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Two Cautions
Caution!
Children and Acetaminophen
Most parents have a false sense of safety
about medications for children purchased without a prescription and
sold as a safe alternative to aspirin and other pain relievers. Unintentionally
and unknowingly they can harm their own children with over-the-counter
medications containing acetaminophen, the active ingredient in Tylenol,
Anacin 3, and many other remedies.
The most recent figures from the American Association of Poison Control
Centers show 71 serious acetaminophen poisoning incidents among children
in 1994, with serious long term or life-threatening results in 10
of them. The Food and Drug Administration reports 13 deaths of children
under 13 from acetaminophen poisoning between 1970 and 1991.
Acetaminophen can damage the liver and cause it to shut down,
leading to permanent disability or death. When taken as directed,
acetaminophen is a safe drug, says Rose Ann Soloway of the Poison
Control Centers. However, medications must be given in the exact doses
stated, and confusion commonly occurs when people don't realize that
the Infant Tylenol, a concentrated liquid, is 3 times stronger than
the children's strength, and that one should never be substituted
for the other.
It is critically important when using products containing acetaminophen
to follow directions carefully. Children are more vulnerable to the
serious effects of medications.
Here are six simple steps to promote child safety with acetaminophen
and other household medications:
- Always follow
instructions exactly.
- Never double
the dose.
- Check the strength
to see if you are using a concentrated version.
- Check with other
caretakers to be sure the medicine wasn't already given.
- Give medication
at times prescribed.
- If you miss
a dose, do not double the next dose.
- Always keep
all medicines out of the reach of children.
Caution! Herbs and Nutritional Supplements
What's the problem?
Televised testimonial promotions, as well as advertisements in health
and nutrition magazines, aggressively promote the use of herbs and
nutritional supplements frequently without explaining potential
dangers or side effects. Nutritional supplements and herbal remedies
are readily available in supermarkets, pharmacies, health food stores,
and offices of herbal practitioners. The fact that herbs are natural
preparations from plants doesn't necessarily mean they are safe. It
has been documented for centuries that some plant substances are toxic
to the liver. Herbal remedies are presently unregulated by any state
or federal medical or health agency, and their safety and effectiveness
have not been scientifically demonstrated.
How concerned are doctors?
Doctors are very concerned that many herbal-related liver injuries
go unrecognized because patients are often not asked about the use
of herbs and diet supplements. Herbal remedies contain multiple ingredients,
and the labeled and actual contents of a product may differ. This
makes it impossible to identify liver attack rates for specific herbs.
In a recent article, Dr. Raymond S. Koff questions the role herbal
products play in undefined hepatitis and fulminant (sudden and severe)
disease. In almost 50% of patients, fulminant disease cannot be related
to any identified hepatitis viruses. Liver injury directly related
to repeated use of herbal products ranges from mild and limited to
extensive disease. Dr. Koff believes that unrecognized herbal use
may be the cause of unidentified hepatitis and cirrhosis.
What herbs may be harmful?
Chaparral has been named as
the source of severe hepatitis leading to a liver transplant in a
60-year-old woman. She had taken two capsules of chaparral daily for
10 months. Three weeks before being hospitalized she increased her
dose to six capsules daily. This case showed signs similar to three
other cases of chaparral related hepatitis although hers was more
severe due to the longer period and the amount she had ingested.
In addition, a Chinese herbal product, JinBuHuan,
has been implicated in clinically diagnosed hepatitis in seven patients.
Other herbs known to be dangerous to the liver include: germander,
comfrey, mistletoe, skullcap, margosa oil, mate tea, Gordolobo yerba
tea, and pennyroral (squawmint
oil). Dr. Koff stresses that "many more may not yet have
been recognized."
Are all herbs harmful to the liver?
Not all herbs are a threat to the liver. Some people use Milk Thistle
to help maintain liver health. To date, the most reliable, and also
very preliminary, studies on people show that Milk Thistle does not
cure liver disease, but that it may improve the way the liver works
in patients with cirrhosis. However, there is no current evidence
to indicate that milk thistle relieves hepatitis symptoms or fights
the virus. Other herbs some use to help improve liver function include
licorice root and ginseng. To help relieve side effects of interferon
therapy, some turn to ginger or St. John's Wort. However, no herbal,
diet supplement, or alternative medicines have been scientifically
proven to cure or even ease symptoms of hepatitis C.
Until doctors ask patients about herbal use and have an adequate reporting
system whose results are backed by adequate scientific research, the
only way to reduce the risk of liver damage is to limit use of herbal
products. People with hepatitis have an already compromised liver,
and some herbs may be an added stress, increasing liver damage.
More on Hepatitis C Treatment Alternatives:
http://nccam.nih.gov/health/hepatitisc/index.htm
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