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Using anti-muscarinic drugs in the management of death rattle: evidence-based guidelines for palliative care.

Bennett, Michael I. and Lucas, Viv and Brennan, Mary and Hughes, Andrew and O'Donnell, Valerie and Wee, Bee (2002) Using anti-muscarinic drugs in the management of death rattle: evidence-based guidelines for palliative care. Palliative Medicine, 16 (5). pp. 369-374.

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Abstract

The management of ‘death rattle' was reviewed by a task group on behalf of the Association for Palliative Medicine's Science Committee. Evidence was searched for the effectiveness of various anti-muscarinic drugs in drying oropharyngeal and bronchial secretions in dying patients. Clinical guidelines were constructed based on evidence from volunteer and clinical studies. Death rattle occurs in half of all dying patients and some response occurs in around 80% of treated patients. Clinical studies demonstrate that subcutaneous hyoscine hydrobromide 400 mg is more effective at improving symptoms at 30 min than glycopyrronium 200 mg by the same route. Volunteer studies demonstrate that intramuscular glycopyrronium 400 mg is as effective in drying secretions at 30 min as a dose of 200 mg given intravenously. Duration of response is shortest for hyoscine butylbromide (1 h) and longest for glycopyrronium (more than 6 h). There is insufficient evidence to support the use of one drug over another in a continuous infusion and prescribers should base decisions on different characteristics of each anti-muscarinic drug.

Item Type: Article
Journal or Publication Title: Palliative Medicine
Uncontrolled Keywords: anti-muscarinic drugs • clinical guidelines • death rattle
Subjects: R Medicine > R Medicine (General)
Departments: Faculty of Health and Medicine > Health Research
ID Code: 32182
Deposited By: Mrs Yaling Zhang
Deposited On: 11 Mar 2010 14:24
Refereed?: Yes
Published?: Published
Last Modified: 26 Jul 2012 17:06
Identification Number:
URI: http://eprints.lancs.ac.uk/id/eprint/32182

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