To dry secretions, which typically means reducing their production or managing excessive fluid buildup in the mouth, throat, or airways, specific medications known as antimuscarinic anticholinergic agents are commonly used.
Understanding Secretions and Their Management
Excessive secretions can occur due to various medical conditions, particularly in situations where swallowing is impaired or nearing the end of life. Managing these secretions is often aimed at improving comfort and reducing symptoms like noisy breathing. The primary method involves using medications that decrease the production of saliva and other bodily fluids.
Medication Options for Drying Secretions
According to medical references, two of the most common medications used to treat secretions are scopolamine and glycopyrrolate. Both belong to the class of antimuscarinic anticholinergic agents.
These medications work by blocking the action of acetylcholine, a neurotransmitter that stimulates various glands, including those that produce saliva and mucus. By blocking acetylcholine, they reduce the amount of secretions produced.
Common Medications and Dosages
Here are the dosage ranges often quoted for these medications when administered subcutaneously (under the skin) as needed (prn):
| Medication | Type of Agent | Subcutaneous Dosage Range | Frequency |
|---|---|---|---|
| Scopolamine | Antimuscarinic Anticholinergic | 0.2-0.6 mg | Every 2-6 hours as needed |
| Glycopyrrolate | Antimuscarinic Anticholinergic | 0.1-0.4 mg | Every 4-6 hours as needed |
Note: These are general dosage ranges, and the appropriate dose and frequency for an individual must always be determined by a healthcare professional based on the specific situation and patient needs.
How They Help
- Scopolamine: Often used for reducing oral and respiratory secretions. It can also help with nausea and vomiting.
- Glycopyrrolate: Effective at reducing saliva and bronchial secretions. It is often preferred in some cases because it has less tendency to cross the blood-brain barrier compared to scopolamine, potentially causing fewer central nervous system side effects like drowsiness or confusion.
Using these medications helps to decrease the volume of secretions, which can make breathing more comfortable and reduce bothersome symptoms like the 'death rattle' (noisy breathing caused by secretions in the airways).
Other Considerations
While medications are the primary method for actively "drying" or reducing secretions, other supportive measures may also be employed, such as:
- Positioning the patient to help fluids drain or pool in a less bothersome location.
- Providing good oral hygiene to manage existing secretions in the mouth.
However, the direct method for reducing the production of secretions in a medical context typically involves the use of medications like scopolamine and glycopyrrolate.
