Anticipatory prescribing of an anticholinergic drug for respiratory tract secretions in the last days of life
If anticipatory prescribing of an anticholinergic drug to be given as required is considered appropriate for respiratory tract secretions in the last days of life, a suitable dose is:
1glycopyrronium 200 micrograms subcutaneously, 2-hourly as required, up to a maximum of 1200 micrograms in 24 hours. Monitor response and consider starting regular therapy. If no improvement occurs after 24 hours or the patient experiences an adverse effect, consider stopping therapyWildiers, 2009 glycopyrronium (glycopyrrolate)
OR
1hyoscine butylbromide 20 mg subcutaneously, 2-hourly as required, up to a maximum of 120 mg in 24 hours. Monitor response and consider starting regular therapy. If no improvement occurs after 24 hours or the patient experiences an adverse effect, consider stopping therapyWildiers, 2009. hyoscine butylbromide
Seek specialist advice if symptom relief is inadequate.