A 85-year-old woman with advanced dementia in a care home has developed hiccoughs that have been persistent for 48 hours. She appears distressed. She ...

Question

A 85-year-old woman with advanced dementia in a care home has developed hiccoughs that have been persistent for 48 hours. She appears distressed. She has metastatic gastric cancer and is receiving palliative care. What is the MOST appropriate pharmacological treatment for persistent hiccoughs in the palliative care setting?

Accepted Answer

Metoclopramide 10 mg TDS if there is a gastric cause, or Baclofen 5-10 mg TDS, or Chlorpromazine if other measures fail

Answer

Chlorpromazine 10-25 mg orally or subcutaneously

Answer

Paracetamol 1 g QDS

Answer

High-flow oxygen

Answer

Gabapentin 600 mg TDS as first-line

uk-dgm MCQ (SBA): Persistent Hiccoughs in Palliative Care