Oral Care Protocol
An oral care protocol is a prescribed, routine care plan that clinicians use to educate and treat patients with cancer for oral care. The foundation of an oral care protocol is good oral hygiene. A protocol should include brushing the teeth with a soft toothbrush. If patients routinely floss, then flossing should be continued unless the patient has a risk of bleeding because of thrombocytopenia or other concerns. Various protocols may include different cleansing and treatment regimens.
Oral Branched-Chain Amino Acids
Branched-chain amino acids are essential amino acids in which the chemical configuration has a branched shape. Tryptophan, an amino acid precursor of serotonin, is thought to play a role in the pathogenesis of cancer anorexia. Uptake of tryptophan into the brain is regulated by a specific transport system, which is competitively shared with the other amino acids, branched-chain amino acids.
Oral Alkalization
SN-38, the active metabolite of irinotecan, has absorption characteristics of weakly basic drugs. Alkalization of the intestinal lumen may reduce reabsorption of SN-38 and its attendant side effects. This approach has been examined related to the topic of diarrhea.
Opioids Proportional to Basal Dose
For the treatment of episodes of cancer-related breakthrough pain, the consensus of research supports administration of an opioid at a dose proportional to the total daily opioid intake. The proportional recommended dose is 10%–20% of the total daily basal dose. This recommendation does not apply to rapid-onset fentanyl.
Opioids--Interventions for Pain Management
The term "opioid" refers to natural, semisynthetic, and synthetic medications that relieve pain by binding to opioid receptors in the nervous system. The term opioid includes all agonists and antagonists with morphine-like activity as well as naturally occurring and synthetic opioid peptides (Miaskowski et al., 2005). Opioids are a mainstay for the management of acute and chronic pain. The use of opioids to manage pain also has been examined in patients with cancer for its effectiveness in managing sleep-wake disturbances.
Opioid Switching
The term opioid refers to natural, semisynthetic and synthetic medications that relieve pain by binding to opioid receptors in the nervous system. The term includes all agonists and antagonists with morphine-like activity. Opioid switching is the change from one specific opioid to a different opioid or from one administration route to another if pain control is inadequate or side effects are a problem. Opioid switching has been studied in patients with refractory cancer pain.
Online Support Groups
Online support groups are Internet-only forums for peer communication. In regard to patients with cancer, researchers have studied the impact of online support groups on a variety of psychosocial symptoms, including anxiety and depression.
Ondansetron as Rescue Medication
Ondansetron is a 5-HT3 receptor antagonist antiemetic that works by blocking serotonin receptors in the chemoreceptor trigger zone. Ondansetron usually is part of an ongoing basal antiemetic regimen. Ondansetron also has been evaluated for use as a rescue medication to treat episodes of chemotherapy-induced nausea and vomiting (CINV) that are not otherwise controlled.
Once Daily Fentanyl Patch
A formulation of fentanyl citrate that is applied once daily has been examined for its effect on pain. Usually, fentanyl patches are changed every 72 hours. The once-daily fentanyl patch has been examined for effectiveness in patients who experience end-of-dose failure with the 72-hour patch.
Omega 3 (Eicosapentaenoic Acid and Others)
Eicosapentaenoic acid (EPA) is an essential omega-3 fatty acid, distinguished from other long-chain polyunsaturated fatty acids by its specific chemical configuration. Bluefish, swordfish, salmon, and mackerel are rich in EPA. EPA has been studied in anorexia, and omega 3 fatty acid supplementation has been evaluated for its effect in fatigue, peripheral neuropathy, and prevention of infection.