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Dear Readers! I started this blog when my daughter was in the NICU. She had ventriculitis. Her CSF report grew E.coli. But, she was injected Teicoplanin directly into her brain. The doctors made two errors here:

Teicoplanin is for gram-positive bacteria only. It does not treat E.coli.
Teicoplanin is not for intraventricular use. The manufacturer strongly discourage injecting Teicoplanin into the brain.

My daughter bled into the brain. She lived for another two years and ultimately died.

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MuGard (Oral mucosal barrier gel)/ Gelclair, Episil for Mucositis

MuGard (Oral mucosal barrier gel) is an oral non-adhesive wound rinse that is used as an oral mucosal protectant in patients with oral ulcers and mucositis.

MuGard (Oral mucosal barrier gel) Uses:

Mucosal protection:
- Irritation.
- Because of tooth extractions, lesions, periodontal and gingival irritation, and oral surgery.
- Chafing.
- Treatment of oral mucosal discomfort brought on by chemotherapy or radiation therapy, as well as defence against further irritation brought on by oral mucositis or stomatitis.
- Minor wounds.
- Recurring aphthous ulcers (canker sores).
- Traumatic ulcers and abrasions brought on by orthodontics, uncomfortable dentures, or illness.
- Cough with pharyngitis (Orafate only).

MuGard (Oral mucosal barrier gel) Dose in Adults

Oral Mucosal Barrier Gel Dose in the Mucosal protection:

P/O:

Episil:
- - two to three times per day, or as necessary, administer one to three pumps to the oral cavity.
- Max duration for continuous use:
  - 30 days
Gelclair:
- 15 millilitres of 1 single-use package dissolved in water should be rinsed, gargled, and spit out three times each day, or as needed.
Mucotrol:
- By swishing around in the mouth, slowly dissolve 1 wafer, 3 times every day or as required.
MuGard:
- Rinse with 5 milliliters 4-6 times everyday (for oral mucositis/stomatitis) or 4-6 times every day or as required (for other ulcerative conditions).
- To fully coat inside of the mouth, it may use up to 10 milliliters if required.

Orafate:

Recurrent Aphthous ulcers (canker sores):
- Single/solitary group of ulcers:
- Apply with cotton-tipped swab twice every day & at bedtime.
- Ulcers throughout mouth:
  - Swish 5 milliliters in the mouth once every day or every 4-6 hours (severe cases).
Following dental cleaning, scaling, root planing:
- Brush 1.25-2.5 milliliter across the affected area of the gums daily for >4 weeks.
Following tooth extraction or gingival (gum) surgery:
- - Until healed, place 1.25-2.5 mL into wound 3 times every day the first day, then twice every day.
Following tonsillectomy or other oral soft tissue surgery:
- Place 2.5-5 milliliters into wound 3 times every day on the first day then twice every day.
Oral inflammation around gums:
- Until healed, brush 1.25-2.5 milliliter across the front and back of gingiva 2 times every day for the first day then once every day at bedtime.
Pharyngitis, sore throat:
- Swish 5 milliliters in mouth twice every day (in the morning after brushing teeth and at bedtime) or every 4-6 hours (severe cases).

ProThelial:

Usual dosage:
- On the first day, 2.5-5 milliliters every 8 hours.
- 2.5-5 milliliter every 12 hours thereafter (max: 40 milliliters every day)
- Prevention of chemo-radiation mucositis (beginning the first day of cancer treatment):
Grade 1 or 2:
- Until 1 week after completion of chemoradiation therapy, use 2.5-5 milliliters 3 times a day for 1 day, followed by 2.5-5 milliliters twice every day.
Grade 3 or 4:
- Continue until 1 week after completion of chemoradiation therapy, 10 milliliters 3 times a day.
- Chemo-radiation mucositis treatment.
Grade 1 or 2:
- 2.5-5 milliliter 3 times a day for 1 day, followed by 2.5-5 milliliters twice every day until 1 week after completion of chemo-radiation therapy.
Grade 3 or 4:
- 10 milliliter 3 times a day for 2 days, followed by 5 to 10 mL twice every day until 1 week after completion of chemo-radiation therapy.

MuGard (Oral mucosal barrier gel) Dose in Children

MuGard (Oral Mucosal Barrier) Dose in the Mucosal protection:

Children older than 12 years and Adolescents:
- P/O:
- Orafate:
- Consider the adult Orafate dosage.

Pregnancy and lactation:

Since it is applied topically, it can be used safely in pregnancy and lactation.

Dose in Kidney disease:

It can be used in kidney disease since it is applied topically.

Dose in liver disease:

It can be used in liver disease since it is applied topically.

Side effects of MuGard/ orafate:

Local infections dystaste

Contraindications to MuGard (Oral mucosal barrier gel):

Hypersensitivity to any ingredient of the formulation

Additional product-specific contraindications

Episil:Hypersensitivity to soya, peanuts, and peppermint oil

Warnings and precautions

Sublingual medication:
- This may decrease the absorption sublingually administered medication.

Monitoring Parameters:

Examine mucositis/ stomatitis symptoms/ severity.

How to administer MuGard (Oral mucosal barrier gel)?

Episil:

Pump into a piece of paper until a steady stream is formed.
Apply liquid stream to the mouth by pressing the pump 1-3 times. Once the gel has formed, wait for it to dry.
Do not swallow
Wait 5 minutes before eating or drinking.

Gelclair:

Take before or after meals, or as directed.
15ml (1 single-use container) of water should be added. Stir well (refer to the product information for more details).
Rinse around your mouth for a minute to thoroughly coat the tongue, palate and throat.
Mix the ingredients together and spit it out.
After treatment, you should avoid eating and drinking for at most 30-60 minutes.
If water is unavailable, may be used undiluted.
If you are unable to rinse, apply directly to your mouth with a sponge or cotton swab.
Intentionally swallowed, there are no adverse effects.

Mucotrol:

Water should be sipped around the mouth and allowed to dissolve slowly.
After treatment, you should not eat or drink for at least one hour.

MuGard

Allow the 5ml to sit in the mouth for at least one minute. Rinse the mouth with the rinse solution.
You must ensure that every part of your oral cavity is coated.
It may take up to 10ml to cover the entire mouth cavity.
You may spit out or swallow any excess rinse.
After treatment, you should not eat or drink for at least one hour.

Orafate

Use the following methods to treat gum inflammation and other oral-related conditions.
You can brush it alone, with toothpaste, or with a tongue depressor, a soft-bristled toothbrush, finger, or tongue depressor.
Mix equal amounts of dentifrice powder, gel, or toothpaste and layer it over the soft tissue.
Apply directly to the gum margin affected. Let it sit for 2 minutes, then gargle with spit.
Apply a layer of toothpaste to the area. After 2 minutes, you can either manually remove it or spit it out.
Place in mouth and gently suck between the teeth.
For canker sores (multiple lesion), sore throat/pharyngitis, swish in the mouth for 10 seconds, then gargle.
Safe to swallow
Avoid eating or drinking after use for at least one hour.

ProThelial

Place the paste in your mouth for 30 seconds.
Apply the paste to the mucosa using the cotton-tipped swab or the tongue.
You can either swish it and then expectorated, or you can swallow it.
It can be combined (1:1) with yogurt or pudding, apple sauce, tapioca or ice cream to enhance its taste.
Avoid eating or drinking after use for at least one hour.

Mechanism of action of MuGard (Oral mucosal barrier gel):

Stick to the mucosal surface and create a protective coating or coating over the lesions and irritated areas. This protects the lesion against further irritation and pain.