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Satellite Manual

3.7.2 Provider Guide: Prevention and Management or Irinotecan induced Diarrhea

3.7.3 Parent Handout: Prevention and Management of Irinotean induced diarrhea

Dear Parent/Patient:

Your child is receiving Irinotecan as part of their chemotherapy.  This drug can cause severe diarrhea. The following tips can help your child cope with diarrhea:

1) BUY LOPERAMIDE (also known as Imodium®). You should have this medication at home before your child’s first chemotherapy treatment.  You can get this at any local pharmacy.  Loperamide comes in a variety of forms (liquid, caplets, dissolving tablets).  Please read the label CAREFULLY and BRING your MEDICATION to your FIRST chemotherapy appointment.

2) Please document your child’s bowel habits BEFORE treatment starts. This is so you can compare your child’s bowel habits before and after treatment, and help you recognize diarrhea promptly.  Please record the following:

________ bowel movements per day OR ____________ bowel movements per week

Stool usually appears:

______HARD    _____ LOOSE   _____FORMED   _____SOFT   _____WATERY 

3) AFTER your child’s chemotherapy has started, please record the following:

Number of bowel movements per day______Is this an increase in number of stools?_____

When did it start? ____________

Stool appears: HARD____   LOOSE____  FORMED____ SOFT_____ WATERY______

4) AFTER your child’s chemotherapy has started, at the FIRST SIGN of diarrhea be sure to           START taking LOPERAMIDE. Please give as follows and ensure your MD/NP has completed     this section:

Child’s weight ______kg

First dose (please give after the FIRST loose stool): __________

Then give:    _________ EVERY __________ hours while awake

AND _________ EVERY _________ while sleeping

DO NOT EXCEED ______________ PER DAY

*ONCE DIARRHEA has stopped for 12 hours, you can STOP giving loperamide

*if using liquid form of medication please confirm dosing with your MD/NP as concentration of medication may differ depending on what brand

5) Call your doctor or oncology team if your child is still having diarrhea after taking loperamide for 24 hours, or if there is fever, nausea/vomiting, or any questions.

OTHER HELPFUL TIPS:

  • Drink plenty of Gatoraide, broth, clear soups or water
  • Eat small meals that are gentle on your stomach. Ex: bananas, rice, applesauce, toast, white meat chicken (no skin), canned fruits
  • Avoid fatty, greasy foods, spicy foods, high fiber foods, beans, or foods containing dairy
  • Avoid milk, coffee, alcohol, or drinks containing caffeine
  • Ensure perianal area is kept clean and dry to prevent irritation
  • Clean perianal area with mild soap and warm water after each bowel movement
  • Allow skin to dry completely, may use a barrier cream for comfort/protection
  • Avoid use of laxatives (peg flakes, lactulose, senekot, docusate)

Printable document: 3.7.3 Parent Handout Prevention and Management of Irinotean induced diarrhea.

3.7.4 Capizzi Methotrexate
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In this Section

  • 1.1 History & Overview
  • 1.2 Acknowledgements
  • 1.3 Committees and Working Groups
  • 1.4 Satellite Manual Disclaimer
  • 2.1 Principles of Satellite Care
  • 2.2 Eligible Patients
    • 2.2.1 Children Eligible for Chemotherapy Administration in a Satellite Centre
    • 2.2.2 Children Not Eligible for Chemotherapy Administration in a Satellite Centre
    • 2.2.3 Children Eligible for the Management of Complications on a Satellite Centre
    • 2.2.4 Eligibility of Children Requiring Supportive Care
  • 2.3 Scope of Satellite Practice
    • 2.3.1 Implementation of Psychosocial Treatment Plan (Process for Communication)
    • 2.3.2 Limitations on Satellite Practice
  • 2.4 Advanced Satellite Practice
  • 3.1 Safe Handling, Administration and Disposal of Chemotherapy Agents
  • 3.2 Accidental Exposure/Spills
  • 3.3 Extravasation Management
    • 3.3.1 Sample Extravasation Documenting Tool
  • 3.4 Injecting SC Medication Via an Insuflon
  • 3.5 Chemotherapy Administration Reference List
  • 3.6 Central Venous Catheter Care
  • 3.7 Chemotherapy Quick Reference
    • 3.7.1 Rapid Hydration Document
    • 3.7.2 Provider Guide: Prevention and Management or Irinotecan induced Diarrhea
    • 3.7.3 Parent Handout: Prevention and Management of Irinotean induced diarrhea
    • 3.7.4 Capizzi Methotrexate
    • 3.7.5 Erwinia L-Asparaginase
  • 4.1 Management of Fever and Neutropenia
    • 4.1.1 Routine Order Sample Sheet
    • 4.1.2 Fever Cards (Sample)
    • 4.1.3 Criteria for low-risk designation. Risk categorization refers to risk of bacteremia and serious complications, including mortality.
  • 4.2 Pentamidine Administration
    • 4.2.1 Inhaled Pentamidine
    • 4.2.2 Intravenous Pentamidine
  • 4.3 Antiemetics
  • 4.4 Treatment of Varicella-Zoster Infections
  • 4.5 TPN Document
  • 4.6 Immunization of Children with Cancer
  • 4.7 Transfusion
  • 4.8 When to consult the Tertiary Centre
  • 5.1 Palliative Care Overview
  • 5.2 Communication
  • 5.3 Settings of Care
  • 5.4 Symptom Management
  • 5.5 End of Life
  • 5.6 When a Child Dies in the Satellite Centre
    • 5.6.1 Reconciling your grief
    • 5.6.2 Funeral arrangement checklist
    • 5.6.3 Helping Children who grieve
    • 5.6.4 Coping with the Holidays
    • 5.6.5 The grieve experience
  • 6.1 Goals and Objectives
  • 6.2 Participant Site Selection
    • 6.2.1 Tertiary Site Selection
    • 6.2.2 Community Site Selection
  • 6.3 POGO’s Roles
    • 6.3.1 PHIPA, Privacy and Research
  • 6.4 Funding
    • 6.4.1 Funding Support for Tertiary Activity
    • 6.4.2 Financial Support for Pediatric Oncology Community Activity
  • 6.5 Infrastructure and Formal Requirements
    • 6.5.1 Tertiary Partners’ Role in Provincial Pediatric Oncology Satellite Program
    • 6.5.2 Satellite Partners’ Role in Provincial Pediatric Oncology Satellite Program
  • 7.1 Preamble
  • 7.2 Investigator responsibilities
  • 7.3 Training Requirements
    • 7.3.1 General Training for Conduct of Research
    • 7.3.2 Protocol Specific Training
  • 7.4 Research Activites that may be completed in satellite centres under supervision of DSI
  • 7.5 Research Activities to be completed in Tertiary Centres Only
  • 7.6 Recognition and Reporting of Adverse Events (AEs)
  • 7.7 Data Transfer
  • 7.8 Pharmacy Drug Accountibility
  • 7.9 Site Inspections and Quality Assurance
  • 8.1 Pediatric Oncology Shared Care Initial Data Transfer Sheet
  • 8.2 Shuttle Sheet
  • 8.3 Psychosocial Communication Tool
  • 9.1 Satellite Readiness/ Preparedness Checklist
  • 9.2 Education Report for Tertiary Centres
  • 9.3 Education Report for Satellite Centres
  • 9.4 Vital Signs Report
  • 9.5 Self- Assessment
  • 9.6 Satellite Contact Form
  • 9.7 Annual Satellite Caseload Report
  • 9.8 POGO Provincial Satellite Program Annual Accounting Report
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