Tags

Type your tag names separated by a space and hit enter

Use of Compounded Dextromethorphan-Quinidine Suspension for Pseudobulbar Affect in Hospice Patients.
J Palliat Med. 2017 03; 20(3):294-297.JP

Abstract

BACKGROUND

Pseudobulbar affect (PBA) consists of unprovoked and uncontrollable episodes of laughing and/or crying. In end-of-life situations, PBA symptoms can be especially distressing to family and friends during an already heightened emotional time. Although a commercial product combining dextromethorphan and quinidine (DMQ) is FDA approved for use in PBA, many hospice patients are unable to swallow any solids or semisolids. An alternative formulation for these patients is needed.

OBJECTIVE

We present here two cases in which we used a compounded DMQ suspension successfully to treat PBA symptoms in the weeks before the patients' death.

DESIGN

A retrospective chart review was completed on the two cases where the DMQ suspension was used. A description of the DMQ suspension formula is described.

SETTING/SUBJECTS

Both patients were under the care of a hospice program; one in home care and one in a skilled nursing facility.

MEASUREMENTS

Episodes of PBA symptoms were summarized in a narrative of the patients' symptom relief.

RESULTS

Both patients tolerated the administration of the DMQ suspension and there were noted improvements in PBA symptoms.

CONCLUSIONS

DMQ suspension is an effective alternative for PBA symptoms in patients who cannot swallow oral solid medication.

Authors+Show Affiliations

1 Niagara Hospice , Lockport, New York. 2 University at Buffalo, The State University of New York, School of Pharmacy and Pharmaceutical Sciences, Buffalo, New York.2 University at Buffalo, The State University of New York, School of Pharmacy and Pharmaceutical Sciences, Buffalo, New York.2 University at Buffalo, The State University of New York, School of Pharmacy and Pharmaceutical Sciences, Buffalo, New York.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

27997281

Citation

Wahler, Robert G., et al. "Use of Compounded Dextromethorphan-Quinidine Suspension for Pseudobulbar Affect in Hospice Patients." Journal of Palliative Medicine, vol. 20, no. 3, 2017, pp. 294-297.
Wahler RG, Reiman AT, Schrader JV. Use of Compounded Dextromethorphan-Quinidine Suspension for Pseudobulbar Affect in Hospice Patients. J Palliat Med. 2017;20(3):294-297.
Wahler, R. G., Reiman, A. T., & Schrader, J. V. (2017). Use of Compounded Dextromethorphan-Quinidine Suspension for Pseudobulbar Affect in Hospice Patients. Journal of Palliative Medicine, 20(3), 294-297. https://doi.org/10.1089/jpm.2016.0277
Wahler RG, Reiman AT, Schrader JV. Use of Compounded Dextromethorphan-Quinidine Suspension for Pseudobulbar Affect in Hospice Patients. J Palliat Med. 2017;20(3):294-297. PubMed PMID: 27997281.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Use of Compounded Dextromethorphan-Quinidine Suspension for Pseudobulbar Affect in Hospice Patients. AU - Wahler,Robert G,Jr AU - Reiman,Alfred T, AU - Schrader,Joshua V, Y1 - 2016/12/20/ PY - 2016/12/21/pubmed PY - 2018/2/24/medline PY - 2016/12/21/entrez KW - dextromethorphan KW - pseudobulbar affect KW - quinidine SP - 294 EP - 297 JF - Journal of palliative medicine JO - J Palliat Med VL - 20 IS - 3 N2 - BACKGROUND: Pseudobulbar affect (PBA) consists of unprovoked and uncontrollable episodes of laughing and/or crying. In end-of-life situations, PBA symptoms can be especially distressing to family and friends during an already heightened emotional time. Although a commercial product combining dextromethorphan and quinidine (DMQ) is FDA approved for use in PBA, many hospice patients are unable to swallow any solids or semisolids. An alternative formulation for these patients is needed. OBJECTIVE: We present here two cases in which we used a compounded DMQ suspension successfully to treat PBA symptoms in the weeks before the patients' death. DESIGN: A retrospective chart review was completed on the two cases where the DMQ suspension was used. A description of the DMQ suspension formula is described. SETTING/SUBJECTS: Both patients were under the care of a hospice program; one in home care and one in a skilled nursing facility. MEASUREMENTS: Episodes of PBA symptoms were summarized in a narrative of the patients' symptom relief. RESULTS: Both patients tolerated the administration of the DMQ suspension and there were noted improvements in PBA symptoms. CONCLUSIONS: DMQ suspension is an effective alternative for PBA symptoms in patients who cannot swallow oral solid medication. SN - 1557-7740 UR - https://www.unboundmedicine.com/medline/citation/27997281/Use_of_Compounded_Dextromethorphan_Quinidine_Suspension_for_Pseudobulbar_Affect_in_Hospice_Patients_ L2 - https://www.liebertpub.com/doi/full/10.1089/jpm.2016.0277?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -