Tylenol, how safe is this drug

[nialloh]

The history behind this post is as follows. I posted this on another site a while ago at the request of one of the admins of that site. Her daughter attempted to commit suicide multiple times (she since grew out of doing that). This was an online gaming site that had a lot of younger members, and we wanted them to understand the danger of taking too much of a "Safe" drug. What this girl did to herself bothered me so much I wanted to share the story in the hope others will learn from it.

Tylenol, how safe is this drug.

This is *******. As many of you know, I'm an RN (Nurse). I recently experienced just how dangerous Tylenol is.

This is not an urban legend, or from someone who heard it from a friend's sisters brother's cousin ...etc. I saw this myself.

I admitted a 23-year-old young woman to my tele/stepdown unit, after she overdosed on Tylenol. We estimate that she took 15 to 20 grams in one go. The max dose is 1 gram at a time, and 4 grams in 24 hours. She was having a fight with her boyfriend, and he didn't want to listen. She had been drinking, and went into the bathroom. She took half a bottle of Tylenol before her boyfriend could stop her. She wouldn't go to the hospital, but finally did 36 hours later, when she started feeling poorly.

Now Tylenol is what is called hepatotoxic, or poisonous to the liver. The liver is the main chemical plant for the body. So when you shock it with this much Tylenol, it stops working properly, is damaged, and is sometimes destroyed, leading to death. Her main advantage was her youth. She wasn't going to die..........YET.

In the ER, she was having some seizure activity and loss of consciousness. She was given the antidote for Tylenol, but the damage was done. Her liver enzymes went through the roof. Unfortunately, so did her renal (kidney) enzymes. She ended up in ICU for a week, and was in hospital for 3 to 4 weeks. Her liver enzymes came down, but there is still damage. Her kidneys never recovered. She is now on dialysis.

If she came to hospital ASAP, she would have been given the antidote then, and probably only received minor damage, and probably not be on dialysis now.

This young woman took Tylenol to get attention. Bad Idea. She crippled herself, and WILL die young. Even though we saved her life now. Even if you don't die, you have to live with the consequences.

If anyone is thinking of suicide, if you are reading this now, you are near friends. There is always someone you can talk to, or if you want it more anonymous, via Internet - http://suicidehotlines.com/national.html or call 1800-784-2433 for a national help line. You Are Not Alone. And a boy/girl is not worth your life. Talk to someone, get some help.

If you find someone who took pills, dial 911 ASAP. Don't let them stop you by saying they are fine. If they were fine, they wouldn't be taking pills. And the faster you get them to hospital, the less damage will be done.

Last thing, she was pregnant at the time, unknown to her. She lost the baby. So, by taking all those pills, it might not only be yourself you are hurting.

[scattycarrot, BSN, RN]

I agree with Ukstudent. Not everyone who overdoses is looking to die. An OD is often an action based on an impulse decision and doesn't usually have any forward planning. Most people have Tylenol in their homes and that is why its often the drug of choice for impulse OD's. This impulse may result from an argument or altercation and the individual may just be letting out a cry for help or wanting attention. This is especailly true of teenage girls. Yes, people taken OD's are intentionally putting themselves at risk by OD'ing, but they don't often appreciate the consequences of their actions and fail to grasp that Tyenol can kill and kill quickly. These individuals wouldn't put a gun to their head or jump in front of a train, as they understand that that will kill you but they will take the top if a bottle of OTC drugs as they can't be that bad, right? Why should the layperson understand that Tyelnol is dangerous? No-one educates them about this so its easy for them to presume that, while they made feel and get sick, they won't die from taking a whole bottle. I have looked after numerous patients who were stunned and scared silly by the fact that they actually made a good effort at taking their life. Its easy for us RN's to look aghast because people don't know that taken too many Tylenol can kill you but people don't know this and what they think is just a cry for help turns into something alot more serious.

I have looked after a young guy, in his 20's, who had an argument with his girlfriend, took over 70 Tylenol tablets, felt a bit unwell but nothing serious and it wasn;t till a day later that he started to have severe RUQ pain and hemaetemisis. He came into the ER, had deranged LFTs and Clotting and the last I saw of him, he was being shipped off to a specialist liver unit with poor odds of survival. Now, he had no idea that the meds he took were dangerous (inconceivable that he thought that but he did!)and was just wanting to hurt his girlfriend. Thats why he didn't seek medical help until he had sypmtons, by which time it was too late.

I just think that those people who really want to kill themselves will but they often do it by forward planning and they aren't the ones that we would reach by education. They don't care if the Tyelnol is dangerous, thats what they want! Its the group of people who OD who don't want to kill themselves that we need to reach and also those people who don't know that you can accidently overdose on it. There needs to be awareness that Tylenol can be a vey dangerous drug. And yes, any drug is unsafe if taken incorrecty but Tylenol is particularly so and having watch patients die from acetomenophen OD's, I know that its a horribly slow death.

I don't think anyone here is saying that it should be banned but there should be an awareness that it isn't a case of 'i am going to throw this bottle down my throat and I will be ok tomorrow'. I agree that suicide prevention is key but as i said previoulsy, alot of these individuals aren't looking to commit suicide. And the argument that its not that Tylenol is unsafe, its suicide thats unsafe makes me think of the..'its not guns that kill people' argument. Yes, Tylenol is safe in safe hands but when its the hands of individuals who are unstable and uneducated about the drugs effects, than it becomes a lethal weapon.

[GregRN]

The point is the same though. Even if educated that Tylenol will hurt, then the person will take enough to hurt. Tylenol is safe. Trying to kill or hurt yourself is what isn't safe. That's where the focus should be. I'll advocate the spending of money to reach out to those who are hurting and need help in order to reach them before they try to hurt themselves. However, I won't be a fan of spending money on talking about how unsafe Tylenol is. The focus should be on the root issue.

[scattycarrot, BSN, RN]

But how do you reach out to people who have no history of depression or history of psych problems, but respond to a negative situation in their lives by reaching for a bottle of tablets and is a reaction which is totally out of character and totally unforeseen? I do appreciate that even if they are educated that Tylenol will hurt, that won't necessarily stop them from OD'ing but I know from personal experience that patients who have taken an OD and are then educated about the dangers of Tylenol are surprised by the info and shocked. If we can give that info before they throw the tablets down their throat than that surely can't be a bad thing. We warn people about the dangers of alcohol and they still drink but that shouldn't and doesn't stop us from providing info and educating them. And even if such awareness only enlightens someone not to keep dosing up on Tylenol every 2 hours or giving their child too many preperations with Tylenol in it, than surely it is a good thing?

[nialloh, RN]

I hate to play the role of Captain Obvious but it's not Tylenol that's unsafe in this story, it's suicide that's unsafe. She didn't mistakenly take half a bottle of Tylenol because she thought it was safe and would be an effective way to treat her whopper of a headache. She took half a bottle of Tylenol to end her life. If you take half a bottle of any medication it's likely going to give you a pretty good head start on meeting that goal.

Sorry, but these kinds of arguments drive me nuts in nursing. Are we supposed to now say that Tylenol is unsafe and should be banned? Are we to say that the patient who took the pills had no idea that they would make her sick or even end her life because they were OTC drugs and are perfectly safe? Are we to say that an education campaign on the harmful effects of OD'ing on Tylenol would have prevented this from happening? This is a story about a suicide attempt, not a story about how unsafe Tylenol is. Putting the focus on anything different does not make progress in solving the problem or getting the appropriate help for people. Change the title of the thread to "Suicide...how can we reach people to get them the help they need" and then I'll be on board.

My original post wasn't really for people who were trying to kill themselves. It was more aimed at people who thought they could get attention for themselves by OD"ing on a "SAFE" drug. I wanted them to know that if they lived, they would have crippled their body. If they get the message about Tylenol, with luck, it might cross over to other med's as well.

People who are really trying to kill themselves don't need my post to know how to do it. OD'ing on anything can kill.