From the Associated Press:

Government experts say the maximum dose listed for Tylenol and dozens of other painkillers should be reduced to help curb deadly overdoses. In a series of votes Tuesday, a Food and Drug Administration panel endorsed lowering the maximum dose of over-the-counter acetaminophen — the key ingredient in Tylenol, Excedrin and other medications.

But panelists rejected a proposal to pull NyQuil, and other cold and cough medicines that combine acetaminophen with other drugs, off the market because of their role in overdosing.

Acetaminophen is one of the most widely used drugs in the U.S. Many patients find it easier on the stomach than other painkillers like ibuprofen and aspirin, which can cause ulcers.

But despite years of educational campaigns and other federal actions, acetaminophen remains the leading cause of liver failure in the U.S., sending 56,000 people to the emergency room annually, according to the FDA.

FDA's experts voted 21-16 to lower the current maximum daily dose of nonprescription acetaminophen, which is 4 grams, or eight pills of a medication like Extra Strength Tylenol.

The group was not asked to recommend an alternative maximum daily dose.

The panel also voted 24-13 to limit the maximum single dose of the drug to 650 milligrams. The current single dose of Johnson & Johnson's Extra Strength Tylenol is 1,000 milligrams, or two tablets.

In a third vote, a majority of panelists said the 1,000-milligram dose should only be available by prescription.

The experts rejected a proposal to pull certain cold and cough medicines off the market. The FDA says patients often pair combination drugs, like Procter & Gamble's NyQuil or Novartis' Theraflu, with pure acetaminophen treatments, like Tylenol, exposing themselves to unsafe levels of the drug.

But panelists cited FDA data that said the medications play a minor role in acetaminophen overdoses, with only 10 percent of acetaminophen-related deaths involving a cold and cough product.

And from msnbc.com:

Government experts say prescription drugs like Vicodin and Percocet that combine a popular painkiller with stronger narcotics should be eliminated because of their role in deadly overdoses.

A Food and Drug Administration panel on Tuesday voted 20-17 that prescription drugs that combine acetaminophen with other painkilling ingredients should be pulled off the market.

But many panelists opposed a sweeping withdraw of products that are so widely used to control severe, chronic pain.

In a separate vote, the panel voted overwhelmingly, 36-1, that if the drugs stay on the market they should carry a black box warning, the most serious safety label available.

Prescription acetaminophen combination drugs were prescribed 200 million times last year, according to FDA data. Vicodin is marketed by Abbott Laboratories, while Percocet is marketed by Endo Pharmaceuticals. Both painkillers also are available in cheaper generic versions.

From ScienceBlogs:

Judging from the press inquiries, expect focus on the Michael Jackson case to be on the anesthetic drug, propofol (Diprivan®).

California nutritionist and registered nurse Ms Cherilyn Lee gave an interview to Campbell Brown on CNN (and this AP exclusive report) describing Michael Jackson's repeated requests of her for the intravenous sedative drug for his insomnia. She wisely rejected his requests, instead providing him with a vitamin and mineral "energy" injection.

However, four days before Jackson's death she reported a frantic phone call from a Jackson staffer to her that led her to believe he had somehow procured the drug or something like it.

Diprivan is the trade name for propofol (PROPE-uh-fawl), a product of AstraZeneca whose healthcare professionals website on the drug is currently closed. Estimated US annual sales of Diprivan are $375-400 million USD. Propofol has a deceptively simple chemical structure and is known chemically as 2,6-diisopropylphenol.

It is a widely-used intravenous anesthetic used primarily for outpatient surgical procedures owing to its very rapid onset of action, sometimes as fast as 30 sec, and rapid recovery.

Propofol has a remarkably good safety record given its widespread use. The average human intravenous dose is 2 to 2.5 mg per kg body weight while the intravenous LD50 (dose that is lethal to 50% of a population) in mice is 50 mg/kg. When used alone, or in combinations with the opioid analgesic fentanyl, it produces a "dissociative analgesia" that is very rarely fatal. Hence, its safety is one of the reasons it is used for outpatient surgery, together with its rapid onset and quick recovery.

While it is a sedative, it has been reported to produce euphoria in some people (the pleasant feelings of well-being most often associated with morphine and other opioids).

The potential risk is from "propofol-related infusion syndrome" - it can produce an elevation in body temperature that is usually not fatal (not "true" malignant hyperthermia as with the rare but fatal side effect of some inhaled anesthetics) but can trigger muscle breakdown called rhabdomyolysis, a rare but devastating side effect that can also occur with statin cholesterol-lowering drugs.

An excellent and timely review of propofol-related infusion syndrome was published in the May issue of Pharmacotherapy by authors from the University of Houston College of Pharmacy and is reprinted at Medscape. Most notable in this review is that while the syndrome is rare, it is fatal in 64% of cases when it does occur.

However, most relevant to the Jackson case is that propofol can cause cardiac tachyarrhythmias (rhythmic disturbances at high heart rate), especially in people predisposed to cardiac problems.