Internal Med Medical News about death rattle; among atropine; hyoscine butylbromide; scopolamine

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Atropine, Hyoscine Butylbromide, or Scopolamine are Equally Effective for the Treatment of Death Rattle in Terminal Care
Journal of Pain and Symptom Management, 07/15/09

Wildiers H et al. - Three hundred and thirty-three eligible patients were randomized to atropine, hyoscine butylbromide, or scopolamine after informed consent from the patient or the appointed representative. For the three drugs, death rattle decreased to a nondisturbing intensity or disappeared after one hour in 42%, 42%, and 37% of cases, respectively. Further, effectiveness improved over time without significant differences among the treatment groups (effectiveness at 24 hours was 76%, 60%, and 68%, respectively). In an analysis on the three groups together, treatment was more effective when started at a lower initial rattle intensity; median survival after start of therapy was 23.9 hours. These data suggest that there are no significant differences in effectiveness or survival time among atropine, hyoscine butylbromide, and scopolamine in the treatment of death rattle.