Waikato DHB Palliative Care Guidelines8. Excessive secretions- Can be a symptom in advanced respiratory disease, head and neck cancers and neuro-degenerative disorders.
- In people who are dying, this may be part of the terminal process known as “Death Rattle”.
- Explanation and reassurance for the patient and family is very helpful.
- Suctioning should be avoided.
- Re-positioning is often helpful .
- Attention to oral hygiene is essential – see chapter 10.
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Drug therapy may be indicated but drying of secretions is not always the most appropriate initial management. When considering the appropriate drug therapy, note the following: - Buscopandoes not cross the blood-brain barrier and therefore causes less sedation and confusion than Hyoscine hydrobromide and Scopoderm TTS™
- Atropine is excitatory and should be avoided.
Hyoscine butylbromide (Buscopan™) - 20-40mg subcut 2-4 hourly.
- 60 -120mg/ 24 hours subcut infusion.
- Better tolerated in the unconscious or semi-conscious patient.
Hyoscine hydrobromide - 0.2-0.4mg subcut 2-4 hourly.
- 0.6 -1.2mg/ 24 hours subcut infusion.
- Recommended for use in the unconscious or semi-conscious patient.
Information last reviewed: June 2009
| Please foward any enquiries about this document to
haggars@waikatodhb.govt.nz | | Next review date: July 2010 | For Palliative Care advice, please call 8691 or the specialist on-call. |
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