Treating Geographic Tongue
Special Concerns Safety and efficacy in children less than 12 years of age have not been established. Side Effects At site of injection Pain and thrombophlebitis. GI Diarrhea, N&V, flatulence, abdominal distention, glossitis. CNS Fatigue, malaise, headache. GU Dysuria, urinary retention. Miscellaneous Itching, chest pain, edema, facial swelling, erythema, chills, tightness in throat, epistaxis, substernal pain, mucosal bleeding, candidiasis. Drug Interactions See also Anti-Infectives and Penicillins. How Supplied See Content
Presents with nonspecific complaints, such as weight loss, diabetes mellitus, diarrhea, and stomatitis necrolytic migratory erythema found anywhere on the body, but most common in the perineum, buttocks, groin, lower abdomen, and lower extremities eruption starts as a pruritic or painful, erythematous patch that blisters centrally, erodes, crusts over, and heals with hyper-pigmentation annular lesions with confluence into plaques confluence in severely affected areas associated mucocutaneous findings, including atrophic glossitis, cheilosis, dystrophic nails, and buccal mucosal inflammation
Note Patients may remain seropositive for long periods and the enzyme-linked immunosorbent assay (ELISA) test cannot be used as a proof of cure. A negative lyme test result does not indicate the absence of disease, nor does a positive result indicate the presence of disease. A positive result is not required to diagnose Lyme disease for someone with clear-cut erythema migrans, and those patients should be treated regardless of test results.
Side Effects See also General Information on Tetracyclines. Additional Side Effects Temporary blurring of vision or stinging following administration. Dermatitis and photosensitivity following ophthalmic use. Use of the tetracycline fiber Oral candidiasis, glossitis, staining of the tongue, severe gingival hyperplasia, minor throat irritation, pain following placement in an abscessed area, throbbing pain, hyper-sensitivity reactions. Drug Interactions See also General Information on Tetracyclines. How Supplied Tetracycline Syrup 125 mg 5 mL. Tetracycline hydrochloride Capsule 100 mg, 250 mg, 500 mg Ointment 3 Ophthalmic ointment 1 Solution 2.2 mg mL
Secondary to vitamin deficiencies, alcoholics suffer from inflammation of the tongue (glossitis), inflammation of the mouth (stomatitis), caries, and perio-dontitis. A low-protein diet, associated with alcoholism, can lead to a zinc deficiency, which impairs the sense of taste and further curbs the appetite of the alcoholic. Parotid gland enlargement may be noted.
Alcoholics are especially susceptible to deficiencies of thiamine, folate, B vitamins, and ascorbic acid. Alcohol intake leads to negative nitrogen balance, increased protein turnover, and inhibition of lipolysis (Bunout, 1999). Deficiencies in folate, vitamin B6, and vitamin B12 play a role in elevated levels of homocysteine, which in turn promotes atherosclerosis and thrombosis formation (Cravo & Camilo, 2000). Ethanol can suppress appetite through its effect on the CNS. Gastric, hepatic, and pancreatic disease my further decrease enteral intake and contribute to maldigestion or malabsorption. Signs of malnutrition include thinning of the hair, ecchymosis, glossitis, abdominal distention, peripheral edema, hypocalcemic tetany, and neuropathy. Nutritional management consists of abstinence and institution of a well-balanced diet and multivitamins, plus thiamine and vitamin B supplements when indicated.
Iron deficiency (hypochromic, microcytic) the most common cause of anemia in the US. Look for low iron ferritin level, elevated total iron-binding capacity (TIBC also known as transferrin), and lowTIBC saturation. Rarely patients have a.craving for ice or dirt (pica) or Plummer-Vinson syndrome (esophageal web producing dysphagia, iron deficiency anemia, and glossitis). In a patient over 40, rule out colon cancer as a cause of chronic blood loss. Iron deficiency anemia is common in women of reproductive age because of menstrual irregularities. Give iron supplements to all infants except full-term infants who are exclusively breast-fed giving cow's milk before 1 year of age may cause anemia through GI bleeding. Start iron supplementation at 4 6 months for full-term infants and at 2 months for preterm infants. Iron supplements also are commonly given during pregnancy and. lactation because of increased demand. To treat iron deficiency anemia, correct the underlying cause if possible and...
Fig. 4.22 Geographic tongue (benign migratory glossitis). There are smooth areas with no filiform papillae. These areas vary in site on the tongue, and the appearance may concern the patient. It is, however, a condition of no significance requiring no treatment other than reassurance. Fig. 4.32 Median rhomboid glossitis.
Contraindications Cardiac arrhythmias due to tachycardia tachycardia caused by digitalis toxicity. Special Concerns Safety and efficacy have not been determined in children less than 12 years of age. Additional Side Effects CV PVCs, hypotension. CNS Hyperactivity, hy-perkinesia, anxiety, confusion, depression, fatigue, syncope. Oral Bad taste or taste change, stomatitis, glossitis, dry mouth. GI Diarrhea, anorexia, loss of appetite, abdominal pain, abdominal cramps. Der-matologic Rash, edema, pruritus, alopecia. Miscellaneous Flushing,
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