Friday, June 01, 2012

Millions risk overdosing on paracetamol by ignoring the recommended daily limit

I will never understand why paracetamol is so often promoted as safe.  Unless you are bleeding somewhere, aspirin is much safer

Millions of people are at risk of unintentionally overdosing on Britain's most popular painkiller, scientists have warned.  Nearly a quarter of adults taking paracetamol are misusing the drug by exceeding the recommended limit with a 24-hour period.

This can lead to accidental overdoses and acute liver damage, according to researchers at Northwestern University in Chicago, who have called for 'urgent attention' to address the problem.

Many users ignore the manufacturer's dosage instructions, while some, particularly the elderly, forget how many tablets they have taken.

Others fail to realise that they are taking various medications containing the active ingredient acetaminophen.

Doctors recommend a maximum daily dose of eight 500mg paracetamol tablets, to be taken no more than two at a time during each four-hour period.

One consequence of an overdose of acetaminophen causing liver failure is a potentially fatal build-up of fluid in the brain.

Lead researcher Dr Michael Wolf and his team looked at the prevalence and potential misuse of pain medication containing acetaminophen as well as the likelihood of overdosing.

They interviewed 500 adult patients receiving care at outpatient general medicine clinics in Atlanta, Georgia, and Chicago, Illinois, between September 2009 and March 2011.

Over half the patients reported some acetaminophen use and 19 per cent were 'heavy users', taking it every day, or at least a couple of times a week, during the previous six months.

The researchers tested whether these patients understood the recommended dosage and were able to self-administer over-the-counter acetaminophen appropriately.

They did this by testing if the patients could work out the proper dosing of a single pharmacy medication over a 24-hour period and then assessing the risk of their 'double-dipping', or simultaneously taking two acetaminophen-containing products, and thereby exceeding the recommended dose.

The scientists found that nearly a quarter of the participants were at risk of overdosing on pain medication using a single paracetamol product, by exceeding the 4g limit in a 24-hour period

Five per cent made serious errors by dosing out more than 6g. In addition, nearly half were at risk of overdosing by 'double-dipping' with two acetaminophen-containing products.

Dr Wolf said: 'Our findings suggest that many consumers do not recognise or differentiate the active ingredient in over-the-counter pain medicines, nor do they necessarily closely adhere to package or label instructions.

'Given the prevalence of the problem, risk of significant adverse effects, and lack of a learned intermediary - for instance, a physician to guide decision making and counsel consumers on proper use - we believe this to be a serious public health threat requiring urgent attention.'

The research is published online in the Journal of General Internal Medicine.


Dark chocolate can help heart-risk patients and cut diabetes (?)

People are too  pesky so this study was run on a "model"

Lovers of dark chocolate have known for some time that their favourite treat can help protect them against high blood pressure and cut the risk of diabetes.

But now scientists say that it can even benefit those who are already at high risk of heart attacks and strokes.

Although regular chocolate eating doesn’t work quite as well as drugs, the researchers say it has virtually no side effects and, perhaps not surprisingly ‘high rates of compliance’.

A team of researchers from universities in Melbourne, Australia, used a mathematical model to predict the effects and cost effectiveness of daily dark chocolate consumption in 2,013 individuals at high risk of heart disease over a decade.

They all had metabolic syndrome – a mix of problems including raised blood pressure, obesity, high fat levels in the blood and an inability to control blood sugar levels – but no history of heart disease or diabetes and they were not on blood pressure drugs.

Daily consumption of 100g of dark chocolate could potentially avert 70 non-fatal and 15 fatal cardiovascular events per 10,000 people treated over ten years, according to the study published on

This could be considered an effective intervention, said the researchers. It would be cost-effective too, costing £25 a year per head of population.

This would cover advertising and possible subsidising of dark chocolate for the less well-off.

The protective effects have been shown only for dark chocolate which is at least 60-70 per cent cocoa. Milk or white chocolate does have not provide the same benefits.

It is rich in flavonoids which are known to have heart protecting effects.

Sceptics say the high calorie content of chocolate tends to offset the benefits.

Previous research shows eating chocolate reduces blood pressure and improves insulin sensitivity, reducing the risk of diabetes.


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