Overdose and death may occur with a single oral dose of between 100 and 150 mg of morphine in a healthy adult who has no tolerance to opiates. This represents the equivalent of between two to three teaspoons (10–15 mL) of opium tincture. Suicide by laudanum was common in the mid-19th century. Prudent medical judgment necessitates toward dispensing very small quantities of opium tincture in small dropper bottles or in pre-filled syringes to reduce the risk of intentional or accidental overdose. Danger of confusion with paregoric
In the United States, opium tincture contains 10 mg per mL of anhydrous morphine. By contrast, opium tinctures weaker cousin, paregoric, also confusingly known as "camphorated tincture of opium", is 1/25th the strength of opium tincture, containing only 0.4 mg of morphine per mL. A 25-fold morphine overdose may occur if opium tincture is used where paregoric is indicated. Opium tincture is almost always dosed in drops, or fractions of a mL, or less commonly, in minims, while paregoric is dosed in teaspoons or tablespoons. Thus, an order for opium tincture containing directions in teaspoons is almost certainly in error.
Clindamycin/benzoyl peroxide is a topical gel used for the treatment of acne. It is a combination of clindamycin, an antibiotic, and benzoyl peroxide, an antiseptic.Common side effects include peeling, itching, and dryness of the skin where the gel was applied.Clindamycin/benzoyl peroxide was approved for medical use in the United States in December 2000. It is available as a generic medication. Medical uses
The gel is used on the skin to treat light to medium acne vulgaris in people 12 years and older. Efficacy
There is an average 52% decrease in inflammatory acne lesions by week 12.The combination is less effective than benzoyl peroxide/salicylic acid after short-term treatment of two to four weeks, but the two treatments showed similar effectiveness after ten to twelve weeks. Pregnancy and lactation
Studies on whether or not the use of clindamycin/benzoyl peroxide gels is teratogenic or has adverse effects on nursing infants have not been performed. While oral clindamycin passes into breast milk, no such data are available for clindamyin in gel form. Limited data regarding topical clindamycin and benzoyl peroxide have shown no safety problems. Contraindications
The gel is not recommended for those who are allergic to clindamycin, benzoyl peroxide, any components of the formulation, or lincomycin. Individuals previously diagnosed with regional enteritis, ulcerative colitis, or antibiotic-associated colitis are also recommended not to use it. Side effects
Common side effects are peeling, itching, redness, dryness, burning, and dermatitis. Benzoyl peroxide bleaches hair, clothes, towels, bedclothing, and the like.