Liver Failure from Acetaminophen Overdose and Toxicity

Some of the nation’s top researchers – including the National Institute of Health (NIH) and the Center for Disease Control (CDC) – have concluded that acetaminophen toxicity is the leading cause of acute liver failure in the United States. In fact, some estimate that up to 40 percent of liver failure cases are directly linked to acetaminophen, a commonly used drug. A popular remedy for aches, pains, fever, swelling, and symptoms of the common cold and influenza, acetaminophen is found in more than 600 over-the-counter brand-name and generic drugs, such as NyQuil, Aspirin-free Excedrin, Bayer Select Maximum-Strength Headache Relief Formula, St. Joseph Aspirin-Free Fever Reducer for Children, and all varieties of Tylenol.

When used appropriately and in small doses, acetaminophen is considered extremely safe. But problems arise when medications containing acetaminophen are taken by moderate to heavy drinkers, consumed in large doses, or used by people who are not eating enough, whether because of illness (such as the stomach flu) or fasting practices. Taking acetaminophen under such conditions can quickly lead to an extremely dangerous condition called acetaminophen toxicity.

Essentially, acetaminophen toxicity is the poisoning of the liver. It occurs when the body cannot process acetaminophen quickly enough, resulting in dangerous depletion of the level of glutathione in the liver. In many cases, this breakdown leads to liver damage, then liver failure or malfunction, and ultimately, death. Acetaminophen toxicity, which kills about 100 people a year and resulted in 56,000 emergency room visits last year alone, need not develop over a long period of time, either. Just taking the drug in high doses during a weekend of binge drinking or while fasting during a weeklong battle with the flu can cause a lethal acetaminophen overdose. In other cases, taking the maximum recommended dose of acetaminophen for an extended period of time can cause acetaminophen toxicity.

Symptoms of acetaminophen overdose and/or toxicity include nausea, vomiting, and abdominal pain, all of which can easily be mistaken as signs of other illnesses. An exclusive minority may also exhibit signs of chronic liver disease, which include gynecomastia, parathyroid enlargement, testicular atrophy, and spider nevi. If you experience any of these problems and have taken Tylenol or any other drug that contains acetaminophen, it is imperative that you contact a medical professional immediately for an evaluation before permanent liver damage or failure occurs.

If you suspect a loved one has been affected by acetaminophen toxicity or an acetaminophen overdose, contact our firm for legal representation. We can help victims of acetaminophen related liver damage or liver failure receive just compensation for their injuries.

Treating Acetaminophen Toxicity

The drug acetylcysteine is used to treat most cases of acetaminophen overdose that is unrelated to alcohol. Typically, acetylcysteine is administered repeatedly (every four hours) in measured doses (70 mg/kg) through a nasogastric tube for a period of 17 hours, with an initial dose of 140 mg/kg kicking off the cycle. In some cases of acetaminophen toxicity, acetylcysteine is administered intravenously. Many medical professionals are also experimenting with herbal remedies, although the Food and Drug Administration have approved none.

Many people mistakenly believe that the primary cause of liver failure is alcohol abuse. However, experts have concluded that while heavy drinking can cause extensive liver damage and chronic liver failure (liver failure that gradually develops), acetaminophen toxicity (poisoning) is in fact the culprit in an estimated 38 percent of cases of acute liver failure (rapid, unexpected deterioration of the liver). Other sources claim it is responsible in more than 70 percent of cases. However, researchers do agree on one thing: acetaminophen, when not used precisely as directed, is dangerous, and the word needs to get out.

Existing warning labels are not enough. Currently, the FDA requires that every bottle of Tylenol and other drugs that contain acetaminophen wear a label that reads,

“If you consume 3 or more alcoholic drinks every day, ask your doctor whether you should take acetaminophen or other pain relievers/fever reducers. Acetaminophen may cause liver damage.”

Clearly, this label is insufficient. It does not inform users of the dangers of using acetaminophen in high doses, for a prolonged period of time, or in dangerous combinations. Although the FDA is making strides in improving these labels – earlier this year, it proposed that the warning be changed to “the risk of liver damage increases if you have three or more alcoholic drinks while using acetaminophen.” However, until people begin to understand the serious risks involved with taking this drug, acetaminophen will remain an inherent danger.

If your loved one has suffered from acetaminophen overdose, prolonged acetaminophen toxicity, or liver failure contact our firm for legal representation today!

Childers Buck & Schlueter
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Tylenol (Acetaminophen) and Alcohol Deadly Mix

Excessive use of the pain reliever acetaminophen may lead to liver failure and death, especially in alcoholics. Rates of coma and death were highest in those admitted to a Dallas emergency room with accidental — rather than suicidal — overdoses of the analgesic. A higher frequency of chronic alcohol abuse among the patients with accidental overdoses may be one explanation.

When acetaminophen is ingested at excessive amounts, toxins form which can lead to life-threatening liver damage. However, the liver normally secretes a toxin fighting compound called glutathione, which counteracts the poison. Chronic alcohol abuse over time causes “depletion of glutathione” — breaking down the body’s defense against even slight overdoses of acetaminophen. The researchers note that other victims of accidental overdose had been fasting while taking the drug. They speculate that starvation may lead to reduced liver glutathione levels, raising toxicity risks.

A spokesperson for McNeil Consumer Products Co., the makers of Tylenol, says Lee’s study “underscores the need for more consumer awareness, which we totally support. You’ve got to read and follow the dosing instructions.” Those label instructions include an “alcohol warning” which reads: “if you generally consume 3 or more alcohol-containing drinks per day, you should consult your physician for advice” on taking the pain reliever.

The New England Journal of Medicine (1997;337(16):1112-1117)

COMMENT: As mentioned in a previous newsletter this toxic liver reaction can be completely avoided if one were to take the supplement N-acetyl Cysteine or L-Glutlamine (usually about 500 mg one to three times per day). These amino acids are two of the rate-limiting components for the formation of glutathione. If one needs to take acetaminophen for any reason on a regular basis it would be wise to take these two supplements to limit liver damage. This study emphasized the importance of this recommendation if one also consumes alcohol on a regular basis. This is not an insignificant observation considering 10% of our popluation are addicted to alcohol.

I find it interesting that it is stated as fact, that Ivins was obsessed with the Kappa Kappa Gamma Sorority but there is scant evidence that this obsession existed at all. He may or may not have had a girlfriend or been rebuffed by a girl that was in that sorority in college in Cincinnati, he may or may not have been to a college campuses within the last 30 years where there may or may not have been a Kappa Kappa Gamma Sorority.

Who besides unnamed US officials, perhaps my mailman, Curveball, can definitively state that there is evidence that this obsession exists at all?

If that obsession even did exist what would it prove? The FBI states there is no evidence that he was in Princeton on the day the anthrax-laced letters were sent. What else is there around that mailbox could he or anyone be connected too.

Exactly where was Ivins the day the anthrax was mailed. Are there credit card receipts, did he get a parking ticket was he online that day what about his cell phone calls?

Did he fly to Princeton did he drive and get gas on the way there or back. If it’s a 195 mile trip almost 400 miles round trip he would have had too.

Lets answer these questions first!.

Who besides unnamed US officials even say that that there was a sorority fixation. Is this the Curveball connection? When you don’t have the evidence ruin the dead mans character. This has the stink of a planted story.

From the AP wire

The mailbox just off the campus of Princeton University where the letters were mailed sits about 100 yards away from where the college’s Kappa Kappa Gamma chapter stores its rush materials, initiation robes and other property. Sorority members do not live there, and the Kappa chapter at Princeton does not provide a house for the women.
Multiple U.S. officials told The Associated Press that Ivins was obsessed with Kappa Kappa Gamma, going back as far as his own college days at the University of Cincinnati when he apparently was rebuffed by a woman in the sorority. The officials all spoke on condition of anonymity because they were not authorized to discuss the case publicly.
There is nothing to indicate Ivins was focused on any one sorority member or other Princeton student, the officials said. Instead, officials said, Ivins’ e-mails and other documents detail his long-standing fixation on the organization.
An adviser to the Kappa Kappa Gamma chapter at Princeton, Katherine Breckinridge Graham, said Monday she was interviewed by FBI agents “over the last couple of years” about the case. She said she could not provide any details about the interview because she signed an FBI nondisclosure form.
However, Graham said there was nothing to indicate that any of the sorority members had anything to do with Ivins.
“Nothing odd went on,” said Graham, an attorney and Kappa alumna.
Kappa Kappa Gamma executive director Lauren Paitson, reached at the sorority’s headquarters in Columbus, Ohio, initially told an AP reporter Monday afternoon she would provide a comment shortly. She did not answer subsequent phone messages or e-mails seeking that response.

Lets start questioning the facts.

A new DNA test suggests that the strain of anthrax came from the warfare defense labs at Fort Detrick, Md., where Ivins worked at for 35 years. But we also know that there could have been dozens of scientists that may have had access to the Anthrax in question.

The FBI has also said there is evidence that there is no evidence that he was in Princeton the day one the anthrax filled envelops where mailed.
Lets take a closer look before we put this one to bed.

Is the case against Ivins more damning then the case was against Steven Jay Hatfill who remained “a person of interest” right up until the time they paid him $5.8 million for ruining his reputation and career? Had he not been so outspoken in declaring his innocence might he have been found dead by an apparent suicide?

According to his therapist Jean Duley we have allowed a homicidal maniac to work with anthrax for at least the past 7 years, as a United States government microbiologist and vaccinologist for 36 years and senior biodefense researcher at the United States Army Medical Research Institute of Infectious Diseases (USAMRIID) in Fort Detrick, Maryland for 18 years. This shows either extraordinary incompetence or very excellent planning.

According to the FBI’s own investigation Ivins the “client” who “has a history dating to his graduate days of homicidal threats, and actions.” Duley added that Ivins’s psychiatrist called him “homicidal, sociopathic with clear intentions,”

Duley added Ivins’ behavior had grown more alarming in recent weeks. On July 9, she said, Ivins showed up for a group session “extremely agitated, out of control,” and said he had bought a bulletproof vest and gun.

“He proceeded to describe to the group a very long and detailed homicidal plan . . . to kill his co-workers because he was about to be indicted on capital murder charges,” she said.

Duley said several psychiatrists who treated Ivins had diagnosed him as a “sociopathic, homicidal killer.” Through her therapy sessions, she added, “I also believe that to be true.”

If you want to commit the perfect crime, first find the perfect patsy. What better candidate could there be then Dr. Bruce Ivins? If you want to rule by fear what better way then an almost invisible poison that could be anywhere. Could this be only a part of a greater conspiracy? I leave it to you to ponder.