Wednesday, September 25, 2019

Earache


Although they can occur at any time of the day, most parents have had the experience of a child crying in the night from the pain of an earache.  There are many things that can cause earache (otalgia), and it may not be associated with ear disease.  Conditions such as an impacted tooth, sinus problems, inflamed tonsils, teething pain, TMJ, and infections in the nose and throat may play a role.

Ear pain may originate from the external, middle, or inner ear, but it is not always possible to tell the location of the pain.  External ear pain can be caused by trauma, swimmer's ear, or foreign bodies in the external ear.  Dental disease can cause ear pain as can other diseases.  Ear pain may also be a side effect of contagious illnesses such as colds, coughs, or eye problems like conjunctivitis.  When babies discover their ears they may pull at them until they hurt, causing mothers to fear their baby may have an ear infection. 

Friday, September 13, 2019

Acetaminophen


Acetaminophen (term used in the United States, Canada, and Japan), APAP, or paracetamol (term used elsewhere) is a widely used OTC pain reliever and fever reducer.  A mild analgesic commonly used for the relief of headaches and other minor aches and pains, it is also a major ingredient in numerous cold and flu remedies.  While it is used to treat inflammatory pain, it is not classified as an NSAID because its anti-inflammatory action is quite weak.  Tylenol (OTC name) is acetaminophen and because it does not reduce inflammation it is not very helpful for people with arthritis or aching joints to use. 

It is imperative that acetaminophen be taken in recommended doses.  It is generally safe for use at these recommended doses, but even small overdoses can have serious health consequences.  It may be more toxic in overdose than other OTC painkillers, but may be less toxic when used chronically at recommended doses.  Acetaminophen is metabolized by the liver and side effects are multiplied if consumed with alcoholic drinks or when fasting. 

Overdoses can cause potentially fatal liver damage.  Severe kidney damage is also a possibility.  Symptoms of overdose begin several hours after ingestion and include nausea, vomiting, and pain as acute liver failure starts.  If an overdose is suspected  taking activated charcoal given within one hour of acetaminophen ingestion may treat the overdose.  Acetylcysteine should be given the acetaminophen levels are high.  Treatment within 10 hours of ingestion reduces the risk to the liver.