Evaluation of Atropine 1% Ophthalmic Solution Administered Sublingually for the Management of Terminal Respiratory Secretions

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 t...

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Bibliographic Details
Published in:American journal of hospice & palliative medicine 2013-06, Vol.30 (4), p.388-392
Main Authors: Protus, Bridget McCrate, Grauer, Phyllis A., Kimbrel, Jason M.
Format: Article
Language:English
Subjects:
Administration, Sublingual
Adult
Aged
Aged, 80 and over
Atropine - administration & dosage
Atropine - therapeutic use
Female
Humans
Male
Middle Aged
Muscarinic Antagonists - administration & dosage
Muscarinic Antagonists - therapeutic use
Nursing
Ophthalmic Solutions - administration & dosage
Ophthalmic Solutions - therapeutic use
Respiratory Sounds - drug effects
Retrospective Studies
Terminal Care - methods
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Summary: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.
ISSN:1049-9091
1938-2715
DOI:10.1177/1049909112453641