Robitussin

Robitussinf AC Robitussin with antihistamine and codeine Each 5 cc. tsp. contains: Glyceryl guaiacolate 100 mg. Pheniramine maleate 7.5 mg. Codeine phosphate 10.0 mg. exempt narcotic ; Alcohol 3.5.

Had EGD performed at an outside institution. Of the 41 patients with EGD reports available, one patient had esophageal telangiectases 1 41; 2.0% ; , 33 patients had telangiectases in the stomach 33 41; 80.5% ; , and 33 patients had telangiectases in the duodenum 33 41; 80.5% ; . Enteroscopy was performed on nine patients, of whom five had telangiectases in the jejunum 5 9; 55.6% ; . Colonoscopy was performed on 32 patients, two at outside institutions, and 10 had telangiectases in the colon 10 32; 31.3% ; . Four patients were diagnosed with nonHHT-related causes of GI bleeding; these diagnoses included colon cancer, solitary rectal ulcer syndrome, hemorrhoids, and a complicated angiodysplasia of the small bowel. Other GI conditions were also demonstrated in a total of 23 patients. These included diverticulosis in 10 patients, peptic ulcer disease in five patients, colonic polyps in four patients, and hemorrhoids in three patients. Also demonstrated were esophageal varices in two patients with symptomatic, HHTrelated liver disease, a gastric polyp in two patients, and antral gastritis, duodenal polyps, celiac sprue, collagenous colitis, solitary rectal ulcer syndrome, and colon cancer each present in one patient. Further testing with angiography in one patient demonstrated a complicated angiodysplasia of the small bowel thought to be unrelated to HHT. This patient also had multiple telangiectases visualized on endoscopy and was thus thought to have bleeding from both HHT-related as well as the nonHHT-related sources. Ten patients had more than 20 telangiectases visualized on EGD. When compared with patients with fewer telangiectases, patients with more than 20 telangiectases had a significantly lower Hb level of 7.9 mg dl, compared with 9.4 mg dl p 0.007 ; . Blood transfusion requirements increased with the number of telangiectases seen on EGD, so that patients with less than seven telangiectases required 8.7 units PRBC patient yr, patients with 719 telangiectases required 13.4 units PRBC patient yr, and patients with more than 20 telangiectases required 28.3 units PRBC patient yr. Of the 16 severe patients, seven were noted to have more than 20 telangiectases visualized on EGD, six were noted to have 719 telangiectases, and three were noted to have less than seven telangiectases. Treatment decisions were made at the time of gastroenterologic evaluation Table 2 ; . The three patients with non HHT-related diagnoses as the sole cause of their GI bleeding were started on appropriate therapy. Twenty-three patients were started on drug therapy. The group of 17 untreated patients consisted of 13 patients lacking significant anemia, four women presenting on hormonal therapy they wished to continue, two patients with contraindications to therapy, and one patient who had started drug therapy before evaluation. Four of these patients had more than one reason for not starting therapy. Table 3 demonstrates the mean and median Hb and blood transfusion requirements in the 40 patients with HHT-related bleeding in the year before and after evaluation. The patient group is divided into 23 treated patients and 17. The great majority of the drawbacks presented by adherent vehicles are avoided by the use of aqueous TC mouthrinses, when the clinician can be certain that the contact time is adequate and that the drug will be in contact with all lesions, however deep or extensive, for the prescribed time. Furthermore, the corticosteroid is reported to be released more readily to the oral mucosa when an aqueous solution is used Ungphaiboon and Maitani, 2001 ; . The main disadvantage of mouthwashes is that the TC will be in contact with all of the mucosa, including unaffected areas, thereby increasing the surface area of absorption and the risk of adverse effects. These problems can be exacerbated by the presence of ulcerated surfaces and by the increased pressure exerted by the liquid on the mucosa as a result of the natural rinsing movements made by the patient. Furthermore, an aqueous preparation can be involuntarily ingested more easily than an adherent vehicle, which would also increase the amount of corticosteroid absorbed and the ensuing possible risk of adverse effects. Hence, patients must be clearly informed about the need to avoid ingesting the drug. Finally, the lesional exposure to the medication in a mouthwash is likely to be brief. Despite the potential shortcomings of TCs in aqueous preparations, excellent outcomes have been achieved Gonzlez-Moles et al., 2002a, b, c ; . The mouthrinse is almost certainly the most widely indicated vehicle in oral medicine, although Thami and Bhalla 2003 ; proposed using the patients' saliva as the vehicle for TCs, which they designated the 'chewand-spit method'. With this approach, the patient is directed to chew or suck a betamethasone 1 mg ; tablet, mixing it in the mouth with his her own saliva and keeping it there without swallowing for as long as possible, generally for 10 to 15 min. This method appears adequate, but has some disadvantages. First, it cannot be guaranteed that the tablet is completely dissolved, so that the final concentration of corticosteroid with which the patient is treated cannot be ensured. Moreover, this approach cannot be used in dry mouths, a frequent condition in some patients--for example, in those with altered emotional states commonly associated with oral lichen planus GonzlezMoles, 2003!