Hematology and Oncology Book


Mouth Care in Cancer

Aka: Mouth Care in Cancer, Mouth Care in Terminally Ill Patients, Cancer Related Mouth Care
  1. Precautions: General Measures
    1. Mouth Care is very important!
    2. Avoid drying agents (e.g. lemon-Glycerin swabs)
      1. See Xerostomia
  2. Management
    1. Dry Mouth or Thrush Prevention
      1. Hydrogen Peroxide at 1/4 strength
      2. Lemon Drops, Pineapple chunks, tart juices
      3. Artificial Saliva
      4. Pilocarpine eye drops used orally
    2. Excessive oral secretions (Noisy Breathing, "death rattle")
      1. Atropine ophthalmic 1% drops, 1-2 drops SL every 6 hours
      2. Glycopyrrolate (Robinul) 1 mg orally or 0.2 to 0.4 mg SQ/IV every 4 hours
      3. Hyoscyamine (Levsin) 0.125 to 0.5 mg SL or SQ every 4 hours
      4. Scopolamine 1.5 mg transdermal patch 1-2 patches applied every 72 hours
    3. Treat Oral Thrush as needed
    4. Oral Mucositis (radiation related)
      1. See Oral Mucositis for symptomatic management
  3. References
    1. Albert (2017) Am Fam Physician 95(6): 356-61 [PubMed]

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