title: Evaluation of atropine 1% ophthalmic solution administered sublingually for the management of terminal respiratory secretions.
abstract: Terminal respiratory secretions (TRS) or "death rattle" is a common symptom in the dying patient. Current practice for the prevention and treatment of TRS involves the use of oral, sublingual, transdermal, or parenteral anticholinergic medications. A retrospective chart review of patients admitted to a hospice inpatient unit for terminal care and treated with sublingual atropine 1% ophthalmic drops for TRS was conducted. A total of 19 of 22 patients treated with atropine had documented reduction or resolution of TRS. This study suggests that atropine 1% ophthalmic drops administered sublingually are a reasonable option for the management of TRS. Problematic cardiac or central nervous system symptoms were not found in the present study. Results should aid hospice programs who are seeking guidance on the management of TRS with atropine 1% ophthalmic drops.
authors: HospiScript Services, Dublin, OH 43017, USA. bprotus@hospiscript.com
authors: Bridget McCrate
authors: BM
authors: Protus
authors: Phyllis A
authors: PA
authors: Grauer
authors: Jason M
authors: JM
authors: Kimbrel
mesh_terms: D000286:Administration, Sublingual; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001285:Atropine / Q000008:administration & dosage* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000008:administration & dosage / Q000627:therapeutic use; D009883:Ophthalmic Solutions / Q000008:administration & dosage / Q000627:therapeutic use; D012135:Respiratory Sounds / Q000187:drug effects*; D012189:Retrospective Studies; D013727:Terminal Care / Q000379:methods*
chemical_list: D018727:Muscarinic Antagonists; D009883:Ophthalmic Solutions; D001285:Atropine