Drug administration adjustments for elderly patients with dysphagia: A case report

ABSTRACT An elderly patient, aged 76 years, diagnosed with dysphagia, depression, hypothyroidism, Alzheimer's disease and mild cognitive deficit, was identified with sertraline and levothyroxine- drug-related problems. Medication Therapy Management (MTM) was used to adjust therapy to the patient's needs by macerating sertraline tablets and solubilizing them in 10-30 mL of orange juice. The patient was advised to take levothyroxine after fasting. Six months later, pharmaceutical follow-up identified an increase in the Mini-Mental State Exam score from 22 to 26 and a decrease in the Clinical Dementia Rating (CDR) scale score from 1.0 to 0.5 in conjunction with mood and physical improvements, as well as a significant decrease in aggressiveness and agitation. Cognitive deficit may be a result of poor drug administration procedures, leading to drug ineffectiveness. Optimizing levothyroxine and sertraline administration, based on knowledge of their physicochemical properties, improves their clinical effectiveness, including the cognition of patients with Alzheimer's disease and dysphagia.

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Main Authors: Mastroianni,Patrícia de Carvalho, Forgerini,Marcela
Format: Digital revista
Language:English
Published: Academia Brasileira de Neurologia, Departamento de Neurologia Cognitiva e Envelhecimento 2018
Online Access:http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1980-57642018000100097
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spelling oai:scielo:S1980-576420180001000972018-04-12Drug administration adjustments for elderly patients with dysphagia: A case reportMastroianni,Patrícia de CarvalhoForgerini,Marcela medication errors medication therapy management pharmaceutical care cognitive dysfunction deglutition disorder sertraline ABSTRACT An elderly patient, aged 76 years, diagnosed with dysphagia, depression, hypothyroidism, Alzheimer's disease and mild cognitive deficit, was identified with sertraline and levothyroxine- drug-related problems. Medication Therapy Management (MTM) was used to adjust therapy to the patient's needs by macerating sertraline tablets and solubilizing them in 10-30 mL of orange juice. The patient was advised to take levothyroxine after fasting. Six months later, pharmaceutical follow-up identified an increase in the Mini-Mental State Exam score from 22 to 26 and a decrease in the Clinical Dementia Rating (CDR) scale score from 1.0 to 0.5 in conjunction with mood and physical improvements, as well as a significant decrease in aggressiveness and agitation. Cognitive deficit may be a result of poor drug administration procedures, leading to drug ineffectiveness. Optimizing levothyroxine and sertraline administration, based on knowledge of their physicochemical properties, improves their clinical effectiveness, including the cognition of patients with Alzheimer's disease and dysphagia.info:eu-repo/semantics/openAccessAcademia Brasileira de Neurologia, Departamento de Neurologia Cognitiva e EnvelhecimentoDementia & Neuropsychologia v.12 n.1 20182018-03-01info:eu-repo/semantics/reporttext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1980-57642018000100097en10.1590/1980-57642018dn12-010015
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country Brasil
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libraryname SciELO
language English
format Digital
author Mastroianni,Patrícia de Carvalho
Forgerini,Marcela
spellingShingle Mastroianni,Patrícia de Carvalho
Forgerini,Marcela
Drug administration adjustments for elderly patients with dysphagia: A case report
author_facet Mastroianni,Patrícia de Carvalho
Forgerini,Marcela
author_sort Mastroianni,Patrícia de Carvalho
title Drug administration adjustments for elderly patients with dysphagia: A case report
title_short Drug administration adjustments for elderly patients with dysphagia: A case report
title_full Drug administration adjustments for elderly patients with dysphagia: A case report
title_fullStr Drug administration adjustments for elderly patients with dysphagia: A case report
title_full_unstemmed Drug administration adjustments for elderly patients with dysphagia: A case report
title_sort drug administration adjustments for elderly patients with dysphagia: a case report
description ABSTRACT An elderly patient, aged 76 years, diagnosed with dysphagia, depression, hypothyroidism, Alzheimer's disease and mild cognitive deficit, was identified with sertraline and levothyroxine- drug-related problems. Medication Therapy Management (MTM) was used to adjust therapy to the patient's needs by macerating sertraline tablets and solubilizing them in 10-30 mL of orange juice. The patient was advised to take levothyroxine after fasting. Six months later, pharmaceutical follow-up identified an increase in the Mini-Mental State Exam score from 22 to 26 and a decrease in the Clinical Dementia Rating (CDR) scale score from 1.0 to 0.5 in conjunction with mood and physical improvements, as well as a significant decrease in aggressiveness and agitation. Cognitive deficit may be a result of poor drug administration procedures, leading to drug ineffectiveness. Optimizing levothyroxine and sertraline administration, based on knowledge of their physicochemical properties, improves their clinical effectiveness, including the cognition of patients with Alzheimer's disease and dysphagia.
publisher Academia Brasileira de Neurologia, Departamento de Neurologia Cognitiva e Envelhecimento
publishDate 2018
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1980-57642018000100097
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