mattn said:
most of u make me laugh honestly.. im not trying to sound like a prick, but come on now... u pop 2,3,4 or more illicit ecstasy tabs, but god forbid you want to combine tylenol with it. does this seem somewhat ridiculous to only me? and opiates with mdma... wow, take some morphine/methadone/oxy with mdma and your body will be buzzing like never before... its an amazing combination and has never reduced my roll, only made it better, even on as little as 2 tabs and 10mg methadone with mild tolerance..
How much do you actually know about the pharmacology of acetaminophin?
What amazes me is the fact that people bitch about the DEA and emergency scheduling of MDMA and how illogical (not to mention potentially unconstitutional) it was and yet these same people think that just because you can buy Tylenol over the counter it is safe as hard candy, as if suddenly the scheduling whims of the agency are rational in this case.
Depending on the individual, toxicity begins at around 4g. That's just 8 Extra Strength Tylenol. Not much of a margin for people who pop three at a time.
Toxicity is definately developed even in adults around 7g.
These figures are substantially reduced for alcholoics, malnourished or anorexics, or if you've been drinking prior to taking the stuff.
Describing the toxicity itself:
"In acute overdose or when maximum daily dose is exceeded over a prolonged period, the normal pathways of metabolism become saturated. Excess APAP is then metabolized in the liver via the mixed function oxidase P450 system to a toxic metabolite, N-acetyl-p-benzoquinone-imine (NAPQI). NAPQI has an extremely short half-life and is rapidly conjugated with glutathione, a sulfhydryl donor, and removed from the system. Under conditions of excessive NAPQI formation or reduced glutathione stores, NAPQI is free to covalently bind to vital proteins and the lipid bilayer of hepatocytes; this results in hepatocellular death and subsequent centrilobular liver necrosis." (Susan E. Farrell, MD "Toxicity, Acetaminophen.")
Acetaminophen is among the most common causes of overdose reporting to American Poison Control Centers. It is the number one cause of hepatic failure related liver transplants in both the U.S. and the U.K.
Wonder why no one has bothered to schedule it?
It's not a pleasent overdose either. Again from Farrell:
Phase 1 (0-24 h)
Asymptomatic
Anorexia
Nausea and vomiting
Diaphoresis
Malaise
Phase 2 (18-72 h)
Decreasing symptoms of phase 1
Right upper quadrant abdominal pain and rising liver enzymes (alanine aminotransferase [ALT], aspartate aminotransferase [AST])
Phase 3 (72-96 h)
Centrilobular hepatic necrosis with accompanying abdominal pain
Jaundice
Coagulopathy
Hepatic encephalopathy
Recurrence of nausea and vomiting
Renal failure
Fatality
Phase 4 (4 d to 3 wk)
Complete resolution of symptoms
Complete resolution of organ failure
Yum! Pass the Tylenol!
