Protocols - Hemorio

ATTACHMENT V – CHEMOTHERAPY SUBJECTS CARE
1 – Odontological evaluation
2 – Nutritional evaluation
3 – Disinfestations: Mebendazole and Tiabendazole
4 – Allopurinol – 5 to 7 mg/kg/day
5 – Vigorous hydration – 3000 ml/m 2 /24 h
6 – Urine alkalinization: Bicarbonate – 4 mEq/kg/day
7 – Oral hygiene with bicarbonate water and nistatin
8 – Nauseas and vomits:
- Metochlorpramide – 40 mg – every 6 h
- Ondasetron – 4 to 8 mg – every 6 h or every 4 h
- Dexamethasone – 4 mg – every 6 h
9 – Estomatitis:
- Commercial anti-septic is contra-indicated, because it increases the irritation;
- Chlorhexidine - 15 ml to rinse the mouth 3x/day (do not swallow)
- Aluminum hydroxide (30 ml) + xilocaine gel (5 ml)
- Parenteral analgesia
10 – Diarrhea:
- Discard infectious cause
- Correction of eventual hydro-electrolytic disorders
- Reevaluation by nutrition
- Kaolin pectin – 30 to 60 ml after each diarrheic evacuation
- Loperamine – initial dose - 4mg and then 2 mg (1 capsule) after each diarrheic evacuation. Do not
surpass 16 capsules / day
11 – Constipation:
- Nutritional reevaluation
- Lactulosis – 1 to 4 tablespoons / day
- Bisacodil – 1 to 3 tabl/day
12 – Bleeding refractory to the transfusion – antifibrinolytic agents (tranexamic acid - 25 to 50 mg/kg/day –
every 8 h)
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