打嗝的藥物治療

物理手法

• Breath holding for 5 to 10 seconds (or as tolerated).
• Performing Valsalva maneuver, holding for five seconds.
• Sipping on or gargling with very cold water.
• Biting into a lemon.
• Pulling on the tongue.
• Swallowing a teaspoon of dry sugar.
• Pressing gently but firmly on the eyeballs.
• While sitting, pulling the knees up to the chest (or leaning forward to compress the chest); hold the position for 30 seconds to one minute if possible.
• Drinking water through a rigid tube with a valve that requires significant suction effort (ie, a forced inspiratory suction and swallow tool [FISST]), which contracts the diaphragm by activating the phrenic nerve, followed by swallowing of water which activates the vagus nerve. 

第一線藥物

• PPI 3-4 wks
• Baclofen 5-10mg tid x10-15d
• Gabapentin 100-400mg tid x10-15d
• Metoclopramide 10mg TID-QID x10-15d

第二線藥物

• Chlorpromazine 25mg TID (10mg if old) x10-15d