Debbie A. our visiting nurse just called to check on Debbi’s status. After providing the rundown, I asked Debbie what I should have done last night to help Debbi avoid the struggle to bring up phlegm. Debbie told me to go in the Hospice Pharmacia ComfortPak we keep in the refrigerator and identify a small container with the red cap. The medicine inside is Atropine in a 1% concentration. The instructions read, “Place 2 drops under the tongue every 4 hours as needed for excess secretions.”
Atropine, like cocaine, comes from a family of drugs called tropane alkaloids. Tropane alkaloids are found in plants like the coca plant and deadly nightshade. Atropine, in specific, is extracted from deadly nightshade whose scientific name is atropa belladonna. In the movie, My Big Fat Greek Wedding, Michael Constantine who plays the patriarch of the family says that every word comes from a Greek root. In this case he is spot on. Atropa is from the Greek atropos which is one of the three fates and its meaning is to “cut the thread of life.” In contrast, belladonna comes from the Italian for beautiful lady because the Italian women used to use the deadly nightshade sap to dilate their pupils… a look that they felt made them more beautiful to their male suitors.
While Atropine is potentially deadly, Wikipedia says that the World Health Organization’s Essential Drug list contains Atropine as a core medicines necessary for a basic health care system. Wikipedia also writes:
Atropine’s actions on the parasympathetic nervous system inhibits salivary, sweat, and mucus glands. This can be useful in treating hyperhidrosis, and can prevent the death rattle of dying patients. Even though atropine has not been officially indicated for either of these purposes by the FDA, it has been used by physicians for these purposes.
I just gave Debbi 2 drops. She is sleeping with her mouth open just enough to insert the tip of the container and see the droplets emerge. I will monitor her breathing and coughing to see if there is any improvement.