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.

[pagandeva2000, LPN]

Can someone explain just HOW Mucomyst is the antidote of Tylenol...I mean, I was reading about the drug, and trying to figure out how this happens. Thanks!

[ktwlpn, LPN]

I think tylenol is very dangerous. There should be a public education campaign, but probably the companies would complain. I've taken care of tylenol OD young people too, and it's alway the same: they broke up with their boyfriend or girlfriend, then they OD on tylenol, everyone comes visits them, they get lots of attention, they think they are fine, not understanding that they just got themselves on a transplant list...

---As another poster said one can OD on water-remember the woman that killed her child with salt a year or so ago? Where does the FDA's responsibility to the public stop?How does personal accountability factor in? There are ample warnings on the labels of every OTC med I've got in the house right now-if I choose not to heed them because I want to harm myself or make a cry for help it is not anyone else's fault but my own.

[Noryn]

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.

do you have any research or evidence to back this up? generally the thing considered most important is time frame they arrive to the er. when given within 8 hours of the exposure it is extremely effective. once the damage has started though its effectiveness decreases quite a bit.

[Noryn]

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.

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

With Ibuprofen you will likely not see significant liver damage, it may cause some elevation in liver enzymes but in extremely large amounts you can develop renal damage.

[NoWhereNear]

I've always wondered why the potential long-term effects of surviving a suicide attempt aren't covered more thoroughly in suicide-prevention materials/classes. A lot of people (especially teenagers) tend to think that if it works, they're dead, and if it doesn't they'll be fine.

I consider the idea that I could live through an attempt and come out the other end disfigured, brain-damaged, on dialysis, blind or god-only-knows what else to be a good deterrent. I think if people were presented with a list that describes what can go wrong with each of the more common methods it might give some people pause.

There's a book called Suicide: Methods and Consequences by Geo Stone that does some of this, though not for the purpose of preventing suicide (quite the contrary, actually) but between reading that and meeting a man who was blind after a failed attempt, I can say with absolute certainty that I will be the last person you ever see trying to off myself.

[mariaroma]

that's a tragic story but i salute you for sharing info like that it can help the people who are trying to kill themselves...

[Fuzzy]

Another point that human medical people sometimes don't understand is that many of these OTC meds are toxic to animals. We see our share of cats and dogs given tylenol, aspirin, and othe NSAIDs by their well meaning owners. Some of these unfortunate pets end up very dead or very sick because of these actions. Cats particularly don't metabolize these drugs very well at all. We have seen anemia, liver failure, kidney failure, and seizures along with GI disorders, heart problems and other weird problems when pets are given these medications. Like in people, it's hard to turn these animals around. Not to mention liver and kidney transplants are not routinely done in pets unless the owner has $$$$$. So please, please, please ask your veterinarian before giving any OTC drugs (not just NSAIDs) to your pet.

Fuzzy

[Noryn]

Can someone explain just HOW Mucomyst is the antidote of Tylenol...I mean, I was reading about the drug, and trying to figure out how this happens. Thanks!

I am playing with wording here but technically "Acetaminophen" is not hepatotoxic. For the most part after you overdose on it your peak level will happen within 4 hours but your symptoms of liver damage wont start showing up usually for about 24-48 hours. Because again the parent compound "Acetaminophen" is not toxic to your liver, when your body starts to break it down then there is a hepatotoxic metabolite that is formed. Normally you have an enzyme that binds to this toxic metabolite but when you overdose there is just too much of the metabolite. Mucomyst prevents this metabolite from damaging the liver.

[nghtfltguy, BSN, RN]

No drug is perfectly safe. you can OD on Benadryl, vitamins, you name it. You can even OD on water.

very well said craig~

tylenol.... *apap* is perfectly safe if taken as directed...

if it weren't then it would not be the main thing in vicodin, percocet,norco, and many other narcs....

it is damaging to the liver if taken in abundance..but so are a lot of other things...

lol craig~... i had a water intoxication pt. last week!!!

good times~

uber iv lasix is what he got!!!

and a foley to boot!~

almost shot his kidneys......

[P_RN, ADN, RN]

Oh my what was his K+ by the time you got him?

[GregRN]

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.

[ukstudent]

I both agree and disagree with you GregRN. The problem with teenage Tylenol OD's, is that most of them are NOT trying to commit suicide. They are trying to make people take notice of them and are very surprised when they find out that they could die a slow and painful death. It is more of a "see what you made me do, now you have to listen to me" type of thing. As a real way to commit suicide, Tylenol is not a good choice of drug. There are much better ones around.