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

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J Pain Palliat Care Pharmacother. 2025 Dec 1:1-5. doi: 10.1080/15360288.2025.2597381. Online ahead of print.

ABSTRACT

Management of "death rattle" at the end of life typically involves the use of anticholinergic agents to reduce airway secretions. However, in patients with myasthenia gravis - an autoimmune condition affecting acetylcholine receptors, causing fatigability and weakness of the skeletal muscles - the use of such agents poses a challenge. Anticholinergic agents antagonize the effects of acetylcholinesterase inhibitors, which are critical for treating myasthenia gravis, and may exacerbate symptoms. We report the case of a terminal patient with underlying myasthenia gravis who had concomitant death rattle. A trial of hyoscine butylbromide was effective in treating the death rattle, while the myasthenic symptoms remained quiescent. To our knowledge, this has not been reported previously.

PMID:41327586 | DOI:10.1080/15360288.2025.2597381


Source: https://pubmed.ncbi.nlm.nih.gov/4132758 ... 22+67771e2