over the counter overdose

Saturday, August 14, 2010

The news seems to be filled with celebrities who become overdose victims. Usually, it’s an accidental poisoning but sometimes it’s because of an intentional ingestion. While alcohol remains the most commonly misused drug and prescription pain medications like Vicodin and Oxycontin make headlines, it is the over-the-counter medications that are forgotten as perhaps most dangerous. The two that don’t get any respect are aspirin (salicylic acid) and Tylenol (acetaminophen).

Aspirin is perhaps nature’s most versatile drug. It’s a pain killer, an anti-inflammatory, controls fever and prevents blood clots. It’s available almost for free; generic aspirin sells for a penny a pill. It seems to be in every medicine cabinet and is there for the taking in an impulsive moment or when thoughts of self harm are overwhelming. Too much aspirin affects almost all the organs in the body. Commonly, it causes ringing in the ears, nausea and vomiting, changes in the acid-base balance in the body, pulmonary edema (fluid buildup in the lungs) and kidney failure. Most other organ systems in the body from the brain to the heart, liver and skin can be involved.

Making the diagnosis is easy if victims volunteer that they overdosed on the drug, otherwise it make take detective work looking at blood tests to make the diagnosis. Like most overdoses, treatment is supportive, making certain that basic body functions like breathing, heartbeat and circulation are maintained, but in significant overdoses, early dialysis may be needed to get rid of the drug from the body.

Tylenol is a nastier drug overdose. The drug is included in Many combination over the counter cold medications, as a stand-alone medication and comes in many user friendly forms (liquid, chewable, tablet, capsule, gelcap…are there more?) The bad news about Tylenol overdose is that there are no symptoms right away. Instead, the damage happens days later, causing the liver to fail. Once that happens, there are few long term treatment options other than liver transplant.

The good news is that Tylenol OD has an antidote, if given in time. Actually, it’s not an antidote in the true sense of the word. Tylenol gets metabolized by the liver into chemicals that causes liver cell death. A medication called mucomyst makes the liver deal with it and leaves the un-metabolized Tylenol hanging in the blood stream and lets the kidneys remove it from the body. The treatment needs to start immediately and can be given by mouth or intravenously.

Accidental overdoses happen and prevention is perhaps the most important treatment. Labels of over-the-counter medicines may not make exciting reading but the fine print will tell people what they might be putting in their body. Adding a cold medication to routine Tylenol and topping it off with a prescription pain killer like Vicodin or Lortab may be just too much Tylenol.

And when it comes to intentional drug overdose, medical treatment needs to happen side by side with psychiatric help and counseling. Perhaps one of the most important things we learn from celebrities is that even those who seemingly have everything do not live utopian lives and need help to cope with
the real world.

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