Management of hiccups in the palliative care population.
There are close to a hundred causes for hiccups, or singultus, the most common of which are gastrointestinal. Causes may be natural or drug induced, and the same agents that are used to treat hiccups may also induce them. Hiccups can be classified by their duration, as follows: up to 48 hours, acute; longer than 48 hours, persistent; and more than two months, intractable. Treatment options for hiccups can include both pharmacologic and nonpharmacologic agents. If the cause of hiccups can be identified, it is, of course, preferable to direct the treatment at that cause. However many times a cause cannot be identified; in this case, general measures or treatments should be instituted. Intractable hiccups can occur in the palliative care population. When they do, it can be extremely distressing and have a significant impact on quality of life. Pharmacologic approaches are often the most rational therapies for these patients. Baclofen seems to be a promising drug for use with both palliative care and perioperative patients, and using garabentin as an add-on to baclofen may also be a reasonable option to consider
Smith
Howard S
HS
Presbyterian University Hospital, University of Pittsburgh Medical Center, Pennsylvania, USA.
Busracamwongs
Atichat
A
D000085:Acetates / Q000627:therapeutic use; D000208:Acute Disease; D000588:Amines; D001418:Baclofen / Q000627:therapeutic use; D015984:Causality; D002908:Chronic Disease; D003509:Cyclohexanecarboxylic Acids; D004359:Drug Therapy, Combination; D018691:Excitatory Amino Acid Antagonists / Q000627:therapeutic use; D000077206:Gabapentin; D006606:Hiccup / Q000145:classification / Q000209:etiology / Q000523:psychology / Q000628:therapy*; D006801:Humans; D009125:Muscle Relaxants, Central / Q000627:therapeutic use; D010166:Palliative Care / Q000379:methods*; D011788:Quality of Life; D012008:Recurrence; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D014636:Valsalva Maneuver; D005680:gamma-Aminobutyric Acid
D000085:Acetates; D000588:Amines; D003509:Cyclohexanecarboxylic Acids; D018691:Excitatory Amino Acid Antagonists; D009125:Muscle Relaxants, Central; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin; D001418:Baclofen