Using Subcutaneous Hyoscine Butylbromide in A Terminal Patient with Myasthenia Gravis: A Case Report

Area of Science:

• Palliative Care
• Neurology
• Pharmacology

Background:

• Death rattle, characterized by noisy breathing, is common in terminal illness.
• Anticholinergic drugs are standard for managing death rattle by reducing secretions.
• Myasthenia gravis (MG) patients require acetylcholinesterase inhibitors, which anticholinergics can antagonize, posing a treatment dilemma.

Purpose of the Study:

• To report a case of successful death rattle management in a patient with myasthenia gravis.
• To evaluate the efficacy and safety of hyoscine butylbromide in this specific patient population.

Main Methods:

• A case report of a terminal patient with both death rattle and myasthenia gravis.
• Administration of hyoscine butylbromide for death rattle management.
• Monitoring of both death rattle symptoms and myasthenic symptoms.

Main Results:

• Hyoscine butylbromide effectively reduced airway secretions, resolving the death rattle.
• The patient's underlying myasthenia gravis symptoms remained stable and did not exacerbate.
• This represents a novel approach to managing death rattle in MG patients.

Conclusions:

• Hyoscine butylbromide can be a safe and effective option for managing death rattle in patients with myasthenia gravis.
• This case highlights the need for careful consideration of drug interactions in complex palliative care scenarios.
• Further research may be warranted to explore this treatment in a broader MG population.