Effects of medication on dysphagia

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Modified Barium Swallow Studies
Effects of Medication on Dysphagia The following are lists of major drug categories used in the geriatric population. This information is important to know when evaluating a patient with dysphagia. Certain medications may compromise the patient’s ability to protect their airway. All information was taken from a PDR Objective: To do no harm and to do what is in the best interest of the patient By: Nat Baumer MD and Ronda Polansky M.S. CCC-SLP Benzodiazepine – Ativan
Purpose: To reduce anxiety and as sleeping agent
Dose: 0.25 mg- 2mg
Route of Administration: IM, PO
Onset of Action: 20-30 minutes
Peak Effect: 1 hour
Duration of Action: 6-8 hours
Side effects: drowsiness, hallucinations, respiratory depression
Other drugs increasing side effects: anti-depressants, opiates, phenothiazines, tranquilizers, antipsychotics
Disease states prolonging drug effect – Kidney impairment
Opiates – Tylenol and Codeine
Purpose: To relieve pain
Dose: 1-2 tablets. 30 mg of codeine and 300 mg of Tylenol per tablet
Route of Administration: PO
Onset of Action: 20 minutes
Peak Effect: 1 hour
Duration of Action: 3 hours
Side effects: drowsiness, respiratory depression
Other drugs increasing side effects: Benzodiazepine, Anti-psychotics, tranquilizers, phenothiazines
Disease states prolonging drug effect – Liver, renal, hypothyroid, prostrate enlargement
Tranquilizer – Haldol – similar to Phenothiazines
Purpose: To control severe behavior and anxiety problems
Dose: 0.25 mg- 2mg
Route of Administration: IM, PO
Nat Baumer MD & R. Polansky M.S. CCC-SLP, 2005 Onset of Action: 10-20 minutes
Peak Effect: 1 hour
Duration of Action: 3-4 hours
Side effects: drowsiness
Other drugs increasing side effects: Opiates, Benzodiazepine, Anti-psychotics,
Disease states prolonging drug effect – Liver
Antipsychotic-Zyprexa
Purpose: To control hallucinations and severe agitation
Dose: 5-10 mg
Route of Administration: IM, PO
Onset of Action: 10-20 minutes
Peak Effect: PO 6 hours, IM 45 minutes
Duration of Action: 30 hours
Side effects: Somulence, decreased cognitive function, dry mouth, diabetes, speech disorder
Other drugs increasing side effects: Opiates, Benzodiazepine, phenothiazines, tranquilizers
Disease states prolonging drug effect – From limited studies there does not appear to be any increased effect of
the drug in patients with kidney, liver, or heart problems.

OTHER IMPORTANT MEDICATION INFORMATION FOR SPEECH PATHOLOGISTS
ADR- Averse Drug Reaction is any response to a drug, which is noxious and unintended. Polypharmacy - refers to tendency of many older people to be on numerous medications at one time. Medications cause suppression of the brainstem, sensory impairment, neuromuscular junction, blockade, and myopathy.
FYI - Other drug induced disorders:
Antihistamine (Benadryl, Chlor-Trimeton) – dysphagia due to decreased salivary flow Botulinum toxin – impaired laryngeal movement Nitroglycerin -Headache
Antacids -Achalasia
Xerostomic side effects/Dry Mouth - Over 200 drugs can reduce salivary flow.
Valium, Lomotol, Haldol, Lasix, Phenergan, Sinemet, Chlor-Trimeton, Bendedryl, Comtrex, Dimetapp. Xerostomia can cause oral phase problems. Food and drug interactions important for a Speech Pathologist to know:
Coumadin (Anticoagulant) – No salad, broccoli, cauliflower, spinach, brussel sprouts, turnip greens, liver.
It is important to know that many items ( food, meds etc.) have the potential to effect clotting time of the pt.
Theophylline (Bronchial Dilator) – No caffeinated beverages
Lasix (Diuretic) – send oranges, OJ, bananas, potatoes
Common pills that can cause damage to esophagus if they become lodged
Vitamin C, denture cleaning pills, tetracycline, doxycycline, quinidine, iron, potassium, aspirin, nonsteroidal anti-inflammatory drugs, and ferrous sulfate Nat Baumer MD & R. Polansky M.S. CCC-SLP, 2005

Source: http://mbssonline.com/pi/Deposit/Final_Effects_of_Dypsphagia.pdf