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Originally posted by scholar:
Ibuprofin is the same as motrin right? My dr has me mixing baby tylenol and baby motrin to keep my baby's fever down.

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Yes. Advil and Motrin are both brand names for ibuprofen. Tylenol is a brand name for acetaminophen (which is called something different in the UK but is the same drug.)
 

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Posted by Wendybird (Member # 84) on :
 
Well if you are in pain definately stick with the tylenol pm and ibuprofen. Stagger them like was suggested - take the ibuprofen then two hours later take the tylenol pm. If still up take some more ibuprofen if needed. I've been told this by many docs.
 

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Posted by Alcon (Member # 6645) on :
 
Weird... I'd never actually looked at Benadryl close enough to notice that. Looks like it can have other active ingredients according to wikipedia. Plus we don't have any cause -- you know -- no allergies.

Wonder why it never worked, but TyPM does...? Guess it's partly psychosomatic?
 

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Posted by pH (Member # 1350) on :
 
With sleep aids, I think a bunch of it is psychosomatic. I mean, just the difference of having the pill be blue instead of pink or yellow makes a difference in your expectations of how it will work. Blue = sleepy!

-pH
 

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Posted by breyerchic04 (Member # 6423) on :
 
It always works for me but then I know it is the same thing. The only reason it doesn't is if my ankle (that I broke junior year) hurts, tylenol pm helps that.
 

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Posted by Alcon (Member # 6645) on :
 
Alright, well having now taken both I'm gonna go pass out. Thanks everyone
 

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Posted by aspectre (Member # 2222) on :
 
"Tylenol is a brand name for acetaminophen (which is called" paracetamol or Panadol "in the UK" and darn near everywhere except the US "but is the same drug.)"

Ibuprophen and acetaminophen work in entirely different manners. Ibuprofen's breakdown products and acetaminophen's breakdown products are detoxified on two separate metabolic pathways. So it is quite safe to use ibuprofen and acetaminophen together; though staggering dosages is preferable.
Same with aspirin and acetaminophen. And naproxen and acetaminophen.

HOWEVER do not take any combination of aspirin, ibuprophen, naproxen, or other NSAIDs together without specific instructions from a physician.

Do not mix acetaminophen with anything containing alcohol. They do interfere with detoxification of each other's breakdown products, and thus can cause liver damage.
Do not use acetaminophen as a hangover cure, not even on the "morning after".

[ August 18, 2007, 04:30 AM: Message edited by: aspectre ]
 

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Posted by pooka (Member # 5003) on :
 
I've heard the action of one inhibits the breakdown of the other, and that they are not safe to take together long term.

Pediatricians even tell people to do it short term, so I don't know if we'll find out for sure. But drugs are never tested in combination so there really isn't any clinical evidence one way or the other.

As a note on acetaminophen and alcohol, keep that in mind with Nyquil.
 

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Posted by ketchupqueen (Member # 6877) on :
 

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I've heard the action of one inhibits the breakdown of the other, and that they are not safe to take together long term.

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Originally posted by aspectre:
Which oughtta tell ya something about drug manufacturers, advertising agencies, and the folks who own the media.
More on alcohol and acetaminophen.

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Originally posted by aspectre:
"...you'd have to drink an entire 6 oz. bottle of Nyquil to get the same amount of total alcohol in a typical 12 oz. beer, or a 5 oz. glass of wine, or a 1½ oz. shot of liquor."

The GreenLizard. There are others which are popular amongst alcoholics and stupid kids who "need their cough medicine". The mutual drug interactions and delayed metabolization&detoxification makes the "kick more potent"; considerably more so than beer, wine, or hard liquor.

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Also "NyQuil should not be taken with medications that contain other antihistamines or cough suppressants..." or with "...monoamine*oxidase*inhibitors (MAOIs) or other drugs containing acetaminophen..."

* A class of antidepressants

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Originally posted by pooka:
I thought Nyquil was dosed by Tablespoons. Still...

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By "studied" I assume you mean case studies, since I didn't think it was ethical to conduct double blind type studies on minors. I'm glad there is research for pediatric research and stuff like that.

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What about Ibuprofen and Reyes syndrome? Is it different enough from Aspirin that that isn't a problem? Mainly I tend to be suspicious of drug companies.

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Reyes is associated with aspirin (acetylsalicylic acid), not with ibuprofen. They have different mechanisms of action, and there isn't any overlap in this area of risk.

I understand and sympathize with the distrust of large pharmaceutical companies. They are businesses, and they are run like businesses -- they have to answer to the bottom line for their stockholders.

On the other hand, in this case, it would be the folk remedy of willow bark tea (salicylic acid) that would have put your children at risk for Reyes, not the manufactured lab drug (ibuprofen). It just isn't always straightforward, more's the pity. I wish to heck it were!

[ August 20, 2007, 11:35 AM: Message edited by: ClaudiaTherese ]
 

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Posted by ketchupqueen (Member # 6877) on :
 
Hey, CT, I have a question: is it possible for one OTC drug or another to work better/differently/not work in some people? For example, I have always taken Tylenol for headaches and either Advil or both (depending on the severity of pain) for muscle aches/strains/etc.

My husband says Tylenol doesn't work on his headaches and takes Advil for them, while Tylenol works better for muscle aches for him. When we first got married I tried to tell him that my way was better (being bossy) but after seeing him suffer the few times he tried it, told him to go back to doing what he was before because it seems to give him better results.

Also, Emma used to get really high fevers in reaction to her shots. Tylenol seemed to have no effect, she almost ended up in the emergency room when she was 3 months old, the only thing that kept her out one night was tepid baths every half hour and sponging her down in between. Her NP said they don't recommend ibuprofen for babies that small, which is the same thing the pharmacist said. But the next time it happened my mom gave me the ped dosing for ibuprofen, had me weigh her, Jeff ran out and got some and it immediately brought her fever down where the Tylenol had had no effect. When she stuck her finger in a pencil sharpener last year, we alternated Tylenol and Motrin, but the Tylenol never seemed to help as much or as long as the Motrin. Is she just not sensitive to Tylenol or something? Is that possible?
 

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Posted by ClaudiaTherese (Member # 923) on :
 
Tylenol is like water to me. It does seem to work for some people, but not others. There is plenty of individual variety in response, and (anecdotally) it seems even more this way to Tylenol than to the other medications people commonly use.

To be fair, though, it's one of the most commonly used medications, so of course it would be one of the most commonly brought up.

In general, it does look like for some kids, Tylenol isn't effective, but ibuprofen is (there are several studies like this one). However, for a lot of kids, it does seem to work.

Never did for me.
 

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Posted by ketchupqueen (Member # 6877) on :
 
I'm very lazy but could you fix the link? Thanks. You're so nice to answer all our annoying questions.
 

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Posted by ketchupqueen (Member # 6877) on :
 
Oh, and you already did.
 

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Posted by ClaudiaTherese (Member # 923) on :
 
*laughing

I can only type so fast.
 

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Posted by ketchupqueen (Member # 6877) on :
 
*cracks the whip at CT*
 

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Posted by ClaudiaTherese (Member # 923) on :
 

 

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Posted by dkw (Member # 3264) on :
 

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Originally posted by ClaudiaTherese:



I've heard it said by pharamcists that acetaminophen has such a narrow therapeutic window (range between effective dose and toxic dose) that it wouldn't be approved these days for over-the-counter use, were it not already grandfathered in as an existing medication. I believe it.]

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I swear I just read this weekend that the reason acetaminophen is the drug of choice in pediatrics is that it's therapeutic window is particularly wide. Maybe that was just in comparison to some other particular drug, though.
 

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Posted by ClaudiaTherese (Member # 923) on :
 
No way! Really? I will go looking.

It's the primary drug of overdose, both intentional and unintentional, but that could be for a whole host of reasons (e.g., frequency of use, ubiquity in multi-formula meds, etc.).

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From Acetaminophen and the U.S. acute liver failure study group: Lowering the risks of hepatic failure

"Acetaminophen is safe but has a narrow therapeutic window."

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Edited again to add:

For example, the standard adult dose of Ibuprofen is 400mg (about 5 mg/kg), and the dose at which serious effects start to occur is 400mg/kg. In contrast, the standard adult dose of Acetaminophen is 650mg (about 8 mg/kg), compared to the toxic dose of 150 mg/kg.

Thus the toxic dose of Ibuprofen is about 40X the standard dose, while the toxic dose of Ibuprofen is only about 18X the standard dose. That's a big difference, and that's why Acetaminophen is said to have a narrower therapeutic window.

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Edited yet again to add: I will go looking for pediatric-specific comparisons later. I knwo they are out there -- in looking for articles about staggered dosing, I came across some about relative toxicity (but did not mark them).

[ August 20, 2007, 05:59 PM: Message edited by: ClaudiaTherese ]
 

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Posted by dkw (Member # 3264) on :
 
I found it. In a paragraph about giving acetaminophen and/or ibuprofen it said that asprin is not recommended for young children because of links to Reye's, stomache irritation and a narrow window between efficacy and toxicity. Which I took to imply that the window for acetaminophen must not be narrow. It did later say that a harmful dose of tylenol would be 10-15 times the standard recommended dose. So the numbers are similar to what you're saying -- I just assumed that 10x was a pretty large window.

Edit: I am reading up, because my babe has roseola.
 

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Posted by ClaudiaTherese (Member # 923) on :
 
Ahhh. By the time I came into training, we didn't really consider aspirin much for any use in kids. It may well be that aspirin has an even more narrow therapeutic window, but right now Tylenol is the concern out there.

I'll look up aspirin later, just for curiosity's sake. Thanks.
 

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Posted by ClaudiaTherese (Member # 923) on :
 
Roseola! I'm so sorry. Popsicles?
 

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Posted by dkw (Member # 3264) on :
 
We got some of the pedialyte freezer pops. He seemed to enjoy sucking on one, but he only ate about 1 inch of it. He's nursing like crazy though, so we're not too worried about dehydration. For him, anyway .
 

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Posted by ClaudiaTherese (Member # 923) on :
 
Good. Sometimes they like the popsicle mushed up like a slushie (to take in a spoon).

Well, you know what they say -- 3-4 days of high fever, then the fever breaks & voila! A rash that's like a sunburn through a lace curtain.

Where are you in the cycle?
 

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Posted by dkw (Member # 3264) on :
 
Possibly day 3 of fever -- but it only got high last night. Could be we caught it early enough and treated it fast enough on the other two days to keep it down. At two this morning it was just over 103, so we called the doctor as soon as the clinic opened and got squeezed in for a visit. Which, since there's not much to do for a viral infection was probably a waste of the co-pay, but worth it for peace of mind.

What's the deal with fever "breaking" -- he didn't sweat at all on Saturday, then Sunday afternoon was soaked in sweat, so we thought he might be over it. Which was why we didn't give him tylenol before bed (oops) and then when we woke up at 2 he was burning up and no sweat again. Until 4 this afternoon, and he once again has sweat pouring off his head. I had always thought that sweating meant the fever had broke -- not so?
 

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Posted by rivka (Member # 4859) on :
 
Google indicates it's a common myth.
 

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Posted by Tante Shvester (Member # 8202) on :
 
Well, fevers wax and wane before they resolve. As the fever rises, the patient feels chills, the extremities feel cold to the touch, and you see gooseflesh and shivering. As the fever drops, the patient feels uncomfortably warm, the extremities feel warm to the touch, and you see flushes and sweating. The patient is most comfortable when the temperature remains steady.
 

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Posted by rivka (Member # 4859) on :
 

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Originally posted by Tante Shvester:
As the fever rises, the patient feels chills, the extremities feel cold to the touch, and you see gooseflesh and shivering. As the fever drops, the patient feels uncomfortably warm, the extremities feel warm to the touch, and you see flushes and sweating.

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Which I suppose is why, when I'm really sick, I know that the fact that I'm all sweaty means I'll be freezing in about 5 minutes.
 

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Posted by ClaudiaTherese (Member # 923) on :
 
I don't think of "fever breaking" as a technical term -- I expect it may have multiple overlapping colloquial usages. I just meant that the fever seems to stop at some point, and then the rash appears. (I'll go looking on the meaning of fever "breaking," though -- it's etymologically interesting.)

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As for aspirin's therapeutic window, the standard adult dose would be two caplets, or 650 mg, which is about 8mg/kg for the standard 80 kg person. The dose at which serious toxicity starts to occur is ~300mg/kg, or about 38X the standard dose. That's quite similar to Ibuprofen.

I'm not sure why the sentence was constructed the way it was, dkw, but I would have taken the same implication from it as you did. I don't think that's true, though, because I don't think aspirin has a markedly narrow therapeutic window -- unlike Tylenol, by contrast to other common medications. I'll check on the peds version of this, though -- who knows? Maybe it is much differently metabolized in kids. I wouldn't know, as we just don't use it for kids routinely any more.

Although the Reyes syndrome connection is in the context of taking aspirin concurrent with a virus, and one might think of giving aspirin for a non-viral insult (such as a sprain), kids have viruses so frequently that it just doesn't seem to ever be a safe time. Most kids of daycare age get 6-8 colds a year, or about 1 every other month. Plus all the other childhood viruses such as roseola! So, no aspirin.

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American Heritage online has the following for fever breaking:

[intransitive verb section]
23. To diminish or discontinue abruptly: The fever is breaking.

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I also find references to "bonebreak fever," but that is dengue fever, a specific disease.

I once knew an [rheumatologist] by the name of Dr. Bone[brake] in Madison, Wisconsin.
Dr. Bonebreak, the orthodontist
Dr Bonebrake, the chiropractor

[ August 21, 2007, 12:23 PM: Message edited by: ClaudiaTherese ]
 

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Posted by scholar (Member # 9232) on :
 

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Originally posted by Tante Shvester:
Well, fevers wax and wane before they resolve. As the fever rises, the patient feels chills, the extremities feel cold to the touch, and you see gooseflesh and shivering. As the fever drops, the patient feels uncomfortably warm, the extremities feel warm to the touch, and you see flushes and sweating. The patient is most comfortable when the temperature remains steady.

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