Article Text

Download PDFPDF
Sialorrhoea treated with inhaled glycopyrronium
  1. Claire Plunkett1,2
  1. 1Palliative Medicine, Farleigh Hospice, Chelmsford, UK
  2. 2Palliative Medicine Department, Mid Essex Hospital Services NHS Trust, Chelmsford, UK
  1. Correspondence to Dr Claire Plunkett, Palliative Medicine, Farleigh Hospice, Chelmsford CM1 7FH, UK; claire.plunkett{at}farleighhospice.org

Abstract

Sialorrhoea or drooling is a distressing and often socially isolating symptom seen in palliative care. Evidence to support efficacy and safety of drug therapy in sialorrhoea is limited. Most drugs, in an adult population, are unlicensed for this indication in the UK including glycopyrronium. A 73-year-old Caucasian man, diagnosed with a right-sided sarcomatoid malignant pleural mesothelioma, presented with difficulty in swallowing and sialorrhoea. A glycopyrronium inhaler (administering 55 μg of glycopyrronium bromide/puff) was initiated in the mornings, increasing up to three times per day as tolerated. He reported a significant decrease in his symptoms 2 days after initiation using a numerical rating scale. A regular dose of one puff two times per day completely resolved the patient’s symptoms within 5 days. This case supports the use of inhaled glycopyrronium as a possible therapy for sialorrhoea in palliative care patients. In addition, doses required for resolution of symptoms were significantly lower when compared with systemic dosages.

View Full Text

Statistics from Altmetric.com

Footnotes

  • Funding The author has not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; internally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.