gelclair concentrated oral rinse, 21 Count x 15ml sachets

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Benzydamine oral rinse (‘Difflam’) is useful where there is painful inflammation of the mouth and throat. The recommended dose is 10-15mL used every 1.5-3 hours. Dilute with an equal volume of water if stinging or numbness occurs.

If using part of a MST sachet mix well with water and use immediately. MST sachets should not be used for doses <5mg as sachets do not disperse equally therefore dosing may be inaccurate Basic oral care (clinical decision required. If antifungal agent to be used choose one absorbed from GI tract eg fluconazole or itraconozole

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Sodium bicarbonate drops may be used 2 or 3 times daily for 1-2 weeks before syringing if the wax is impacted. The patient should be advised to lie with the affected ear uppermost for 5-10 minutes after use of the ear drops. Use of sodium bicarbonate drops for up to a month may alleviate the need for syringing altogether. Require long term on-going monitoring and dose adjustment to ensure efficacy and minimise toxicity by a specialist First-line treatment for oral candidiasis for immunocompetent adult and children older than 2 years of age,in line with SCAN guidelines. For patients who do experience nosebleeds use Vaseline to both sides of the nose twice a day ideally before using the spray. Please note that these guidelines only provide starting doses for oral immediate release morphine and not MST preparations

Grey / Non-Formulary: Medicines, which the Nottinghamshire APC has actively reviewed and does not recommend for use at present due to limited clinical and/or cost effective data. ACBS: patients suffering from dry mouth as a result of having (or having undergone) radiotherapy, or sicca syndrome, apply to oral mucosa as required. Weaker versions which can also be used for mouth ulcers are dentinox teething gel (0.33% lidocaine) or Instillagel (2% lidocaine, tastes foul)If you are allergic to Gelclair (mucosal coating gel (gelclair)); any part of Gelclair (mucosal coating gel (gelclair)); or any other drugs, foods, or substances. Tell your doctor about the allergy and If you use Gelclair (mucosal coating gel (gelclair)) on a regular basis, use a missed dose as soon as you think about it. For periodontitis (as an adjunct to gingival scaling and root planing). May be difficult to obtain. Appropriate pain control is recommended together with the continuation of good oral hygiene, as tolerated. The patient's pain should be assessed using the assessment tool in Appendix 3. For oral candidiasis if miconazole oral gel is unsuitable or not tolerated,in line with SCAN guidelines.

Mouth care is an essential aspect of palliative care in all settings and should be considered part of daily routine patient care, see the Scottish Palliative Care Guidelines, Mouth Care.

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Risk Minimisation Materials: glycopyrronium bromide 400micrograms/mL (Sialanar® 320micrograms/mL oral solution) May be prescribed underACBSforpatients suffering from dry mouth as a result of having (or having undergone) radiotherapy, or sicca syndrome, spray onto oral and pharyngeal mucosa as required. Increased discomfort and delayed healing of mouth ulcers can be caused by secondary bacterial infection. Use of chlorhexidine mouthwash may be beneficial. Ask the child to swallow or observe the swallowing process. Ask the parent if there are any notable changes.