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. Steroid inhalers not a breath of fresh air for asthmatic kids

    by Dr. Alan Inglis

    I've met plenty of patients who have children or grandchildren taking steroid inhalers. They all had pretty much the same reaction when their doctors first prescribed this aggressive medication for their loved ones.

    You know the reaction… your head kind of cocks to the side and your eyes narrow as you wonder, "Is this really safe?" Of course, most patients are afraid to say anything – and I understand not wanting to take any chances when it comes to a child's ability to breathe.

    But trust your instincts. These inhalers can be incredibly unsafe, and research is showing that they're not always very effective.

    A recent study from the University of Leicester in England reexamined the protocol at many hospitals, where children who are admitted with sudden wheezing attacks often are given steroid inhalers.

    The researchers compared preschoolers who were given prednisolone with those given a placebo. There was no significant difference in the comparative length of hospital stays for 687 kids ranging in age from 10 months to five years. There was no real difference in symptom relief, either.

    Another recent study, this one from Canada, looked at the benefits of using fluticasone as a preventive. Researchers concluded that the possible stunted growth from the steroid was more dangerous than any potential gains the drug provided for soothing wheezing.

    You've heard me say before that the hardest thing for a doctor to do is nothing. I understand that the wheezing sound an asthmatic child makes is frightening, and could lead a doctor to prescribe an aggressive medication. But before you let your children or grandchildren take a medication that lists everything from coughing up blood to psychosis as its side effects, you need to ask some tough questions about whether it's going to do any good.

    And, if we're honest, very often the answer will be no.

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