, Tylenol aggravates my autistic spectrum shit, and NSAIDS make my stomach bleed.

Oh well. I can tolerate Naproxen for short periods, but I always stop before my stomach starts to hurt. A bleeding stomach is the worst sort of pain, especially when it keeps you awake all night.

Opiates have surprisingly few adverse side effects when used in moderation but, just like alcohol, a significant portion of the population is unable to use them in moderation.

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Response to Judi Lynn (Original post)

Sat Nov 7, 2020, 01:18 AM

19. Headline doesn't match the story

A bit over the top.

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