Pharmacist-led care in palliative settings: Using anticholinergics thoughtfully and compassionately

Pharmacist-led care in palliative settings: Using anticholinergics thoughtfully and compassionately 
Pharmacy times; by Diana Violanti, PharmD, Pamela S. Moore, PharmD, BCGP, and Alana Hippensteele; 5/5/25 
The use of anticholinergic agents to manage terminal secretions, often referred to as the death rattle, remains a nuanced and evolving area of end-of-life care. While these medications are frequently used in hospice and palliative care settings to reduce secretion-related sounds that may be distressing to caregivers, their efficacy in improving patient comfort is less clear and often debated. ... Diana Violanti, PharmD, and Pamela S. Moore, PharmD, BCGP, discuss the nuanced use of anticholinergic agents for managing terminal secretions at end of life, highlighting practical considerations, timing, safety concerns such as delirium, and the limited yet evolving evidence supporting their role in palliative care.