Tylenol overdose and the public's ignorance.

  1. I had a Tylenol overdose pt yesterday, suicide attempt. In my opinion, the public is grossly undereducated about Tylenol and it's effects on the body. My pt had people rallying around him all day yesterday, got the clearance from mental health to be discharged, and was ready to go home! Unfortunately, his Hepatic panel was sky high, he still had an Aceteminphen level of 20 over 40 hrs post ingestion, still needing a N-acetylcysteine drip, and he might very well end up on a transplant list.

    I tried to explain to him that Tylenol doesn't kill you right away, but can cause liver damage. Finally, the doc came in and laid it all out for the pt.

    In my opinion, a public service campaign on a national level is needed regarding the dangers of Tylenol. This is needed for chronic pain sufferers, who don't understand that Tylenol is an ingredient in many products, and that it is toxic if over used. And it's needed for everyone else who might used Tylenol overdose as a cry for help and attention.

    From my observation of my pt, he definately was basking in the attention, both from the girlfriend who had just dumped him, and his friends who had rallyed to his side. Meanwhile, he may end up dying while awaiting a liver transplant.

    I think the public needs more information about Tylenol.
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    About GardenDove

    Joined: Oct '06; Posts: 1,256; Likes: 65


  3. by   GeminiTwinRN
    I agree. When I worked on the ICU, we always knew when an OD pt had been "serious" about their suicide attempt. They seemed to always have taken an overdose of Tylenol.

    The general public needs to be educated about acetominophen and its toxicity, that's for sure.
  4. by   SmilingBluEyes
    True, and in getting all that attention, his liver may be history. Sad.

    I agree we have to get the word out; acetominophen is omni-present in so many drugs. Overdoses are very common.
  5. by   Spidey's mom
    Quote from SmilingBluEyes
    True, and in getting all that attention, his liver may be history. Sad.

    I agree we have to get the word out; acetominophen is omni-present in so many drugs. Overdoses are very common.
    One of the things that bugs me is the recommendation of using Tylenol PM for insomnia. You don't need the acetominophen unless you are in pain - just take the 'benedryl" all by itself. I've had people take the T-PM and then take a pain reliever too - not realizing there is TYLENOL IN TYLENOL.

  6. by   santhony44
    Everyone seems to think that because it's OTC, it's harmless. People are really surprised when I tell them that it can kill you very dead.

    I am in a clinic and talk to people about this frequently. Many also don't realize that acetaminophen is also an ingredient in other prescription and non-prescription meds.
    When I review their medications I try to point things like that out.

    Sometimes I'm surprised more people don't poison themselves. Maybe they do, and we just don't realize it.

    I also point out that a Tylenol OD doesn't kill you fast, that it's a slow, miserable death- just in case.
  7. by   GardenDove
    I wonder what we can do to initiate some action on the part of public health officials. I really think this is a serious public health problem. Yes, we individual nurses can do our part, but I also think some media public service type campaigns would be in order.
  8. by   TazziRN
    You're right, Dove. I've lost track of how many young girls took a handful of Tylenol because they got into a fight with BF/Mom/Dad/whoever and decided to scare them. No one is more surprised than the pt when she ends up in ICU.

    The public just doesn't understand that just because a script isn't necessary, the med is not completely harmless.
  9. by   ayla2004
    its called paracetamol in the UK and limited to buying 32 500g tablets at any one time for shops.
    their is a chemical that can the added to paracetamol at manufacture that stops it destroying the liver.
    However a A&E(ER) nurse told me that they didn't do this cause we can treat paracetamol posining and people will then find a way that we can't treat.
    'we eduacte surgical patients on discharge if they are already on say
    paracetomol and codeine(50-8) we won't give them take home drugs to stop them getting confused
  10. by   caseybail87
    My daughter had chronic knee pain. She took too much tylenol over a 2 week period. She thought she had food poisoning. A trip to the ER, admission and within 36 hours, vent, coma, continuous dialysis, bolt to measure icp and 18 days later, she herniated her brain. She was 23 and left a 3yo and 4yo. When she was first admitted, I asked her what the dosage for tylenol was. Her reply was shocking. She stated "The doctor prescribs 800mg of motrin and said I could take 4 OTC ibuprofen at once and tylenol is the same right?" I asked several of her friends..they had the same thought process. The public doesn't get it. Ask someone about side effects or dosage of tylenol...most dont have a clue. They think if its OTC it's safe...Tylenol needs to be by Rx only! Its too dangerous!!! People need to know. My daughter died of ACCIDENTAL overdose...On the death certificate, cause: acetaminophen overdose accidental. My Life will never be the same. If I can save just one person...
  11. by   CCL RN
    So sorry to hear about your daughtes death-and of her children losing their mother.

    When I was in pharmacology, my teacher said that if Tylenol Had to go through the FDA as a new med today it would NEVER pass.

    Dangerous stuff.
  12. by   elkpark
    Not only is there the very common public misconception (about OTC meds in general) that "if it's OTC, it must be safe," but McNeill (the company that makes brand-name Tylenol) has run all those TV commercials and magazine ads for many years informing everyone of how safe Tylenol is ...
  13. by   CCL RN
    Also, my husband always gets confused with Tylenol. Ours comes from Costco and is labeled "non-aspirin" so he always assumes it's ibuprofen too. Many times he's brought me Tylenol in bed when I've asked for ibuprofen. I've corrected him several, I mean, several times.
  14. by   mama_d
    I don't even have Tylenol in the house. We use ibubrofen for run of the mill pain mgmt. Our 12 year old gets migraines, and takes 400 mg of ibuprofen for mgmt of them...he is already aware of his dosage and the various names it goes by, as well as the fact that Aleve and all of the names it goes by are in the same class.

    There is a real lack of education on this subject, I completely agree. The Tylenol left the house after I discovered that hubby was combining Ultracet, Vicodin, and Tylenol for pain issues while dealing with a tooth abcess. After living with a nurse for ten years he still didn't know that all of them had Tylenol in them, although he was aware of the possible effects of a Tylenol OD from previous discussions. His question as a lay-person was "Why isn't it clear that all these things have Tylenol in them?" I could only agree with him that it should be clearer.

    How is it that all the commercials for prescription meds have to have that long list of possible adverse reactions, but no one knows what Tylenol OD can do?