Rx Note

Introduction A hiccup occurs due to an involuntary, intermittent, spasmodic contraction of the diaphragm and intercostal muscles. Although hiccups most commonly are self-limited (last for <48 hours), they can become prolonged and decrease quality of life by interrupting eating, drinking, sleeping and conversation; exacerbating pain; causing insomnia, fatigue and mental stress; or adversely affecting moods. Hiccups lasting >48 hours are classified as persistent, while those lasting >1 month are considered intractable. Management Treatment of hiccups should be focused on the underlying cause when possible. For patients not known to have an advanced malignancy and who experience hiccups lasting more than 48 hours, a thorough history, physical examination and some laboratory testing should be performed to try to determine the underlying aetiology, even though in many patients a specific cause is not found. Medications associated with hiccups include dexamethasone, diazepam, midaz...

Introduction Galactagogues are medications or other substances believed to assist initiation, maintenance or augmentation of maternal milk production. The routine use of galactagogues is not recommended because there is Limited evidence to support their efficacy Oral galactagogues (natural therapies or drugs) for increasing breast milk production in mothers of non-hospitalised term infants, 2020 Efficacy and Safety of Domperidone and Metoclopramide in Breastfeeding: A Systematic Review and Meta-Analysis, 2021 Because of potential safety concerns. Domperidone - risk of arrythmias Metoclopramide - CNS adverse effects and risk of tardive dyskinesia Hence, before initiating a galactagogue, women should attempt nonpharmacologic methods of increasing milk production such as Ensuring adequate hydration Skin-to-skin holding with baby Self-breast massage Relaxation techniques Unrestricted frequency and duration of breastfeeding Dosage Regimens The most commonly used prescription agents are dop...