Why is scopolamine used in hospice patients?
The drug hyoscine has several indications for symptom control for patients with end-stage disease. The transdermal preparation, Scopoderm, is most widely used to control excess salivary secretions but it can also have a role in the management of terminal secretions and in the control of nausea.
What drugs decrease secretions?
Two of the most common medications used to treat secretions are both antimuscarinic anticholinergic agents: scopolamine and glycopyrrolate.
What are respiratory secretions at the end of life?
In the last days of a person’s life, secretions (fluid) might build up in the airways as they become too weak to cough and clear them. This causes a gurgling or rattling sound when the person breathes in and out and is sometimes called ‘the death rattle’.
How long does it take for a scopolamine patch to work for secretions?
The scopolamine patch releases ~1 mg over 72 hours. It takes 24 hours to reach steady state and for acute symptoms other drugs should be used.
Why do dying patients have secretions?
Terminal respiratory secretions are a sign that the patient is transitioning to the final stage of the dying process. At this point, their body naturally begins to conserve energy and many organ functions slow or cease.
Why do people get secretions when dying?
How do you stop scopolamine withdrawal?
Meclizine has been used successfully to treat scopolamine withdrawal syndrome. A suggested meclizine regimen for scopolamine withdrawal is 50 mg orally every 6 to 8 hours before or at the onset of the withdrawal symptoms for 2 to 3 days, tapering gradually to 25 mg every 8 hours and finally tapering off over a week.
What does scopolamine withdrawal feel like?
Common symptoms included nausea, headache, and blurred vision. These symptoms were consistent with rebound cholinergic activity and included dizziness, nausea, vomiting, paresthesias of the hands and feet, dysphoria, and hypotension.