Adverse Effects

While most parents believe that children's acetaminophen is perfectly safe because it is a nonpre-scription medication, it does pose a special risk in children. An overdose—or even a normal dose combined with other medications, or when a child has not eaten—can overwhelm the child's liver. In extreme cases, the liver may be damaged beyond repair.

An overdose typically causes nausea, vomiting, and loss of appetite, all of which usually disappear in a day or two. However, it is during this time that liver failure may be occurring. Liver damage can be reversed with intravenous administration of an antidote, if given in time.

achievement test Achievement tests are standardized measures of knowledge, information, or procedural learning (such as how to do something). This type of assessment is used to measure student learning in comparison to a norm.

Achievement tests may assess general academic skill areas, such as reading, writing, or mathematics, or they may test for content knowledge in a specific academic subject such as biology or American history. Achievement tests are used by school systems to provide a standard measure of individual student performance and to provide an aggregated measure of performance that enables school systems to evaluate their effectiveness. Achievement tests are also used as part of the diagnostic assessment of individuals to determine whether they have a learning disability and therefore qualify for special education services.

acne The most common skin disease in the United States, this very common inflammatory reaction in oil-producing follicles usually appears on the face, shoulders, and back. While most common during the teenage years, it may also affect newborns. Because it can lead to permanent scarring on the face, acne can have profound and long-lasting psychological effects.

In boys, acne usually begins in early adolescence, tends to be more severe than in girls, and improves in the early to mid-twenties. In girls, acne usually begins in the mid-teens and is often less severe. In some individuals, the problem can continue into adulthood.


Acne is not caused by diet (chocolate or fats), dirt, or surface oil. Normally, oil is produced in glands in the skin, traveling up to the hair follicles and flowing out onto the surface of the skin. When oil glands within the hair follicles are stimulated and begin to enlarge, usually as a result of hormonal changes at puberty, they begin to produce more oil. Acne bacteria (Propionibacterium acnes) inside the follicles multiply and produce fatty acids, which irritate the lining of the pores. At the same time, the number of thicker cells in the lining of the pores increases and they clump together, narrowing and clogging the pore openings with oil, skin cells, and debris.

As the pressure builds within these clogged pores, the constant production of oil together with irritation from bacteria ruptures the pore walls. When the oil pathway gets blocked and the plug pushes up to the surface, it causes a blackhead (comedo). When the opening is very tightly closed, the material behind it causes a whitehead.

While there are many factors behind the inflammatory changes seen in acne, one of the most important is the different levels of bacteria found on the skin. While acne is not a bacterial infection, experts believe that inflammation results from the by-products released by the bacterium Propionibacterium acnes found deep in the follicle.

Emotional stress, cosmetics, genetics, and certain drugs (such as birth control pills) may worsen the condition. Estrogen, however, will improve acne.

Acne is hereditary, and the tendency to develop it runs in families. If both parents have acne, then three out of four of their children will also have acne. Oil in cosmetics also can contribute to acne, which is why makeup should be washed off each night.


There are excellent types of therapy for all kinds of acne, including topical treatment, antibiotics, and hormonal manipulation. Most teenagers benefit from a combination of peeling the skin, destroying bacteria, and applying products that affect white-heads and blackheads.

Treatments should begin with soap and water cleansing every night, with a good diet, and regular exercise. For milder cases, medications containing benzoyl peroxide (5 percent) or those containing sulfur or a combination of sulfur and resorcinol or salicylic acid are effective.

Since oil buildup attracts bacteria, and the bacteria's fatty acids irritate the skin, one of the best ways to fight acne is to kill the bacteria. Those products that are effective in treating acne actually cut down the oil production of the glands slightly and destroy bacteria in the follicle. The most popular antibiotics in the treatment of acne are tetra-cycline, minocycline, and erythromycin. For milder cases, antibiotics can be used directly on the skin. For more advanced cases, they are taken orally.

Retin-A, a drug related to vitamin A, is an effective treatment for whiteheads and blackheads. It is often combined with benzoyl peroxide or antibiotics. Those with the most severe types of acne may be given a stronger vitamin-A-related drug called Accutane (isotretinoin). This drug has more serious side effects, including birth defects, and requires strict medical supervision.

It's possible that some cases of acne can be controlled by regulating the androgen/estrogen hormone balance in those girls who have an increased activity of the enzyme that converts testosterone (a male hormone) into a more potent form that affects the oil glands. Since androgen has been implicated in the increased secretion of oil that starts a blemish, androgen blockers that reduce the size of oil glands may help girls whose acne is associated with other changes, such as excessive hair growth or balding. These drugs could be in the form of high-estrogen birth control pills.

Steroids are very effective for inflammatory or cystic acne when injected into a lesion; this can heal the cyst in about 24 hours.

acne, infant Acne is not unusual among new-borns; it is triggered by hormones passed from the mother before birth. The hormones cause the glands in the skin to produce oil; if these glands become blocked and inflamed, whiteheads and pimples may develop on the newborn's face.

Newborn acne usually clears up on its own in three or four months. If it is troublesome or persistent, a pediatrician may prescribe a topical medication. Contrary to popular belief, infant acne is not associated with the development of acne in adolescence. Rarely, however, infantile acne becomes severe and persists for months or even a few years. This is usually associated with a family history of acne (usually in the father) and is often followed by severe acne in adolescence.

A doctor should evaluate the skin condition so as to rule out both seborrhea dermatitis and miliaria.

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