http://www.nytimes.com/2009/07/01/health/01fda.html?hp

The FDA...  ::)

Ant

Some quotes from Red Ant's article that just struck me as stupid and/or hilarious:

and the panel noted that patients who take Percocet and Vicodin for long periods often need higher and higher doses to achieve the same effect.

WELL DUH!  That happens with EVERY medicine you take, not just painkillers!  Your body adjusts to that level because you build up a tolerance to it, therefore you have to get a stronger strength.  Everyone who has had to be on long term medicine knows this fact.  It's common f*cking knowledge, unless you're part of the FDA. ::)

And more than 400 people die and 42,000 are hospitalized every year in the United States from overdoses.

And more than a million people die every day from different causes and are hospitalized for different reasons.

“The usual dose people take probably ought to be lowered in order to ensure a greater margin of safety.”

Which will cause people to take MORE of it because the lower dose will not work anymore.  Once again, DUH.

The committee was concerned that manufacturers presently sell two different strengths of pediatric liquid formulations, leading to confusion among doctors and parents.

Only if the parent/doctor is a dumbshyt and doesn't read the back of the bottle/box.

And this is only my observation, but all the times I've been prescribed Vicodin, it has said ON THE BOTTLE to not take acetaminophen while using Vicodin.  Furthermore, Vicodin is a painkiller, so why would any reasonable person (I'm not including the legal meds junkies in this) take more pain medicine on top of that? ???

Yeah, Jess, all I could do was roll my eyes at it.

As for why someone would take tylenol on top of vicodin, I have no idea. Tylenol, imo, is only good for one thing: fever. It kicks ass on fever like nothing else, but as a painkiller it is useless.

Every prescription I've got for the last 5+ years has paperwork acommpanying it, describing the dangers, interactions, etc. There's also the pharmacist councelling or whatever they call it, where the pharmacist explains the drug to you.

What wasn't explained is why the FDA is going after vicodin and percocet - are those drugs responsible for most the ER visits and deaths?

If they ban those two... well, I won't miss Vicodin, and there's always Percodan.  ;D

Ant

Only if the parent/doctor is a dumbshyt and doesn't read the back of the bottle/box.

And this is only my observation, but all the times I've been prescribed Vicodin, it has said ON THE BOTTLE to not take acetaminophen while using Vicodin.  Furthermore, Vicodin is a painkiller, so why would any reasonable person (I'm not including the legal meds junkies in this) take more pain medicine on top of that? ???


People don't read the bottles, that's one problem.

That, and the fact that the vast majority of people do not need acetaminophen.  In 2000 there were 52 deaths due to aspririn overdose; all but three were linked to suicide.

I did some more research.  Turns out that misuse/abuse of aceteminophen is the #1 cause of liver failure in the United States.  Larger than even alcohol abuse.

Yeah, Jess, all I could do was roll my eyes at it.

As for why someone would take tylenol on top of vicodin, I have no idea. Tylenol, imo, is only good for one thing: fever. It kicks ass on fever like nothing else, but as a painkiller it is useless.

Every prescription I've got for the last 5+ years has paperwork acommpanying it, describing the dangers, interactions, etc. There's also the pharmacist councelling or whatever they call it, where the pharmacist explains the drug to you.

What wasn't explained is why the FDA is going after vicodin and percocet - are those drugs responsible for most the ER visits and deaths?

If they ban those two... well, I won't miss Vicodin, and there's always Percodan.  ;D

Ant


Totally off topic, but I love getting the paper with my Paxil prescription that says, "May increase suicide risk."  I howl everytime I see it.

Tylenol PWNS the fever.  I keep it on hand in the winter time for the boy (but am smart enough to read the instructions ;)) because that stuff works like a charm.  That, or Motrin.


People don't read the bottles, that's one problem.

That, and the fact that the vast majority of people do not need acetaminophen.  In 2000 there were 52 deaths due to aspririn overdose; all but three were linked to suicide.

I did some more research.  Turns out that misuse/abuse of aceteminophen is the #1 cause of liver failure in the United States.  Larger than even alcohol abuse.



It still begs the question as to why someone would misuse/abuse acetaminophen.  It just seems so weird.  I can see people abusing other prescription painkillers, but Tylenol?

Acetaminophen is the poor man's root canal.

That is, a big reason folks are stuffing their faces with painkillers is their lousy goddam health "insurance" won't cover the necessary procedures. 

Now the government doesn't even want us to have our analgesics! 

Pssst...hey buddy, you lookin' to score some Tylenol..."

As for the addictive properties of meds such as Vicodin, I think we've established the failure of prohibition already.

Jesus, this is a sh*t idea!
::)

It still begs the question as to why someone would misuse/abuse acetaminophen.  It just seems so weird.  I can see people abusing other prescription painkillers, but Tylenol?


It is the old adage.  "If one is good, then THREE is better!".

Or you have somebody who has an ailment that tylenol will not alleviate the pain.  Rather than see a doctor, etc, they simply take MORE TYLENOL thinking that this will do the trick.

It is the old adage.  "If one is good, then THREE is better!".

Or you have somebody who has an ailment that tylenol will not alleviate the pain.  Rather than see a doctor, etc, they simply take MORE TYLENOL thinking that this will do the trick.


As above, what the patient might need is a lidocaine injection, followed by a diskectomy, followed by 10 sessions of physical therapy, but thanks to our healthcare system, he might not be able to afford it, so more Tylenol seems like the only option.
::)

It still begs the question as to why someone would misuse/abuse acetaminophen.  It just seems so weird.  I can see people abusing other prescription painkillers, but Tylenol?


Depends on how the "abuse" is defined.

1) The first group of "abusers" are dumb people who attempt suicide without doing any research.  (I'm not getting into the suicide debate -- I'm calling "dumb" on these folks because they're using a method that's guaranteed to result in a slow and painful death, and whether it's a "cry for help" or a serious attempt, that's probably not what they wanted.)  These are the people who gobble a bottle of the most available pill in the house, which is often Tylenol.  They cry themselves to sleep, and wake up the next day feeling fine and a bit silly.  Two days later, they start to feel a little bit off, and by the time they go to the hospital, it's too late.  They spend their last days in agony in the hospital awaiting a liver transplant that never comes in time.

Technically, however, that's "abusing" Tylenol.

2) Alcoholics (and regular drinkers, and even the occasional binge drinker who wakes up with a hangover) who don't realize that the liver's metabolism of alcohol (the step with the aldehyde dehydrogenase) depletes sulfylhydrils (hanging off molecules of glutathione and cystine) in the liver.  Run out of those, and throw some acetaminophen into the mix, and the liver - rather than metabolizing the acetaminophen into nontoxic metabolites - turns it into NAPQI, and if you don't have enough glutathione to metabolize it, then Very Bad Things(tm) start to happen.

Technically, they wind up in the hospital due to having taken too much Tylenol. 

3) Opiate abusers who don't know (or care) what else they're taking.  The combination of acetaominophen and opiates isn't done solely to kill opiate abusers, as there's a synergistic effect between acetaminophen and opiates that makes the combination more effective at reducing pain than either medication taken alone.  Similarly, the popularity of combining acetominophen with pseudoephedrine combinations isn't done for anti-meth reasons -- there's a legitimate pharmaceutical reason for combining a drug that's effective at reducing fevers with a decongestant.  Ditto for the mixing of acetaminophen with that-other-thing-that's-not-polite-to-talk-about in cough syrups. 

That said, I'm sure it was a factor, especially on the opiate side.  If you're using opiates to recover from pain, you're not using them long enough to develop a tolerance, and the synergistic effect means you need to take fewer pills.  Win for the patient.

If you're abusing opiates a'la Limbaugh, you're going to develop a tolerance for the opiates... as a "happy" side-effect, you'll get to a point where, in order to get the high, you're also eating enough acetaminophen to fry your liver.  Although these people would prefer to buy products without the acetaminophen, since those products aren't available without a heavily-monitored prescription, they fry their livers in an attempt to get a high.

Technically, however, they also fall under the category of people "abusing" acetaminophen, even though it's not the acetaminophen that's giving them the high. 

The real problems, however, are deeper than that.  They're...

3) People who shouldn't be taking acetaminophen (typically hung-over students or alcoholics), but who don't know they're taking acetaminophen because they don't read the labels on their OTC cold medications and headache remedies. 

4) People who think that all over-the-counter pain relievers are alike, and who therefore don't realize that Tylenol isn't an NSAID, and isn't going to do much against certain types of pain.  And who decide that if it's not effective, they should just take a few more pills.

And it's all compounded by the unhappy fact that...

5) Acetaminophen's one of those annoying drugs that has a narrow range between the "effective dose" and the "lethal dose".  Take XYZ times the effective dose of alcohol, and most people will throw most of it up before they're halfway done.  Take XYZ times the effective dose of other OTC medications, and you'll probably have a very unpleasant time of it, but you'll ultimately recover (depending on the drug, you'll need medical help) none the worse for wear.  Take XYZ times the effective dose of Tylenol, and without a liver transplant, you'll be dead within a week.  The problem with acetaminophen is that "XYZ" is a smaller number than it is for many other OTC or prescription meds.

Summary:  Before taking any OTC or prescription medication, read the label.  Ask your doctor.  If you don't have one, ask any pharmacist at any drugstore.  Near as I can figure out, tylenol's not the bad guy here.  People who don't know what they're ingesting, and how it interacts with other things they may have been ingesting, are the problem.  As a rule of thumb, if you're a heavy drinker or have a hangover, avoid acetaminophen (also known as paracetamol) and any products (you are reading the label) that contain it... like the plague.  Tylenol's an effective treatment for fever and for some forms of pain, but not other forms of pain -- for example, if your pain is from inflammation, and you're not otherwise contraindicated (again, this reading-the-label thing of which I speak, the labels are pretty clear) consider an NSAID like aspirin or ibuprofen.

Disclaimer:  I'm not a doctor, I just read the labels on every package of medication I take, remember some stuff from first-year undergrad chemistry and biology courses, and I like to google a whole lotta stuff, and I like to type a lot.  If you want medical advice, see that big bold stuff up there and ask someone who actually knows what they're talking about.  The guy who graduated last in med school still gets to be called "Doctor", and for good reason.

Summary:  Before taking any OTC or prescription medication, read the label.  Ask your doctor.  If you don't have one, ask any pharmacist at any drugstore.  Near as I can figure out, tylenol's not the bad guy here.  People who don't know what they're ingesting, and how it interacts with other things they may have been ingesting, are the problem. 


Yes, that's what it boils down to.  OTC does not mean it can't hurt you.  My mother had a stroke at the age 41.  I was a rather minor brain hemorrhage, but it put her in intensive care for weeks and then in slow recovery for six months.  What happened.  She was taking tons and tons of aspirin for a knee injury.  She didn't consult with her doctor about the risks because she assumed their weren't any.  Aspirin reduces clotting.  On top of that, she got flu.  Blood pressure dropped...and that was that.  I wake up to find out mom's unconscious at the ER and they're not sure what's wrong.  Freaked me out!  Well, she did pull through without permanent damage, but it was pretty scary for a while!
:o