Articles: hyoscine-therapeutic-use.
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J Pain Palliat Care Pharmacother · Jan 2008
Randomized Controlled Trial Comparative StudyA pilot phase II randomized, cross-over, double-blinded, controlled efficacy study of octreotide versus hyoscine hydrobromide for control of noisy breathing at the end-of-life.
Noisy breathing at the end of life (noisy breathing ("NB") occurs in up to 90% of people. Interventions have not been systematically evaluated. There has been clinical observation coupled with a proposed mechanism of effect that supports a role for octreotide in management of NB. ⋯ There was no difference in the median time to administration of the second medication (3 hours). Two participants in each arm had a 2 category reduction of intensity after the second medication. Although feasible to consent and study this population in a way that respects autonomy and dignity even in the terminal hours of life, this pilot study suggests reconsideration of the pharmacological interventions (choice of agents, dosing, timing of dosing and pharmacokinetic profiles), standardizing of non-pharmacological care; and ways to measure directly family distress before further randomized studies for this symptom.
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Anesthesia and analgesia · Jan 2007
Randomized Controlled TrialTransdermal scopolamine: an alternative to ondansetron and droperidol for the prevention of postoperative and postdischarge emetic symptoms.
Given the controversy regarding the use of droperidol and the high cost of the 5-HT3 antagonists, a cost-effective alternative for routine use as a prophylactic antiemetic would be desirable. We designed two parallel, randomized, double-blind sham and placebo-controlled studies to compare the early and late antiemetic efficacy and adverse event profile of transdermal scopolamine (TDS) 1.5 mg, to ondansetron 4 mg IV, and droperidol 1.25 mg IV for antiemetic prophylaxis as part of a multimodal regimen in "at risk" surgical populations. ⋯ Premedication with TDS was as effective as droperidol (1.25 mg) or ondansetron (4 mg) in preventing nausea and vomiting in the early and late postoperative periods. However, the use of a TDS patch is more likely to produce a dry mouth.
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Randomized Controlled Trial Clinical Trial
The GI Cocktail is no more effective than plain liquid antacid: a randomized, double blind clinical trial.
The "GI Cocktail" is a mixture of medications often given in the Emergency Department (ED) for dyspepsia symptoms. Several combinations are used, but the most effective has not yet been determined. This study compared three combinations commonly given for dyspepsia. ⋯ There was no statistically significant difference in pain relief between the three groups on univariate analysis or multivariable regression. In conclusion, the addition of Donnatal or Donnatal + lidocaine to an antacid did not relieve dyspepsia better than plain antacid. The "GI Cocktail" concoction may not be necessary.
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J Pain Symptom Manage · Oct 2003
Respiratory tract secretions in the dying patient: a retrospective study.
Respiratory tract secretions (RTS), the sound created by poorly-cleared mucous in the hypopharynx or bronchial tree, can be alarming for dying patients, relatives and staff. Increased knowledge into the etiology of RTS and its response to treatment is needed to improve future management. We studied retrospectively the data from 202 patients who died on a 30-bed specialist palliative care unit during a one-year period. ⋯ Of these, 30.5% responded within four hours, 33.9% after four hours, and 35.5% died with RTS. Increasing the dose for nonresponders had no significant effect. Significant risk factors for developing RTS were found to be prolonged dying phase, primary lung cancer and male gender.