Knowledge about key elements in hepatotoxicity is critical to keeping each other safe in an evolving world of healthcare and medicine. Remember:
A valuable resource for information on hepatotoxicity is the FDA!
Investigations into drugs, definative information, and procedures for reporting possible problems associated with a product can be found at http://www.fda.gov/.
Don't forget to ask your health-care provider and pharmacist any questions or concerns!
Over the counter products can cause severe hepatotoxicity! OTC products are not always "safe." Alcohol, liver infections, and drug/food interactions can be dangerous when used with certain OTC products. Accidental overdoses are common!
Acetaminophen is now the number one cause of acute liver failure in the America!
-Many products other than Tylenol contain acetaminophen (OTC and prescribed)
-Read labels. Remember, APAP is the abbreviation for acetaminophen.
-Calculate your dosages. Do not exceed 4000 mg per day (4 grams) normally.
Diet pills have a long history of complications! Consult your health-care provider with their use.
-Take as directed and dedicate yourself to the lifestyle changes that accompany diet therapies.
-Note any changes indicating hepatotoxicity and contact your heath-care provider immediately!
Alcohol changes your normal liver function! Alcohol is a damaging chemical to the liver and can cause greater complications with OTC and prescribed therapies.
Food and drug interactions in the liver are serious!
-Grapefruit interactions can be deadly! Grapefruit leads to hepatotoxicity of many medications. Be aware of drug interactions with grapefruit. You may have to alter your diet!
-Fatty foods may impact the liver's ability to process toxins and fuction normally! A liver riddled with fat may not function efficiently.
Herbal products are not regulated by the FDA and are often linked to liver damage!
Tell your health-care provider when you are using herbal therapy in combination with medications. Be aware of interactions your medications may have with certain supplements, including acetaminophen.
Many prescriptions are well known to induce liver damage, including: Cholesterol lowering medications, Antibiotics, and Antidiabetics.
-Ask your health-care provider about side effects of your medications, specifically in the liver.
-Remember many factors can cause hepatotoxicity of prescription drugs including: age, food interactions, alcohol consumption, and other drug interactions.
Hepatotoxicity will likely continue to be an issue as more medications are developed to battle common health issues. The key to avoiding complications with your liver is to stay in the know about current products as well as your own body changes. Too often, the hepatotoxic dangers lurking in the medicine cabinet are unknown to people. Unfortunately, the realization of these dangers can be a situation of "too little, too late" and serious consequences result.
With this in mind, it raises the question, how can we change this outlook in our community? Is it up to the FDA, the healthcare system, or maybe...YOU?? Who will you tell??
For more information on drug-induced hepatotoxicity, please visit:
http://emedicine.medscape.com/article/169814-overview
http://www.pharmacologyonline.org/PDF/dili.pdf
What exactly is hepatotoxicity, and why should I be worried?
The liver is a vital organ that is responsible for many body functions, including blood cell composition, breakdown of nutrients we eat, balancing cholesterols, and ridding our body of foreign chemicals, such as alcohol and drugs.
Hepatotoxicity is damage that occurs to the liver by chemical means. Medications that we use every day can ultimately be damaging our liver!
Unfortunately, hepatotoxicity from commonly known drugs is often a cause of liver injury. It is estimated as many as 1000 drugs can be blamed for some form of liver damage.
The liver’s role in detoxification makes it especially vulnerable to damaging substances. Liver cells, hepatocytes, can be injured by various pathways depending on the type of drug being metabolized. Reactive particles can destruct the cellular components of the hepatocytes, leading to cell death. Other metabolites alter liver enzymes responsible for drug metabolism leading to toxicity. Drug fragments can also bind to liver proteins initiating an autoimmune attack on the liver tissue.
Effects of hepatotoxicity can be seen throughout the body. General symptoms include: nausea, vomiting, upper right stomach pain, loss of appetite, brown urine, and yellowing of the skin and eyes (jaundice.) It is important to note these changes early and notify the health-care provider immediately if they are experienced. Early intervention is the safest way to limit damage to the liver!
Who is at risk for hepatotoxicity? EVERYONE! It may be a patient you are monitoring, a family member you are educating, or yourself. Concerns extend far beyond high dosages of prescription medications. Hepatotoxicity can result from combining multiple drugs, alcohol consumption with medications, genetic predispositions, age-related metabolism rates, and underlying diseases. Over-the-counter products, such as Tylenol, and herbal remedies, that are often considered “safe”, play a HUGE role in liver damage.
The key to lowering your risk is EDUCATION. Knowledge about hepatotoxicity is critical to keeping EVERYONE safe.
Reference:
Kaplowitz, N. (2004). Drug-induced liver injury. Clinical Infectious Diseases: An Official Publication Of The Infectious Diseases Society Of America, 38 Suppl 2S44-8. http://libproxy.uta.edu:2066/.
More information on hepatotoxicity, like specific symptoms to look out for can be found here: http://www.liverdisordersfocus.com/articles/liver-disorders/drug-induced-liver-damage.php
Hepatotoxicity is damage that occurs to the liver by chemical means. Medications that we use every day can ultimately be damaging our liver!
Unfortunately, hepatotoxicity from commonly known drugs is often a cause of liver injury. It is estimated as many as 1000 drugs can be blamed for some form of liver damage.
The liver’s role in detoxification makes it especially vulnerable to damaging substances. Liver cells, hepatocytes, can be injured by various pathways depending on the type of drug being metabolized. Reactive particles can destruct the cellular components of the hepatocytes, leading to cell death. Other metabolites alter liver enzymes responsible for drug metabolism leading to toxicity. Drug fragments can also bind to liver proteins initiating an autoimmune attack on the liver tissue.
Effects of hepatotoxicity can be seen throughout the body. General symptoms include: nausea, vomiting, upper right stomach pain, loss of appetite, brown urine, and yellowing of the skin and eyes (jaundice.) It is important to note these changes early and notify the health-care provider immediately if they are experienced. Early intervention is the safest way to limit damage to the liver!
Who is at risk for hepatotoxicity? EVERYONE! It may be a patient you are monitoring, a family member you are educating, or yourself. Concerns extend far beyond high dosages of prescription medications. Hepatotoxicity can result from combining multiple drugs, alcohol consumption with medications, genetic predispositions, age-related metabolism rates, and underlying diseases. Over-the-counter products, such as Tylenol, and herbal remedies, that are often considered “safe”, play a HUGE role in liver damage.
The key to lowering your risk is EDUCATION. Knowledge about hepatotoxicity is critical to keeping EVERYONE safe.
Reference:
Kaplowitz, N. (2004). Drug-induced liver injury. Clinical Infectious Diseases: An Official Publication Of The Infectious Diseases Society Of America, 38 Suppl 2S44-8. http://libproxy.uta.edu:2066/.
More information on hepatotoxicity, like specific symptoms to look out for can be found here: http://www.liverdisordersfocus.com/articles/liver-disorders/drug-induced-liver-damage.php
Showing posts with label OTC Hepatotoxicity. Show all posts
Showing posts with label OTC Hepatotoxicity. Show all posts
Tuesday, October 27, 2009
Wednesday, October 21, 2009
Herbal Supplements: Benefit or Risk?
The use of herbal products has become one of the biggest trends in recent years, as more “natural” drug therapy becomes popular. There are over 29,000 products available on the market. One reason for this is the rise in costs of perscription medication . The public believes that herbal supplements are harmless and reliable for treating or preventing many diseases. A major concern about herbal supplements is the risk of side effects. The FDA does not regulate their use, and the research on them is slim to none. The drugs are placed on the market on a trial and error basis, without any review of the benefits or risks. The producers of herbal supplements are not required to post warnings on labels; this has led to severe liver hepatotoxicity and damage to other organ systems.Health professionals and the makers of herbal supplements are at odds on this subject. Because of the public view about herbal medication and the "all natural ingredients", use of these supplements has doubled over the last ten years. Between 20% to 30% of consumers have been admitted to a hepatic-clinic for liver injury. Ironically enough, herbal medications seem to be used most by people who have liver diseases.
The risk to the liver can be severe. Cases that have been reported liver injury from mild, emergency transplant, and even death. This can be a surprising fact to most of the public, considering that the consensus of herbal supplements is harmless. In a public survey, 1 out of every 6 consumers report taking an herbal supplement in conjunction with their current prescriptions. This can be a dangerous combination!
There are thousands of stories about this herbal supplement side effects. The major concerns seem to be hepatotoxicity, especially associated with herbal products taken before surgery and use of these medications by the elderly. There are so many herbal products that it is almost impossible to list them along with potential side effects here; however, the number one injury most often cited is to the liver. Hepatotoxicity is at greater risk when acetaminophin and herabal supplements are taking together. Some of the most dangerous herbal drugs to the liver are; Black cohosh, Kava, Echinacea.
The lesson of the day: ask your healthcare provider before combining any drugs, perscriptioin or over-the-counter, with herbal medications.
Are you at risk??
References:
Barger, L. Herbs and Pain Relievers Don't Mix: The Dangers of Mixing Herbal Supplements and OTC Pain Relivers. Retrieved October 22, 2009. http.//herbalmedicine.suite101.com
Larson, A. Hepatotoxicity Due to Herbal Medications. Retrieved October 22, 2009. www.uptodate.com/patients
Sunday, October 18, 2009
How high of a price are you willing to pay to be thin?
The FDA is reviewing the safety of orlistat after liver damage was reported in patients taking Xenical, a prescribed therapy, and Alli, an over-the-counter product. Both products contain orlistat and are approved as part of weight-loss therapies for obese, adult patients when combined with nutritionally balanced diets.
Alli recently became available over-the-counter however, it is concerning that this potentially damaging product is readily obtained without health-care provider supervision. Most people believe over-the-counter products have few side effects in comparison to their prescribed counterparts. As we can see with this diet pill, that is often not the case.
Between 1999 and 2008, 32 episodes of serious liver injury associated with orlistat have been reported to the FDA. Symptoms associated with the use of these products include fever, jaundice (yellowing of the skin and eyes), right upper abdominal pain, nausea, loss of appetite, brown urine, muscle weakness, and fatigue.
Although orlistat has not been definately linked to hepatotoxicity, the FDA continues to investigate the effect of such therapies on the liver. When taking these medications, only take the prescribed amount, and be aware of hepatotoxic symptoms. If you do experience such effects, report these immediately to your health care provider as well as the FDA's MedWatch Adverse Event Reporting program.
Please visit the FDA website for more information and reporting procedures:
http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/DrugSafetyInformationforHeathcareProfessionals/ucm179166.htm
Alli recently became available over-the-counter however, it is concerning that this potentially damaging product is readily obtained without health-care provider supervision. Most people believe over-the-counter products have few side effects in comparison to their prescribed counterparts. As we can see with this diet pill, that is often not the case.
Between 1999 and 2008, 32 episodes of serious liver injury associated with orlistat have been reported to the FDA. Symptoms associated with the use of these products include fever, jaundice (yellowing of the skin and eyes), right upper abdominal pain, nausea, loss of appetite, brown urine, muscle weakness, and fatigue.
Although orlistat has not been definately linked to hepatotoxicity, the FDA continues to investigate the effect of such therapies on the liver. When taking these medications, only take the prescribed amount, and be aware of hepatotoxic symptoms. If you do experience such effects, report these immediately to your health care provider as well as the FDA's MedWatch Adverse Event Reporting program.
Please visit the FDA website for more information and reporting procedures:
http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/DrugSafetyInformationforHeathcareProfessionals/ucm179166.htm
Are You at Risk for Over-the-Counter Hepatotoxicity?
Below are factors that contribute to unintentional overdoses of over-the-counter (OTC) products:
1. Consumers perceive that OTC products are extremely safe and not likely to lead to serious toxicity. The marketing of OTC products emphasizes their safety and this perception may be reinforced by the availability of package sizes with large numbers of pills.
2. Consumers do not read the labels or follow the directions for use on OTC and prescription products.
3. Some of the prescription products are not adequately labeled to identify acetaminophen as an ingredient. Acetaminophen is often labeled as APAP on the prescription containers.
4. Consumers are not aware that acetaminophen can cause serious liver injury, in part because product labels do not adequately warn of this problem.
5. Consumers are not aware that acetaminophen is present in many OTC and prescription products and are not aware that they are exceeding the maximum daily dose.
1. Consumers perceive that OTC products are extremely safe and not likely to lead to serious toxicity. The marketing of OTC products emphasizes their safety and this perception may be reinforced by the availability of package sizes with large numbers of pills.
2. Consumers do not read the labels or follow the directions for use on OTC and prescription products.
3. Some of the prescription products are not adequately labeled to identify acetaminophen as an ingredient. Acetaminophen is often labeled as APAP on the prescription containers.
4. Consumers are not aware that acetaminophen can cause serious liver injury, in part because product labels do not adequately warn of this problem.
5. Consumers are not aware that acetaminophen is present in many OTC and prescription products and are not aware that they are exceeding the maximum daily dose.
6. Some populations (e.g., certain alcohol users and people with liver disease) are more susceptible to hepatic injury.
7. The symptoms of acetaminophen overdose may not appear for up to three days, so people may continue to take acetaminophen and increase the damage. The symptoms of liver injury may mimic the condition that they are treating (e.g., flu symptoms).
8. Because patients may not get adequate pain relief after taking the recommended dosage of acetaminophen, they may take more than the recommended amount or use other products that also contain acetaminophen.
9. Patients develop tolerance to narcotics and need to increase the dose of prescription combination products. If they do this on their own, they may not realize that they are increasing the dose of acetaminophen to toxic levels.
10. Combination narcotic products are commonly used because of limited non-narcotic options and greater restrictions on availability for higher scheduled single-ingredient narcotic analgesics.
For more information, please read the full report by The Acetominophen Hepatotoxicity Group.
References:
The Acetaminophen Hepatotoxicity Working Group Center for Drug and Evaluation Research, F. D. (2008). Recommendations for FDA Interventions to Decrease the Occurence of Acetaminophen Hepatotoxicity.
Friday, October 16, 2009
Seeing through the confusion, should we stop taking Tylenol/acetaminophen?
It seems acetaminophen is constantly being investigated by the FDA due to the prevalence hepatotoxicity it causes. Interventions to reduce these adverse events continue to evolve, but what should something more be done to protect consumers from possible liver damage associated with acetominophen while new, lower dosages are considered?
It could take quite a while for the FDA to definatively decide about new dosages of acetaminophen. In the mean time, people and doctors are baffled. The vote that took place in June from the panel was for the reduction of the current recommended dose of acetaminophen. Another vote included making certain products containing 500 mg or more available through prescription only. Once a decision from the FDA is reached, it could still take years for it to actually take effect.
Acetaminophen related hepatotoxicity is a major concern for the FDA because it is one of the most commonly used pain relievers on the market. In 2004, they released a campaign to inform the public about the dangers of acetaminophen misuse. Some believe that it has not been fully effective in reducing the amount of toxicity because it is still at the top of the list of drugs that commonly cause liver damage.
Some have countered that doctors and pharmacists need to be the ones to take note of the dangers related to acetaminophen. Currently, the recommended daily dose is 4 g, but pharmacists say that they have seen doctors prescribe much more than that. Who's responsibility is it to reach the consumer?
In the end, what has one representative said about the safety of the current dose? People have no need to worry, that as long as it is used correctly 4 grams per day should be just fine.
Is acetaminophen (brand name, Tylenol) cause for concern? Next time you reach into the medicine cabinet, what will cross your mind?
For more details, view the article:
http://libproxy.uta.edu:2066/login.aspx?direct=true&db=rzh&AN=2010377171&site=ehost-live
This is a video with the discussion of safety:
http://www.youtube.com/watch?v=K7WCSwEWjdk
Reference:
Traynor, A., (2009). FDA’s acetaminophen meeting sparks confusion.
American Journal of Health-System Pharmacy, 66(16), 1422, 1425-6.
Retrieved from: http://libproxy.uta.edu:2066/login.aspx?
direct=true&db=rzh&AN=2010377171&site=ehost-live
It could take quite a while for the FDA to definatively decide about new dosages of acetaminophen. In the mean time, people and doctors are baffled. The vote that took place in June from the panel was for the reduction of the current recommended dose of acetaminophen. Another vote included making certain products containing 500 mg or more available through prescription only. Once a decision from the FDA is reached, it could still take years for it to actually take effect.
Acetaminophen related hepatotoxicity is a major concern for the FDA because it is one of the most commonly used pain relievers on the market. In 2004, they released a campaign to inform the public about the dangers of acetaminophen misuse. Some believe that it has not been fully effective in reducing the amount of toxicity because it is still at the top of the list of drugs that commonly cause liver damage.
Some have countered that doctors and pharmacists need to be the ones to take note of the dangers related to acetaminophen. Currently, the recommended daily dose is 4 g, but pharmacists say that they have seen doctors prescribe much more than that. Who's responsibility is it to reach the consumer?
In the end, what has one representative said about the safety of the current dose? People have no need to worry, that as long as it is used correctly 4 grams per day should be just fine.
Is acetaminophen (brand name, Tylenol) cause for concern? Next time you reach into the medicine cabinet, what will cross your mind?
For more details, view the article:
http://libproxy.uta.edu:2066/login.aspx?direct=true&db=rzh&AN=2010377171&site=ehost-live
This is a video with the discussion of safety:
http://www.youtube.com/watch?v=K7WCSwEWjdk
Reference:
Traynor, A., (2009). FDA’s acetaminophen meeting sparks confusion.
American Journal of Health-System Pharmacy, 66(16), 1422, 1425-6.
Retrieved from: http://libproxy.uta.edu:2066/login.aspx?
direct=true&db=rzh&AN=2010377171&site=ehost-live
Tuesday, October 13, 2009
Is Tylenol a threat?
Hepatotoxicity is often related to excess amounts of acetaminophen (Tylenol) taken. It is interesting to find that most people do not consider the harm that over-the-counter pain relievers can cause. Having certain conditions of the liver, such as cirrhosis or viral infections, and/or using them in excess can result in side effects as severe as liver failure!
When using these medications, it is important to check the labels for ingredients. Certain medications, including cold and flu remedies, contain acetaminophen. Many people take multiple drugs at one time that each contain acetaminophen. This results in an acetominophen overdose that causes dangerous hepatotoxicity and can be fatal! Some medications list acetaminophen as APAP, it's chemical name abbreviated. Recognizing this is critical in keeping your liver safe from acetominophen hepatotoxicity!!
In 2007, reports from the American Association of Poison Control Centers stated that:
-18,108 people in the US had been poisoned by taking acetaminophen products like Tylenol
-75,814 people in the US had been poisoned by medication containing acetaminophen
-1,239 reports from poison resulted in death
-348 of these deaths were a result from acetaminophen
These are alarming statistics to see, especially since these drugs are so easily available. Due to the liver damage caused by acetaminophen, it has been suggested to the FDA that the recommended dosage be reduced. New recommendations are going to be voted on in the future, and they will probably be much lower than the current standard of two tablets in a dose.
To view the article follow this link:
http://www.cleveland.com/healthfit/index.ssf/2009/09/is_two_too_many_fda_is_reconsi.html
Reference:
Suchetka, D., (2009). Is two too many? FDA is reconsidering the proper dosage levels for OTC painkillers. Northeast OH Healthy Living and Medical Consumer News. http://www.cleveland.com/healthfit/index.ssf/2009/09/is_two_too_many_fda_is_reconsi.html
When using these medications, it is important to check the labels for ingredients. Certain medications, including cold and flu remedies, contain acetaminophen. Many people take multiple drugs at one time that each contain acetaminophen. This results in an acetominophen overdose that causes dangerous hepatotoxicity and can be fatal! Some medications list acetaminophen as APAP, it's chemical name abbreviated. Recognizing this is critical in keeping your liver safe from acetominophen hepatotoxicity!!
In 2007, reports from the American Association of Poison Control Centers stated that:
-18,108 people in the US had been poisoned by taking acetaminophen products like Tylenol
-75,814 people in the US had been poisoned by medication containing acetaminophen
-1,239 reports from poison resulted in death
-348 of these deaths were a result from acetaminophen
These are alarming statistics to see, especially since these drugs are so easily available. Due to the liver damage caused by acetaminophen, it has been suggested to the FDA that the recommended dosage be reduced. New recommendations are going to be voted on in the future, and they will probably be much lower than the current standard of two tablets in a dose.
To view the article follow this link:
http://www.cleveland.com/healthfit/index.ssf/2009/09/is_two_too_many_fda_is_reconsi.html
Reference:
Suchetka, D., (2009). Is two too many? FDA is reconsidering the proper dosage levels for OTC painkillers. Northeast OH Healthy Living and Medical Consumer News. http://www.cleveland.com/healthfit/index.ssf/2009/09/is_two_too_many_fda_is_reconsi.html
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