dose

  1. New instructions for Tylenol

    Way too many people are taking way too much Tylenol -- and Johnson & Johnson's latest window-dressing maneuvers won't fix a thing.

    J&J says the changes it will make -- next year, mind you, not today -- will help stop the overuse that's turned the drug's main ingredient, acetaminophen, into the leading cause of liver failure in the United States.

    But they're not changing the drug.

    They're not even changing the dose.

    They're simply changing the maximum number of pills a patient should take each day from eight to six.

    Big stinking deal -- and when you consider the musty odor that's led to a recall of some Tylenol products, I do mean "stinking." Anyone who's been paying attention can tell you that the real problem isn't the instructions on the label, or even that awful smell.

    It's the drug itself -- along with the fact that drug makers have put it into just about everything from painkillers like J&J's Tylenol to cold meds like Procter & Gamble's Nyquil... not to mention prescription drugs such as Vicodin and Percocet.

    Many people overdose on acetaminophen simply because they have no idea how much they've taken.

    Then, they find out the hard way what happens when you take too much -- and liver failure is just the beginning. One study earlier this year found people who pop just four Tylenols a week have double the risk of blood cancers.

    Two other recent studies found that kids given acetaminophen regularly -- say, to reduce an ordinary and often harmless low-grade fever -- have a higher risk of asthma, wheezing, and other breathing problems.

    And let's not forget the infamous recalls of both regular and children's Tylenol lines due to quality control issues ranging from that musty odor I mentioned earlier to bacterial contamination and "tiny particles" -- including bits of metal -- in the medicine.

    Throw in all the other problems linked to acetaminophen -- nausea, vomiting, abdominal pain and allergic reactions, just to name a few -- and it's bad news all around, no matter how many pills you take.

  2. Human error goes digital

    Looks like computers are only human after all.

    Computers were supposed to change healthcare permanently and forever, and in many ways they have.

    But when it comes to slashing the number of medical mistakes, we still have a long way to go -- because it turns out computers are just as likely as humans to botch drug prescriptions.

    Researchers looked at data on 3,850 electronic prescriptions filled at pharmacy chain locations in three states during a four-week period in 2008.

    The researchers say they found mistakes in 11.7 percent of all prescriptions and that four percent were serious enough
    that they could have led to adverse events, according to the study in the Journal of the American Medical Informatics Association.

    That's right in line with the error rate we've (sadly) come to expect from the traditional handwritten prescriptions --which proves that many of the problems don't stem from a doctor's poor handwriting.

    They stem from a poor attention to detail.

    Most of the mistakes were omissions: The researchers say more than 60 percent of the errors involved missing details
    such as dose, frequency, and number of days.

    Now, if you're like me, you're probably wondering why the software allows e-prescriptions to be sent to the pharmacy
    with all those missing blanks.

    Short answer: It doesn't.

    Just about all the programs used for electronic prescriptions have a setting that rejects the prescription if it contains missing data, forcing the doctor to fill it all in before it can be sent.

    But docs aren't using it -- that setting is either being shut off, or it was never turned on in the first place.

    These programs also have a setting that figures out possible drug interactions as well as the maximum dose of each med -- and again, docs aren't using it.

    The researchers say simply switching on those two functions alone would have prevented 77 percent of the errors uncovered by their study.

    I think it's time someone rewrites the software so those functions can't be turned off.

    In the meantime, whether your prescription comes from a pen or a machine, the same rules apply: Ask your doctor what you're taking, how much you should take and when you should stop.

    Write it down if you have to.

    And then make sure the drug label that ends up in your hands matches what you were told in the exam room.

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