1. But It Is Over the Counter!!! By Nayri Hatsakorzian Touro University- College of Pharmacy

3. Tylenol Acetaminophen, APAP Used for pain and fever Comes in regular strength (325 mg), extra strength (500 mg) or tylenol arthritis (650 mg) Formulations for children and infants exist Found in many OTC medication in combination with others – Vicodin, Teraflu, Triaminic, Nyquil, Dayquil, Excedrin. – medication that says cold/flu/pain…take a look in the back! How to take tylenol? – Take 1-2 tablets by mouth every 4-6 hour for pain as needed

4. What happens when you took too much of it? – Hepatotoxic?? Huh, what’s that? When does that happen? – It will never happen to me!! – Let’s do some math to decide!

5. FDA & APAP New FDA regulations – In 2009 FDA decided to strengthen the warnings on liver toxicity and Acetaminophen use. – Liver transplant, death. – Maximum dose is ??? mg – Maximum dose ??? tables

6. Now it is 3200 mg a day – 3200 mg = 3.2 grams Used to be 4000 mg a day 4000 mg = 4 grams In tablets it means – 6 tablets if you are taking ES FDA & APAP

7. What are the signs and symptoms of liver toxicity? Nausea Vomiting Loss of appetite Sweating Extreme tiredness Unusual bleeding or bruising Pain in the upper right part of the stomach Yellowing of the skin or eyes Flu-like symptoms You may even not feel anything!!

8. Aspirin Salicylic acid Used in pain, fever, and inflammation Mostly seen as 81 mg and 325 mg BABY aspirin is NOT for babies How to take aspirin? – Take 1-2 tablets by mouth every 4-6 hours as needed.

9. What happens when you take too much?? Dizziness, drowsiness, headache, lightheadedness, and lethargy are the signs of salicylate toxicity. Other symptoms include uncontrollable flapping movements of the hands, increased thirst, and visual impairment. In severe aspirin overdose: – seizures, hallucinations, severe nervousness, excitement, confusion, wheezing or shortness of breath, and unexplained fever may occur. – In young children the only signs of overdose may be behavioral changes.

10. Talk to you pharmacist, or intern pharmacist when you are buying or looking to buy over the counter medications Always ask the pharmacist when you are buying over the counter medication for children Ask, learn and empower. October in pharmacists’ month.

11. Thank you for listening