I am curious about Levsin...I know it is cheaper and probably works much faster since it's sl...how often do you use it and is it better than the trans derm scope?

Where I work, we're more likely to give scopolamine SC than anything SL. I've always wondered how viable the SL route is once the mouth is so dry from mouth breating during those last few hours. We usually insert a SC catheter and give all meds that way by that point.

Levsin comes in liquid form and is readily absorbed in the buccal cavity.

I like transdermal scop.; our local pharmacy compounds it. Atropine gtts can also be helpful.

Just my personal preference, but I would rather not have to be sticking people who are so close to death; not when there are viable alternatives.

Interesting discussion. Levsin SL vs. Scop TD. Both very effective. Literature states Scop approximately 85 % effective at onset death rattle. Has anyone tried Scop 0.4 mg sc loading dose followed by application of Scop 1.4 mg TD for pt who are not edematous. Seems effective with fewer s/sx of dry mouth. Then again, what ever happened to positioning techniques?

Positioning...an absolutely essential part of helping with the secretions.