tag:blogger.com,1999:blog-19102494.post329609199701630010..comments2023-10-07T07:52:24.587-07:00Comments on CLL Diary: Ibuprofen and AIHADavid Arensonhttp://www.blogger.com/profile/13876562687586184006noreply@blogger.comBlogger6125tag:blogger.com,1999:blog-19102494.post-29782040892091062502008-10-29T12:38:00.000-07:002008-10-29T12:38:00.000-07:00Part 2 is coming, and yes I made the trip. It's so...Part 2 is coming, and yes I made the trip. It's somewhat more complex to write about than most other topics and I've been very busy here. It's high eBay season and we're remodeling the house. When I have any time left over, I drool on myself. Or rediscover things in the back of the liquor cabinet.David Arensonhttps://www.blogger.com/profile/13876562687586184006noreply@blogger.comtag:blogger.com,1999:blog-19102494.post-90901123790751690422008-10-24T19:45:00.000-07:002008-10-24T19:45:00.000-07:00So, where's part II of "My visit to the NCI"?You p...So, where's part II of "My visit to the NCI"?<BR/><BR/>You posted on otters, the October surprise engineered by the Democrats to elect their candidate, and ibuprofen.<BR/><BR/>Did you make the trip or not?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-19102494.post-86150799919574959922008-10-16T07:20:00.000-07:002008-10-16T07:20:00.000-07:00To be a bit more specific about acetaminophen, the...To be a bit more specific about acetaminophen, the likelihood of renal disease from chronic "abuse" is probably greater, but people need to understand that they should limit use to less than 3 grams (6 extra strength tablets) per 24 hours (preferably less than 2 grams per 24 hours) and the acetaminophen is often part of OTC cold/Flu remedies such as Nyquil (which has 1,000 mg of acetaminphen per dose) so they need to read labels and avoid taking Dayquil or Nyquil along with acetaminophen for example. (you could easily take a 2 gram dose doing that).<BR/><BR/>The use of alcohol and calorie restriction (ie, dieting, starvation or just poor eating habits as may be seen in alcoholics) will also magnify the toxicity by decreasing levels of hepatic glutathione which is used to "detoxify" the toxic metabolite of acetaminophen produced in the liver to some extent whenever acetaminophen is taken.<BR/><BR/>To summarize: chronic use, co-use of toxins such as alcohol, calorie restriction and use of excessive doses (even when accidental) may lead to hepatotoxicity (liver damage) which may result in chronic liver disease or more dramatically in acute liver failure (which is seen most often when acetaminophen is taken as a purposeful overdose in a suicide attempt or gesture). In the latter cases intensive supportive care and emergency liver transplantation may be the only way to save a life...but chronic liver disease from from acetaminophen use, by itself, is not a common reason for liver transplant.<BR/><BR/>Chronic renal disease from either acetaminophen or NSAID use is common!<BR/><BR/>One useful technique to consider is to alternate doses of acetaminophen and NSAIDs such as naprosyn or ibuprofen every 6-to-8 hours as needed for acute pain. I am not a fan of the chronic use of any of these drugs for chronic pain.<BR/><BR/>DWCLLAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-19102494.post-75654654117154902022008-10-15T21:04:00.000-07:002008-10-15T21:04:00.000-07:00One must be very careful to follow the recommendat...One must be very careful to follow the recommendations regarding the use of acetaminophen. The difference between and effective dose and an overdose is not very great.<BR/><BR/>One of the most frequent causes of liver transplants is Tylenol overdose. Obviously, a serious side effect.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-19102494.post-92221692707700384052008-10-15T10:50:00.000-07:002008-10-15T10:50:00.000-07:00A much more frequent problem when NSAIDs are used ...A much more frequent problem when NSAIDs are used frequently is Peptic Ulcer disease and the attendant complications thereof such as bleeding, obstruction and with these problems potential need for transfusion and/or surgical intervention. Neither of these would be good things in people with CLL.<BR/><BR/>DWCLLAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-19102494.post-45302421350086933992008-10-15T04:59:00.000-07:002008-10-15T04:59:00.000-07:00Thanks David. I was not aware of the potential lin...Thanks David. I was not aware of the potential link between AIHA and ibuprofen. Like many Americans I have used NSAIDs. Now, with steroid-induced osteopenia and related hip pain, I have been using it daily. I, too, am Coombs positive and battled AIHA in 2006 --- will be sure to put that question to my local hem/onc when I see him in a few weeks.Pathttps://www.blogger.com/profile/12352803363425803168noreply@blogger.com