MND-SIALORRHEA

SUMMARY

1. Determine if the patient is suffering sialorrhea or thickening of secretions.

2. Reduce production of saliva via pharmacologic and non-pharmacologic means.

3. Pharmacologic means: TCA (amitriptyline), anticholinergics (atropine, hyoscine), glycopyrrolate, salivary botulinum toxin injection, low-dose unilateral salivary gland radiotherapy.

4. Non-pharmacologic means: suction machine and bibs.

5. For thick mucus: frozen dark grape juice (contains mucolytic enzymes), nebulized normal saline, mucolytic agents (bromhexine).

6. Chest physiotherapy and deep breathing exercises to expectorate secretions.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].