Phone: (281) 272-MBSS or 1-866-675-MBSS Fax: (281) 272-6281 or 1-877-676-MBSS 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
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