Survey of patient knowledge related to acetaminophen recognition, dosing, and toxicity

Hornsby, Lori B.; Whitley, Heather P.; Hester, E. Kelly; Melissa, Thompson; Donaldson, Amy R.

doi:10.1331/japha.2010.08175

Cited by 44 publications

(42 citation statements)

References 8 publications

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“…Moreover, popular use among the general population might make the patients insensitive to the risk of these drugs. Indeed, many studies have revealed that even among adults, Tylenol (Janssen Korea, Hwasung, Korea) is used frequently without accurate knowledge15) of the risks involved 16). Such findings emphasize the significance of drug accessibility in the choice of drugs for suicide attempts among children and adolescents.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of Drug Overdose in Young Suicide Attempters

Kweon

Hwang

Yeon

et al. 2012

Clin Psychopharmacol Neurosci

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ObjectiveFew studies have focused on the characteristic features of drug overdose in children and adolescents who have attempted suicide in Korea. The present study examined the characteristics of drug overdose in children and adolescents who visited the emergency room following drug ingestion for a suicide attempt.MethodsThe medical records of 28 patients who were treated in the emergency room following a drug overdose from January 2008 to March 2011 were analyzed. Demographic and clinical variables related to the suicide attempts were examined.ResultsThe mean age of the patients was 16.6±1.7 years (range 11-19 years), and 20 of the patients (71.4%) were female. Most of the patients (n=23, 82.1%) overdosed on a single drug; acetaminophen-containing analgesics were the most common (n=12, 42.9%). Depression was the most common psychiatric disorder (n=22, 78.6%), and interpersonal conflict was the most common precipitating factor of the suicide attempts (n=11, 39.3%). This was the first suicide attempt for approximately 80% of the patients. About one fourth of the patients (n=7, 25%) had follow-up visits at the psychiatric outpatient clinic.ConclusionEarly screening and psychiatric intervention for depression may be an important factor in preventing childhood and adolescent suicide attempts. Developing coping strategies to manage interpersonal conflicts may also be helpful. Moreover, policies restricting the amount and kind of drugs purchased by teenagers may be necessary to prevent drug overdose in this age group.

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Section: Discussionmentioning

confidence: 99%

Characteristics of Drug Overdose in Young Suicide Attempters

Kweon

Hwang

Yeon

et al. 2012

Clin Psychopharmacol Neurosci

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“…These responses were coded as incorrect. Some studies provided a similar ‘not sure’ or ‘I don’t know’ option,42,52,54,55 while others did not,43,53 but there is no identifiable pattern between these two groups of studies which explains the variability seen. Our study boasts a more diverse patient population than others, but that does not appear to contribute to the variability, as studies measuring lower patient knowledge of Tylenol® were similar in demographics to those which measured higher patient knowledge in this study.…”

Section: Discussionmentioning

confidence: 99%

Limited Knowledge of Acetaminophen in Patients with Liver Disease

Saab

Konyn

Viramontes

et al. 2016

JCTH

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Background and Aims: Unintentional acetaminophen overdose remains the leading cause of acute liver failure in the United States. Patients with underlying liver disease are at higher risk of poor outcomes from acetaminophen overdose. Limited knowledge of acetaminophen may be a preventable contributor to elevated rates of overdose and thus acute liver failure. The purpose of this study is to assess knowledge of acetaminophen dosing and presence of acetaminophen in common combination products in patients with liver disease.Methods: We performed a cross-sectional study of patients with liver disease at the Pfleger Liver Institute at the University of California, Los Angeles between June 2015 and August 2016. Patients completed a demographic questionnaire and an acetaminophen knowledge survey. Additional information was obtained from the medical record.Results: Of 401 patients with liver disease, 30 (15.7%) were able to correctly identify that people without liver disease can safely take up to 4 g/day of acetaminophen. The majority of patients (79.9%–86.8%) did not know that Norco® (hydrocone/acetaminophen), Vicodin® (hydrocone/acetaminophen) and Percocet® (oxycodone/acetaminophen) contained acetaminophen. Only 45.3% of the patients knew that Tylenol® #3 contained acetaminophen.Conclusions: We conclude that patients with liver disease have critically low levels of knowledge of acetaminophen, putting them at risk both of acetaminophen overdose, as well as undermedication, and inadequate management of chronic pain. We recommend an increase in education efforts regarding acetaminophen dosage and its safety in the setting of liver disease. Increasing education for those at risk of low acetaminophen knowledge is essential to minimizing acetaminophen overdose rates and optimizing pain management.

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“…Paracetamol is widely available over the counter and in prescription products and many combination products contain paracetamol, but patients may equate the drug’s familiarity with safety and wrongly consider it more or less harmless. Twelve percent of patients believe that it is not possible to ingest a toxic dose of paracetamol [54]. Furthermore, even patients who understand the potential toxicity of paracetamol may be unaware that it is found in a wide range of over-the-counter products from cold medicines to headache remedies.…”

Section: Current Analgesics Used To Treat Arthritis-related Painmentioning

confidence: 99%

“…Furthermore, even patients who understand the potential toxicity of paracetamol may be unaware that it is found in a wide range of over-the-counter products from cold medicines to headache remedies. Patients taking such over-the-counter products may be unaware of “hidden paracetamol” in such products and unaware of the risk of high cumulative doses [54]. …”

Section: Current Analgesics Used To Treat Arthritis-related Painmentioning

confidence: 99%

Pain Treatment in Arthritis-Related Pain: Beyond NSAIDs

Laar¹,

Pergolizzi²,

Mellinghoff³

et al. 2012

TORJ

120

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Managing pain from chronic conditions, such as, but not limited to, osteoarthritis and rheumatoid arthritis, requires the clinician to balance the need for effective analgesia against safety risks associated with analgesic agents. Osteoarthritis and rheumatoid arthritis pain is incompletely understood but involves both nociceptive and non-nociceptive mechanisms, including neuropathic mechanisms. Prevailing guidelines for arthritis-related pain do not differentiate between nociceptive and non-nociceptive pain, sometimes leading to recommendations that do not fully address the nature of pain. NSAIDs are effective in treating the nociceptive arthritis-related pain. However, safety concerns of NSAIDs may cause clinicians to undertreat arthritis-related pain. In this context, combination therapy may be more appropriate to manage the different pain mechanisms involved. A panel convened in November 2010 found that among the currently recommended analgesic products for arthritis-related pain, fixed-low-dose combination products hold promise for pain control because such products allow lower doses of individual agents resulting in decreased toxicity and acceptable efficacy due to synergy between the individual drugs. Better evidence and recommendations are required to improve treatment of chronic arthritis-related pain.

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Survey of patient knowledge related to acetaminophen recognition, dosing, and toxicity

Cited by 44 publications

References 8 publications

Characteristics of Drug Overdose in Young Suicide Attempters

Characteristics of Drug Overdose in Young Suicide Attempters

Limited Knowledge of Acetaminophen in Patients with Liver Disease

Pain Treatment in Arthritis-Related Pain: Beyond NSAIDs

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