Alcohol And Synthetic Aspirin

[tutsiwarrior]

what is the last word regarding drinking, liver damage and synthetic aspirin? Most places you can't find aspirin but if you can't find relief from a hangover you might as well be dead. Paracetemol available most places but I heard a long time ago that alcohol is contraindicated for use as a pain killer if one has been drinking...liver damage can be acute.

Anyone have any info?

[dr_Pat_Pong]

what is the last word regarding drinking, liver damage and synthetic aspirin? Most places you can't find aspirin but if you can't find relief from a hangover you might as well be dead. Paracetemol available most places but I heard a long time ago that alcohol is contraindicated for use as a pain killer if one has been drinking...liver damage can be acute.

Anyone have any info?

Ask Pepe Tutsi. He's a medical man, and I am sure that he'd offer some advice.

[ProThaiExpat]

It seems to me from the information given, the danger of liver damage from injesting alcohol is far greater than from the headache relief any medication taken for hangovers.

There was an article in the American Medical Association journal years ago that reported that a physician in Chicago was doing stomach studies by photographing stomach disorders through endoscopy.

One morning, three of his patients showed up with hangovers and he decided this was a great time to test the wisdom of the old adage "A hair of the dog".

He proceeded to photograph the stomachs of the patients with hangovers and then administrered one ounce of medicinal alcohol to each patient, waited a few minutes, and then re-photographed their stomachs.

The contrast from the first and second photographs in each patient was astounding.

The first photographs of the hangower victims showed violently red stomachs, excreting many acids, etc.

The "after" photographs showed pink, healthy, relaxed and nearly normal stomach linings.

While I had long before reading this article discovered this truth empirically, (Analgesics never worked for my hangovers) I took this "medical advice" to heart and continued to "cure" my hangovers with additional "mediciine", (usually laced with milk). Of course, I didn't stop with one dose of "medicine", as the doctor had, so I continued my downward spiral to total, non-functioning alcoholism.

My point is well demonstrated by the story of the sailor who went into a drug store and whispered to the clerk, "give me some dramamine and some condoms, as I am going overseas tomorrow".

A little old lady waiting in line behind him who overheard his request whispered into the sailor's ear "Why do you do it if it makes you sick?"

[KevinN]

well TYLENOL is posed to be hard on your liver if taken in large doses,and same with alcohol, and if you take any meds. and then drink alcohol,the liver will quit working on metabolizing the meds and go to work on the alcohol as it is easier to work on,and the meds just keep circulating around thru your system and pretty soon,you have OD'ed on a normal dose of the meds,,thats why a lot of people die from drugs and alcohol,even with out taking a large dose of the drug.It just stays in your system to long..

[tutsiwarrior]

OK...let me put the question another way. A couple of analgesic tablets and a liter of water before bed is a good idea if one has been drinking excessively in order to be able to get up and go into work the next morning as most of us would agree.

In this regard is aspirin preferable to paracetamol/tylenol or is there no difference?

[cathyy]

Tylenol and Paracetamol are both brand names for acetaminophen. MANY other medicines, like cold or headache meds, contain acetaminophen as well. Acetaminophen is liver toxic. The maximum daily dose of acetaminophen is 4 g in adults and 90 mg/kg in children. A single ingestion of 7.5 g in an adult or more than 150 mg/kg in a child is a potentially toxic dose. Two extra-strength Tylenols is one gram.

Alcohol is also liver toxic. Putting the two together is plain foolish. A dose as low as 4g in 24 hours (the maximum daily dose on the package!) can cause toxicity when combined with alcohol. Toxic doses may be lethal, may leave permanent liver damage, or may leave no permanent harm. It depends on your liver's ability to metabolize it and to heal itself. Regular alcohol consumption compromises both of those abilities.

Take aspirin instead if you must indulge. Not ibuprofen, not naproxen, simple aspirin. And make sure it doesn't smell like vinegar. If the aspirin smells like vinegar it's breaking down chemically and won't work very well. Aspirin doesn't keep all that well, so buy the small bottles.

[tutsiwarrior]

cathayy...thanks very much for your info. My concern has to do with 2 tabs and water before bed. You have illustrated that tylenol, etc combined with alcohol from liquor is more harmful than aspirin in the same combination...such was my understanding.

Oh woe...why is aspirin so hard to come by? Go to the pharmacist at Tesco and mention aspirin and there is a subhuman response, unless you can see the green and white BAYER ASPIRIN box on the shelf behind them. Must only be falangs that acknowlege the alcoholic connection and thousands of thai drunks happily inbibe Sang Som and tylenol with a view toward immortality.

[cathyy]

Analgesics and water are overrated for hangover control. You need to drink something like Gatorade, and take some B-complex vitamins. Treat the problem, not the symptoms.

The best hangover cure I ever saw was homemade borscht. A friend made a batch every year the day before his (typically 3-day) birthday party.

[KevinN]

I have never seen BEETS for sale here in LOS,so how am I gonna make a pot of Borscht?

And a lot of people have an alergy to asprin, and if you are a serious drinking man, then what is wrong with a little hangover?

I used to wake up every morning feeling sorry for the people that didn't drink to access,,

They had nothing to look foreward to,,they felt as good when they woke up as they was going to all day.

[p1p]

Paracetamol, (acetaminophen in the USA) relieves pain and fever in adults and children, and it is the most widely accepted medicine for this purpose. It is used mainly for its pain relief properties either as a medicine prescribed by a doctor or it can be purchased as an over-the-counter medicine both in retail pharmacies or grocers shops.

There are virtually no groups of people who should not take paracetamol, and interactions with other treatments are not a problem.

When taken at the recommended dosage, there are virtually no side-effects.

Its pain relief (analgesic) and fever relief (antipyretic) effects are similar to those of aspirin and it works in a similar, though not identical, way. Unlike aspirin, however, increasing the dose does not result in clinically useful anti-inflammatory activity. Paracetamol is therefore not of value for reducing inflammation in the treatment of chronic rheumatic diseases as are the non-steroidal anti-inflammatory drugs like aspirin. Nevertheless, paracetamol does provide useful pain relief and is considered the first line treatment in osteoarthritis.

Paracetamol can be combined with decongestant ingredients to help relieve the symptoms of the common cold, influenza and sinusitis by relieving headache, general aches, nasal congestion and fever.

Paracetamol and its combinations are mainly available as tablets for immediate consumption or for dissolving in water before consumption. It is suitable for all age groups including the very young for whom it may be used following immunisation procedures, and it is available in liquid formulations for young children.

When used according to recommendations paracetamol has a remarkably good safety record, but there is a media myth that it is more dangerous than other medicines. The following are some of the causes of this misconception.

Paracetamol is familiar to the lay public and journalists, who will name it when reporting overdoses. Other less widely known medicines are usually not named in newspaper reports.

Newspapers often report unsubstantiated and inaccurate stories about overdose deaths from low doses of paracetamol. In fact, death seldom occurs from a single dose of less than 30 tablets, and if it does there are likely to be contributing factors such as chronic alcohol abuse or severe malnutrition.

Unlike deaths from overdoses of most medicines, a fatal overdose of paracetamol has a relatively long time course to death. This means that virtually all cases spend time in hospital. Hospital doctors and nurses therefore treat more of these cases than other fatal overdose cases (which are likely to be brought in dead), and some may form strong opinions against paracetamol while being less aware of all the other medicines overdose cases.

The long time course to death is harrowing for relatives, who may, understandably, vent their feelings by becoming angry towards the paracetamol used in the overdose.

In many inquests paracetamol is mentioned as being found present when it was not actually the cause of death. Such cases are commonly misreported as paracetamol deaths, thus exaggerating the role of paracetamol in overdosage. A report in the British Medical Journal in 1997 suggested that as many as 50% of reported paracetamol deaths were not actually due to paracetamol.

Fatal overdoses are sometimes rationalised by relatives as being accidental, and due to the taking of different products containing paracetamol. However, research shows that 97-98% of paracetamol overdoses are taken deliberately. In the remaining 2-3% of cases the paracetamol may have been taken for therapeutic purposes but with a reckless disregard for the dosage instructions.

If the overdose is large enough to completely overwhelm the liver it cannot recover and death will follow. This is what is meant by the term 'irreversible liver damage.'

Regarding overdoses, you should note that in large, untreated overdoses paracetamol may cause liver damage, but the liver recovers completely within a matter of months with no permanent damage.

Regarding Paracetamol and Alcohol: Paracetamol and alcohol are metabolised by the same oxidative enzymes and alcohol may even confer some protection to the liver in the event of a paracetamol overdose.

In certain circumstances, alcoholics may be at higher risk of liver injury in the event of a paracetamol overdose. However, paracetamol is used as an analgesic for patients in hospital liver units, including alcoholic patients.

Some brief details regarding the biochemistry of paracetamol and paracetamol overdoses follows: Paracetamol is rapidly absorbed, the soluble form being absorbed faster than the solid tablet form. The peak blood level for both forms is similar and is usually less than 20 mg/litre following a 1000 mg dose. Peak serum levels usually occur 30 minutes to 2 hours after ingestion. Elimination from the body is rapid with a half-life of about two hours.

Paracetamol is primarily metabolised by the liver. Most of it is combined with glucuronide and sulphate, which account for about 90% of the dose excreted. About 5% of the dose is excreted unchanged and a further 5% is oxidised to a benzoquinoneimine, which is then combined with glutathione and metabolised on to cysteine and mercapturate compounds which are safely excreted.

Paracetamol and its two primary metabolites are remarkably safe compounds, and the hepatotoxicity of paracetamol arises only through the 5% that is oxidised. The immediate oxidation metabolite, benzoquinoneimine, is a highly reactive substance that normally combines with glutathione. As the dose of paracetamol increases, the quantity of benzoquinoneimine produced increases too. There then comes a point where the glutathione stores in the liver have been completely used up and the rate of production of new glutathione cannot keep up with the rate of production of the benzoquinoneimine. It is at this point that the benzoquinoneimine attaches to liver protein and causes liver injury.

The time required for the liver to become depleted of glutathione, and for the benzoquinoneimine to build up and cause fatal liver damage, is three to four days. During the early stages of this process, there may be few overt symptoms, and it is important that in cases of suspected overdose the patient does not wait for symptoms to appear before seeking medical help. It is estimated that liver injury may begin to occur at a single dose of paracetamol of 15g (30 standard tablets) or over.

Treatment of overdose consists of skilled hospital management of the patient, including where necessary the administration of an antidote, n-acetylcysteine, which is administered intravenously. The antidote restores the liver's capacity to produce glutathione for combination with the benzoquinoneimine, and appears to have further protective effects on the liver.

The administration of antidote within 12 hours of overdose is highly effective and is able to remove the risk of liver injury. Antidote therapy is also very effective up to 24 hours and there is evidence for benefit from antidote administration up to 48 hours following overdose.

Paracetamol overdose can be successfully treated providing patients receive skilled treatment early, and the early diagnosis and treatment of any suspected overdose is a goal to be pursued.