29th December 2024

Noisy secretions

Often, noisy secretions cause more distress to relatives than to the patient themselves. NICE guidelines recommend treatment if they are causing distress to the patient or to their carers.

Infection should be considered as a possible reversible cause.

The main conservative measure is to reposition the patient onto one side with their upper body elevated.

Pharmacological management options include:

• Glycopyrronium bromide
• Hyoscine butylbromide
• Hyoscine hydrobromide (although this may cause sedation or confusion)

It is important to monitor and treat side effects – dry mouth, delirium, sedation – and to consider stopping medications if the side effects outweigh the benefits.