II. Precautions: General Measures
- Mouth Care is very important!
- Avoid drying agents (e.g. lemon-Glycerin swabs)
- See Xerostomia
III. Management
-
Dry Mouth or Thrush Prevention
- Hydrogen Peroxide at 1/4 strength
- Lemon Drops, Pineapple chunks, tart juices
- Artificial Saliva
- Pilocarpine eye drops used orally
- Excessive oral secretions (Noisy Breathing, "death rattle")
- Atropine ophthalmic 1% drops, 1-2 drops SL every 6 hours
- Glycopyrrolate (Robinul) 1 mg orally or 0.2 to 0.4 mg SQ/IV every 4 hours
- Hyoscyamine (Levsin) 0.125 to 0.5 mg SL or SQ every 4 hours
- Scopolamine 1.5 mg transdermal patch 1-2 patches applied every 72 hours
- Treat Oral Thrush as needed
-
Oral Mucositis (radiation related)
- See Oral Mucositis for symptomatic management