Scopolamine: new preparations. Reference treatment for death rattle

(1) The reference symptomatic drug treatment of death rattle is the use of atropinic agents such as scopolamine or atropine. (2) Marketing authorisation has now been granted in France for scopolamine in this indication, both for a subcutaneous preparation and a transdermal patch. (3) The clinical file on subcutaneous scopolamine delivery mainly comprises non comparative data on 200 patients studied prospectively and 196 patients studied retrospectively. (4) The assessment of transdermal scopolamine patches is limited to a few published cases. (5) Available data show the efficacy of scopolamine, when administered after aspiration of the back of the throat. (6) The main adverse effects are neuropsychological (excitation, hallucinations, delirium). (7) In practice, injectable scopolamine is the reference drug for symptomatic treatment of death rattle.