The dead tissue forms a thick, gray coating that can build up in the throat or nose. This thick gray coating is called a "pseudomembrane". It can cover tissues in the nose, tonsils, voice box, and throat, making it very hard to breathe and swallow. Symptoms can also include cardiac arrhythmias, myocarditis, and cranial and peripheral nerve palsies. Diphtheritic croup
Laryngeal diphtheria can lead to a characteristic swollen neck and throat, or "bull neck". The swollen throat is often accompanied by a serious respiratory condition, characterized by a brassy or "barking" cough, stridor, hoarseness, and difficulty breathing; and historically referred to variously as "diphtheritic croup", "true croup", or sometimes simply as "croup". Diphtheritic croup is extremely rare in countries where diphtheria vaccination is customary. As a result, the term "croup" nowadays most often refers to an unrelated viral illness that produces similar but milder respiratory symptoms. Transmission
Human-to-human transmission of diphtheria typically occurs through the air when an infected individual coughs or sneezes. Breathing in particles released from the infected individual leads to infection. Contact with any lesions on the skin can also lead to transmission of diphtheria, but this is uncommon. Indirect infections can occur, as well. If an infected individual touches a surface or object, the bacteria can be left behind and remain viable. Also, some evidence indicates diphtheria has the potential to be zoonotic, but this has yet to be confirmed. Corynebacterium ulcerans has been found in some animals, which would suggest zoonotic potential.
Delsym is an American brand of cough medicine owned by Reckitt, and manufactured at Unither Manufacturing in Rochester, NY. It is different from most brands of cough medicine in that the active ingredient is "time released". The time release feature allows the drug to suppress the cough reflex for a longer period of time. The active ingredient per teaspoon (5 mL) is dextromethorphan polistirex, equivalent to dextromethorphan HBr 30 mg. Method of action
The active ingredient, dextromethorphan (metabolized to dextrorphan), is surrounded by an edible plastic called polistirex. When the Delsym arrives in the stomach, an initial amount of dextromethorphan is immediately released into the bloodstream while the rest is surrounded by a plastic that is slowly dissolved by stomach acid. After the polistirex is dissolved sufficiently, more dextromethorphan is released. Recreational use
Intentionally consuming more than the recommended dosage of Delsym may result in euphoria, lack of coordination, hallucinations, apathy, feelings of dissociation, and disorientation. This is due to dextromethorphan as well as its pharmacologically-active metabolite dextrorphan, both dissociative drugs that work as NMDA receptor antagonists the same way nitrous oxide (N2O), ketamine, and phencyclidine (PCP) do. Because of the abuse potential, many pharmacies and large retail chains have begun taking precautions such as restricting sales to those under age 18 and limiting the number of sales of dextromethorphan-containing products per customer. References
External links
Official website