title: Oesophageal spasm, vomiting and hyoscine hydrobromide patch.
abstract: We report the case of a 60-year-old woman with metastatic breast cancer whose intractable nausea and vomiting were effectively managed with a hyoscine hydrobromide (scopolamine) patch. Contrast swallow revealed oesophageal spasm to be the underlying cause. Symptom relief may be attributed to the antimuscarinic properties of the patch, allowing lower oesophageal sphincter relaxation. Following patch use she was able to enjoy small meals and fluids without symptoms. This is the first time this mechanism of action of scopolamine for alleviating nausea and vomiting has been described in the literature.
authors.affiliation: Department of Palliative Medicine, Hospiscare, Exeter, Devon, UK.
authors.forename: Fay
authors.initials: F
authors.lastname: Murray-Brown
authors.affiliation: Upper GI Surgery SpR, University Hospital of Wales, Cardiff, UK.
authors.forename: I Llion
authors.initials: IL
authors.lastname: Davies
mesh_terms: D000279:Administration, Cutaneous; D001943:Breast Neoplasms / Q000150:complications* / Q000556:secondary; D015155:Esophageal Spasm, Diffuse / Q000150:complications*; D005260:Female; D006801:Humans; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D009325:Nausea / Q000188:drug therapy* / Q000209:etiology; D012601:Scopolamine / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome; D014839:Vomiting / Q000188:drug therapy* / Q000209:etiology
chemical_list: D018727:Muscarinic Antagonists; D012601:Scopolamine
keywords: Clinical assessment; Drug administration; Hospice care