Today’s article subject was sparked by a television commercial. It showed a woman obviously suffering from a head cold. You could tell because she was talking funny, her nose was bright red and she was holding wads of facial tissues.

“I took a nighttime cold reliever, but my nose is still stopped up,” she says to the camera and is answered by a voice that says that the product she took doesn’t have a stuffy nose reducer and that she should have taken his recommended brand. The next shot is this woman looking absolutely fine because she took the different medicine.

At first look the commercial isn’t revolutionary. Not even the inference that she was perfectly symptom free the next morning. Yeah sure. What was particularly bothersome, however, is the illusion that the woman actually took the second drug after taking the first one that seemingly wasn’t working.

If that woman took the recommended dose of Nyquil she would have gotten 1300 milligrams (mg) of acetaminophen. The recommended dose of Alka Selzer Plus would have added another 650 mgs for a total of 1950 mgs. Assume she took a couple of Tylenol for her headache and she was consuming another 650 to 1,000 mgs depending on the dose’s strength so she easily could have ingested the maximum 3,000 mgs recommended dosage for a 24-hour period in just one evening.

Add to the scenario that the woman had a cocktail before dinner and a couple of glasses of wine with her meal and she was possibly putting herself in jeopardy for liver damage; especially if she repeated this treatment over the course of a week.

Acetaminophen has long been considered one of the safest pain relievers, according to the Harvard Medical School’s website. Aspirin, ibuprofen, naproxen and other nonsteriodal anti-inflammatory drugs can be hard on the stomach.

“Acetaminophen provides the kind of ‘fast relief’ so often promised in commercials. It leaves the gastrointestinal tract quickly. Blood concentrations peak within an hour after taking an oral dose.

“Like many drugs, acetaminophen is metabolized in the liver. Most of it gets broken down and altered into substances that are uneventfully excreted in the urine. But a small percentage is rendered into a compound that’s extremely harmful to liver cells. The full name is so unwieldy that it’s almost always referred to by its initials, NAPQI (also a mouthful but an improvement).

“Usually, NAPQI is rendered harmless because it combines with glutathione, another compound in the liver. But if there’s too much NAPQI, which can happen with an acetaminophen overdose, or not enough glutathione to sop up NAPQI, which happens if you haven’t eaten well or are malnourished, then liver damage can occur.”

So the point isn’t that you should stop taking acetaminophen. It’s still safe and effective when taken as directed. The point is that you should know what you’re taking. Many prescribed pain relievers contain acetaminophen as well as over-the-counter meds, so be sure to consult your pharmacist and your medical practitioner before you take any over-the-counter medications for pain, colds, indigestion or heartburn. And be frank with your PCP about your alcohol consumption.

Kathy Hubbard is a trustee on Bonner General Hospital Foundation Board. She can be reached at [email protected] or by calling her at 264-4029.