Anti-Secretory Agents

Transdermal Anticholinergics for the Treatment of “Death Rattle” and Excessive Secretions

Difficulty clearing upper airway secretions (death rattle) is a problem for half of all dying patients. Treatment often includes the use of anticholinergic drugs, such as scopolamine (also known as hyoscine) or atropine. Transdermal scopolamine has several indications for symptom control in patients with end-stage disease: control of excess salivary secretions, management of terminal secretions, and control of nausea.

Palliat Med. 2002 Sep;16(5):369-74
Using anti-muscarinic drugs in the management of death rattle: evidence-based guidelines for palliative care.
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J Pain Symptom Manage. 2002 Apr;23(4):310-7
Death rattle: prevalence, prevention and treatment.
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Prescrire Int. 2001 Aug;10(54):99-101
Scopolamine: new preparations. Reference treatment for death rattle.
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Otolaryngol Head Neck Surg. 1990 Oct;103(4):615-8
Reduction of salivary flow with transdermal scopolamine: a four-year experience.
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