From the Physician’s Desk … Weekly Blog!
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Have a headache? Grab some Motrin (Ibuprofen).
Knee pain? Use some Tylenol (Acetaminophen)
Headache persists? Take more Tylenol? Hip now hurting too. Can you take more Motrin?
Having pain medications available over-the-counter (OTC) is a good thing. But too often, many are not aware of some of the necessary, basic, associated precautions. Recently, while visiting my Dad, he jokingly noted the ever growing, long list of “side-effects” spewed about medications in commercials. Like most he wondered, “why take the medication, if the side effects seem to cause more harm?” But, that is for another blog *smile* Let’s tackle the pain medications that millions DO use daily! Let’s define NSAIDs and then we will start with Acetaminophen (Tylenol).
JUST THE BASICS
Non-Steroidal Anti-inflammatory drugs (NSAIDs) are a group of OTC medications use to decrease mild-moderate pain, reduce fever, and decrease inflammation without the worrisome effect of steroids. Ibuprofen (Advil, Motrin, Caldolor, Midol, etc.,), Naproxen (Aleve, Naprosyn, Anaprox, etc.,), Aspirin (Zorprin, Bayer aspirin, St. Joseph aspirin, etc.,), among others. Acetaminophen is NOT a NSAID.
- The primary difference between NSAIDs and acetaminophen (Actamin, Pandadol, Tylenol) lies in the way each relieves pain. Acetaminophen works primarily in the brain to block pain messages and seems to influence the parts of the brain that help reduce fever. That means it can help relieve headaches and minor pains. But it’s not as effective against pain associated with inflammation.
- Inflammation is a common feature of many chronic conditions and injuries. NSAIDs reduce the level of chemicals that are involved in inflammation. Treatment with NSAIDs can lead to less swelling and less pain.
- Some pain pills, such as Excedrin Migraine, combine an NSAID — in this case aspirin – with acetaminophen
Acetaminophen (Tylenol) overdose is one of the most common poisoning worldwide! Why? Because taking too much pain reliever can cause liver failure or even death! YES…sudden liver failure (see videos below).
The FDA has set the recommended maximum for adults at 4,000 milligram (mg) per day. It is quite easy to hit this max though! One gel tablet of extra strength Tylenol, for example, contains 500mg. Do you ever take just ONE Tylenol though? My colleague just indicated that he never takes less than 3 extra-strength pills at a time! That’s 1500 mg at one time…do this 3 times in one day and will be above the max!
Overdoses from acetaminophen send 55,000 to 80,000 people in the U.S. to the emergency room each year and kill at least 500, according to the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA).
Acetaminophen can be found in more than 600 over-the-counter and prescription products used by nearly one in four American adults every week, including household brands like Nyquil cold formula, Excedrin pain tablets, Theraflu and Sudafed sinus pills.
So how do these accidental acetaminophen deaths occur?
Imagine you’ve had major dental surgery, and your dentist prescribes a five-day supply of Percocet.
- You take the recommended 2 pills every six hours for 2,600 mg of acetaminophen, well below the 4,000-mg-a-day safety threshold.
- But you’re still experiencing pain, so you decide to add Extra Strength Tylenol, six caplets a day for another 3,000 milligrams.
- Now you’re feeling better but you still have trouble sleeping, so you take Nyquil, for another 650 milligrams (unaware of the acetaminophen content of the other medications).
After a few days on this 6,250 milligram regimen, experts say acute liver damage is a real risk. Add a couple beers or wine to this…and, well, you get the picture! (Alcohol affects the liver also…)
- Normal/Regular dose of Tylenol ~325mg
- Extra-Strength 500mg to 650mg
- MAX daily recommended dose 4,000mg
PLEASE continue to use Acetaminophen and Acetaminophen products, as needed. Just be aware of the dose limits and use wisely!
Now you know…
Ipsa Scientia Potestas est ——— Knowledge itself is power!
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Your Family Friendly Doc … Dr McGann!
See you next week…