Survey shows shocking lack of knowledge about acetaminophen dangers

Pop Quiz

This is only a test, but a passing grade could help save your life.

Three questions:
1) What is Panadol?
2) What is para-acetylaminophenol
3) What is APAP?

Pencils down! How did you do?

If you answered “acetaminophen” for each question–congratulations–you aced the test with 100 percent correct. Gold star for you.

If you didn’t get them all (or any), don’t feel too bad. Outside of doctors and other health care professionals, it appears that very few people would pass the test. Which is one of the key reasons why acetaminophen has become the number one cause of acute liver failure in the U.S.

Who’s keeping the gate?

Just so you never fail this test again, here’s the Answer Key:
1) Panadol is the brand name of acetaminophen in the UK
2) Para-acetylaminophenol is the chemical name for acetaminophen
3) APAP is an abbreviation for para-acetylaminophenol

That third answer is probably the most worrisome.

Many prescription drug information sheets use the “APAP” abbreviation to designate acetaminophen as an ingredient. So no matter how carefully you might read an insert, if you don’t know the meaning of the abbreviation, you wouldn’t realize you were taking acetaminophen.

And that’s how some people end up in the ER with dire liver emergencies.

It appears that FDA officials, with their signature cluelessness, have helped put acetaminophen at the top of the liver damage chart.

Just two years ago, an FDA panel concluded that there was little evidence that consumers misuse over-the-counter products.

I’m sure ER personnel would have scoffed in their faces. Meanwhile, researchers at Northwestern University Medical School put the panel’s conclusion to the test by interviewing participants in several focus groups in Chicago and Atlanta.

Their findings:

• Nearly 60 percent of the subjects admitted that they didn’t read OTC drug labels to check ingredients
• Less than one-third of the subjects knew that Tylenol contained acetaminophen

If the Northwestern survey accurately represents the way the general population behaves with an OTC cold medication or an allergy remedy, it’s no wonder thousands of patients are treated for acetaminophen toxicity every year.

As one Northwestern researcher put it: “Unlike prescription products, there is no gatekeeper, no one monitoring how you take it.”

But when so many prescription products simply use “APAP” to designate acetaminophen, well…we suddenly have no one keeping the gate.

The Northwestern team proposes that a universal icon should be established and used on EVERY product that contains acetaminophen.

Great idea. But it can’t be some wimpy little icon that appears on drug inserts. It needs to be a big, bold, colorful icon, stamped on the front label of every box and bottle that contains the drug.

So who’s move is it? Will the FDA direct drug makers to do the right thing? Or will drug companies step up and set a uniform industry standard?

While we wait for them to finish this round of “Rock, Paper, Scissors,” we can start to protect ourselves.

Make sure you know the different ways that products indicate acetaminophen as an active ingredient–and make sure your family does too.

Sources:
“Public confused about ingredients in pain relievers” Northwestern University press release, 5/2/11, eurekalert.org