![]() ![]() With improvements in pharmaceutical products used to combat other side effects such as nausea and vomiting, oral mucositis is now receiving more attention and focus. 1 Oral mucositis can become a serious problem for any cancer patient, as it may necessitate the use of parenteral nutrition, can lead to infection, and results in pain and discomfort for the patient. Development of oral mucositis can also increase mortality by nearly 40% in severe cases. This condition can range from mild to severe and represents a common cause of dose reduction and treatment delays. One of the often overlooked and under-researched complications of cancer treatment is oral mucositis. This review will provide a comprehensive examination of available options for children who have oral mucositis. With achievements in other areas of supportive care in patients undergoing chemotherapy, oral mucositis should represent the forefront of new research. Palifermin, a keratinocyte growth factor, may be a future option after its use in children is explored. Current options include the use of antimicrobial mouthwashes, amino acid rinses, and topical healing agents. ![]() Few pharmacologic agents have been approved to either prevent the development or alleviate the symptoms of oral mucositis. A number of assessment scales have been developed to better qualify the symptoms associated with this condition. ![]() Oral mucositis also leads to an increased risk of infection and can often delay further chemotherapy treatment. Severity can range from mild, painless tissue changes to bleeding ulcerations that prevent oral intake and require narcotic pain relievers. Lesions develop as a result of chemotherapeutic agents attacking the rapidly dividing cells of the gastrointestinal tract. ![]() All rights reserved.Oral mucositis affects more than three-fourths of patients undergoing chemotherapy and represents a significant burden to patients and caregivers. The delivery of the diphenhydramine and aluminum hydroxide-magnesium hydroxide-simethicone could be separated, allowing for a swish-and-swallow method of administration.Ī BUD of 21 days is recommended for lidocaine prepared with diphenhydramine and aluminum hydroxide-magnesium hydroxide-simethicone in ratios of 1:1:1 and 1:2.5:2.5 and stored at room temperature in amber oral plastic syringes.Ĭhromatography drug stability high pressure liquid lidocaine magic mouthwash mucositis.Ĭopyright © 2017 by the American Society of Health-System Pharmacists, Inc. Utilizing a 90-day BUD, lidocaine can be packaged separately from other magic mouthwash ingredients in individual dosage units and applied to the oral cavity using the swish-and-spit method. Based on the stability data, published safety concerns, and lack of efficacy in combination, packaging and dispensing lidocaine separately from other ingredients are recommended when administering magic mouthwash mixtures. A stability-indicating high-performance liquid chromatographic method was developed and validated for system suitability, accuracy, repeatability, intermediate precision, specificity, linearity, and robustness.īased on the calculated percentages versus the initial concentration and the results from an analysis of variance comparing the two formulations, a BUD of 21 days is deemed appropriate for both magic mouthwash formulations. The lidocaine concentrations in these samples were measured periodically for 90 days. Unit-dose single-product lidocaine samples were also prepared to serve as controls and stored in oral amber syringes. Two formulations of mouthwash containing oral topical lidocaine 2% (viscous), diphenhydramine 2.5 mg/mL, and aluminum hydroxide-magnesium hydroxide-simethicone were prepared in 1:1:1 and 1:2.5:2.5 ratios, divided into 3-mL samples, and stored in unit-dose oral amber syringes. Beyond-use dating (BUD) of lidocaine alone and in two "magic mouthwash" preparations stored in amber oral syringes at room temperature was determined. ![]()
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