Drive or operate heavy machinery, until you know how Oxycodone HCl tablets affects you. Oxycodone HCl tablets can make you sleepy, dizzy, or lightheaded. Ask your healthcare provider or pharmacist if you are not sure if you take a MAOI, including the linezolid. Patients should be periodically reassessed to determine the need for continued use of this drug. Apparent elimination half-life of oxycodone following the administration of oxycodone is approximately 4 hours. This medication may not be approved by the FDA for the treatment of this condition. pezi.info rifampicin
Ask your pharmacist about the safe use of those products. Metoclopramide. This may be manifest as symptoms consistent with serotonin syndrome or neuroleptic malignant syndrome. IRT is surprisingly easy to learn and to use. The basic technique can often be mastered in a few hours; once learned, it's used for only a few minutes a day for a matter of days or weeks. The concomitant use of Mirtazapine Tablets with MAOIs intended to treat psychiatric disorders is contraindicated. Mirtazapine Tablets should also not be started in a patient who is being treated with MAOIs such as linezolid or intravenous methylene blue.
Prolonged use of morphine sulfate oral solution during pregnancy can cause withdrawal symptoms in your newborn baby that could be life-threatening if not recognized and treated. Metabolized by CYP2D6, CYP3A4, and CYP1A2; a b not a potent inhibitor of CYP2D6, CYP3A4, and CYP1A2. Instruct patients not to share Oxycodone Hydrochloride Capsules with others and to take steps to protect Oxycodone Hydrochloride Capsules from theft or misuse. Instruct patients to take steps to store Oxycodone Hydrochloride Capsules securely and to dispose of unused Oxycodone Hydrochloride Capsules by flushing down the toilet.
Nervous: agitation, anxiety, confusion, dry mouth, hypertonia, hypesthesia, nervousness, neuralgia, personality disorder, tremor, and vasodilation. Get emergency help right away if you take too much Oxycodone Hydrochloride Capsules overdose. When you first start taking Oxycodone Hydrochloride Capsules, when your dose is changed, or if you take too much overdose serious or life-threatening breathing problems that can lead to death may occur. Shelby Harris, PsyD, director of the behavioral sleep medicine program at Montefiore Medical Center's Sleep-Wake Disorders Center in New York City. "But there are effective treatments.
Opioids may also obscure the clinical course in a patient with a head injury. Avoid the use of tramadol hydrochloride tablets in patients with impaired consciousness or coma. Overestimating the Methadone hydrochloride tablets dosage when converting patients from another opioid product can result in fatal overdose with the first dose. If concomitant use is necessary, consider dosage reduction of Methadone hydrochloride tablets until stable drug effects are achieved. Monitor patients for respiratory depression and sedation at frequent intervals. Voriconazole can inhibit the activity of CYP3A4, CYP2C9, and CYP2C19. As treatment for solid tumors in combination with conventional therapy: 10-50 mg along with radiotherapy, chemotherapy, or interleukin 2 IL-2. Melatonin is typically started 7 days before the start of chemotherapy and continued throughout full treatment course. Morphine Sulfate Tablets are not recommended for use in women during and immediately prior to labor, when use of shorter-acting analgesics or other analgesic techniques are more appropriate. Opioid analgesics, including Morphine Sulfate Tablets, can prolong labor through actions that temporarily reduce the strength, duration, and frequency of uterine contractions. However, this effect is not consistent and may be offset by an increased rate of cervical dilatation, which tends to shorten labor. Monitor neonates exposed to opioid analgesics during labor for signs of excess sedation and respiratory depression. If concomitant use is warranted, carefully observe the patient, particularly during treatment initiation and dose adjustment. Discontinue Oxycodone HCl if serotonin syndrome is suspected.
Take this medication by with or without food as directed by your doctor, usually once a day. Your doctor may direct you to take this medication with low-dose usually at dosages of 81-325 milligrams a day. Follow your doctor's instructions carefully. Inform female patients of reproductive potential that prolonged use of tramadol hydrochloride tablets during pregnancy can result in neonatal opioid withdrawal syndrome, which may be life-threatening if not recognized and treated and that the patient should inform their healthcare provider if they have used opioids at any time during their pregnancy, especially near the time of birth. Oxycodone hydrochloride was genotoxic in an in vitro mouse lymphoma assay in the presence of metabolic activation. There was no evidence of genotoxic potential in an in vitro bacterial reverse mutation assay Salmonella typhimurium and Escherichia coli or in an assay for chromosomal aberrations in vivo mouse bone marrow micronucleus assay. It is also used to prevent a problem caused by disease . It may help you think more clearly. See Figure 1 for additional information. It's a common misconception. Take your prescribed dose as indicated by your health care provider. The maximum dosage is 1 or 2 tablets every 4 to 6 hours, as needed for pain relief. Do not take more than your prescribed dose and do not take more than 8 tablets per day. If you miss a dose, take your next dose at your usual time. condylox
HydrOXYzine: May enhance the CNS depressant effect of CNS Depressants. Use of opioid analgesics, including tramadol hydrochloride tablets, may impact the duration of labor due to inhibitory actions on uterine contractions or facilitatory actions on cervical dilation. Oxycodone HCl tablets dosage than to overestimate the 24-hour Oxycodone HCl tablets dosage and manage an adverse reaction due to overdose. If a patient has been receiving opioid-containing medications prior to taking Oxycodone HCl tablets, the potency of the prior opioid relative to Oxycodone should be factored into the selection of the total daily dose TDD of Oxycodone. Morphine Sulfate Tablets are contraindicated in patients with gastrointestinal obstruction, including paralytic ileus. Carbon dioxide CO2 retention from opioid-induced respiratory depression can exacerbate the sedating effects of opioids. Patients should be monitored for the emergence of serotonin syndrome. Monitor patients for increased respiratory and CNS depression when morphine sulfate oral solution is used concomitantly with cimetidine. CNS Depressants: May enhance the CNS depressant effect of Mirtazapine. Morphine sulfate oral solution may cause severe hypotension including orthostatic hypotension and syncope in ambulatory patients. There are several published reports on the potential genetic toxicity of Methadone. Methadone tested positive in the in vivo mouse dominant lethal assay and the in vivo mammalian spermatogonial chromosome aberration test. Additionally, Methadone tested positive in the E. coli DNA repair system and Neurospora crassa and mouse lymphoma forward mutation assays. In contrast, Methadone tested negative in tests for chromosome breakage and disjunction and sex-linked recessive lethal gene mutations in germ cells of Drosophila using feeding and injection procedures. Mechanism of action as an antidepressant is unclear, but is presumed to be linked to potentiation of noradrenergic and serotonergic activity in the CNS resulting from its antagonism at central presynaptic α 2-adrenergic autoreceptors and heteroreceptors. Do not change your dose. Take Methadone hydrochloride tablets exactly as prescribed by your healthcare provider. Use the lowest dose possible for the shortest time needed. Levy says. "I had mine, and that was that. I didn't think it was the sort of problem that could be treated. The morphine in morphine sulfate oral solution may cause spasm of the sphincter of Oddi. Opioids may cause increases in serum amylase. Monitor patients with biliary tract disease, including acute pancreatitis, for worsening symptoms.
Individually titrate Morphine Sulfate Tablets to a dose that provides adequate analgesia and minimizes adverse reactions. This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. The concomitant use of P-gp inhibitors can increase the exposure to morphine by two-fold and can increase the risk of hypotension, respiratory depression, profound sedation, coma, and death. The ACOG recommends that therapy with antidepressants during pregnancy be individualized; treatment of depression during pregnancy should incorporate the clinical expertise of the mental health clinician, obstetrician, primary health care provider, and pediatrician. According to the American Psychiatric Association APA the risks of medication treatment should be weighed against other treatment options and untreated depression. Consideration should be given to using agents with safety data in pregnancy. For women who discontinue antidepressant medications during pregnancy and who may be at high risk for postpartum depression, the medications can be restarted following delivery. Treatment algorithms have been developed by the ACOG and the APA for the management of depression in women prior to conception and during pregnancy ACOG 2008; APA 2010; Yonkers 2009. These studies revealed no evidence of teratogenicity or embryo-fetal toxicity due to Oxycodone. Discuss specific use of drug and side effects with patient as it relates to treatment. HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Instruct patients how to properly take tramadol hydrochloride tablets. While patients may notice improvement with mirtazapine tablet therapy in 1 to 4 weeks, they should be advised to continue therapy as directed. MAO inhibitors those intended to treat psychiatric disorders and also others, such as linezolid and intravenous methylene blue. Stopping the medication too early may result in a return of the infection. Since oxycodone is extensively metabolized in the liver, its clearance may decrease in patients with hepatic impairment. Initiate therapy in these patients with a lower than usual dosage of Oxycodone Hydrochloride Capsules and titrate carefully. Accidental ingestion of even one dose of Morphine Sulfate Tablets, especially by children, can result in respiratory depression and death due to an overdose of morphine. The safety and efficacy of Oxycodone HCl in pediatric patients have not been evaluated. Never give anyone your Methadone hydrochloride tablets. They could die from taking it. Store Methadone hydrochloride tablets away from children and in a safe place to prevent stealing or abuse. Selling or giving away Methadone hydrochloride tablets is against the law. buy cheapest adalat visa europe
Possible increased appetite and weight gain. High serotonin levels may cause changes in body temperature, blood pressure and behavior, leading to a medical condition called Serotonin Syndrome. Serotonin Syndrome may be life threatening. Continue taking it until the full prescribed amount is finished, even if symptoms disappear after a few days. Stopping the medication too early may result in a relapse of the infection. The potential for these risks should not, however, prevent the proper management of pain in any given patient. Patients at increased risk may be prescribed opioids such as Morphine Sulfate Tablets, but use in such patients necessitates intensive counseling about the risks and proper use of Morphine Sulfate Tablets along with intensive monitoring for signs of addiction, abuse, and misuse. Neonatal opioid withdrawal syndrome presents irritability, hyperactivity, and abnormal sleep pattern, high pitched cry, tremor, vomiting, diarrhea, and failure to gain weight. The onset, duration, and severity of neonatal opioid withdrawal syndrome vary based on the specific opioid use, duration of use, timing and amount of last maternal use, and rate of elimination of the drug by the newborn. P450 3A4 inducer such as rifampin, carbamazepine, and phenytoin, may result in an increase in tramadol plasma concentrations, which could increase or prolong adverse reactions, increase the risk for serious adverse events including seizures and serotonin syndrome, and may cause potentially fatal respiratory depression. Prolonged use of morphine sulfate oral solution during pregnancy can result in withdrawal in the neonate. Neonatal opioid withdrawal syndrome, unlike opioid withdrawal syndrome in adults, may be life-threatening if not recognized and treated, and requires management according to protocols developed by neonatology experts. Observe newborns for signs of neonatal opioid withdrawal syndrome and manage accordingly. Tablets were administered to 2796 patients in clinical studies. The conditions and duration of exposure to mirtazapine varied greatly, and included in overlapping categories open and double-blind studies, uncontrolled and controlled studies, inpatient and outpatient studies, fixed dose and titration studies. Untoward events associated with this exposure were recorded by clinical investigators using terminology of their own choosing. Consequently, it is not possible to provide a meaningful estimate of the proportion of individuals experiencing adverse events without first grouping similar types of untoward events into a smaller number of standardized event categories. Ask if you are not sure. Orally Disintegrating Tablets, as with other drugs effective in the treatment of major depressive disorder, is unknown. Neonatal opioid withdrawal syndrome presents as irritability, hyperactivity and abnormal sleep pattern, high pitched cry, tremor, vomiting, diarrhea, and failure to gain weight. The onset, duration, and severity of neonatal opioid withdrawal syndrome vary based on the specific opioid used, duration of use, timing and amount of last maternal use, and rate of elimination of the drug by the newborn. Human Data: Reported studies have generally compared the benefit of Methadone to the risk of untreated addiction to illicit drugs; the relevance of these findings to pain patients prescribed Methadone during pregnancy is unclear. Pregnant women involved in Methadone maintenance programs have been reported to have significantly improved prenatal care leading to significantly reduced incidence of obstetric and fetal complications and neonatal morbidity and mortality when compared to women using illicit drugs. Several factors, including maternal use of illicit drugs, nutrition, infection and psychosocial circumstances, complicate the interpretation of investigations of the children of women who take Methadone during pregnancy. Information is limited regarding dose and duration of Methadone use during pregnancy, and most maternal exposure appears to occur after the first trimester of pregnancy. Based on animal data, advise pregnant women of the potential risk to a fetus.
What should I avoid while taking Mirtazapine Tablets? What should I avoid while taking REMERONSolTab? Butorphanol, nalbuphine, pentazocine, buprenorphine. Some NMDA receptor antagonists have been shown to produce neurotoxic effects in animals. Mirtazapine Tablets, compared to 7% for placebo and 8% for amitriptyline. The conversion factors in this table are only for the conversion from another oral opioid analgesic to Methadone hydrochloride tablets. Cyproterone: May decrease the serum concentration of CYP1A2 Substrates. Opioids are sought by drug abusers and people with addiction disorders and are subject to criminal diversion. Consider these risks when prescribing or dispensing Oxycodone HCl. He's one of the researchers who worked on the JAMA study and the author of four books on sleep medicine, including Sound Sleep, Sound Mind. Evaluate patients developing QT prolongation while on Methadone treatment for the presence of modifiable risk factors, such as concomitant medications with cardiac effects, drugs that might cause electrolyte abnormalities, and drugs that might act as inhibitors of Methadone metabolism. Hepatic impairment may reduce clearance. If you miss a dose of mirtazapine, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once. Tryptophan: May enhance the serotonergic effect of Mirtazapine. This could result in serotonin syndrome. erythromycin online deutschland
There is a relationship between increasing Oxycodone plasma concentration and increasing frequency of dose-related opioid adverse reactions such as nausea, vomiting, CNS effects, and respiratory depression. The tablet can be administered without regard to meals. Severe allergic reactions rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue; abnormal thinking; confusion; decreased coordination; fainting; fast or irregular heartbeat; joint pain; mouth or nose sores; new or worsening agitation, panic attacks, aggressiveness, impulsiveness, irritability, hostility, exaggerated feeling of well-being, trouble sleeping, restlessness, or inability to sit still; red, swollen, blistered, or peeling skin; seizures; severe or persistent headache or dizziness; shortness of breath; suicidal thoughts or actions; symptoms of infection eg, fever, chills, sore throat, flu-like symptoms; symptoms of low blood sodium levels eg, difficulty concentrating or thinking, memory problems, sluggishness, unsteadiness, unusual weakness; tremors; unusual or severe mental or mood changes; worsening of depression. Instruct patients not to share Methadone hydrochloride tablets with others and to take steps to protect Methadone hydrochloride tablets from theft or misuse. For patients on a regimen of more than one opioid, calculate the approximate oral Methadone dose for each opioid and sum the totals to obtain the approximate total Methadone daily dose. Reserve concomitant prescribing of morphine sulfate oral solution and benzodiazepines or other CNS depressants for use in patients for whom alternative treatment options are inadequate.
When switching between the oral solution and tablet formulations, care should be taken as slight pharmacokinetic differences may exist. Have not provided adequate analgesia or are not expected to provide adequate analgesia. Smith WT, Glaudin V, Panagides J et al. Mirtazapine vs. amitriptyline vs. placebo in the treatment of major depressive disorder. Psychopharmacol Bull. Inform patients that Oxycodone HCl may impair the ability to perform potentially hazardous activities such as driving a car or operating dangerous machinery. Patients should be advised to notify their physician if they are breastfeeding an infant. Methadone hydrochloride tablets may cause severe hypotension including orthostatic hypotension and syncope in ambulatory patients. The use of Oxycodone Capsules is not recommended for patients taking MAOIs or within 14 days of stopping such treatment. Tramadol hydrochloride tablets, like other opioids, can be diverted for non-medical use into illicit channels of distribution. Careful record-keeping of prescribing information, including quantity, frequency, and renewal requests, as required by state and federal law, is strongly advised. Neonatal opioid withdrawal syndrome can present as irritability, hyperactivity and abnormal sleep pattern, high pitched cry, tremor, vomiting, diarrhea and failure to gain weight. The onset, duration, and severity of neonatal opioid withdrawal syndrome vary based on the specific opioid used, duration of use, timing and amount of last maternal use, and rate of elimination of the drug by the newborn. Prolonged use of Oxycodone HCl during pregnancy can result in neonatal opioid withdrawal syndrome, which may be life-threatening if not recognized and treated, and requires management according to protocols developed by neonatology experts. However, based on postmarketing reports, there is a possibility of more serious outcomes including fatalities at dosages much higher than the therapeutic dose, especially with mixed overdoses. In these cases, QT prolongation and Torsades de Pointes have also been reported see and sections. Opioids may also obscure the clinical course in a patient with a head injury. Morphine pharmacokinetics have been reported to be significantly altered in patients with cirrhosis. Morphine sulfate oral solution contains morphine, a substance with a high potential for abuse similar to other opioids including fentanyl, hydrocodone, hydromorphone, methadone, oxycodone, oxymorphone, and tapentadol. Drink alcohol or use prescription or over-the-counter medicines that contain alcohol. Using products containing alcohol during treatment with morphine sulfate oral solution may cause you to overdose and die. CYP3A4 Inhibitors Moderate: May decrease the metabolism of CYP3A4 Substrates. loratadine
It works by stopping the growth of bacteria. At least 14 days should elapse between discontinuation of an MAOI intended to treat psychiatric disorders and initiation of therapy with Mirtazapine Tablets. Most likely to occur within first few weeks of treatment and characterized by unpleasant or distressing restlessness and need to move often accompanied by an inability to sit or stand still. Increasing the dose in these patients may be detrimental. After you stop taking Methadone hydrochloride tablets, flush any unused tablets down the toilet. Selective Serotonin Reuptake Inhibitors. Specifically, the risk of psychomotor impairment may be enhanced. Available data with Oxycodone HCl in pregnant women are insufficient to inform a drug-associated risk for major birth defects and miscarriage.
Consult your doctor about a plan to gradually increase your as symptoms improve. Morphine is a full opioid agonist and is relatively selective for the mu-opioid receptor, although it can bind to other opioid receptors at higher doses. The principal therapeutic action of morphine is analgesia. Like all full opioid agonists, there is no ceiling effect for analgesia with morphine. Clinically, dosage is titrated to provide adequate analgesia and may be limited by adverse reactions, including respiratory and CNS depression. In managing overdosage, consider the possibility of multiple-drug involvement. Decreased White Blood Cells called neutrophils, which are needed to fight infections. Tell your doctor if you have any indication of infection such as fever, chills, sore throat, or mouth or nose sores, especially symptoms which are flu-like. Asunaprevir: May increase the serum concentration of CYP2D6 Substrates. Use mirtazapine as directed by your doctor. Check the label on the medicine for exact dosing instructions. The duration of analgesic action of Methadone is 4 to 8 hours based on single-dose studies but the plasma elimination half-life is 8 to 59 hours. The possibility of a suicide attempt is inherent in major depression and may persist until remission occurs. Worsening depression and severe abrupt suicidality that are not part of the presenting symptoms may require discontinuation or modification of drug therapy. Use caution in high-risk patients during initiation of therapy. Mirtazapine Tablets are rapidly and completely absorbed following oral administration and have a half-life of about 20 to 40 hours. Peak plasma concentrations are reached within about 2 hours following an oral dose. The presence of food in the stomach has a minimal effect on both the rate and extent of absorption and does not require a dosage adjustment. Chronic Nightmare or Bad Dream? generic meclizine money order pharmacy
If the prescribed concentration is changed, instruct patients on how to correctly measure the new dose to avoid errors which could result in accidental overdose and death. Mallinckrodt, the “M” brand mark, the Mallinckrodt Pharmaceuticals logo and M are trademarks of a Mallinckrodt company. Hyponatremia has been reported very rarely with the use of mirtazapine. Caution should be exercised in patients at risk, such as elderly patients or patients concomitantly treated with medications known to cause hyponatremia. Food and Drug Administration. WebMD does not endorse any specific product, service, or treatment. Tramadol hydrochloride tablets contain tramadol, an opioid agonist and inhibitor of norepinephrine and serotonin reuptake. Although the mode of action is not completely understood, the analgesic effect of tramadol is believed to be due to both binding to μ-opioid receptors and weak inhibition of re-uptake of norepinephrine and serotonin. This information is generalized and not intended as specific medical advice. The effects of concomitant use or discontinuation of cytochrome P450 3A4 inducers, 3A4 inhibitors, or 2D6 inhibitors with tramadol are complex. Methadone may enhance the neuromuscular blocking action of skeletal muscle relaxants and produce an increased degree of respiratory depression. There are no adequate and well-controlled studies in pregnant women. N-desmethyl and N-oxide metabolite. Antidepressant medicines have other side effects. Store at room temperature at 77 degrees F 25 degrees C away from light and moisture. Brief storage between 59-86 degrees F 15-30 degrees C is permitted. not store in the bathroom. Keep all medicines away from children and pets.
Information from oxycodone tablets indicate that patients with renal impairment had higher plasma concentrations of oxycodone than subjects with normal renal function. Initiate therapy with a lower than usual dosage of Oxycodone Hydrochloride Capsules and titrate carefully. There is inter-patient variability in the potency of opioid drugs and opioid formulations. Therefore, a conservative approach is advised when determining the total daily dosage of Oxycodone Hydrochloride Capsules. It is safer to underestimate a patient's 24-hour Oxycodone Hydrochloride Capsules dosage than to overestimate the 24-hour Oxycodone Hydrochloride Capsules dosage and manage an adverse reaction due to overdose. Your healthcare provider or pharmacist can tell you if it is safe to take REMERONSolTab with your other medicines. Do not start or stop any medicine while taking REMERONSolTab without talking to your healthcare provider first. Methadone hydrochloride tablets may impair the mental or physical abilities needed to perform potentially hazardous activities such as driving a car or operating machinery. Morphine sulfate oral solution exposes patients and other users to the risks of opioid addiction, abuse, and misuse, which can lead to overdose and death. albenza vs generic drug
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Halikas JA. Org 3770 mirtazapine versus trazodone: a placebo controlled trial in depressed elderly patients. Hum Psychopharmacol. Oxycodone HCl passes into breast milk and may harm your baby. It is not known if this drug passes into milk. Consult your doctor before -feeding. Instruct nursing mothers using Methadone hydrochloride tablets to watch for signs of Methadone toxicity in their infants, which include increased sleepiness more than usual difficulty breastfeeding, breathing difficulties, or limpness.
Free and conjugated norOxycodone, free and conjugated Oxycodone, and oxymorphone are excreted in human urine following a single oral dose of Oxycodone. Opioids may also obscure the clinical course in a patient with a head injury. Avoid the use of Morphine Sulfate Tablets in patients with impaired consciousness or coma. The electrocardiograms for 338 patients who received Mirtazapine Tablets and 261 patients who received placebo in 6-week, placebo-controlled trials were analyzed. Management of pain severe enough to require daily, around-the-clock, long-term opioid treatment and for which alternative treatment options are inadequate.
Physical dependence may not occur to a clinically significant degree until after several days to weeks of continued opioid usage. Use with caution; clearance may be reduced; refer to adult dosing. Dosing errors can result in accidental overdose and death. Avoid dosing errors that may result from confusion between mg and mL and confusion with morphine solutions of different concentrations, when prescribing, dispensing, and administering morphine sulfate oral solution. Ensure that the dose is communicated clearly and dispensed accurately. Always use the enclosed calibrated oral syringe when administering morphine sulfate oral solution to ensure the dose is measured and administered accurately. A household teaspoon or tablespoon is not an adequate measuring device. Given the inexactitude of the household spoon measure and the possibility of using a tablespoon instead of a teaspoon, which could lead to overdosage, it is strongly recommended that caregivers obtain and use a calibrated measuring device. Healthcare providers should recommend a calibrated device that can measure and deliver the prescribed dose accurately, and instruct caregivers to use extreme caution in measuring the dosage.
PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using mirtazapine while you are pregnant. It is not known if this medicine is found in breast milk. If you are or will be breast-feeding while you use mirtazapine, check with your doctor. Discuss any possible risks to your baby. Patients who are to receive Mirtazapine Tablets should be warned about the risk of developing agranulocytosis. Patients should be advised to contact their physician if they experience any indication of infection such as fever, chills, sore throat, mucous membrane ulceration, or other possible signs of infection. Particular attention should be paid to any flu-like complaints or other symptoms that might suggest infection.