Early Opioid Use
Early opioid use refers to managing chronic pain by using opioids to treat levels of pain lower than the levels the World Health Organization’s (WHO's) three-step pain relief ladder specifies for treating with opioids. The WHO suggests beginning treatment at step 1, using nonopioids with or without adjuvant medication, and moving to step 2, using weak opioids, if pain persists.
EACA (Epsilon-Aminocaproic acid)
Epsilon-aminocaproic acid is a potent antifibrinolytic agent used to control bleeding by inhibiting the plasmin-plasminogen system. It can be administered orally or intravenously and is excreted in the urine. Major side effects include cardiac arrhythmias, hypotension, rhabdomyolysis, and creation of thrombi. It may be beneficial in the prevention of bleeding, but additional studies are necessary.
Duloxetine
Duloxetine is a serotonin-norepinephrine reuptake inhibitor (SNRI) antidepressant. Antidepressants in general have been examined for treatment of depression in patients with cancer. Duloxetine specifically has been examined for its effect on pain and peripheral neuropathy.
Drain Antisepsis
The irrigation of surgical drains with an antiseptic solution was investigated for its effect on postoperative drain cultures and surgical site infections in patients undergoing surgery for cancer.
Doxepin Mouthwash
Doxepin is a tricyclic antidepressant and has anxiolytic properties. Doxepin also has been used to suppress itching and has antihistamine effects. Doxepin mouth rinse has been evaluated in patients with cancer for management of painful mucositis.
Dose Interruption or Modification
Dose interruption or modification involves delay in planned treatment or reduction in treatment dosages. This is generally done in response to treatment-related toxicities.
Donepezil
Donepezil is a centrally active cholinesterase inhibitor that has been used to treat dementia in patients with Alzheimer disease. It may improve the ability to think and remember in these patients, and has also been studied in patients with cancer for fatigue and cognitive impairment.
Distance Meditation
Distance meditation involves an individual meditating to accomplish distant psychological healing. In a study of distance medication's effects on depression, a healthcare professional examined medical files of patients and meditated for the patients based on those files. There was no direct interaction or contact with the patient.
Diphenoxylate
Diphenoxylate is an opioid agonist used in the treatment of diarrhea. It prolongs transit time by slowing intestinal contractions and peristalsis and allows the intestines to draw moisture from stool to prevent loose or liquid stools.
Dioctahedral Smectite and Iodine Glycerine Cream (DSIG)
Dioctahedral smectite is a naturally absorbent clay formed from a sheet of aluminomagnesium silicate. It is thought to reduce microbes, enhance the intestinal barrier, and prevent damage to the mucosa. Iodine is a nonantibiotic antiseptic that has antimicrobial properties.