Alarm over ignorance-based OTC meds misuse

Only 41 percent of the people questioned in a new study said they read the labels of medications they take.

That lack of knowledge about popular pain relievers -- and ignorance, in particular, of acetaminophen being in more than 600 over-the-counter and prescription medicines, could be a key reason acetaminophen overdose has become the leading cause of acute liver failure in the U.S., researchers say.

The study showed only 31 percent of participants knew Tylenol contained acetaminophen; 47 percent knew Motrin contained ibuprofen; 19 percent knew Aleve contained naproxen sodium; and 19 percent knew Advil contained ibuprofen. Some 75 percent did know Bayer contained aspirin.

The researchers are suggesting a solution: a universal icon for labels of medications containing acetaminophen to alert users to its presence.

"It's incredibly alarming," said Michael Wolf, an associate professor of medicine at Northwestern University Feinberg School of Medicine and senior author of the study published today in the American Journal of Preventive Medicine.

"People may unintentionally misuse these medicines to a point where they cause severe liver damage," Wolf said. "It's easy to exceed the safe limit if people don't realize how much acetaminophen they are taking. Unlike prescription products, there is no gatekeeper, no one monitoring how you take it."

The study, sponsored by Tylenol, says misuse of acetaminophen results in more than 30,000 hospitalizations every year, and up to two-thirds of overdoses are unintentional -- people aren't aware of how much they're supposed to take, and how often.

On "The Early Show" Tuesday, Dr. Travis Stork, co-host of the daytime medical-talk show, "The Doctors," explained that most of the overdoses are the result of longer, chronic overdosing that affects someone without his or her knowledge. Where I do see people present problems in the ER is when they tell me they've been taking Tylenol (acetaminophen) and Vicodin (which contains acetaminophen) for their pain, which can result in a toxic dose.

The problem, he says, is that it's confusing. If you're spending six months of your life and are overdosing on acetaminophen without realizing it, you'll wake up and have acutely gone into massive liver failure. You can do it over time and not even be aware of it.

And, he says, it's not just acetaminophen that can be toxic. People who overdose on ibuprofen can develop ulcers and it can affect kidney function in some people.

All the medicines have possible drawbacks.

It can be a problem for kids, too. A lot of times, Stork points out, people will say, "My kid has a cold" and give them a bunch of medications at a time -- and little do they know, they're doubling or tripling their dose.

For kids, it's hard for parents to give proper doses. The label will say, "For six year olds, give your kid this much," but if your six year old is the tiniest one in the class, they may get a dose that's too big. The confusion is massive and it's an inherent flaw in our system. Also, sometimes the dose will be a teaspoon, but when your kid's not feeling well and you're in a panic, you end up using a tablespoon. Plus, not all teaspoons are equal.

Ibuprofen and aspirin, Stork notes, are non-steroidal, anti-inflammatory drugs -- the key word being anti-inflammatory, because they prevent inflammation at the site of the injury. Acetaminophen works centrally in the brain.

They're all effective and to some extent, Stork says, but you have to ask yourself what works best for you.

"As I say on 'The Doctors' all the time, you really have to be your own CEO when it comes to medication: know your ingredients, know your dosing, and know the side-effects.