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Reply #101: tylenol with codeine suicide -- from an MD's pov [View All]

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mainer Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Aug-02-08 07:34 PM
Response to Original message
101. tylenol with codeine suicide -- from an MD's pov
Edited on Sat Aug-02-08 07:37 PM by mainer
This is what set my alarm bells ringing. First, from what I understand, he was discovered comatose at home and died two days later in a hospital.

A few things.

There are two drug components to consider. First, the acetaminophen component (Tylenol.) This kills patients via toxicity to the liver. If discovered early, it IS survivable and treatable. Immediately after ingestion, the patient does not become comatose. The symptoms of hepatic toxicity do not set in for several days, so this is clearly not what killed him, as he was discovered already comatose.

The codeine component could kill a patient in the same way that any other morphine derivative can, with respiratory depression. There are four different levels of codeine combined with tylenol, depending on the particular pill prescribed, ranging from 8 mg. per tablet to 60 mg. per tablet. (Tylenol 1,2,3, or 4.) The LD 50 (dose that kills 50% of people) for codeine is 800 mg. So yes, it's possible to die of a codeine overdose if you take enough of the strongest dose (60 mg/ tab.) At the lowest dose (8 g) you'd have to take 100 tabs. And very few physicians I know of would prescribe that many tablets at a time. More likely, it would be in numbers of 30 tabs or so.

THE REAL PROBELM, HOWEVER, is that he lived for two days after being discovered!!!

Anyone with an overdose of a morphine derivative is easily treated with a quick IV dose of Narcan, which quickly counteracts morphine's effects. If he was still alive and breathing when discovered, he SHOULD HAVE SURVIVED with a simple dose of Narcan.

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