Singultus: Avoiding a hiccup in care

Gardecki, Jeffrey; Espinosa, James; Lucerna, Alan; Bernhardt, J.

doi:10.1016/j.ajem.2016.12.056

Cited by 4 publications

(7 citation statements)

References 5 publications

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“…Persistent and intractable hiccups may signify a more serious underlying etiology such as gastrointestinal and cardiovascular disorders; central nervous system (CNS) abnormalities; ear, nose, and throat (ENT) conditions or pneumological problems; metabolic/endocrine disorders; infections; and psychogenic disorders including excitation, hyperventilation, malingering, somatization, and stress [6,9,[16][17][18][19][20][21].…”

Section: Introductionmentioning

confidence: 99%

Protracted Hiccups Induced by Aripiprazole and Regressed after Administration of Gabapentin

Carbone

Tagliarini

Rocca

et al. 2021

Case Reports in Psychiatry

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Hiccups are sudden, repeated, and involuntary contractions of the diaphragm muscle (myoclonic contraction). It involves a reflex arc that, once activated, causes a strong contraction of the diaphragm immediately followed by the closure of the glottis translating into the classic “hic” sound. Hiccups can be short, persistent, and intractable depending on the duration. The most disabling hiccups often represent the epiphenomenon of a medical condition such as gastrointestinal and cardiovascular disorders; central nervous system (CNS) abnormalities; ear, nose, and throat (ENT) conditions or pneumological problems; metabolic/endocrine disorders; infections; and psychogenic disorders. Some drugs, such as aripiprazole, a second-generation antipsychotic, can induce the onset of variable hiccups. We describe herein the cases of three hospitalized patients who developed insistent hiccups after taking aripiprazole and who positively responded to low doses of gabapentin. It is probable that aripiprazole, prescribed at a low dosage (<7.5 mg/day), would act as a dopamine agonist by stimulating D2 and D3 receptors at the “hiccup center” level—located in the brain stem—thus triggering the hiccup. On the other hand, gabapentin led to a complete regression of the hiccup probably by reducing the nerve impulse transmission and modulating the diaphragmatic activity. The present case series suggests the use of low doses of gabapentin as an effective treatment for aripiprazole-induced hiccups. However, our knowledge of the neurotransmitter functioning of the hiccup reflex arc is still limited, and further research is needed to characterize the neurotransmitters involved in hiccups for potential novel therapeutic targets.

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Section: Introductionmentioning

confidence: 99%

Protracted Hiccups Induced by Aripiprazole and Regressed after Administration of Gabapentin

Carbone

Tagliarini

Rocca

et al. 2021

Case Reports in Psychiatry

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“…Usualmente, no se le da la importancia que amerita y es un motivo de consulta frecuente en el servicio de urgencias (2,3). Los mecanismos fisiopatológicos no se han dilucidado del todo; sin embargo, se cree que es causado por contracciones involuntarias del diafragma y los músculos intercostales, que resulta en una rápida entrada de aire a los pulmones y el cierre de la vía aérea superior (1,2,3). Los impulsos nerviosos del singulto implican estructuras como los quimiorreceptores del área postrema y neurotransmisores como GABA y dopamina en el nivel central.…”

Section: Introductionunclassified

Neumonía adquirida en la comunidad como causa de singulto en paciente con infección por VIH: reporte de caso y revisión de literatura

et al. 2021

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El singulto es una manifestación clínica común, de etiología multifactorial que funciona como un arco reflejo frente a noxas irritativas y es mediado por estimulación simpática. Dentro de las causas se han descrito procesos infecciosos como la neumonía, sin embargo, con una baja representatividad. Presentamos el caso de un hombre de 34 años con diagnóstico de infección por virus de la inmunodeficiencia humana (VIH) en estadio 3 con única manifestación clínica inicial de singulto documentando neumonía adquirida en comunidad como etiología. Este caso destaca la importancia del estudio del singulto especialmente en pacientes en contexto de inmunosupresión ya que en ellos la clínica que subyace un proceso infeccioso no suele ser evidente.

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“…Hiccup bouts are usually self-limited and last < 48 hours. Persistent hiccups last >48 hours, and intractable hiccups last greater than two months [ 1 , 2 ]. Prolonged bouts of hiccups can produce significant morbidity and are most effectively managed by treating the underlying condition if it can be identified in the emergency department (ED).…”

Section: Introductionmentioning

confidence: 99%

“…There are many causes of hiccups including gastric distention, aerophagia, ventriculoperitoneal shunts, hydrocephalus, multiple sclerosis, strokes, epidural or subdural hematomas, diffuse axonal injury, cerebral contusions, encephalitis, meningitis, brain abscesses, neurosyphilis, laryngitis, pharyngitis, irritation of the tympanic membrane, retropharyngeal abscess, peritonsillar abscesses, mediastinitis, esophagitis, bronchitis, pneumonia, myocardial infarction, pericarditis, aortic aneurysms, pericarditis, misplaced pacemaker wires, small bowel obstruction, perihepatitis, subphrenic abscess, goiter, tumor or cyst of the neck, barbiturates, steroids, methyldopa, and electrolyte abnormalities [ 1 – 4 ]. Chlorpromazine (Thorazine), a phenothiazine type first-generation antipsychotic drug, is likely the most effective and well-studied pharmaceutical drug for hiccups [ 1 , 2 ]. Chlorpromazine has several potential adverse effects including sedation and the potential to prolong the cardiac QTc [ 1 , 2 ].…”

Section: Introductionmentioning

confidence: 99%

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A Hiccup in Hiccup Management: Cardiac Arrest from Previously Undiagnosed Congenital Long QT Syndrome

Hughes

Sheele

2018

Case Reports in Emergency Medicine

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Singultus: Avoiding a hiccup in care

Cited by 4 publications

References 5 publications

Protracted Hiccups Induced by Aripiprazole and Regressed after Administration of Gabapentin

Protracted Hiccups Induced by Aripiprazole and Regressed after Administration of Gabapentin

Neumonía adquirida en la comunidad como causa de singulto en paciente con infección por VIH: reporte de caso y revisión de literatura

A Hiccup in Hiccup Management: Cardiac Arrest from Previously Undiagnosed Congenital Long QT Syndrome

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