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February 03, 2005

Tylenol...that evil controlled substance

I recently went down to Brazil for a business trip. A friend there asked me to bring him some Tylenol Flu capsules, which for some odd reason he couldn't find there. Please note that one can buy Codeine over-the-counter in Brazil (and believe me, I have), but evidently not Tylenol...
Anyhow, I mosied to the local chain pharmacy to pick up a few boxes, and was confronted by "Daytime" and "Nighttime" formulas. Argh. So I took 2 boxes of Day and 1 of Night, just to cover all the bases. When I handed them to the clerk, she told me that she wasn't allowed to sell me three boxes...

"Excuse me?"
"I'm sorry, but we're not allowed to sell more than two boxes, because you might OD on it."
"Ma'am, there are a helluva lot of things I'm gonna OD on long before I get desperate enough to pop 30 Tylenols."
"I know; I think it's retarded, but I have to get the manager to override the resgister to let me ring it up."

So over came the pasty-faced manager, who mumbled something about it being "the law" as he put his VERY SPECIAL KEY OF GREAT IMPORTANCE into the register, but I doubt that even a "retarded" (if I may quote the clerk) state like New Jersey would have such a rule; I'm more inclined to think it's some Nervous Nelly corporate policy.

Mind you, NJ did outlaw over-easy eggs for awhile...

Posted by Mr. Bingley at February 3, 2005 09:10 AM

Comments

By the way, what the hell kind of time zone are you in, anyway?

Posted by: Ken Summers at February 3, 2005 10:01 AM

VERY SPECIAL KEY OF GREAT IMPORTANCE!

Hi Mr. B.!

Posted by: Emily at February 3, 2005 11:09 AM

hello there!
those keys are viagra for store managers, me thinks

Posted by: Mr. Bingley at February 3, 2005 01:34 PM

Greetings all. Since I've had a bad cold all week, I've been doing my damnedest to OD on Tylenol, yet to no avail. Oh well. ;-)

Posted by: Dave J at February 3, 2005 01:55 PM

By the way, what the hell kind of time zone are you in, anyway?

That would be the Twilight Zone, duh.

Posted by: tree hugging sister at February 3, 2005 01:59 PM

hi dave! i hope you feel better!

of course, in gainesville there probably aren't many restrictions on drugs, are there?

Posted by: Mr. Bingley at February 3, 2005 02:10 PM

Gainesville? I worked in Tallahassee and now I'm back up here in Gloucester, north of Boston.

But yeah, definitely not much in the way of drug restrictions for the Criminoles. ;-)

Posted by: Dave J at February 3, 2005 02:19 PM

oops, i knew it was tallahassee; i didn't realize you're back up north, though. well, you were smart enough to get my bungled (bingled?) point!

say hi to the gorton's fisherman for me!

Posted by: Mr. Bingley at February 3, 2005 02:35 PM

Mr. B., it's not the Tylenol, although ODing on the active ingredient (acetaminophen), or mixing Tylenol with alcohol will kill your liver.

Each Tylenol Flu tablet contains 30 mg of psuedoephedine, the primary precursor for crystal meth. It's a state law in many states that you either have to sign for large purchases or can't purchase more than one or two boxes of pseudoephedrine-containing meds at a time.

It's still a stupid law, though.

Posted by: John at February 3, 2005 02:41 PM

*notes "at a time"* Thanks John..

What a lovely blog.. I wonder who lives here?..

Posted by: peteb at February 3, 2005 02:47 PM

hi john!
yeah, i knew about the acetaminophen/booze/liver bye-bye scenario, which is why on those exceedingly rare (coughcough) times when i drink i never take any of that stuff; i just make sure to end the night drinking water to try and keep a lid on the hangover.
i'd forgotton about the pseudo-eph angle. it's got to be somewhat of a booger to purify it though, no?

Posted by: Mr. Bingley at February 3, 2005 02:50 PM

hi pete! you january baby you!

Posted by: Mr. Bingley at February 3, 2005 02:50 PM

Cold water extraction. At least that's what the cooks do to get the acetaminophen out of Percocet.

Tylenol Flu's got 3 ingredients; acetaminophem dextomethorphan, and pseudoephedrine (plus excipients: whatever's in the gel caps to make the gel). I'd think that a competent cook would look for Sudafed or some other product that only contains pseudoephedrine before they'd start monkeying around with a 3-component agent such as Tylenol Flu.

Posted by: John at February 3, 2005 03:15 PM

No Bingster. Pseudofed cures boogers, that's why you take it.

And you don't even have to drink for tylenol to do it's dirty work, which is great if you're on a tight budget. Swallow a bottle or so and there's a good chance, in about 3 days, that you'll suffer a complete renal shutdown, with very little chance of anyone doing anything about it. (Found that out during a deployment in the PI, but it's a whole 'nother story.) Aspirin's so yesterday, where pumping your stomach was dramatic AND effective.

Posted by: tree hugging sister at February 3, 2005 03:15 PM

i knew i should have paid attention in chemistry; i was too busy burning shit and gazing at the pretty colors...

yep, it seems starting with sudafed makes more sense.

i mean, it seems like a lot of effort, though, no? just go buy a six pack of old milwaukee

Posted by: Mr. Bingley at February 3, 2005 03:18 PM

THS - not to nitpick, but don't you mean hepatic shutdown? As far as I know, acetaminophen is pretty innocuous to the kidneys.

Posted by: John at February 3, 2005 03:19 PM

Wow, John, and I thought I could nitpick. My hat's off to you, and (believe me) that's high praise. ;-)

Posted by: Dave J at February 3, 2005 03:21 PM

Mr. B, those activities should not have impared your ability to absorb Chemistry. I maintain that every chemist was at one time a closet pyromaniac. I won't inject any personal anecdotes, since I'm not sure if the statute of limitations is up yet.

Posted by: John at February 3, 2005 03:21 PM

some day my liver's gonna make some kick-ass foie gras.

the only medicine i take is booze.

Posted by: Mr. Bingley at February 3, 2005 03:21 PM

Dave J - maybe you and I should start a blog. We can nitpick everyone from the scientific and legal angles.

Posted by: John at February 3, 2005 03:24 PM

the only chemistry class anecdote i'll relate is strictly g-rated: a friend and i snuck in before class one day and filled all the gas lines with water before a spectrum analysis session. class starts, the teacher turns on the gas main, and instantly we have 25 little fountains around the room.

Posted by: Mr. Bingley at February 3, 2005 03:25 PM

Oh, you mean you didn't attach the gas hose to the air intake on those vacuum aspirators they screw on to the faucets? You then turn on both the gas and the water and light the stream of gas coming out of the faucet while the water is running, yelling "fire water!" at the teacher. (Hangs head in shame) Yeah, we were geeks.

Posted by: John at February 3, 2005 03:28 PM

Mr. B. - Marauding Geek Prankster.

Posted by: Emily at February 3, 2005 03:28 PM

No offence taken John! Actually, we WERE told renal, the caveat being it was Navy doctors and 1984. So I tip my hat to your grasp of bodily functions and the adverse effects of known substances.

Posted by: tree hugging sister at February 3, 2005 03:29 PM

john, i am humbled

Posted by: Mr. Bingley at February 3, 2005 03:30 PM

THS- I'll check into this further. Sometimes, if a drug is cleared by the kidneys, an OD can cause a spike in the blood concentration such that the stuff will precipitate out of solution, physically clogging the little tubes in the kidneys. That can be irreversible if there is enough drug substance being cleared. I didn't think acetaminophen would do that, though.

Posted by: John at February 3, 2005 03:32 PM

Well, the hoot was we're all like 'what kinda fuckin' idiot would try to commit suicide with Tylenol??!!' They'd pumped her stomach and one normally gets sent home after an aspirin overdose, but they kept her for four more days. The explanation being that Tyl's effects didn't become apparent until day 3 ~ if nothing, great, you go home. But, if things are meant to go badly, they do so most ferociously at that time. The squids at the hospital were quite concerned and we learned something we would have never guessed in a million years.

And your clinical disections are precious! Welcome aboard, as I don't think we've been properly introduced.

Posted by: tree hugging sister at February 3, 2005 03:42 PM

THS - you were right. Renal faiure is a rare (~2% of ODs) complication. While hepatic failure tends to manifest after 3-5 days, the renal effects are slower to manifest (6-9days) - thanks, I learned something new.

It looks like the renal effects are due to a variety of mechanims, and might show up even in the absence of liver damage:

"Renal tissue has been examined in a small number of patients and usually reveals acute tubular necrosis [3,4]. Vascular endothelial damage also can occur, so that both direct toxicity and ischemia may contribute to the tubular injury [3]. These pathologic findings are consistent with the clinical presentation, as the urinalysis generally reveals granular and epithelial cell casts."

Posted by: John at February 3, 2005 03:49 PM

My pleasure, John. Trust me, it's delicious to be right on the odd occassion. Especially something that happened 20 years ago. (Vitamin E's your friend ~ keeps the plaque from forming.{8^P)

Posted by: tree hugging sister at February 3, 2005 03:58 PM

yeah, but john don't ask her about anything from 5 minutes ago.

Posted by: Mr. Bingley at February 3, 2005 04:00 PM

Now, if only there was an explanation for the quizzical but catchy SPAM email I just got from...lemme see here...my good friend Estela Nicholas, subject line to wit:

Sildenafil treats impotence by helping you have an erection egg

And sorry Ken, I deleted it.

Posted by: tree hugging sister at February 3, 2005 04:03 PM

Ken's still worried about that erection that lasted longer than 4 hours - he's too embarrassed to go to the doctor.

Posted by: John at February 3, 2005 04:05 PM

Wrong, John. The little lady wouldn't let me go to the doctor. Go figure.

And not to pick nits with John and Dave, but I think you meant to say "not to pick nits" and "I thought I could pick nits", respectively.

Posted by: Ken Summers at February 3, 2005 04:14 PM

Doctor'd be like 'well, you begged me for it and now you don't want it...'

Stay home, tough it out.

Posted by: tree hugging sister at February 3, 2005 04:14 PM

And Ken, that little post makes you a Nit WIT!

Posted by: tree hugging sister at February 3, 2005 04:15 PM

This is as good a place as any for me to tell the story about my friend Chris who used to work at the emergency room at a hospital in Arcata (the same one where I had my pinky sewn back on). He came home one morning to tell us that his boss's boss's boss's boss - some hoity-toity high-up administrator - had been brough in the night before because he had a light bulb stuck in his ass.

You are all better people for knowing this. No need to thank me.

Posted by: Emily at February 3, 2005 04:43 PM

Well at least it wasn't a gerbil.

Posted by: Ken Summers at February 3, 2005 04:44 PM

So that means the first doctor with a scope saw the light!

Posted by: tree hugging sister at February 3, 2005 04:46 PM

"Dammit, nurse, I said a 'BUD' light!"

Posted by: Ken Summers at February 3, 2005 05:00 PM

i won't crack any jokes about that

Posted by: Mr. Bingley at February 3, 2005 05:46 PM

I've heard a hole lot of jokes like that.

Posted by: Ken Summers at February 3, 2005 05:48 PM

"And not to pick nits with John and Dave, but I think you meant to say 'not to pick nits' and 'I thought I could pick nits', respectively."

Not that I'd EVER accuse of you showing your age, Ken, but unlike less self-confident languages that have state institutions trying hopelessly to control them, English evolves based on this thing called "usage." "To nitpick" is now a perfectly acceptable verb:
http://dictionary.reference.com/search?q=nitpick

:-p

Posted by: Dave J at February 3, 2005 05:52 PM

Not that I'd EVER accuse of you showing your age, Ken

or make insinuations about your hygiene, either.

Posted by: Mr. Bingley at February 3, 2005 05:54 PM

Bah! LIES!

We grammar-nazis stand athwart changes in usage yelling "Stop!", not to prevent changes but to prevent mongrelization and debasement.

Not to, you know, pick nits or anything.

Posted by: Ken Summers at February 3, 2005 06:09 PM

Sildenafil treats impotence by helping you have an erection egg

I like my erection eggs sunny-side up, m'self.

Posted by: dangermouse at February 5, 2005 06:53 PM

not an over-easy man?

Posted by: Mr. Bingley at February 5, 2005 07:01 PM