Nebulized Lidocaine Solution for Control of Intractable Cough in a Patient with Metastatic Malignant Melanoma

Abstract

Clinical Pearls Each of these special features conveys an idea, concept, or fact that may be useful in your pharmaceutical practice, but may not be widely known, published, or taught. A 76-year-old male with a diagnosis of metastatic malignant melanoma was experiencing problems with a chronic cough. The cough had initially been managed with guaifenesin with codeine syrup and later with benzonatate capsules, but had become intractable. The patient's paroxysmal coughing resulted in dyspnea, gagging, vomiting, and fatigue—and had a significant impact on the patient's quality of life. The patient was evaluated, and no significant comorbid conditions or drug therapies that might have been aggravating his condition were noted. The patient was evaluated for pharmacologic treatment options. After discussing the pros and cons of each modality, it was decided that nebulized lidocaine would be used as a palliative measure for controlling the patient's intractable cough. A follow-up review of the patient's clinical course revealed that lidocaine was effective in controlling the cough with no adverse consequences.