1. ABH Gel: Comforting Cure or Pricey Placebo?
- Author
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Trista Askins Bailey, Amie Taggart Blaszczyk, and Shannon Tapia
- Subjects
medicine.medical_specialty ,Palliative care ,Psychomotor agitation ,Nausea ,Lorazepam ,Placebo ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,030212 general & internal medicine ,Intensive care medicine ,General Nursing ,business.industry ,Health Policy ,Palliative Care ,Diphenhydramine ,Hospices ,General Medicine ,Vomiting ,Haloperidol ,Delirium ,Geriatrics and Gerontology ,medicine.symptom ,business ,030217 neurology & neurosurgery ,Antipsychotic Agents ,medicine.drug - Abstract
Despite a lack of evidence of benefit, the compounded product ABH gel (lorazepam, diphenhydramine, and haloperidol) continues to be prescribed for individuals in hospice and palliative care settings for the treatment of nausea and vomiting and terminal delirium. More effective and reliable pharmacological and nonpharmacological strategies exist for the treatment of these conditions in the palliative care and hospice settings. We discuss the pharmacokinetic and clinical evidence for the individual components of ABH gel, as well as the compounded product, and attempt to understand the mechanism of effect that some purport to see, as well as why the compound continues to enjoy such a cult following. Truly, the continued use of ABH gel makes for a pricey placebo and delays the treatment of end-of-life symptoms with modalities that work.
- Published
- 2021
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