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J Pain Symptom Manage · Jul 2003
Case ReportsAnticholinergic agents for the treatment of "death rattle" in patients with myasthenia gravis.
- Jeffrey L Spiess and Shane D Scott.
- Department of Internal Medicine, Division of Hematology, Oncology, and Blood & Marrow Transplantation, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa 52242, USA.
- J Pain Symptom Manage. 2003 Jul 1; 26 (1): 684-6.
AbstractDifficulty clearing upper airway secretions (death rattle) is a frequent problem at the end of life. Treatment often includes the use of anticholinergic drugs. Myasthenia gravis is a disease characterized by muscle weakness and fatigue caused by an immune-mediated deficiency of acetylcholine receptors at the neuromuscular junction, and it is treated with anticholinesterase agents. We report the case of a patient dying of myasthenia gravis who had problems with the "death rattle" and who presented a dilemma as to whether the use of anticholinergics would be helpful or would cause deterioration of her myasthenia. This is accompanied by a review of the relevant literature.
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