You have a headache and it’s a severe headache, so severe that you can’t function. You decide to take two Tylenol (650 mg). Two hours later you feel a little better but the pain is still severe enough to keep you from your daily tasks. The directions on the bottle read take 2 tablets every 4 to 6 hours, so you’re probably thinking taking two tablets a couple of hours early shouldn’t hurt anything, and your headache is about to get the best of you. You think about it for another minute or two and then decide to take an additional two tablets. Is there anything wrong with what you just did? Perhaps you rationalize it by saying that taking two more tablets equaled about 1300 mg which is probably prescription strength (a doctor would have prescribed this), and taking the additional two tablets did alleviate the pain; the headache is gone! You actually feel better and can function. But the truth is without the advice of a physician you should never exceed the recommended dose of any over the counter medication, particularly Tylenol.

Tylenol, a common and popular medication, is made of acetaminophen a pharmaceutical analgesic and antipyretic agent. It is the most widely used analgesic in the United States; used primarily for the relief of fever and other minor aches and pains. Access to acetaminophen is quite easy and because of this there is a huge potential for overdose and toxicity.

This may be surprising to learn, but acetaminophen toxicity is by far the most common cause of acute liver failure in both the United States and the United Kingdom. There are two reasons for this: (1) Widespread availability and (2) people underestimate the potential for toxicity.

The recommended dose for Tylenol is 325 – 650 mg every four to six hours. In adults the minimum toxic dose of acetaminophen for a single ingestion is 7.5 to 10 grams. Which means it would take the ingestion of 7,500 mg to 10,000 mg to be toxic. The half life of Tylenol is about four hours, but the concentration is peaked (at its fullest potential) two hours after ingestion. So though you may feel no relief in two hours the medication is still in your system.

You’re probably saying “well that could never happen to me. I could never ingest that much medication without realizing it.” Well…. it doesn’t take long to develop a tolerance for medication. Also In just a two hour period our above scenario had you ingesting 1300 mg. What if there was no relief after taking the 1300 mg? How long would you wait before taking an additional two tablets or more? Granted this is just a case scenario, but it does happen.

The thing to note here is that when you’re in pain you just want to feel better and when you’re in severe pain it’s hard to maintain the proper perspective. This is how so many people have gone into acetaminophen toxicity and liver failure.

Signs of acetaminophen toxicity include anorexia, nausea, vomiting, malaise (a feeling of general discomfort), and diaphoresis (increased perspiration). More severe symptoms may include right upper quadrant pain and tenderness liver enlargement and decreased urinary output. Once hepatic failure (liver failure) has occurred there is jaundice (yellowing of the skin or eyes), renal failure, bleeding, encephalopathy (disease of the brain) and cardiomyopathy (disease of the heart muscle), which could lead to death.

Never underestimate the potency of any drug with acetaminophen in it, and always follow the directions as given. If over the counter analgesics aren’t enough to relieve your pain seek the advice of a physician for something stronger and don’t exceed the recommended dose. If you are taking Tylenol or any analgesic at home document the dose taken and the time on a medication log. This will help you to better remember not to overlap your dosage times. If you have developed a dependency please seek help.

Here is a number that you can call. 1-800-662-HELP or visit the website http://www.findtreatment.samhsa.gov

Doing these things could protect your liver and your life.

REFERENCES:

Wilkiperdia : http://en.wilkipedia.org/wilki/Acetamenophen

Emedicine : Toxicity, Acetamenophen – Germaine L Defendi, MD, MS, FAAP

http://www.emedicine.com/ped/topic7.htm



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Migraine is a type of headache and a recognised medical condition. Migraine is widespread in the population. In the U.S., 18% of women and 6% of men report having had at least one migraine episode in the previous year. Migraines afflict about 30 million people in the United States. They may occur at any age, but usually begin between the ages of 10 and 40 and diminish after age 50. Some people experience several migraines a month, while others have only a few migraines throughout their lifetime. Approximately 75% of migraine sufferers are women.

Migraines’ secondary characteristics are inconsistent. Triggers precipitating a particular episode of migraine vary widely. The efficacy of the simplest treatment, applying warmth or coolness to the affected area of the head, varies between persons, sometimes worsening the migraine. Migraines are classified as either “with aura” or “without aura.” Migraine is a neurological disorder that generally involves recurring headaches. Other symptoms may occur with the headaches. Migraines are often classified based on whether they include an early symptom called an aura. Visual aura is the most common of the neurological events.

Migraine is a true organic neurological disease. Migraine with aura is characterized by a neurological phenomenon (aura) that is experienced 10 to 30 minutes before the headache. Most auras are visual and are described as bright shimmering lights around objects or at the edges of the field of vision (called scintillating scotomas) or zigzag lines, wavy images, or hallucinations. Migraine without aura is the most prevalent type and may occur on one or both sides (bilateral) of the head. Tiredness or mood changes may be experienced the day before the headache. Nausea, vomiting, and sensitivity to light (photophobia) often accompany migraine without aura. Migraine headaches affect about 11 out of 100 people. They are a common type of chronic, recurring headache. They most commonly occur in women and usually begin between the ages of 10 and 46. In some cases, they appear to run in families. A migraine is caused by abnormal brain activity, which is triggered by stress, food, or some other factor.

Migraine-specific therapies are designed specifically to treat migraine attacks. Ergotamine preparations are no longer readily available. Several medications may need to be tried before you find one that works. A class of drugs known as triptans can relieve a migraine once it starts. Rest in a quiet, darkened room. Drink fluids to prevent dehydration, especially if vomiting occurs. Several medications may help relieve symptoms. However, the effectiveness of migraine medications is highly variable in different people.

Some medicines can prevent migraines. These include propranolol, amitriptyline, ergonovine, cyproheptadine, clonidine, methysergide, calcium channel antagonists, valproic acid, carbamazepine, topiramate (Topamax), and many others. Ergotamine tartrate preparations constrict the arteries of the head and may be used alone or in combination with other drugs such as caffeine (Cafergot), phenobarbital, or Fioricet. Propoxyphene or other medications that relieve pain or inflammation may provide relief for some people. Nausea should be treated early with Reglan, Compazine, or other anti-emetics.

Migraines Treatment Tips

1. Conventional treatment focuses on three areas: trigger avoidance, symptomatic control, and preventive drugs.

2. Moderation in alcohol and caffeine intake, consistency in sleep habits, and regular meals may be helpful.

3. Triptans are a mid-line treatment suitable for many migraineurs with typical migraines.

4. Ergot drugs can be used either as a preventive or abortive therapy, though their relative expense.

5. Sumatriptan and related selective serotonin receptor agonists are now the therapy of choice for chronic migraine attacks.

6. Anti-emetics by suppository or injection may be needed in cases where vomiting dominates the symptoms.

7. Amidrine is sometimes prescribed for migraine headaches.

8. Intravenous chlorpromazine has proven very effective in treating status migrainosus–intractable and unremitting migraine.

9. Diet, visualization, and self-hypnosis are also alternative treatments and prevention approaches.

10. Massage therapy and physical therapy are often very effective forms of treatment to reduce the frequency and intensity of migraines.

11. Massage therapy of the jaw area can also reduce such pain.

12. Botox is being used by many headache specialists for patients with frequent or chronic migraines with encouraging results.

13. Try to avoid any factors that have triggered a migraine in the past.



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Coming soon…there will be some big changes in Tylenol (acetaminophen or APAP) products -including OTC products and prescription (Vicoden, Percocet, etc.)

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When it comes to curing the common headache most people reach for either an aspirin or a paracetamol tablet, but which should you choose?

Both aspirin and paracetamol (also referred to as acetaminophen) have been used to treat headaches since the end of the 19th century and while they are both essentially analgesics (pain killers) there are some very important differences between these two drugs.

Aspirin works by binding to and blocking an enzyme which is necessary for the production of a group of natural body hormones known as prostaglandins. These body biochemicals come into play whenever you suffer inflammation, such as that which occurs whenever body tissue is injured.

If you catch your finger in a drawer while you are closing it the damage to the tissue of your finger will begin the production of prostaglandins at the site of the injury and these prostaglandins will send signals along the nerves from the finger to the brain which you perceive as pain. At the same time it also provides the stimulus which will cause your finger to swell and, in this case, swelling is simply the body’s reaction to the increased flow of blood into the area surrounding the injury. By interfering with the production of prostaglandins aspirin both reduces the pain felt and also the degree of swelling.

Unlike aspirin, paracetamol does not act as an anti-inflammatory and does not block the effects of the enzyme necessary for the production of prostaglandins, but it does inhibit this enzyme. In other words, it acts to block the pain but not to reduce the swelling.

There are several advantages to using paracetamol not the least of which is that it does not weaken the lining of the stomach or carry the risk of kidney damage, both of which are risks with the prolonged use of aspirin. In addition, it does not interfere with blood clotting as does aspirin and so is safer in the event of sustaining a cut or for people who are prone to nose bleeds. Paracetamol can also be taken safely by people suffering from certain diseases, such as Reye’s syndrome, where the use of aspirin is considered to be unsafe.

As with most drugs there are of course risks with paracetamol and these are seen particularly when it is taken in improper or high dosages. For example, taking paracetamol on a regular daily basis can result in what are known as rebound headaches and, at high enough dosages, paracetamol can lead to liver damage and ultimately to death. These risks are of course low, but they can be increased substantially by, for example, taking paracetamol in conjunction with alcohol.

Some of the signs to watch for in the overuse of paracetamol are tarry, black or bloody stools, a skin rash and a sore throat. Very occasionally overuse will also result in lip ulcers or in white spots inside the mouth.

Whether you should reach for the aspirin or a paracetamol tablet to cure your headache is something of a matter of personal choice and for most people who suffer only occasional headaches it probably does not matter, unless other conditions would make you susceptible to the risk of side effects from one or other of these two drugs. If you find however that you are having to reach for either too frequently then you should consult your physician to discuss the best course of action for curing your headaches.



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Everyday people overdose from painkiller such as Vicodin and OxyContin. Recent studies have suggested that painkiller drug abuse has surpassed car accidents in causes of death. People who survive painkiller overdoses are typically left permanently brain damaged. What people don’t realize is that the drug that can really kill you is the Acetaminophen.

Acetaminophen is the active ingredient in the over-the-counter painkiller, Tylenol. Because Tylenol can be given to anyone, including children and pregnant women, people assume it is perfectly safe. However, more people die from overdosing on Acetaminophen than any other legal drug. Many people don’t even realize that is what they are doing. Acetaminophen is present in everything from prescription pain killers to cold medicine. A person may take some cold medicine and then later take some Excedrin for a migraine, and not even realize there is Acetaminophen in both medicines.

Acetaminophen can also build up in your system, so the longer you are taking painkillers, the easier it will be for you to overdose. There are two things you can do to decrease your risk of an accidental drug overdose. The first thing is to read the ingredient list on any drugs you take, regardless of what it is or how safe you think it is. Secondly, if you are taking regular painkillers for a chronic condition, try other pain relief methods. For example, depending on where the pain is and what is causing it, you can try a chiropractor, acupuncture or medical massage to alleviate the pain.

If you come to realize your regular consumption of painkillers haws gone beyond a physical need and become a psychological addition, than you need to immediate seek professional help. There are rehab centers and programs specifically designed for people with addictions to painkillers. Even if the painkillers you are taking are over-the-counter. Most people see drug addiction as the use of illegal drugs or even prescription drugs. However, anytime you can’t stop your self from taking something, you have an addiction.



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There are two primary types of analgesics: narcotic (opioid) and non-narcotic (nonopioid) analgesics.

Non-narcotic analgesics are drugs that have principally analgesic, antipyretic, and anti-inflammatory actions. Acetaminophen is the most commonly used over-the-counter non-narcotic analgesic. Other drugs are not technically part of the analgesic family, but are nonetheless considered analgesics in practice. These include nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin.

Acetaminophen and NSAIDs can effectively relieve mild to moderate headache and pain of musculoskeletal origin. For moderate to severe pain, they can be used in combination with opioid drugs to enhance pain relief.

Opioids are stronger analgesics that are used when pain signals are too severe to be controlled by non-narcotic analgesics.

The primary difference between opioids and non-opioids is in the way how they produce their analgesic effects. The opioid drugs reduce pain by working on special pain receptors in the nervous system, primarily located in the brain and spinal cord. The non-opioids, on the other hand, work more directly on injured body tissues. The opioids decrease the brain’s awareness of the pain, whereas the non-opioids affect some of the chemical changes that normally take place wherever body tissues are injured or damaged. These chemical changes at the site of the injury typically result in inflammation and increased pain sensitivity.

The long-term use of opioids can lead to tolerance, dose escalation, and physical dependence. Tolerance refers to the fact that the drug loses itТs pain relieving effectiveness when used over time. That is, tolerance occurs when you need to take more of the drug in order to obtain the same degree of pain relief. However, tolerance is not considered to be a problem by most pain specialists. Many patients with chronic pain who are taking opioids are able to maintain their dosage level without increasing the amount taken.

Physical dependence is an automatic consequence of taking opioids over time. Physical dependence is apparent when one abruptly stops taking the drug or reduces the amount taken, which leads to withdrawal reactions.

Non-opioid pain relievers are often preferred for most types of chronic pain, because they do not produce tolerance or physical dependence and are not associated with abuse or addiction. However, they have two serious drawbacks. The first drawback has to do with ceiling effects. Non-opioids have upper limit of pain relief that can be achieved. Once that upper limit or ceiling is reached, taking additional medication will not provide any further pain relief. Opioids, on the other hand, tend not to have a ceiling. That is, the more you take, the more pain relief you will get. It is for this reason that non-opioids are effective only for mild to moderate pain, whereas opioids are useful for more severe pain intensity.

The second major drawback of the non-opioids are their side effects. Although most non-opioids are quite safe when used for temporary acute pain, problems may arise when people take them over a long period of time (for chronic pain). This is especially true when large quantities of non-opioids are taken. Most are aware of the adverse effects of these drugs on the gastrointestinal system. However, excessive use of the non-opioids can also damage your liver or your kidneys. Opioids have negative side effects as well. However, it is interesting that many pain specialists now believe that opioids, when used as prescribed, are often safer than the non-opioids. Side effects of the opioids include respiratory depression, dizziness, nausea, vomiting, constipation, sedation, and mental clouding. Many of these side effects can be minimized or eliminated with proper medical management.



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How is your back feeling lately?

Has it driven you to look for pain relief?

1.) Introduction

It is one thing to have an aching back, and it is another to have constant lower back pain that is excruciating and unbearable. It takes the idea of being in pain to a whole different level when that pain continues and even exacerbates when you sit. What are you supposed to do? Stand up all day and night? It is not very likely to happen.

2.) Why Does My Lower Back Hurt When I Sit?

Surprisingly, some people only experience lower back pain when they sit. Their backs do not hurt when they walk or when they stretch out in bed; only upon sitting. Well what causes this? It all has to do with the quantity of stress that your spine has to endure. When a person sits, that stress amount is increased. Moreover, if it is a slouching posture, the stress on the spine increases even more. Add in additional stress from a muscle strain or a herniated disc, and the pain becomes agonizing.

3.) Back Pain Relief

After suffering for a while, the reasons why you are hurting become obsolete, and your only thought is the discovery of a cure for what ails you. There are a few steps you can take to reduce pain in your lower back that occurs from sitting.

First of all, you can be selective about the chairs in which you sit. A high back chair that has arm rests (so you will be less inclined to slouch) can be very helpful and will prop up your entire body. Secondly, when sitting, it is important that you keep your knees and hips positioned at a ninety degree angle; this is the correct angle for proper posture and will help decrease stress on your back.

Unfortunately, working alone, neither of these tips will give you a great deal of relief for lower back pain. One of the best way to alleviate your pain is through the use of a back brace. A brace functions by providing support to the back in a variety of ways.

How a Back Brace Helps

1) Alleviates hurting. Using a brace aids you by reducing lower back pain that causes you to hurt when you sit. In many cases, the support will provide you with some relief immediately by reducing the movement of your spine.

2) Improves back stability. The back brace supports your back by keeping your spine more stable. Not only does this fixed position give your muscles times to heal, but it also retrains your posture to avoid further injuries.

No longer do you have to suffer from intense, lower back pain. There are ways to reduce the aching and enjoy a relatively pain-free, seating experience.

Note: This is health information. Speak to your local, licensed orthotist when it comes to medical advice on braces for your spine.



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Acetaminophen is the most popular painkiller in the US. It is best known by the brand name Tylenol but is sold under 97 different brand names. It is known as paracetamol in many parts of the world. It is also sold in combination with other drugs in more than 100 products.

During cold and flu season, people who take acetaminophen for arthritis are at risk for acetaminophen poisoning. Taking just twice the recommended dose of acetaminophen can cause acute liver failure. Unfortunately, this has already happened to an alarming number of people because it isn’t hard to do. Two years ago, more than 56,000 people visited the emergency room due to accidental acetaminophen overdoses and 100 people died from unintentionally taking too much. Worse yet, the numbers appear to be growing.

How Can This Happen?

This happens so easily because acetaminophen is found in many different products. If you are taking the maximum recommended dose of just two acetaminophen-containing products, you can easily take an overdose.

For example, the maximum recommended dose of acetaminophen per day is 4000 mg. That equals 8 extra strength acetaminophen pills per day. You might easily take that much for arthritis pain.

Now let’s say you get the flu and decide to take a Cold & Flu product for your aches and stuffiness. Many of them include acetaminophen as the primary ingredient for reducing fevers and aches and pains. So, that will dose you with 1000 mg of acetaminophen every 6 hours or another 4000 mg a day.

By taking both products at the maximum recommend dose, you put yourself at risk for acute liver failure.

The problem doesn’t end there. You might get a head ache and pop some Excedrin. That’s 500 mg more acetaminophen per dose. Maybe you are in a car accident or have some dental work done. Prescription narcotics like Vicodin and Percocet contain from 325 mg to 750 mg of acetaminophen inside each pill. That can quickly add up.

Other Acetaminophen Complications for People with Arthritis

For some people, arthritis is caused by suboptimal detoxification pathways. Such people do not have the level of enzymes necessary to carry out the sulfoxidation necessary for a body to properly process and detoxify acetaminophen. In these circumstances, even the recommended level of acetaminophen may cause acetaminophen poisoning.

Furthermore, this same pathway is necessary for detoxifying many of the chemicals we are exposed to in our environment and through our food. This means that our detoxification system can also be weakened through chemical exposure. Similarly, if we swamp our system with acetaminophen, we don’t have enough detoxification power left to fully deal with all the other assaults in our daily environment.

If you have any known food sensitivities or chemical sensitivities, it is best to assume that your sulfoxidation pathways are already challenged enough, without adding the extra burden of acetaminophen in your system.

How to Avoid Acetaminophen Poisoning

Carefully read the label of any cold or flu medicine or painkiller that you are considering to ascertain how much acetaminophen it contains. Healthy young adults should never exceed 4000 mg/day total from all sources for short term use. For long-term use healthy young adults should never exceed 3250 mg/day, according to clinical pharmacist Sandra Dawson, RPh, MSHA who lectures on pain management in long term care.

People who are vulnerable to damage from acetaminophen should take no more than 2000 to 3000 mg per day, according to Dr William Lee of the University of Texas Southwestern Medical Center. This lower maximum dose includes the healthy elderly since liver and kidney function generally decline with age.



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The term “pain relief machine” is a very confusing phrase and it’s understandable how people can not differentiate a “muscle stimulator” from a “tens unit” to an “interferential unit” or “pulsed galvanic stimulator” or a “micro amperage stimulator”.

Four of the 5 listed units are actually intended to be used for the treatment of chronic and acute pain.

On the internet the following terms are searched on and the patient often gets some reference to a “pain machine” as a solution and then the confusion really begins.

* neck traction
* sciatic nerve pain
* sciatic nerve pain relief
* back pain relief machine
* pain relief machine
* sciatic nerve treatment
* painreliefmachine.com
* sore neck stretches
* stretches for sore neck

Of the 5 machines listed the only one that is not intended for pain relief is a “muscle stimulator” which should be correctly called a “functional electrical stimulator” – FES. The purpose of a muscle stimulator is to help a patient restore function or prevent atrophy to muscles. All of the listed “pain machines” can literally be adjusted to the point that a muscle contraction can be elicited but that is not the purpose of a “pain machine”.

There are basically three methods of controlling pain that each of the pain machines relies upon.

1. Melzack/Wall Gate Control Theory:

This is simply the process of stopping the transmission of the pain impulse to the spinal cord for transmission to the brain where the pain is perceived. The method of operation is to stimulate non-pain fibers so the actual pain message is not transmitted and the pain impulse is not transmitted. When that happens the brain does not receive the message therefore there is no pain. In reality though for the chronic pain patient the actual results are less transmissions rather than 100% total cessation meaning pain reduction, not total pain elimination.

2. Sjolund Opioid Peptide Production ( Pain Killers)

In this application, which rarely ever works, the actual pain fibers, c fibers, are stimulated for 20 – 30 minutes and that stimulation by the pain machine results in the brain increasing the production of pain killers, aka endorphins and enkaphlins are the general terms used. As long as there is an increased amount of the peptides in the blood stream then the pain is not felt. As the peptides wear off and decrease in total volume then the pain reappears. This is not theory but has been proved however as stated earlier this application rarely is effective for the vast preponderance of chronic pain patients.

3. Glial Dysregulation of Pain and Opioid Actions

This is very recent, appearing in research being done by Linda Watkins, PhD. – Univ. of Colorado – Boulder. Her work involves the blocking of pathological pain by inhibiting glial activation in the spinal column where the glial cells exist. The glial cells actually release many neuroexcitatory substances which can lead to pain amplification.

The latter explanation helps to clarify what is now occurring with the use of interferential pain machines, unlike the other tens, micro, PGS machines where there is no carryover or residual pain relief once the pain machine is turned off. With interferential therapy there is residual or carryover pain relief during and following the treatment for hours or in some situations days/weeks. Glial cell inhibition may explain the effects of portable interferential units as well as replicate the clinical interferential treatments.



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There are a number of reasons why alcohol consumption causes you to want to smoke, some more apparent than others. Read on to find out what all of them are!

First, there’s the obvious one that drinking alcohol lowers your inhibitions and, especially for someone who is trying to quit smoking, makes it harder to resist their temptation to smoke. This is difficult to change because of the way alcohol works with your body, but has its roots in the second reason why drinking makes you want to smoke.

More importantly, though, is that for anybody who has smoked cigarettes for any real period of time (and let’s face it, if you’ve been smoking for two months you aren’t reading this article!) you’ve developed a substantial connection between drinking and smoking. Look outside every bar you can find and you’re guaranteed to find a smattering of cigarette butts lying around there.

Especially as someone who has just started smoking, having one after a few drinks is an excellent feeling. As such, the groundwork is laid for a continuing connection that will become rather difficult to break unless approached correctly. Luckily, that correct approach isn’t really too surprising: you just need to teach your subconscious that smoking and drinking don’t have to be linked, that you can enjoy a few drinks without having to light up a cigarette.

IT sounds weird (and almost like a basis for alcoholism) but practice drinking without smoking, and you’ll notice that over time you’ll become less inclined to smoke when you’re drinking. Just don’t overdo it with the drinks!



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