scopolamine patches

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Specializes in Acute Care.

I know they are primarily for N/V, but do they help with excess secretions too? I recently had a patient who had excessive secretions - she was dying. The Dr wrote to suction her Q 15 minutes (on a med surg floor when I had 4 or 5 other patients), but also ordered a scop patch. I noticed a short while after I applied it, her secretions suddenly decreased. She died a few hours later, but I didn't know if the lack of secretions was caused by her body shutting down of the patch.

Help?

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Specializes in ICU/Critical Care.

Yes they do help with excessive secretions. The lack of secretions was caused by the patch not by her dying.

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as detroit stated, scope patches are frequently used for excess secretions and they work like a gem.

it's the anticholinergic properties that contribute to its effectiveness.

that said, please do not suction dying patients.

i'm not talking about a quick sweep of the mouth, but deep-suction.

i can't think of anything more invasive and unpeaceful.

leslie

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Specializes in too many to remember.

We used scop patches in hospice care but also used Atropine 1% opthamalic gtts at end of life to decrease the "rattle" and I have had excellent results with both of these drugs. The Atropine gtts could be given po or sl and hourly if needed. It is also comforting to the family.

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We used scop patches in hospice care but also used Atropine 1% opthamalic gtts at end of life to decrease the "rattle" and I have had excellent results with both of these drugs. The Atropine gtts could be given po or sl and hourly if needed. It is also comforting to the family.

yep, atropine gtts...

and levsin gtts as well.

leslie

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Specializes in psych, addictions, hospice, education.

About suctioning...it is said to actually increase secretions in the dying patient, so besides being very uncomfy, it's counter-productive...

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Has anyone ever encountered reactions to scop patches? Such as confusion, combativeness, etc. A friend recently had a ca pt with these s/s and it ended up being a reaction to the scop patches. I had never heard of that before - wondering if anyone else has.

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Specializes in psych, addictions, hospice, education.

I've heard of it, and I just looked it up...common reactions!

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Specializes in Too many to list.
Has anyone ever encountered reactions to scop patches? Such as confusion, combativeness, etc. A friend recently had a ca pt with these s/s and it ended up being a reaction to the scop patches. I had never heard of that before - wondering if anyone else has.

http://www.nature.com/npp/journal/v32/n5/full/1301208a.html

'Anticholinergic' muscarinic antagonists such as scopolamine or atropine may evoke a psychotic state termed 'anticholinergic syndrome' or 'antimuscarinic psychosis'. Noteworthy, in comparison to the dopamine (DA)-releasing psychotomimetic amphetamine, which induces psychosis characterized by hallucinations and delusions (Snyder, 1973), antimuscarinic-induced psychosis includes in addition disorganized thinking, attentional impairments, and delirium, characteristics of endogenous schizophrenia

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Specializes in Peds Critical Care, Dialysis, General.

I used a scop patch on a cruise. While it did take care of the nausea, my mouth felt like the Sahara. I was waking up about every 2 hours to get something to drink!. I found my self unable to read, d/t some dilation of my pupils. But, at least, no nausea and I could enjoy myself (with drink in hand).

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thanks guys! It was something that I've never heard of - and of-course didn't take the time to look up being the holiday season and all. We've used scop patches for secretions on hospice pts and it was a reaction that I was VERY suprised about.

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