OK, my friends this may help or may make you more confused. It is a topic I've been working on for a mother's magazine. I put some of my comments in red below. It may take up the whole page... Here is some of my research:
There are several studies in children that have said alternating acetaminophen and ibuprophen works best over a 3 day period for fever. BUT, the studies were done with 12.5mg of acetaminophen 6 hours and ibuprophen 5 mg. over an 8 hour period. This study was done on only 500 children.
So, doctors who do not study the details of the studies began a few years ago recommending this treatment. Parents went home and gave their children full doses in shorter time periods the childrens dosage is 160 mg, adults range from 200-500 and infant is 80mg per .8 ml. Both companies have issued warning after warning telling people not to do this practice. Also, the poison control offices have issued warnings that it is not safe to mix NSAIDS.
So, now there are dozens of studies to test the toxicity of the both drugs separately and together on the liver due to the high level of overdose and poisonings happening. That is why there is a huge campaign to ban all of these meds for kids under 12. Now, they may change the exact usage labeling and in small dosages over longer time periods it may turn out to have no affect on the liver. But while they are still studying this it is safer to not end up in the hospital waiting for a liver transplant.
The interesting thing is that when you start polling doctors in various specialties, they do not all agree about anything. The dosage, the practice, the time etc. Now that is the scariest part about the whole controversy.
Heres the trick: the liver doesnt fully develop until after the age of 23 years old (thats why we dont drink alcohol until 21.) All drugs have to metabolize through the liver.
Heres an older wiki-answers listing.
According to doctors and the poison control center, alternating between ibuprofen (advil, motrin) and acetaminophen (tylenol) is safe in adults, and relatively safe in children. Most doctors and nurse practitioners recommend this practice usually only when a child is fighting a severe fever and is not responding to just one or the other of these OTC medications.
The independent dosage amount and timing guidelines still prevail, so read labels carefully. It is recommended that you keep track on paper the time and type (ibuprofen vs. acetaminophen) of dosages you are giving a child to avoid accidentally exceeding the recommended dosage by repeating the same medication as opposed to alternating between the two.
Notice there are no dates showing when this was answered? It could be new information or outdated information. There is no reference information.
But when you start looking at the following discussions you find other answers:
Don't believe either of us. Research it yourself at
www. Tylenol.com or
www.About.com
Tylenol is acetaminophen. Excess use of acetaminophen causes liver damage and failure.
A lot of people take too much acetaminophen because they don't realize it's in
cough syrup
cold aids
prescription pain relievers
Use of Tylenol with other pain relievers such as
aspirin,
ibuprofenAdvil, Motrin
naproxen sodiumAleve
ketoprofen
prescription pain relievers
is not recommended, unless directed by your doctor.
Parents should be cautious when giving acetaminophen to children. For example, the infant drop formula is three times more concentrated than the children's suspension. It's important to read drug labels every time you use a drug and to make sure that your child is getting the children's formula and your infant is getting the infants' formula.
Tylenol should not be taken with alcohol. Alcohol increases its toxicity.
Please go to my message board. There is an email from Tylenol there. Better yet, research it yourself.
Prevention specialist are recommending dont do it unless you are very careful about the dosage, age of patient, and timing because this is ongoing science.
The hard part is: what do we do when our child is in pain? But we dont want to make a bad situation worse?
Heres a little more information:
Definition
Acetaminophen overdose is one of the most common poisonings worldwide. People often think that acetaminophen, a pain-relieving medicine, is extremely safe. However, it may be deadly if taken in large doses.
Symptoms
Abdominal pain
Appetite loss
Coma
Convulsions
Diarrhea
Irritability
Nausea
Sweating
Upset stomach
Vomiting
Note: Symptoms may not occur until 12 or more hours after the acetaminophen was swallowed.
It is available over the counter without prescription, has few side effects, and reacts with very few medications.[citation needed] However, it can cause liver, kidney, other organ damage, and have fatal interactions with alcohol and other substances, even in the recommended dosages.[1] The brand is owned by McNeil Consumer Healthcare[2].
Acetaminophen causes three times as many cases of liver failure as all other drugs combined,[7] and is the most common cause of acute liver failure in the United States,[6] [8] accounting for 39% of cases. While it occurs through overdosing[5], even recommended doses especially combined with even small amounts of alcohol, have caused irreversible liver failure[9] [10]
Acetaminophen is metabolized in the liver, resulting in a by-product, N-acetyl-p-benzoquinone imine (NAPQI), that can damage liver cells, but is typically converted into a harmless substance by an antioxidant glutathione. However, large doses of acetaminophen overwhelms the body's supply of glutathione, resulting in destruction of the liver cells. [11]
People who have the highest risk for Acetaminophen related kidney failure include: heavy drinkers (three or more drinks per day), elderly men, and persons with pre-existing liver or kidney damage.[12] In infants and small children, studies have indicated that the toxic dose is less than twice the recommended dose.[13].
A study published by the Journal of the American Medical Association in 2006 suggests problems even in healthy people taking the pain reliever as directed.[14] Healthy adults taking maximum doses of Tylenol for two weeks had abnormal liver test results. Dr. Neil Kaplowitz of the University of Southern California, co-author of the study, said, "I would urge the public not to exceed four grams a day. This is a drug that has a rather narrow safety window..."[15]
According to a preliminary study conducted by the University of Washington, mixing acetaminophen and caffeine may cause liver damage, especially in heavy caffeine drinkers. Researchers discovered that caffeine can triple the amount of, N-acetyl-p-benzoquinone imine (NAPQI), the dangerous by product which destroys liver cells. [16]. This reaction can also be casused by large doses of painkillers that combine caffeine and acetaminophen (e.g., Anacin, Excedrin & Midol). These products are often used to treat migraines and menstrual discomfort. Dr. Sid Nelson, a professor of medicinal chemistry at the University of Washington said, "Caffeine can interact with an enzyme that can form a toxic metabolite of acetaminophen in such a way that it increases the formation of that toxic metabolite," [17]
Symptoms from an overdose of acetaminophen typically appear after 24 hours, or in some cases up to 48 hours; however, getting immediate treatment prior to symptoms occurring, can greatly improve the outcome. The antidote to acetaminophen overdose, N-acetylcysteine (NAC), is most effective when taken within eight-hours of an overdose.[18] Due to the delayed symptoms and the importance of immediate treatment, overdoses of acetaminophen kill about 12% of those who seek treatment.[9] Typical symptoms range from nausea and malaise to extreme upper abdominal pain in the region of the liver.
Tylenol is only one among many popular medications containing acetaminophen, but few users realize that it is contained in hundreds of other pain relievers and cold remedies, and that combined usage has a cummulative effect. Fifteen percent of accidental overdoses involve the simultaneous use of more than one product containing acetaminophen.[19] Products from common brands include acetaminophen: Excedrin, Midol, Theraflu, Alka-Seltzer and NyQuil, as well as prescription narcotics such as Vicodin and Percocet. Following the recommended dosages for each, but in combination can far exceed safe limits for acetaminophen intake.[20] The manufacturers of Tylenol recommend, "You should not take two or more products that contain acetaminophen at the same time." [21]
Just like it to be in a LODGE as opposed to the tiny house we grew up in. Hmmmmmm....a lodge not unlike WILDNERNESS lodge at WDW. Ian, can we pretend on day when we are there that it is snowing outside?
- way to go!! Loved all the pics - what an amazing young man (& my buddy)
we'll see you in March
