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Gastrointestinal
Hiccups
ہچکیاں
Hiccups are commonly associated with acid peptic disease (APD). Baclofen is the drug of choice.
- ICD-10
- —
- Source
- OPD handbook pp.133, 201
- Status
- Draft
Not yet reviewed by a clinician. Check doses and brands against current national guidelines before use.
Symptoms
- Hiccups
Diagnosis
- Rule out APD (history, examination, investigations)
- Rule out CKD (serum electrolytes and renal parameters)
Treatment
Step 1 of 5
1. Drug of choice
- Baclofen (muscle relaxant) 10 mg TDS for 5 days (Urdu note)
Prescription
Step 2 of 5
Non-pharmacological measures (page 201)
- Valsalva manoeuvre
- Carotid sinus massage
- Digital ocular globe pressure
- Breath holding
- Hyperventilation
- Mental distraction
Step 3 of 5
Pharmacological options (page 201)
- Inj Xylocain 1 ampoule in a glass of milk and drink
Prescription
ChlorpromazineAntipsychotic (used for intractable hiccups)
Dose25 mg PO, TDS (as read)
Brand Tab Largactil
MetoclopramideProkinetic / antiemetic
DoseInj 10 mg IV stat; Tab 10 mg 1 × TDS PO
Brand Inj Metomide / Tab Metomide
Also sold as Maxolone, Maxolon, Metaclon, Metomide
Step 4 of 5
2. Rule out causes
- Rule out APD: history, examination and investigations
- Rule out CKD: serum electrolytes (S/E) and renal parameters (RPM)
Step 5 of 5
3. Referral
- Refer to a consultant physician if there is no response to initial treatment