291–300 of 322 posts
The article kinda glossed over it, but one fact under-appreciated by the general public is just how dangerous acetaminophen overdoses can be . Scientists often talk about the "therapeutic index" or "safety ratio" of a drug. It's the LD50 (dose at which 50% of recipients die) divided by the effective dose. Common hard drugs like heroin or methamphetamine have a safety ratio of about 6-10 [1]. "Soft" drugs like marijua…
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I blame doctors and nurses. At least the ones I personally know tell patients "Advil" and "Tylenol" and never mention ibuprofen or acetaminophen. Actually, it's true for pretty much all OTC medications - they just use the branded names Immodium, not loperamide. Claritin. Zyrtec. Benadryl. Dramamine (drowsy/non-drowsy). The list goes on. When asked, they always tell me one of two things: 1. They were trained on these…
Eh, from what I gather from the healthcare professionals I know, I think that is mostly doctors adapting to the language accessible to their clientele. I don’t think it’s about being “easy” as much as it is “doable”. I’ve heard that it’s often hard to even get an accurate list of current medications out of a person, brand name or not. Now I suppose ibuprofen/acetaminophen is common enough that people may be familiar…
And since I was always more familiar with acetaminophen and ibuprofen, when a doctor would say "Take Tylenol", I would have to ask what the active ingredient is because I didn't know.
They'd actually have to think about it before telling me.
Tylenol is second nature to them. Acetaminophen makes them think.
Oh, and forget about something like dramamine. I'd be told "Non-drowsy dramamine". I'd ask "So you mean meclizine?", and I've literally been told (multiple times) "I actually don't know what the ingredient is."
Ditto for some of the antihistamines (I still don't know what Claritin vs Zyrtec is - are they the same?)
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Eh, from what I gather from the healthcare professionals I know, I think that is mostly doctors adapting to the language accessible to their clientele. I don’t think it’s about being “easy” as much as it is “doable”. I’ve heard that it’s often hard to even get an accurate list of current medications out of a person, brand name or not. Now I suppose ibuprofen/acetaminophen is common enough that people may be familiar…
> I’ve had multiple doctors remark specifically about my use of generic drug name in discussion. “So I presume you’re a little bit familiar already”, etc. And since I was always more familiar with acetaminophen and ibuprofen, when a doctor would say "Take Tylenol", I would have to ask what the active ingredient is because I didn't know. They'd actually have to think about it before telling me. Tylenol is second natur…
Also meclizine causes drowsiness and you should have been warned that this is a common side effect, I was warned when I was prescribed this (it's also on the drug information sheet that comes from the pharmacy). So it might just be that your doctor isn't that good.
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> I’ve had multiple doctors remark specifically about my use of generic drug name in discussion. “So I presume you’re a little bit familiar already”, etc. And since I was always more familiar with acetaminophen and ibuprofen, when a doctor would say "Take Tylenol", I would have to ask what the active ingredient is because I didn't know. They'd actually have to think about it before telling me. Tylenol is second natur…
I haven't had that experience. I use generic names with all of my doctors and family who work in healthcare; they follow suit. Also meclizine causes drowsiness and you should have been warned that this is a common side effect, I was warned when I was prescribed this (it's also on the drug information sheet that comes from the pharmacy). So it might just be that your doctor isn't that good.
I just checked - Dramamine actually calls it "less drowsy". They have non-drowsy be ginger, which is mostly a placebo (there's a lawsuit about it!).
But this highlights my point: Telling someone "less drowsy" dramamine and there is a good chance they'll buy either the regular or the non-drowsy. Just tell them the ingredient to look for!
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Ibuprofen is hard on the kidneys and stomach too. And bleeding/clotting issues. Sooo ya :) Better just stay off the beer hubby. Remember, beer makes you fat also.
Wow, that's a really weird tone for a hackernews comment.
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I haven't had that experience. I use generic names with all of my doctors and family who work in healthcare; they follow suit. Also meclizine causes drowsiness and you should have been warned that this is a common side effect, I was warned when I was prescribed this (it's also on the drug information sheet that comes from the pharmacy). So it might just be that your doctor isn't that good.
Regular dose shouldn't cause much drowsiness in most people. I take it all the time when flying (even double dose sometimes). I once took a double dose of regular dramamine and I was out within 30 minutes. I just checked - Dramamine actually calls it "less drowsy". They have non-drowsy be ginger, which is mostly a placebo (there's a lawsuit about it!). But this highlights my point: Telling someone "less drowsy" drama…
Either way, what you describe doesn't sound like a good experience. When I had some issue that necessitated meclizine, the PA wrote a prescription, explained what it was, warned me to be aware of drowsiness until I knew how it affected me, and I picked it up for $1-2 after insurance.
If I had a provider who was anything less than 100% confident and knowledgable about what they wanted me to take, I would be seeing someone else.
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Not to chastise you or your wife, there is an actual "Liver Warning" on Tylenol Product labels. They warn against 4000mg/day or with alcohol consumption. It's not an on/off switch, the damage occurs on a ramp that achieves a critical point after so much consumption. Saying this to encourage label reading and to refute those who might try to characterize your wife's experience as anecdotal. And for those who stop read…
Alcohol can actually be protective in a paracetamol overdose. Paracetamol itself isn't relatively dangerous, the metabolic product created by the liver is. Alcohol use acutely reduces the levels of these enzymes which convert paracetamol into it's toxic byproduct as ethanol preferentially binds to the same enzyme for it's own metabolism. Therefore, acute alcohol consumption can reduce the harmful effects of paracetam…
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Regular dose shouldn't cause much drowsiness in most people. I take it all the time when flying (even double dose sometimes). I once took a double dose of regular dramamine and I was out within 30 minutes. I just checked - Dramamine actually calls it "less drowsy". They have non-drowsy be ginger, which is mostly a placebo (there's a lawsuit about it!). But this highlights my point: Telling someone "less drowsy" drama…
Most side effects don't happen to people taking a drug. The warning isn't because of the likelihood of drowsiness, but the magnitude of risk caused by someone who may become drowsy when doing some other dangerous activity. Either way, what you describe doesn't sound like a good experience. When I had some issue that necessitated meclizine, the PA wrote a prescription, explained what it was, warned me to be aware of d…
Which is why most doctors don't mention them, either.
Look, everything I've been prescribed has a long list of side effects - many quite serious. Just read the pamphlet that comes with it. It's rare that a doctor mentions any, unless the side effect is decently common.
> When I had some issue that necessitated meclizine, the PA wrote a prescription, explained what it was, warned me to be aware of drowsiness until I knew how it affected me, and I picked it up for $1-2 after insurance.
Could it be possible your dose was higher than normal? For me, meclizine is like buying regular ibuprofen - insurance doesn't even enter into the picture. It's not what one normally considers a "prescription medication". Just like being prescribed Tylenol, you typically don't go to the pharmacist with it and say "Give me some" (and if you do, they just tell you to browse the aisles).
> If I had a provider who was anything less than 100% confident and knowledgable about what they wanted me to take, I would be seeing someone else.
I would suggest you re-evaluate your stance. The best doctors (and professionals), are the ones who are always doubting themselves, and the most confident ones are usually the ones who are just faking it - it takes only a few probing questions to expose their facade.
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Most side effects don't happen to people taking a drug. The warning isn't because of the likelihood of drowsiness, but the magnitude of risk caused by someone who may become drowsy when doing some other dangerous activity. Either way, what you describe doesn't sound like a good experience. When I had some issue that necessitated meclizine, the PA wrote a prescription, explained what it was, warned me to be aware of d…
> Most side effects don't happen to people taking a drug. Which is why most doctors don't mention them, either. Look, everything I've been prescribed has a long list of side effects - many quite serious. Just read the pamphlet that comes with it. It's rare that a doctor mentions any, unless the side effect is decently common. > When I had some issue that necessitated meclizine, the PA wrote a prescription, explained…
Earlier quoted context omitted.
Not to chastise you or your wife, there is an actual "Liver Warning" on Tylenol Product labels. They warn against 4000mg/day or with alcohol consumption. It's not an on/off switch, the damage occurs on a ramp that achieves a critical point after so much consumption. Saying this to encourage label reading and to refute those who might try to characterize your wife's experience as anecdotal. And for those who stop read…
Alcohol can actually be protective in a paracetamol overdose. Paracetamol itself isn't relatively dangerous, the metabolic product created by the liver is. Alcohol use acutely reduces the levels of these enzymes which convert paracetamol into it's toxic byproduct as ethanol preferentially binds to the same enzyme for it's own metabolism. Therefore, acute alcohol consumption can reduce the harmful effects of paracetam…