II. Precautions: General Measures

  1. Mouth Care is very important!
  2. Avoid drying agents (e.g. lemon-Glycerin swabs)
    1. See Xerostomia

III. 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

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