Oral drug therapy in elderly with dysphagia: Between a rock and a hard place!

Clinical Interventions in Aging

Volumn 12, Issue , 2017, Pages 241-251

  Logrippo, Serena ^a   Ricci, Giovanna ^a   Sestili, Matteo ^b   Cespi, Marco ^a   Ferrara, Letizia ^b   Palmieri, Giovanni F ^a   Ganzetti, Roberta ^b   Bonacucina, Giulia ^a   Blasi, Paolo ^a  

^a UNIVERSITY OF CAMERINO   (Italy)

^b INRCA   (Italy)

Author keywords

Compounding; Dysphagia; Gastrointestinal tract toxicity; Geriatric medicine; Modified release formulations

Indexed keywords

ALENDRONIC ACID; BISPHOSPHONIC ACID DERIVATIVE; FERROUS SULFATE; NONSTEROID ANTIINFLAMMATORY AGENT; POTASSIUM CHLORIDE; RISEDRONIC ACID; TETRACYCLINE DERIVATIVE;

ADVERSE DRUG REACTION; AGED; CLINICAL PRACTICE; DRUG CAPSULE; DRUG INDICATION; DRUG LABELING; DRUG TOXICITY; DYSPHAGIA; ELDERLY CARE; GASTROINTESTINAL TRACT; GERIATRICS; HUMAN; INFORMED CONSENT; LEGAL ASPECT; MEDICAL ERROR; MEDICAL ETHICS; OFF LABEL DRUG USE; ORAL DRUG ADMINISTRATION; PHARMACEUTICS; PRESCRIPTION; REVIEW; TABLET FORMULATION; PATHOPHYSIOLOGY; TABLET;

ADMINISTRATION, ORAL; AGED; DEGLUTITION DISORDERS; HUMANS; TABLETS;

EID: 85011977656     PISSN: 11769092     EISSN: 11781998     Source Type: Journal    
DOI: 10.2147/CIA.S121905     Document Type: Review

References (93)

1. Vaupel JW. Biodemography of human ageing. Nature. 2010;464(7288): 536-542.
2. Stegemann S, Ecker F, Maio M, et al. Geriatric drug therapy: neglecting the inevitable majority. Ageing Res Rev. 2010;9(4): 384-398.
3. Singh S, Bajorek B. Pharmacotherapy in the ageing patient: the impact of age per se (a review). Ageing Res Rev. 2015;24(Pt B): 99-110.
4. Nobili A, Garattini S, Mannucci P. Multiple diseases and polypharmacy in the elderly: challenges for the internist of the third millennium. J Comorbidity. 2011;1(1): 28-44.
5. Hajjar ER, Cafiero AC, Hanlon JT. Polypharmacy in elderly patients. Am J Geriatr Pharmacother. 2007;5(4): 345-351.
6. Stegemann S, Gosch M, Breitkreutz J. Swallowing dysfunction and dysphagia is an unrecognized challenge for oral drug therapy. Int J Pharm. 2012;430(1-2): 197-206.
7. Humbert IA, Robbins J. Dysphagia in the elderly. Phys Med Rehabil Clin N Am. 2008;19(4): 853-866, ix-x.
8. Fusco S, Cariati D, Schepisi R, et al. Management of oral drug therapy in elderly patients with dysphagia. J Gerontol Geriatr. 2016;64(1): 9-20.
9. Langmore SE, Terpenning MS, Schork A, et al. Predictors of aspiration pneumonia: how important is dysphagia? Dysphagia. 1998;13(2): 69-81.
10. Roy N, Stemple J, Merrill RM, Thomas L. Dysphagia in the elderly: preliminary evidence of prevalence, risk factors, and socioemotional effects. Ann Otol Rhinol Laryngol. 2007;116(11): 858-865.
11. Kawashima K, Motohashi Y, Fujishima I. Prevalence of dysphagia among community-dwelling elderly individuals as estimated using a questionnaire for dysphagia screening. Dysphagia. 2004;19(4): 266-271.
12. Holland G, Jayasekeran V, Pendleton N, Horan M, Jones M, Hamdy S. Prevalence and symptom profiling of oropharyngeal dysphagia in a community dwelling of an elderly population: a self-reporting questionnaire survey. Dis Esophagus. 2011;24(7): 476-480.
13. Hughes SM. Management of dysphagia in stroke patients. Nurs Older People. 2011;23(3): 21-24.
14. Perry L, Love CP. Screening for dysphagia and aspiration in acute stroke: a systematic review. Dysphagia. 2001;16(1): 7-18.
15. Daniels SK. Neurological disorders affecting oral, pharyngeal swallowing. GI Motil. 2006.
16. Perry L. Screening swallowing function of patients with acute stroke. Part one: identification, implementation and initial evaluation of a screening tool for use by nurses. J Clin Nurs. 2001;10(4): 463-473.
17. Setacci C, Sirignano A, Ricci G, Spagnolo AG, Pugliese F, Speziale F. A new ethical and medico-legal issue: vascular surgery and the postoperative cognitive dysfunction. J Cardiovasc Surg (Torino). 2015;56(4): 607-615.
18. Nilsson H, Ekberg O, Olsson R, Hindfelt B. Quantitative aspects of swallowing in an elderly nondysphagic population. Dysphagia. 1996;11(3): 180-184.
19. Rivlin MM. Protecting elderly people: flaws in ageist arguments. BMJ. 1995;310(6988): 1179-1182.
20. Etzioni DA, Liu JH, Maggard MA, Ko CY. The aging population and its impact on the surgery workforce. Ann Surg. 2003;238(2): 170-177.
21. Marengoni A, Angleman S, Melis R, et al. Aging with multimorbidity: a systematic review of the literature. Ageing Res Rev. 2011;10(4): 430-439.
22. Schiele JT, Quinzler R, Klimm H-D, Pruszydlo MG, Haefeli WE. Difficulties swallowing solid oral dosage forms in a general practice population: prevalence, causes, and relationship to dosage forms. Eur J Clin Pharmacol. 2013;69(4): 937-948.
23. Stubbs J, Haw C, Dickens G. Dose form modification - a common but potentially hazardous practice. A literature review and study of medication administration to older psychiatric inpatients. Int Psychogeriatr. 2008;20(3): 616-627.
24. Haw C, Stubbs J. Administration of medicines in food and drink: a study of older inpatients with severe mental illness. Int Psychogeriatr. 2010;22(3): 409-416.
25. US Food and Drug. Available from: http://www.fda.gov/Drugs/GuidanceComplianceRegulatoryInformation/PharmacyCompounding/ucm339764.htm#what. Accessed December 1, 2015.
26. Bonacucina G, Logrippo S, Cespi M, et al. Chemical and microbiological stability studies of an aqueous solution of pravastatin sodium salt for drug therapy of the dysphagic patients. Eur J Hosp Pharm. 2016;23(5): 288-293.
27. Sestili M, Ferrara L, Logrippo S, Ganzetti R. Detection of medication errors in hospital discharge communications of patients on enteral nutrition. Nutr Ther Metab. 2014;32(3): 152-154.
28. Kyle G. Medication management in older people with dementia. J Community Nurs. 2012;26: 31.
29. Alldred D, Standage C. Medication errors in care homes. Nurs Times. 2010;107(24): 14-15.
30. Bennett B, Howard C, Barnes H, Jones A. Medication management in patients with dysphagia: a service evaluation. Nurs Stand. 2013;27(41): 41-48.
31. Kelly J, Wright D. Administering medication to adult patients with dysphagia: part 2. Nurs Stand. 2010;24(26): 61-68.
32. Kelly J, Wright D, Wood J. Medicine administration errors in patients with dysphagia in secondary care: a multi-centre observational study. J Adv Nurs. 2011;67(12): 2615-2627.
33. Verrue C, Mehuys E, Boussery K, Remon JP, Petrovic M. Tablet-splitting: a common yet not so innocent practice. J Adv Nurs. 2011;67(1): 26-32.
34. James A. The legal and clinical implications of crushing tablet medication. Nurs Times. 2003;100(50): 28-29.
35. Kelly J, Eggleton A, Wright D. An analysis of two incidents of medicine administration to a patient with dysphagia. J Clin Nurs. 2011;20(1-2): 146-155.
36. Cornish P. "Avoid the crush": hazards of medication administration in patients with dysphagia or a feeding tube. CMAJ. 2005;172(7): 871-872.
37. Beckwith MC, Feddema SS, Barton RG, Graves C. A guide to drug therapy in patients with enteral feeding tubes: dosage form selection and administration methods. Hosp Pharm. 2004;39(3): 225-237.
38. Boada M, Arranz FJ. Transdermal is better than oral: observational research of the satisfaction of caregivers of patients with alzheimer’s disease treated with rivastigmine. Dement Geriatr Cogn Disord. 2013;35(1-2): 23-33.
39. Salmon D, Pont E, Chevallard H, et al. Pharmaceutical and safety considerations of tablet crushing in patients undergoing enteral intubation. Int J Pharm. 2013;443(1-2): 146-153.
40. Sestili M, Logrippo S, Cespi M, et al. Inappropriate prescribing of solid oral dosage forms in elderly dysphagic patients: a retrospective study. Eur J Clin Pharmacol. 2017.
41. Florence AT. An Introduction to Clinical Pharmaceutics. 1st ed. Press P, editor. London: Pharmaceutical Press; 2010.
42. Buckton G, Beezer AE. The relationship between particle size and solubility. Int J Pharm. 1992;82(3): R7-R10.
43. Ridolfo AS, Thompkins L, Bechtol LD, Carmichael RH. Benoxaprofen, a new anti-inflammatory agent: particle-size effect on dissolution rate and oral absorption in humans. J Pharm Sci. 1979;68(7): 850-852.
44. Zafar MU, Farkouh ME, Fuster V, Chesebro JH. Crushed clopidogrel administered via nasogastric tube has faster and greater absorption than oral whole tablets. J Interv Cardiol. 2009;22(4): 385-389.
45. Henney HR, Fitzpatrick A, Stewart J, Runyan JD. Relative bioavailability of tizanidine hydrochloride capsule formulation compared with capsule contents administered in applesauce: a single-dose, open-label, randomized, two-way, crossover study in fasted healthy adult subjects. Clin Ther. 2008;30(12): 2263-2271.
46. Manrique YJ, Lee DJ, Islam F, et al. Crushed tablets: does the administration of food vehicles and thickened fluids to aid medication swallowing alter drug release? J Pharm Pharm Sci. 2014;17(2): 207-219.
47. Royal Society of Chemistry. Implications of altering oral solid-dose formulations; 2011. Available from: http://dysphagia-medicine.com/. Accessed April 7, 2016.
48. Oral dosage forms that should not be crushed 2015. Available from: www.ismp.org/tools/donotcrush.pdf. Accessed November 12, 2015.
49. Do Not Rush to Crush/Society of Hospital Pharmacists Australia. Available from: http://www.shpa.org.au/Publications/Do-not-Rush-to-Crush. Accessed April 7, 2016.
50. Schier JG, Howland MA, Hoffman RS, Nelson LS. Fatality from administration of labetalol and crushed extended-release nifedipine. Ann Pharmacother. 2003;37(10): 1420-1423.
51. Ferron GM, Ku S, Abell M, et al. Oral bioavailability of pantoprazole suspended in sodium bicarbonate solution. Am J Health Syst Pharm. 2003;60(13): 1324-1329.
52. Dentinger PJ, Swenson CF, Anaizi NH. Stability of pantoprazole in an extemporaneously compounded oral liquid. Am J Health Syst Pharm. 2002;59(10): 953-956.
53. Committee for Medicinal Products for Human use (CHMP). Guideline on the pharmacokinetic and clinical evaluation of modified release dosage forms (EMA/CPMP/EWP/280/96 Corr1). 2013: 6. Available from: http://www.ema.europa.eu/docs/en_GB/document_library/Scientific_guideline/2013/03/WC500140482.pdf. Accessed December 10, 2015.
54. EMA/CHMP/EWP/280/96, (CHMP) C for MP for HU. Guideline on the Pharmacokinetic and Clinical Evaluation of Modified Release Dosage Forms (EMA/CPMP/EWP/280/96 Corr1). London: 2014.
55. ISMP. To chew, or not to chew? Patient died after chewing medication; 2016. Available from: https://www.ismp.org/consumers/chewable.asp. Accessed April 7, 2016.
56. Gudin J, Levy-Cooperman N, Kopecky EA, Fleming AB. Comparing the effect of tampering on the oral pharmacokinetic profiles of two extended-release oxycodone formulations with abuse-deterrent properties. Pain Med. 2015;16(11): 2142-2151.
57. Habib WA, Alanizi AS, Abdelhamid MM, Alanizi FK. Accuracy of tablet splitting: comparison study between hand splitting and tablet cutter. Saudi Pharm J. 2014;22(5): 454-459.
58. Messina R, Becker R, van Riet-Nales DA, Stegemann S. Results from a preliminary review of scientific evidence for appropriateness of preparations, dosage forms and other product design elements for older adult patients. Int J Pharm. 2015;478(2): 822-828.
59. De Spiegeleer B, Wynendaele E, Bracke N, et al. Regulatory development of geriatric medicines: to GIP or not to GIP? Ageing Res Rev. 2016;27: 23-36.
60. Jain V, Pitchumoni CS. Gastrointestinal side effects of prescription medications in the older adult. J Clin Gastroenterol. 2009;43(2): 103-110.
61. Liabeuf S, Gras V, Moragny J, Laroche ML, Andrejak M. Ulceration of the oral mucosa following direct contact with ferrous sulfate in elderly patients: a case report and a review of the French National Pharmacovigilance Database. Clin Interv Aging. 2014;9: 737-740.
62. Graham DY. What the gastroenterologist should know about the gastrointestinal safety profiles of bisphosphonates. Dig Dis Sci. 2002;47(8): 1665-1678.
63. Bonavina L, DeMeester TR, McChesney L, Schwizer W, Albertucci M, Bailey RT. Drug-induced esophageal strictures. Ann Surg. 1987;206(2): 173-183.
64. Fennerty MB. NSAID-related gastrointestinal injury. Evidence-based approach to a preventable complication. Postgrad Med. 2001;110(3): 87-88, 91-94.
65. Crowson TD, Head LH, Ferrante WA. Esophageal ulcers associated with tetracycline therapy. JAMA. 1976;235(25): 2747-2748.
66. Abraham SC, Yardley JH, Wu TT. Erosive injury to the upper gastrointestinal tract in patients receiving iron medication: an underrecognized entity. Am J Surg Pathol. 1999;23(10): 1241-1247.
67. Cimino-Mathews A, Broman JH, Westra WH, Illei PB. Iron pill-induced tumefactive mucosal injury of the hypopharynx. Am J Surg Pathol. 2010;34(11): 1720-1722.
68. Areia M, Gradiz R, Souto P, et al. Iron-induced esophageal ulceration. Endoscopy. 2007;39(Suppl 1): E326.
69. Kim ST, Kaisar OM, Clarke BE, et al. "Iron lung": distinctive bronchoscopic features of acute iron tablet aspiration. Respirology. 2003;8(4): 541-543.
70. Jinbu Y, Demitsu T. Oral ulcerations due to drug medications. Jpn Dent Sci Rev. 2014;50(2): 40-46.
71. Rosenthal T, Adar R, Militianu J, Deutsch V. Esophageal ulceration and oral potassium chloride ingestion. Chest. 1974;65(4): 463-465.
72. Zografos GN, Georgiadou D, Thomas D, Kaltsas G, Digalakis M. Drug-induced esophagitis. Dis Esophagus. 2009;22(8): 633-637.
73. Sinar DR, Bozymski EM, Blackshear JL. Effects of oral potassium supplements on upper gastrointestinal mucosa: multicenter clinical comparison of three formulations and placebo. Clin Ther. 1986;8(2): 157-163.
74. Pusztaszeri MP, Genta RM, Cryer BL. Drug-induced injury in the gastrointestinal tract: clinical and pathologic considerations. Nat Clin Pract Gastroenterol Hepatol. 2007;4(8): 442-453.
75. Singh G. Recent considerations in nonsteroidal anti-inflammatory drug gastropathy. Am J Med. 1998;105(1B): 31S-38S.
76. Cryer B. Nonsteroidal anti-inflammatory drug gastrointestinal toxicity. Curr Opin Gastroenterol. 2001;17(6): 503-551.
77. Somasundaram S, Simpson R, Rafi S, Shergill JK, Bjarnason I, Wrigglesworth J. 2,4-Diamino-6-hydroxy pyrimidine inhibits NSAIDs induced nitrosyl-complex EPR signals and ulcer in rat jejunum. BMC Gastroenterol. 2002;2: 1-7.
78. Bjarnason I, Zanelli G, Prouse P, et al. Blood and protein loss via small-intestinal inflammation induced by non-steroidal anti-inflammatory drugs. Lancet. 1987;2(8561): 711-714.
79. Gibson GR, Whitacre EB, Ricotti CA. Colitis induced by nonsteroidal anti-inflammatory drugs. Report of four cases and review of the literature. Arch Intern Med. 1992;152(3): 625-632.
80. Bott S, Prakash C, McCallum RW. Medication-induced esophageal injury: survey of the literature. Am J Gastroenterol. 1987;82(8): 758-763.
81. Jaspersen D. Drug-induced oesophageal disorders: pathogenesis, incidence, prevention and management. Drug Saf. 2000;22(3): 237-249.
82. Levine MS. Drug-induced, caustic, and radiation esophagitis. In: Radiology of the Esophagus. Texas: Society of Abdominal Radiology; 1989: 73-89.
83. Gencosmanoglu R, Kurtkaya-Yapicier O, Tiftikci A, Avsar E, Tozun N, Oran ES. Mid-esophageal ulceration and candidiasis-associated distal esophagitis as two distinct clinical patterns of tetracycline or doxycycline-induced esophageal injury. J Clin Gastroenterol. 2004;38(6): 484-489.
84. Kadayifci A, Gulsen MT, Koruk M, Savas MC. Doxycycline-induced pill esophagitis. Dis Esophagus. 2004;17(2): 168-171.
85. Griffith R, Griffiths H, Jordan S. Administration of medicines. Part 1: the law and nursing. Nurs Stand. 2003;18(2): 47-53; quiz 54, 56.
86. Minghetti P, Palmieri I, Selmin F. When authorized medicinal products are not available: possible alternatives to meet legitimate expectations of patients. J Pharm Heal Serv Res. 2010;1(3): 107-112.
87. Mueller PS, Hook CC, Fleming KC. Ethical issues in geriatrics: a guide for clinicians. Mayo Clin Proc. 2004;79(4): 554-562.
88. Nissen L. Australian Don’t Rush to Crush Handbook. 1st ed. The Society of Hospital Pharmacists of Australia. Australia: Collingwood Victoria; 2013.
89. Mitchell JF. Oral dosage forms that should not be crushed. ISMP. 2015: 1-15. Available from: http://www.ismp.org/tools/donotcrush.pdf. Accessed April 7, 2016.
90. Wright D, Chapman N, Foundling-Miah M, et al. Consensus Guideline on the Medication Management of Adults with Swallowing Difficulties Supplement Produced in Association with Consensus Guideline on the Medication Management of Adults with Swallowing Difficulties. Chesham Bucks, UK: MGP Ltd Location; 2006.
91. Wrexham Maelor Hospital. General guidelines for administration of medications to patients with swallowing difficulties. Available from: http://www.newtguidelines.com/SwallowingDifficulties.html.. Chesham Bucks, UK: MGP Ltd Location.
92. EMA/165974/2013, (CHMP) C for MP for HU. Concept Paper on the Need for a Reflection Paper on Quality Aspects of Medicines for Older People. London, UK: 2013.
93. EMA/281009/2013, Evaluation HMD and. Mandate, Objectives and Rules of Procedure for the CHMP Geriatric Expert Group (GEG). London, UK: 2013.