Abstract
Answer D: Metoclopramide
According to the 2013 Scottish Palliative Care Guidelines management options for intractable hiccups include:
Non-pharmacological management including sipping iced water, breathing in a paper bag, interrupting normal breathing, drinking from the opposite side of the cup and rubbing the soft palate with a swab Pharmacological management including an anti-flatulent such as peppermint water, antacid containing simeticone, prokinetic such as domperidone or metoclopramide, treating gastro-oesophageal reflux disease with a proton pump inhibitor, and dexamethasone Other options may be recommended by a specialist and include haloperidol, baclofen, levomepromazine or nifedipine Although chlorpromazine is licensed for treatment of intractable hiccups, the National Institute for Health and Care Excellence suggests avoiding in palliative care situations because of its potential adverse effects
Scottish palliative care guidelines www.palliativecareguidelines. scot.nhs.uk
http://cks.nice.org.uk/hiccups#!scenario