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- W2000510502 abstract "1.Recognize the significant morbidity and etiology of intractable hiccups, especially in the palliative care population.2.Review treatment options for intractable hiccups. Hiccups, which are usually self-limited and benign, can become intractable and be associated with significant morbidity, especially in palliative care patients. Management of intractable hiccups (IH) poses a challenge to the palliative care provider. We present a case of a patient with IH who responded to the combination of scheduled baclofen and olanzapine. Current therapies for the management of IH are also reviewed. A 45-year-old male with multiple myeloma and plasma cell leukemia, status-post autologous and allogenic bone marrow transplantation developed IH for which a palliative care consultation was requested. As oral intake was poor secondary to his hiccups, total parenteral nutrition (TPN) had been initiated. A thorough assessment revealed that the potential etiologies of his hiccups were most likely related to methylprednisolone, the malignancy itself, and recent chemotherapy. Initial treatment with oral and intravenous chlorpromazine resulted in limited improvement and significant sedation. Palliative care service recommendations included a trial of scheduled metoclopramide and later, a retrial of chlorpromazine; both plans failed. Haloperidol and atropine were tried without success and the patient declined the option of a phrenic nerve block. Baclofen 10 mg PO TID and olanzapine 7.5 mg PO QHS were started; while the baclofen provided significant relief, the patient had a remarkable response to olanzapine. Within 24 hours of the initiation of olanzapine, the patient was able to tolerate an oral diet. Three weeks later the patient was discharged to home and TPN was discontinued. IH in the palliative care patient can be debilitating and difficult to manage. Several therapies have been proposed. Pharmacologic interventions include traditional options such as chlorpromazine, haloperidol, and metoclopramide. Non-traditional choices such as baclofen and olanzapine may be also considered in the management of IH." @default.
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- W2000510502 date "2012-02-01" @default.
- W2000510502 modified "2023-10-18" @default.
- W2000510502 title "Management of Intractable Hiccups in a Patient With Multiple Myeloma and Plasma Cell Leukemia (737)" @default.
- W2000510502 doi "https://doi.org/10.1016/j.jpainsymman.2011.12.215" @default.
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