Freedom of information legislation and medical records In recent months Canadians have been aware of the abuses relating to federal government files, which have included the misuse of medical records. Recognizing the growing desire by individuals for more access to files and the need for governments to be more open in their dealings with the public, the federal government enacted the Human Rights Act and proclaimed the relevant sections of that act effective during the first quarter of 1978. In November 1977, Nova Scotia proclaimed legislation relating to access to or use of personal information in the immediate control of government departments in the Freedom of Information Act. However, further amendments to the Hospital Act may have excluded hospital medical records from the Freedom of Information Act. No other provincial government has legislation as pervasive as these two acts. It would seem logical that such legislation will be forthcoming from other provinces in the near future. Such legislation carries the potential for introducing major ethical and social problems to members of the public, particularly the health professionals. In addition, an increased administrative burden on the civil service can be predicted. As recently as Dec. 19, 1977 an article in Time reported that the introduction of the Freedom of Information Act in the United States had become "the hottest growth industry in Washington these days... it soaks up millions of dollars, employs hundreds of civil servants and is driving many of them to distraction."1 On first analysis the Canadian legislation appeared to be a landmark of justice, protecting the rights of the individual by preventing storage of incorrect information, providing the means to correct false information and avoiding the abuse of personal files for purposes other than those for which the data were originally collected. The government made the effort to distinguish between accessibility and intru-
sion and tried to balance government relevant issue may be whether damages efficiency with citizens' needs of free suffered directly by a patient or inaccess. On close inspection of the en- directly by his family as a result of suing legislation, however, it became the release of mental health informaobvious that, although these acts spe- tion could result in medical malpractice cifically considered medical records, suits on the grounds that a reasonable, their originators seem to have miscal- prudent practitioner would have known culated the full implications for the the likely consequences of having public they sought to protect. For shown such information to a patient. What should be the response of a health professionals, the acts will affect clinical service, administration, research practitioner to a request from a Royal and possibly provincially funded edu- Canadian Mounted Police officer for cation. Several questions regarding each an arrestee's medical record when the officer does not have a subpoena? of these areas need to be answered. Several questions have arisen regardIn clinical service what information must be shown to the patient? Such ing administrative problems; for exinformation should include a descrip- ample, Who is responsible for medical tion of the symptoms; the tentative and records? Is there a distinction between final diagnoses; the proposed therapies the duties of a physician who collects and monitoring programs for side ef- the information and the duties of a fects; and the subjective comments that health record administrator who keeps have been made about the patient - the files? Who should have access to for example, that he or she has a "ma- a child's medical records? Is it possible for a child to obtain access to his own nipulative personality". Will the medical profession adopt records through the appointment of the potentially dangerous (clinically and an adult legal representative? How will patients distinguish belegally) position of failing to record controversial or sensitive information tween care provided in an institution in an attempt to avoid problems con- subject to provincial legislation and care provided in federal institutions not cerning disclosure? What rights will the patient have to subject to provincial legislation? What duty is there and on whom his own mental health records? The does the responsibility rest to interpret approaches two obvious but extreme to this issue would be to allow a patient the information contained in the file full access to all information or only so a patient can fully understand it? to that information the physician be- Will the medical profession be prelieves would be in the patient's in- pared to delegate this task to a health terests. A third approach, apparently ombudsperson, such as an upgraded being considered by the federal gov- health record administrator? There is ernment for records that fall under the already conflict with current legislation federal act, is to allow the patient to in the hospital acts about the congo to a practitioner who is not involved fidentiality of records. What will be the costs of the addirectly with the case. If the neutral third party decides that the file should ministrative impact on the overburbe shown to the patient, the physician dened health delivery systems and who holding the file must either show it to should pay these costs? This legislation will affect research the patient or forward it to the third party practitioner, who will show it to and will raise questions such as What the patient. One could be concerned impact will restrictions on further use that this approach may lead to "shop- of information have on epidemiologic ping around" by patients in an attempt research or public health investigations? to find a lenient practitioner. The more What effect will there be on the disCMA JOURNAL/FEBRUARY 18, 1978/VOL. 118 343
BENTYLOL®
closure of confidential reports by nonfederal referees to such national agencies as the Medical Research Council and the research programs and the nonmedical use of drugs directorates of Health and Welfare Canada? Provincially funded education may also be affected by this legislation. Will evaluatory comments on students and on all examinations based on a subjective response be entitled to a third party referee? Will university medical school records be part of the public access file? As a consequence of this legislation future patient and health professional behaviour may be affected. Patients may become more interested in their own health records and even family records. Communication between patients and their health advisers may be improved. Practitioners will become more precise and objective about what they record. There will be an increase in physician-patient time to explain fully facts and opinions in the record, which will alleviate the patient's potential subsequent anxiety and possibly that of the physician. Some lawsuits may be prevented whereas others may be made likely. Unfortunately epidemiologic research may be inhibited. The usefulness of medical records may be limited and the productivity of the health services may be reduced by the increased administrative overload. These questions must be answered to implement the law as it now stands. Perhaps it is time to begin discussing the potential extension of patient and public entitlements to such information before legislation or judicial interpretations force the issues. For instance, should relevant health information be made public when an individual seeks public office? Compare the harassment of Bert Lance with the current demands in the US for the disclosure of relevant financial information to the impact of the release of medical information in the career of US Senator Thomas Eagleton. In the light of recent biographies, one has to wonder whether the late Mackenzie King would have become Prime Minister of Canada if such disclosure legislation had been present at that time? No doubt computers will be blamed for causing the situation in which we now find ourselves, but computers are responsible only for making the situation more apparent; human greed and cunning have to accept the lion's share of the blame. One could argue that computer technology could supply part of the solution by providing validated information to persons who need it and are authorized to possess it while preventing access to those who do not. In conclusion, we as health profes-
sionals should support all laudable attempts at legislation that prevent the storage and misuse of incorrect personal data and provide legitimate access to files. However, we should ensure that such legislation does not carry with it the potential danger of overburdening the practitioners of health care, of diminishing the value of clinical service. of exposing physicians to new legal risks and, on the bottom line, of increasing the suffering of our patients. Once again we are in the position of reacting to a fait accompli. Before we succumb we must make determined efforts through our associations to communicate with legislators to ensure that the impact on the health system of future federal, provincial and municipal legislation is considered very carefully. If we do not stand up and be counted we must accept the consequences. DAVID B. SHIRES, MB, CH B, CCFP Associate professor Department of family medicine Daihousie University Halifax, N5 GAYLEN DUNCAN, PH D Director, Office of the minister responsible for communications Halifax, N5
(dicyclomine hydrochloride) Tablets, Capsules, Syrup, Injection Antispasmodic DESCRIPTION For antispasmodic action alone 1. Bentylol 10mg capsules: 10mg dicyclomine hydrochloride in each blue capsule. 2. Bentylols.yru1p: 10mg dicyclomine hydrochloride in each ml) pink syrup. 3. Bentylol 20mg tablets: 20 mgd icyclomine hydrochloride in each blue tablet. 4. Bentylol Injection: Ampoule-2 ml. Each ml contains 10 mg di cyclomine hydrochloride, in water for injection, made isotonic with sodium chloride. Vial- 10 ml. Each ml contains 10mg dicyclomine hydrochloride,. in water for injection, made isotonic with sodium chloride. 0.5% chlorobutanol hydrous (chloral derivative) added as a preservative. For antispasmodic action pius sedation
1. * Bentylol 10mg with Phenobarbital capsules: 10mg dicyclomine hydrochloride and 15 mg phenobarbital in each blue and white capsule. 2. *Bentylol 20mg with Phenobarbital tablets: 20mg dlcyclomine hydrochloride and 15 mg phenobarbita in each white tablet. 3. with Phenobarbital syrup: 10 mg dic clomine in each f.easpoonful (5 ACTIONS Antispasmodic. Bentylol has a direct relaxant effect on the smooth muscle of the gastrointestinal tract as well as a depressant effect on parasympathetic function. These dual act ions produce relief of spasm with minimum atropine-like effects. Phenobarbital exerts a sedative effect. INDICATIONS AND CLINICAL USE Oral dosage forms 1. Symptomatic control of functional gastrointestinal disorders. Primary condition diagnosed as: chronic irritable colon, spastic constipation, mucous colitispylorospasm, biliary dyskinesia, or spastic colitis. Bentylol is effectively used to treat symptoms of these conditions such as: abdominal cramps and pain, gas or belching, flatulence, and diarrhoea. 2. Gastrointestinal spasm secondary to organic diseases, such as: peptic ulcer, hiatal hernia, esophagi is, gastritis, duodenitis, cholecystitis, diverticulitis, and chronic ulcerative colitis. 3. Infant colic. (syrup torm only) Injectable form Symptomatic treatment of the above conditions in adults when a rapid onset of therapeutic action is desired or when persistent nausea and vomiting preclude the use of oral administration. CONTRAINDICATIONS
Reference 1. Bureaucracy's great paper chase. Time: Dec. 19, 1977
BOOKS This list is an acknowledgement of books received. It does not preclude review at a later date. ADMINISTERING NURSING SERVICE. 2nd ed. Marie DiVincenti. 467 pp. Illust. Little, Brown and Company (Inc.), Boston, 1977. Price not stated. ISBN 0-216-18651-1 BIOFEEDBACK. Vol. 2, 1977. WilfrId I. Hume. 74 pp. Eden Press, Montreal, 1977. $10. ISBN 0-88831. 008-0 BLUNT CHEST TRAUMA. General Principles of Management. Marvin M. Kirsh and Herbert Sloan. 274 pp. Illust. Little, Brown and Company (Inc.), Boston, 1977. PrIce not stated. ISBN 0-316-49501-8 CHEST PAIN: An Integrated Diagnostic Approach. Edited by Donald L. Levene, Ronald F. Billings. Geoffrey M. Davies and others. 203 pp. Illust. Lea & Febiger. Philadelphia; The Macmillan Company of Canada Limited, Toronto, 1977. Price not stated, paperbound. ISBN 0-8121-0610-5 CLINICAL AND EXPERIMENTAL HYPNOSIS. In Medicine, Dentistry, and Psychology. 2nd ed. William S. Kroger. 406 pp. J.B. Lippincott Company of Canada, Toronto, 1977. Price not stated. ISBN 0-397-50377-6 CLINICAL ELECTROCARDIOGRAPHY. A Simplified Approach. Ary Louis Goldberger and Emanuel Goldberger. 263 pp. The C.V. Mosby Company, Saint Louis, 1977. $11.45, paperbound. ISBN 0-80161859-2 COMPREHENSIVE ARTHROSCOPIC EXAMINATION OF THE KNEE. Lanny 1. Johnson. 156 pp. IlIust. The CV. Mosby Company, Saint Louis, $51.25. ISBN 0-8016-2534-3 COMPUTER METHODS. The Fundamentals of DigItal Nuclear Medicine. David E. Lleberman. 225 pp. IlIust. The C.V. Mosby Company. Saint Louis, 1977. $16, paperbound. ISBN 0-8016-3009-6
344 CMA JOURNAL/FEBRUARY 18, 1978/VOL. 118
continued on page 388
Dicyclomine hydrochloride is contraindicated in patients with frank urinary retention, stenosing peptic ulcer, and pyloric or duodenal obstruction. WARNING
Phenobarbital may be habit forming. PRECAUTION Although studies have failed to demonstrate adverse effects of dicyclomine hydrochloride in glaucoma, it should be prescribed with caution in patients known to have or suspected of having glaucoma. ADVERSE REACTIONS Adverse reactions seldom occur with dicyclomine hydrochloride; however, in susceptible individuals, atropinelike effects such as dry mouth or thirst and dizziness may occur. On rare occasions, fatigue, sedation, blurred vision, rash, constipation, anorexia, nausea and vomiting, headache, impotence, and urinary retention have also been reported. With the injectable form there may be a temporary sensation of light-headedness and occasionally local irritation. SYMPTOMS AND TREATMENT OF OVERDOSE
The signs and symptoms of overdose are headache, nausea, vomiting, blurred vision, dilated pupils, hot, dry skin, dizziness, dryness of the mouth, difficulty in swallowing, CNS stimulation. Treatment should consist of gastric lavage, emetics, and activated charcoal. Barbiturates may be used either orally or intramuscularly for sedation but they should not be used if Bentylol with Phenobarbital has been ingested. If indicated, parenteral cholinerg ic agents such as Urecholine* (bethanecol chloride USP) should be used. DOSAGE AND ADMINISTRATION Bentylol 10 mg capsules and syrup (plain and with *phenobarbital): Adults: 1 or 2 capsules or teaspoonfuls of syrup three or four times daily. Children: 1 capsule or iteaspoonful of syrup three or four times daily. Infants: 1/2 teaspoonful of syrup three or four times daily. (May be diluted with an equal volume of water.) Bentylol2omgtab lets (plain and with . phenobarbital): Adults:ltablet three or four times daily. Ben ty lol Injection: Adult5: 2 ml (20 m eve four to six hours intramuscularly only. NOT FOR INTRAVENDUS USE. DOSAGE FORMS
Bottl.s o?100, 500, and 5000 *io mg Capsules with Phenobarbital Bottles of 100,500, and 5000 20mg Tablets Bottles of 100 *20 mg Tablets with Phenobarbital Bottles of 100 Syrup (plain and with ..phenobarbital) 250 ml bottles Injection 2 ml ampoules and 10 ml multiple dose vials Product Information as of March, 1976 Pklf acage norm ation amended as of February, 1977) ullrescribing Information available upon request.
MerrelI
THE WM. S. MERRELL COMPANY
Division of Richardson-Merrell (Canada) Ltd., Weston, Ontario. M9L 1 R9
Im.1
7.019 (WOO6A) Printed July, 1977
sion and tried to balance government relevant issue may be whether damages efficiency with citizens' needs of free suffered directly by a patient or inaccess. On close inspection of the en- directly by his family as a result of suing legislation, however, it became the release of mental health informaobvious that, although these acts spe- tion could result in medical malpractice cifically considered medical records, suits on the grounds that a reasonable, their originators seem to have miscal- prudent practitioner would have known culated the full implications for the the likely consequences of having public they sought to protect. For shown such information to a patient. What should be the response of a health professionals, the acts will affect clinical service, administration, research practitioner to a request from a Royal and possibly provincially funded edu- Canadian Mounted Police officer for cation. Several questions regarding each an arrestee's medical record when the officer does not have a subpoena? of these areas need to be answered. Several questions have arisen regardIn clinical service what information must be shown to the patient? Such ing administrative problems; for exinformation should include a descrip- ample, Who is responsible for medical tion of the symptoms; the tentative and records? Is there a distinction between final diagnoses; the proposed therapies the duties of a physician who collects and monitoring programs for side ef- the information and the duties of a fects; and the subjective comments that health record administrator who keeps have been made about the patient - the files? Who should have access to for example, that he or she has a "ma- a child's medical records? Is it possible for a child to obtain access to his own nipulative personality". Will the medical profession adopt records through the appointment of the potentially dangerous (clinically and an adult legal representative? How will patients distinguish belegally) position of failing to record controversial or sensitive information tween care provided in an institution in an attempt to avoid problems con- subject to provincial legislation and care provided in federal institutions not cerning disclosure? What rights will the patient have to subject to provincial legislation? What duty is there and on whom his own mental health records? The does the responsibility rest to interpret approaches two obvious but extreme to this issue would be to allow a patient the information contained in the file full access to all information or only so a patient can fully understand it? to that information the physician be- Will the medical profession be prelieves would be in the patient's in- pared to delegate this task to a health terests. A third approach, apparently ombudsperson, such as an upgraded being considered by the federal gov- health record administrator? There is ernment for records that fall under the already conflict with current legislation federal act, is to allow the patient to in the hospital acts about the congo to a practitioner who is not involved fidentiality of records. What will be the costs of the addirectly with the case. If the neutral third party decides that the file should ministrative impact on the overburbe shown to the patient, the physician dened health delivery systems and who holding the file must either show it to should pay these costs? This legislation will affect research the patient or forward it to the third party practitioner, who will show it to and will raise questions such as What the patient. One could be concerned impact will restrictions on further use that this approach may lead to "shop- of information have on epidemiologic ping around" by patients in an attempt research or public health investigations? to find a lenient practitioner. The more What effect will there be on the disCMA JOURNAL/FEBRUARY 18, 1978/VOL. 118 343
BENTYLOL®
closure of confidential reports by nonfederal referees to such national agencies as the Medical Research Council and the research programs and the nonmedical use of drugs directorates of Health and Welfare Canada? Provincially funded education may also be affected by this legislation. Will evaluatory comments on students and on all examinations based on a subjective response be entitled to a third party referee? Will university medical school records be part of the public access file? As a consequence of this legislation future patient and health professional behaviour may be affected. Patients may become more interested in their own health records and even family records. Communication between patients and their health advisers may be improved. Practitioners will become more precise and objective about what they record. There will be an increase in physician-patient time to explain fully facts and opinions in the record, which will alleviate the patient's potential subsequent anxiety and possibly that of the physician. Some lawsuits may be prevented whereas others may be made likely. Unfortunately epidemiologic research may be inhibited. The usefulness of medical records may be limited and the productivity of the health services may be reduced by the increased administrative overload. These questions must be answered to implement the law as it now stands. Perhaps it is time to begin discussing the potential extension of patient and public entitlements to such information before legislation or judicial interpretations force the issues. For instance, should relevant health information be made public when an individual seeks public office? Compare the harassment of Bert Lance with the current demands in the US for the disclosure of relevant financial information to the impact of the release of medical information in the career of US Senator Thomas Eagleton. In the light of recent biographies, one has to wonder whether the late Mackenzie King would have become Prime Minister of Canada if such disclosure legislation had been present at that time? No doubt computers will be blamed for causing the situation in which we now find ourselves, but computers are responsible only for making the situation more apparent; human greed and cunning have to accept the lion's share of the blame. One could argue that computer technology could supply part of the solution by providing validated information to persons who need it and are authorized to possess it while preventing access to those who do not. In conclusion, we as health profes-
sionals should support all laudable attempts at legislation that prevent the storage and misuse of incorrect personal data and provide legitimate access to files. However, we should ensure that such legislation does not carry with it the potential danger of overburdening the practitioners of health care, of diminishing the value of clinical service. of exposing physicians to new legal risks and, on the bottom line, of increasing the suffering of our patients. Once again we are in the position of reacting to a fait accompli. Before we succumb we must make determined efforts through our associations to communicate with legislators to ensure that the impact on the health system of future federal, provincial and municipal legislation is considered very carefully. If we do not stand up and be counted we must accept the consequences. DAVID B. SHIRES, MB, CH B, CCFP Associate professor Department of family medicine Daihousie University Halifax, N5 GAYLEN DUNCAN, PH D Director, Office of the minister responsible for communications Halifax, N5
(dicyclomine hydrochloride) Tablets, Capsules, Syrup, Injection Antispasmodic DESCRIPTION For antispasmodic action alone 1. Bentylol 10mg capsules: 10mg dicyclomine hydrochloride in each blue capsule. 2. Bentylols.yru1p: 10mg dicyclomine hydrochloride in each ml) pink syrup. 3. Bentylol 20mg tablets: 20 mgd icyclomine hydrochloride in each blue tablet. 4. Bentylol Injection: Ampoule-2 ml. Each ml contains 10 mg di cyclomine hydrochloride, in water for injection, made isotonic with sodium chloride. Vial- 10 ml. Each ml contains 10mg dicyclomine hydrochloride,. in water for injection, made isotonic with sodium chloride. 0.5% chlorobutanol hydrous (chloral derivative) added as a preservative. For antispasmodic action pius sedation
1. * Bentylol 10mg with Phenobarbital capsules: 10mg dicyclomine hydrochloride and 15 mg phenobarbital in each blue and white capsule. 2. *Bentylol 20mg with Phenobarbital tablets: 20mg dlcyclomine hydrochloride and 15 mg phenobarbita in each white tablet. 3. with Phenobarbital syrup: 10 mg dic clomine in each f.easpoonful (5 ACTIONS Antispasmodic. Bentylol has a direct relaxant effect on the smooth muscle of the gastrointestinal tract as well as a depressant effect on parasympathetic function. These dual act ions produce relief of spasm with minimum atropine-like effects. Phenobarbital exerts a sedative effect. INDICATIONS AND CLINICAL USE Oral dosage forms 1. Symptomatic control of functional gastrointestinal disorders. Primary condition diagnosed as: chronic irritable colon, spastic constipation, mucous colitispylorospasm, biliary dyskinesia, or spastic colitis. Bentylol is effectively used to treat symptoms of these conditions such as: abdominal cramps and pain, gas or belching, flatulence, and diarrhoea. 2. Gastrointestinal spasm secondary to organic diseases, such as: peptic ulcer, hiatal hernia, esophagi is, gastritis, duodenitis, cholecystitis, diverticulitis, and chronic ulcerative colitis. 3. Infant colic. (syrup torm only) Injectable form Symptomatic treatment of the above conditions in adults when a rapid onset of therapeutic action is desired or when persistent nausea and vomiting preclude the use of oral administration. CONTRAINDICATIONS
Reference 1. Bureaucracy's great paper chase. Time: Dec. 19, 1977
BOOKS This list is an acknowledgement of books received. It does not preclude review at a later date. ADMINISTERING NURSING SERVICE. 2nd ed. Marie DiVincenti. 467 pp. Illust. Little, Brown and Company (Inc.), Boston, 1977. Price not stated. ISBN 0-216-18651-1 BIOFEEDBACK. Vol. 2, 1977. WilfrId I. Hume. 74 pp. Eden Press, Montreal, 1977. $10. ISBN 0-88831. 008-0 BLUNT CHEST TRAUMA. General Principles of Management. Marvin M. Kirsh and Herbert Sloan. 274 pp. Illust. Little, Brown and Company (Inc.), Boston, 1977. PrIce not stated. ISBN 0-316-49501-8 CHEST PAIN: An Integrated Diagnostic Approach. Edited by Donald L. Levene, Ronald F. Billings. Geoffrey M. Davies and others. 203 pp. Illust. Lea & Febiger. Philadelphia; The Macmillan Company of Canada Limited, Toronto, 1977. Price not stated, paperbound. ISBN 0-8121-0610-5 CLINICAL AND EXPERIMENTAL HYPNOSIS. In Medicine, Dentistry, and Psychology. 2nd ed. William S. Kroger. 406 pp. J.B. Lippincott Company of Canada, Toronto, 1977. Price not stated. ISBN 0-397-50377-6 CLINICAL ELECTROCARDIOGRAPHY. A Simplified Approach. Ary Louis Goldberger and Emanuel Goldberger. 263 pp. The C.V. Mosby Company, Saint Louis, 1977. $11.45, paperbound. ISBN 0-80161859-2 COMPREHENSIVE ARTHROSCOPIC EXAMINATION OF THE KNEE. Lanny 1. Johnson. 156 pp. IlIust. The CV. Mosby Company, Saint Louis, $51.25. ISBN 0-8016-2534-3 COMPUTER METHODS. The Fundamentals of DigItal Nuclear Medicine. David E. Lleberman. 225 pp. IlIust. The C.V. Mosby Company. Saint Louis, 1977. $16, paperbound. ISBN 0-8016-3009-6
344 CMA JOURNAL/FEBRUARY 18, 1978/VOL. 118
continued on page 388
Dicyclomine hydrochloride is contraindicated in patients with frank urinary retention, stenosing peptic ulcer, and pyloric or duodenal obstruction. WARNING
Phenobarbital may be habit forming. PRECAUTION Although studies have failed to demonstrate adverse effects of dicyclomine hydrochloride in glaucoma, it should be prescribed with caution in patients known to have or suspected of having glaucoma. ADVERSE REACTIONS Adverse reactions seldom occur with dicyclomine hydrochloride; however, in susceptible individuals, atropinelike effects such as dry mouth or thirst and dizziness may occur. On rare occasions, fatigue, sedation, blurred vision, rash, constipation, anorexia, nausea and vomiting, headache, impotence, and urinary retention have also been reported. With the injectable form there may be a temporary sensation of light-headedness and occasionally local irritation. SYMPTOMS AND TREATMENT OF OVERDOSE
The signs and symptoms of overdose are headache, nausea, vomiting, blurred vision, dilated pupils, hot, dry skin, dizziness, dryness of the mouth, difficulty in swallowing, CNS stimulation. Treatment should consist of gastric lavage, emetics, and activated charcoal. Barbiturates may be used either orally or intramuscularly for sedation but they should not be used if Bentylol with Phenobarbital has been ingested. If indicated, parenteral cholinerg ic agents such as Urecholine* (bethanecol chloride USP) should be used. DOSAGE AND ADMINISTRATION Bentylol 10 mg capsules and syrup (plain and with *phenobarbital): Adults: 1 or 2 capsules or teaspoonfuls of syrup three or four times daily. Children: 1 capsule or iteaspoonful of syrup three or four times daily. Infants: 1/2 teaspoonful of syrup three or four times daily. (May be diluted with an equal volume of water.) Bentylol2omgtab lets (plain and with . phenobarbital): Adults:ltablet three or four times daily. Ben ty lol Injection: Adult5: 2 ml (20 m eve four to six hours intramuscularly only. NOT FOR INTRAVENDUS USE. DOSAGE FORMS
Bottl.s o?100, 500, and 5000 *io mg Capsules with Phenobarbital Bottles of 100,500, and 5000 20mg Tablets Bottles of 100 *20 mg Tablets with Phenobarbital Bottles of 100 Syrup (plain and with ..phenobarbital) 250 ml bottles Injection 2 ml ampoules and 10 ml multiple dose vials Product Information as of March, 1976 Pklf acage norm ation amended as of February, 1977) ullrescribing Information available upon request.
MerrelI
THE WM. S. MERRELL COMPANY
Division of Richardson-Merrell (Canada) Ltd., Weston, Ontario. M9L 1 R9
Im.1
7.019 (WOO6A) Printed July, 1977
