siderea took my post about Tylenol/acetaminophen/paracetamol and and ran with it.
Here's a prime bit, but really, read the whole thing and the comments:
3) Alcohol makes acetaminophen stronger, and lowers the fatal acetaminophen dose. Don't be drinking and taking acetaminophen.
3a) More specifically, acetaminophen is metabolized by CYP2E1 (among other CYP isoenzymes). Ethanol is a CYP2E1 inducer, and apparently, it's the metabolites of acetaminophen overwhelming the liver which is dangerous, so anything which increases the rate of CYP2E1 activity is dangerous with acetaminophen. You know what else is listed as a CYP2E1 inducer? Tobacco smoking.
3b) While we're at it, CYP1A2 and CYP2D6 are also involved. You know what interacts with CYP1A2 and CYP2D6? Everything. Inducers include tobacco, broccoli, brussel sprouts, Echinacea, chargrilled meat (hey, I'm just copying this from Wikipedia), cauliflower and insulin.
3c) Also, you'll want to have been very careful not to have inherited or mutated an extra copy (or multiple extra copies) of the gene for CYP2D6 (or presumably CYP1A2 or CYP2E1), something which it is speculated is the source of some people's unusually high susceptibility to acetaminophen overdose. Good luck with that.
4) There are legitimate reasons to prefer acetaminophen over ibuprofen and aspirin. You should know what they are if you're taking it, and you should take considered steps to prevent accidents. In a house with a child or other cognitively impaired party, it belongs in a locked medicine chest.
And I'm wondering whether having acetominiophen in prescription drugs which contain opiates might really be intentional murder. Or it might just be sloppiness-- opiates are bad, adding bad things to bad drugs might discourage use, fail to think about actual consequences because it's a bad drug.
Anyone else remember Triage? It was about a conspiracy of non-preference utilitarians who were using looser and looser standards to kill people who were "better dead".
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