Instruct: Given a question, retrieve documents that answer the question.
Query: How common is acetaminophen poisoning?
Paracetamol poisoning was first described in the 1960s.[4] Rates of poisoning vary significantly between regions of the world.[6] In the United States more than 100,000 cases occur a year.[2] In the United Kingdom it is the medication responsible for the greatest number of overdoses.[5] Young children are most commonly affected.[2] In the United States and the United Kingdom paracetamol is the most common cause of acute liver failure.[7][2]
On the same day, the American Society for the Prevention of Cruelty to Animals announces that "fears of widespread contamination of pet food with acetaminophen are unfounded," confirming the results of FDA investigators. The ASPCA collaborated with toxicologists with the California Animal Health and Food Safety System at the University of California, Davis. They found no acetaminophen contamination in three cans of the same food that tested positive for acetaminophen at a Texas laboratory. Additionally, since the cat that had eaten the food suffered kidney, but not liver, failure, acetaminophen poisoning seems unlikely.
Paracetamol poisoning, also known as acetaminophen poisoning, is caused by excessive use of the medication paracetamol (acetaminophen).[3] Most people have few or non-specific symptoms in the first 24hours following overdose.[1] This may include feeling tired, abdominal pain, or nausea.[1] This is typically followed by a couple of days without any symptoms after which yellowish skin, blood clotting problems, and confusion occurs as a result of liver failure.[1] Additional complications may include kidney failure, pancreatitis, low blood sugar, and lactic acidosis.[1] If death does not occur, people tend to recover fully over a couple of weeks.[1] Without treatment some cases will resolve while others will result in death.[1]
In the late 20th century, an increasing number of products used for everyday life proved to be poisonous. The risk of being poisoned nowadays lies more in the accidental factor, where poison be induced or taken by accident. Poisoning is the 4th most common cause of death within young people. Accidental ingestions are most common in children less than 5 years old.
Fiorcet historically contained 50 mg of butalbital, 40 mg of caffeine, and 325 mg of acetaminophen per dose. However, in accordance with FDA guidelines advising manufacturers to limit doses of acetaminophen in prescription drugs, the acetaminophen content was lowered to 300 mg as of 2014. 
Acute overdoses of paracetamol can cause potentially fatal liver damage. In 2011, the U.S. Food and Drug Administration launched a public-education program to help consumers avoid overdose, warning: "Acetaminophen can cause serious liver damage if more than directed is used." In a 2011 Safety Warning, the FDA immediately required manufacturers to update labels of all prescription combination acetaminophen products to warn of the potential risk for severe liver injury and required that such combinations contain no more than 325 mg of acetaminophen. Overdoses are frequently related to high-dose recreational use of prescription opioids, as these opioids are most often combined with acetaminophen. The overdose risk may be heightened by frequent consumption of alcohol.
"Acetaminophen has been associated with cases of acute liver failure, at times resulting in liver transplant and death. Most of the cases of liver injury are associated with the use of acetaminophen at doses that exceed 4000 milligrams per day, and often involve more than one acetaminophen-containing product."
For postoperative pain, it is more or less equal to ibuprofen. For pain relief, it is similar to paracetamol (acetaminophen). And in osteoarthritis, acetaminophen is the first line treatment. In knee and hip osteoarthritis, acetaminophen may be ineffective.
Before the poisonings, Tylenol brands held around 35% of the US market for acetaminophen and in the immediate aftermath, fell to 8%. Within a year sales had rebounded to the prior levels.[9] J&J's handling of the crisis has been widely cited as an example of optimal crisis management.[10]
Over-the-counter drugs, like acetaminophen, aspirin, or NSAIDs(ibuprofen, Naproxen, Ketoprofen), can be effective but tend to only be helpful as a treatment for a few times in a week at most. For those with gastrointestinal problems (ulcers and bleeding) acetaminophen is the better choice over aspirin, however both provide roughly equivalent pain relief. It is important to note that large daily doses of acetaminophen should be avoided as it may cause liver damage especially in those that consume 3 or more drinks/day and those with pre-existing liver disease. Ibuprofen, one of the NSAIDs listed above, is a common choice for pain relief but may also lead to gastrointestinal discomfort.
It is postulated that "H. sabdariffa" interacts with diclofenac, chloroquine and acetaminophen by altering the pharmacokinetics. In healthy human volunteers, the "H. sabdariffa" extract was found to reduce the excretion of diclofenac upon co-administration. Additionally, co-administration of Karkade ("H. sabdariffa"), a common Sudanese beverage, was found to reduce chloroquine bioavailability. However, no statistically significant changes were observed in the pharmacokinetics of acetaminophen when administered with the Zobo ("H.sabdariffa") drink. Further studies are needed to demonstrate clinical significance.
The FDA announces that acetaminophen has not been found in five samples of cat food and two samples of dog food.
FDA spokesman Mike Herndon says that, "At this point, FDA sees no compelling need to analyze any more samples for acetaminophen." A third, independent lab also did not detect acetaminophen. It is not clear whether the FDA checked samples of the same brands of food in which acetaminophen was allegedly found because the initial laboratory could not initiate contact with the FDA or publicly identify the manufacturer because of client confidentiality. Only if the FDA contacted the lab could information be shared, and the FDA did not do this until June 12.
During the latter part of the 20th century, the number of poisonings from salicylates declined, mainly because of the increased popularity of other over-the-counter analgesics such as paracetamol (acetaminophen). Fifty-two deaths involving single-ingredient aspirin were reported in the United States in 2000; however, in all but three of these cases, the reason for the ingestion of lethal doses was intentional—predominantly suicidal.
Some common household chemicals are particularly dangerous to dogs:Poisoning with pain medications is common. Aspirin, paracetamol (acetaminophen, Tylenol), ibuprofen (Advil), and naproxen (Aleve) can all cause severe clinical signs in dogs, including vomiting blood, diarrhea, and abdominal pain. Specifically, aspirin can cause metabolic acidosis and bleeding disorders, acetaminophen can cause liver disease, ibuprofen can cause kidney disease, and naproxen can cause ulcers in the stomach, which can perforate. Treatment depends on the clinical signs.
Many medications have antipyretic effects and thus are useful for fever but not in treating illness, including:The U.S. Food and Drug Administration (FDA) notes that improper dosing is one of the biggest problems in giving acetaminophen (paracetamol) to children. The effectiveness of acetaminophen alone as an antipyretic in children is uncertain, with some evidence showing it is no better than physical methods. Therapies involving alternating doses of acetaminophen and ibuprofen have shown greater antipyretic effect than either drug alone. One meta-analysis indicated that ibuprofen is more effective than acetaminophen in children at similar doses when both are given alone.
Additionally, compounds such as N-acetylcysteine (NAC) and alpha lipoic acid (ALA, not to be confused with the unrelated alpha-linolenic acid) are both capable of helping to regenerate glutathione levels. NAC in particular is commonly used to treat overdose of acetaminophen, a type of potentially fatal poisoning which is harmful in part due to severe depletion of glutathione levels. It is a precursor of cysteine.
On June 30, 2009, an FDA advisory panel recommended that Percocet, Vicodin, and every other combination of acetaminophen with narcotic analgesics be limited in their sales because of their contributions to an alleged 400 acetaminophen-related deaths in the United States each year, that were attributed to acetaminophen overdose and associated liver damage.
Common medications causing a minor negative drug interaction include: Insulin and Metformin. Common medications checked in combination, but that are not known to create a negative drug interaction, include: Aspirin, Cymbalta (duloxetine), Fish Oil, Acetaminophen, Vitamin B12, Vitamin C, Vitamin D3, and Zyrtec.
Hydrocodone/paracetamol, also known as hydrocodone/acetaminophen, is the combination of the pain medications hydrocodone and paracetamol (acetaminophen). It is used to treat moderate to severe pain. It is taken by mouth. Recreational use is common in the United States.
Common side effects include dizziness, sleepiness, constipation, and vomiting. Serious side effects include addiction, respiratory depression (a decreased effort to breathe), low blood pressure, serotonin syndrome, severe allergic reactions, and liver failure. Use during pregnancy may harm the baby. Use with alcohol is not recommended. Hydrocodone works by binding to the mu-opioid receptor. How acetaminophen works is unclear.
Hydrocodone/paracetamol was approved for medical use in the United States in 1982. In the United States it is a schedule II controlled substance. In 2016 it was the 13th most prescribed medication in the United States with more than 43 million prescriptions. It is not available in the United Kingdom. It is sold under the trade name Vicodin among others.
Overuse of common drugs such as ibuprofen, and acetaminophen (paracetamol) can also cause chronic kidney disease.
The Chicago Tylenol murders were a series of poisoning deaths resulting from drug tampering in the Chicago metropolitan area in 1982. The victims had all taken Tylenol-branded acetaminophen capsules that had been laced with potassium cyanide. A total of seven people died in the original poisonings, with several more deaths in subsequent copycat crimes.
Many herbal and antioxidant remedies have been advocated for chronic liver disease but the evidence is not conclusive. Some support may be found in the orthodox medical use of two of these: N-acetyl cysteine (NAC), is the treatment of choice for acetaminophen overdose; both NAC and milk-thistle (Silybum marianum) or its derivative silibinin are used in liver poisoning from certain mushrooms, notably Amanita phalloides, although the use of milk-thistle is controversial. Some common herbs are known or suspected to be harmful to the liver, including black cohosh, ma huang, chaparral, comfrey, germander, greater celandine, kava, mistletoe, pennyroyal, skull cap and valerian.
Due to the high concentrations of non-opiate substances relative to the diamorphine content of the drug, abuse and overdose of cheese are more dangerous than pure-form opiate overdoses. Emergency personnel must address the overdose effects of each component of the drug, since the contents and concentrations of each component vary widely among batches they must wait for either the completion of the toxicology report to begin treatment or wait for the effects of each drugs overdose to manifest. The acetaminophen content of the drug induces severe, irreversible damage to the liver when taken in high doses for long periods of time. Very high doses of acetaminophen are capable of producing acute liver failure and death within hours, patients who survive this acute phase of the toxicity generally require dialysis and eventually a liver transplant. Due to the many methods of preparation a user can not know how much acetaminophen is in any given batch and therefore can not reliably determine a safe dose. A dose of the last batch which produced no toxic effects may produce lethal effects in the next batch.
One strategy for reducing harm done by acetaminophen overdoses is selling paracetamol pre-combined in tablets either with an emetic[49] or an antidote. Paradote was a tablet sold in the UK which combined 500mg paracetamol with 100mg methionine,[51] an amino acid formerly[17] used in the treatment of paracetamol overdose.
"Rabbits" was used as a stimulus in a psychological experiment on the effects of acetaminophen on existential crisis. The research, in a paper entitled "The Common Pain of Surrealism and Death" suggested that acetaminophen acted to suppress the effects of surrealism.