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February 3, 2012
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Acetaminophen (Tylenol) Poisoning

Medical Author:
Michael J Ameres, MD
Coauthor:
Daniel Crough, MD
Medical Editor:
Charles Patrick Davis, MD, PhD
Charles Patrick Davis, MD, PhD
Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

View Full Profile

Drug-Induced Liver Disease

Drug-induced liver diseases are diseases of the liver that are caused by physician-prescribed medications, over-the-counter medications, vitamins, hormones, herbs, illicit ("recreational") drugs, and environmental toxins.

Many drugs can cause liver diseases. Examples include pain-relievers such as acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs), certain antibiotics, antidepressants, anti-cancer agents, and drugs used in controlling high blood pressure, high cholesterol , diabetes, and irregular heart rhythms.

Drug-induced liver diseases vary widely in severity. The spectrum of diseases include 1) abnormal blood levels of liver enzymes without symptoms, 2) hepatitis (inflammation of liver cells), 3) necrosis (death of liver cells), 4) steatosis (accumulation of fat in the liver), 5) cirrhosis (advanced scarring of the liver), 6) fulminant hepatitis (severe, life-threatening liver failure), and 7) blood clots of the veins within the liver.

Patients with mild drug induced liver disease may have few or no symptoms or signs. Patients with more serious disease (such as hepatitis and necrosis) develop symptoms and signs such as fatigue, weakness, vague abdominal pain, loss of appetite, yellowing of the skin or jaundice due to the accumulation of bilirubin in the blood, itching, and easy bruising due to decreased production of blood clotting factors by the diseased liver. Patients with advanced cirrhosis can develop fluid accumulation in the legs (edema) and abdomen (ascites), mental confusion or coma, kidney failure, vulnerability to bacterial infections, and gastrointestinal bleeding.

SOURCE:
MedTerms.com. Drug-induced liver disease.

Read the rest of the drug-induced liver disease definition »

Acetaminophen (Tylenol) Poisoning Overview

Acetaminophen is one of the most common medications found in households. It is used for the treatment of pain and to lower fever. However, the drug manufacturer has recalled preparations of Tylenol this year (2011) due to problems in its manufacturing process and as a result, many stores in the US have no Tylenol available (Nov., 2011). In addition, the new recommended maximum dose per day is being dropped from 4000 mg to 3000 mg because of people taking other medications that have acetaminophen as an added compound. Inadvertently, people taking maximum Tylenol doses were overdosing because they were also taking other medicines at the same time that contained acetaminophen. Tylenol plans to have these new recommended lower doses listed on their products by about January of 2012.

Over many years, it has been used countless times by many people and it has proven to be a safe and effective medication. However, if taken in excess amounts (overdose, whether on purpose or by accident), acetaminophen can cause life-threatening illness.

  • Acetaminophen is the active ingredient in Tylenol. It is also found in many other over-the-counter medications people can buy at the drug store and in many prescription drugs as follows:
    • Common drugs include Actifed, Alka-Seltzer Plus, Benadryl, Butalbital, Co-Gesic, Contac, Darvocet, Excedrin, Fioricet, Lortab, Midrin, Norco, Percocet, Robitussin, Sedapap, Sinutab, Sudafed, TheraFlu, Unisom With Pain, Vick's Nyquil and DayQuil, Vicodin, Wygesic, and Zydone (and others).
  • Acetaminophen in overdose can seriously damage the liver. If the damage is severe, a liver transplant may be necessary in order to save a life.
    • The antidote to acetaminophen overdose is N-acetylcysteine (NAC). It is most effective when given within 8 hours of ingesting acetaminophen. Indeed, NAC can prevent liver failure if given early enough. For this reason, it is absolutely necessary that acetaminophen poisoning be recognized, diagnosed, and treated as early as possible.

Acetaminophen (Tylenol) Poisoning Causes

Illness from acetaminophen overdose is caused primarily by liver damage.

  • Acetaminophen is primarily metabolized by the liver. Too much acetaminophen can overwhelm the way the liver normally functions.
  • If the liver is already damaged because of infection, alcohol abuse, or other illness, a person may be more susceptible to damage from acetaminophen overdose. For this reason, people with liver illnesses or people who chronically consume large amounts of alcohol should be particularly careful when taking acetaminophen and should consult their doctor prior to taking acetaminophen compounds. The US Food and Drug Administration (FDA) currently recommends that anyone consuming more than three alcoholic beverages per day should not take acetaminophen or other over-the-counter pain medications.
  • Long-term use of acetaminophen in recommended doses has not been shown to be harmful to the liver, even when combined with moderate (about one alcoholic beverage per day) alcohol consumption.

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Acetaminophen (Tylenol) Poisoning - Symptoms

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What symptoms did you experience with acetaminophen poisoning?

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Acetaminophen Poisoning (Tylenol)

Alcoholism »

Alcoholism Overview

Alcohol problems vary in severity from mild to life threatening and affect the individual, the person's family, and society in numerous adverse ways. Despite all of the focus on drugs such as cocaine, alcohol remains the number one drug problem in the United States. According to community surveys, over 13% of adults in the United States will experience alcohol abuse or dependence (also referred to as alcoholism) at some point in their lives.

Withdrawal, for those physically dependent on alcohol, is much more dangerous than withdrawal from heroin or other narcotic drugs.

  • Alcohol abuse refers to excessive or problematic use with one or more of the following:

    • Failure to fulfill major obligations at work, school, or home

    • Recurrent use in situations where it is hazardous (such as driving a car or operating machinery)

    • Legal problems

    • Contin...


Read the Alcoholism article »


Read What Your Physician is Reading on Medscape

Toxicity, Acetaminophen »

Acetaminophen is the most widely used pharmaceutical analgesic and antipyretic agent in the United States and the world; it is contained in more than 100 products.

Read More on Medscape Reference »

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