title: Sublingually administered scopolamine for nausea in terminally ill cancer patients.
abstract: OBJECTIVE
  The primary aim of this study was to clarify the effect of sublingual scopolamine on the intensity of nausea.
  
  
  METHODS
  This was an open uncontrolled study, and the study participants were cancer patients consecutively admitted to a palliative care unit in Japan. When the patients had nausea, they were administered a solution of scopolamine at 0.15 mg sublingually. The intensities of nausea were assessed using the 6-point Numerical Rating Scale (NRS 0 = no nausea to 5 = worst nausea) before and 15, 30, and 60 min after administration. Primary endpoints were (1) changes in the NRS of nausea and (2) percentage of patients who achieved a decrease in NRS of 1 or more points 15 min after treatment.
  
  
  RESULTS
  Twenty-six patients were recruited for this study. The median NRS significantly decreased from 3.0 (range, 1-5) to 1.5 (0-5) after 15 min, and 84 % (n = 21) of the patients achieved a decrease in NRS of 1 or more points after 15 min. In addition, the median NRS significantly decreased from 3.0 (before) to 0 (30 min) and 0 (60 min). The percentage of patients who achieved a decrease in NRS over 1 point was 96 % (n = 25) in 30 min and 100 % (n = 26) in 60 min. Fifteen percent (n = 4) showed drowsiness. No other adverse effects were reported.
  
  
  CONCLUSIONS
  Sublingually administered scopolamine may be effective for managing nausea in terminally ill cancer patients. Randomized controlled trials are promising.
authors.affiliation: Seirei Hospice, Seirei Mikatahara General Hospital, 3453 Mikatahara-Cho, Kita-Ku, Hamamatsu, Shizuoka, 433-8558, Japan, k.imai@sis.seirei.or.jp.
authors.forename: Kengo
authors.initials: K
authors.lastname: Imai
authors.forename: Masayuki
authors.initials: M
authors.lastname: Ikenaga
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Kodama
authors.forename: Seitetsu
authors.initials: S
authors.lastname: Kanemura
authors.forename: Keiko
authors.initials: K
authors.lastname: Tamura
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Morita
mesh_terms: D000286:Administration, Sublingual; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000932:Antiemetics / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000188:drug therapy* / Q000209:etiology*; D009369:Neoplasms / Q000150:complications* / Q000188:drug therapy*; D010166:Palliative Care / Q000379:methods*; D012601:Scopolamine / Q000008:administration & dosage*; D019452:Terminally Ill
chemical_list: D000932:Antiemetics; D012601:Scopolamine