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.

[ukstudent]

her main advantage was her youth. she wasn't going to die..........yet.

this makes it seem that young people can't die immediatelyfrom tylenol, they can and do.

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.

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.

mucomyst can reduce the continued damage to the liver but it is not an a fail safe antidote. to tell people that there is an antidote might make some stupid teenager think it will be "safe to take" as they can then tell someone what they took, go to the er and get the "antidote". take enough tylenol and no amount of mucomyst is going to help them.

[longjourneydream]

i wonder what could be done to educate the public more about this issue - tylenol specific, but all medication in general - that would be something wonderful to see! :)

in my opinion no drug is safe; if not taken as directed.

i was hearing that tylenol is or was at one time, very popular with teens when it comes to drug of choice for suicide.

it can be one of the most slow and painful deaths.

what a shame...

[madwife2002, BSN, RN]

In the UK there have been so many deaths from over taking tylenol that it does carry a government warning and there are attempts to educate. A lot of people are unaware especially when they are taking OTC cold remides that they contain tylenol and therefore take the cough medicine, the decongestants, flu and cold remides and then take tylenol on top-thus causing an OD. Many pts have done this in the UK and then presnted to the ER with severe liver problems.

Televison adverts warn about the excessive use of tylenol known as Paracetamol in the UK.

I now live and work overhere and sometimes worry about RN's laxidasical attitude towards tylenol because I aggree with the OP not enough is done to educate. I was recently looking after a staff member who was taking percocet and vicoden every three hours alternatly and i said you need to be very careful you are going to overdose on the tylenol, she hadnt even considered that and neither has the previous RN's who had been looking after her!!!

[santhony44, MSN, RN, NP]

I educate people every chance I get; I'm in family practice. It's amazing how many people have no idea that they can OD on Tylenol!! Or that taking Tylenol is not a good idea if you're a heavy drinker.

I've also run across several that don't understand the concept that the same ingredient is present in more than one medication (guess what, Tylenol PM has the same thing in it that regular Tylenol does!!). When I have the medication right there, I point out the generic ingredient name and remind them to read the label before they buy anything.

I try to be especially vigilant about this with parents of babies and small children. So many are so fever-phobic that they may be in danger of OD-ing the kid on Tylenol because they're worried about the fever of 102. I don't advise the use of alternating of Tylenol and Motrin largely because I'm afraid they'll forget which one was given last and OD the kid.

As others have said, absolutely nothing is safe if not used correctly, and you have the occasional bad outcome even with correct use.

[CyndieRN2007]

Yes Susan,

Many heavy drinkers are not aware of the risk of taking tylenol. I advise someone about this everyday......"Wow, I didnt know I shouldnt take tylenol for a hang over after I drank a 30 pack the night before....." LOL

[graceomalleyRN, RN]

I learned this in the 1st grade (and I'm 41 now). That you could OD even on aspirin. This was in the early 70's and I thank my school district for giving us this information early.

I have a personal experience too. This may be a bit too self-revelatory, but here goes.

When my DSD was 15 1/2, I found a 19 year old from her YOUTH GROUP in her bedroom. At 4:45 a.m. She had been undressed. We kicked the young man out on his ear, and as my husband and I stood there in shock, too stunned to even yell or speak, my DSD marched straight to the bathroom and downed a bottle of Ibuprofen. I found it especially cruel and manipulative, as her own mother had committed suicide when she was young and this had been devastating to her father.

She spent the next few hours having her stomach pumped, some sort of charcoal solution, etc. We had to watch her endure this which was heart-wrenching. She was then Baker-acted to a facility in the Tampa area, where she spent the next 48 hours contemplating her actions. The doctors believed she escaped liver damage before she left the ED.

I should say that she was an AP student who always was in the 99th percentile on all standardized tests across the board. She's struggled for years but is now almost 21 and, while she still has problems, is overcoming them and is a junior in college. I'm so proud of her, and I can't wait to see her when she comes home in 11 days.

I add this about her intelligence because I am not sure whether or not knowing the possible side effects would permeate that innate teenage sense of invincibility. Sometimes their emotions get ahead of them whether we like it or not. It could NOT hurt though to discuss the side effects of these medications.

Moral: virtually any substance which is safe for "use as directed" can be used to OD on, as my DSD learned the hard way.

[nialloh, RN]

mucomyst can reduce the continued damage to the liver but it is not an a fail safe antidote. to tell people that there is an antidote might make some stupid teenager think it will be "safe to take" as they can then tell someone what they took, go to the er and get the "antidote". take enough tylenol and no amount of mucomyst is going to help them.

acetadote is the antidote, mucomyst also protects the kidneys which are also hit.

as to my point of not dying yet, i ment that she had a little time for treatment, but without it, she would die.

[ukstudent]

Acetadote and Mucomyst are both trade names for acetylcysteine. Acetylcysteine can be given via inhalation, oral and iv.

[nialloh, RN]

Acetadote and Mucomyst are both trade names for acetylcysteine. Acetylcysteine can be given via inhalation, oral and iv.

Oops, I stand corrected. As they say, it is always a good to close your mouth before foot is inserted. :)

[EricJRN, MSN, RN]

While I'm all for educating young people about the dangers of drugs, I'm not sure in this specific case whether education about meds would have made a difference. Rather than a case where someone took a few too many Tylenol for a headache or maybe took a few while drinking, this seems like a clearly intentional OD (15,000-20,000 mg). The child took the Tylenol, it seems, precisely because of an understanding that it was dangerous.

To prevent this particular situation, education about resources for depression and suicide prevention would likely be the more effective intervention. It can awkward discussing "the S word" with children and adolescents, and talking to them about medication dangers may seem easier, but I think it misses the root of the problem here.

[nialloh, RN]

I don't think this girl was trying to kill herself. I think she did it because she was mad at her boyfriend, and wanted to scare him. She just didn't realize the damage that Tylenol can do. Even with the liver damage, they were still having a hard time believing it.

[pagandeva2000, LPN]

This is good to know. It reminded me to take more time to explain to patients that come to my clinic the risks of ODing on tylenol. Thank you very much!