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

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...

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Autores principales: Mastroianni, Patrícia de Carvalho, Forgerini, Marcela
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Associação de Neurologia Cognitiva e do Comportamento 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5901257/
https://www.ncbi.nlm.nih.gov/pubmed/29682241
http://dx.doi.org/10.1590/1980-57642018dn12-010015
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author Mastroianni, Patrícia de Carvalho
Forgerini, Marcela
author_facet Mastroianni, Patrícia de Carvalho
Forgerini, Marcela
author_sort Mastroianni, Patrícia de Carvalho
collection PubMed
description 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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spelling pubmed-59012572018-04-20 Drug administration adjustments for elderly patients with dysphagia: A case report Mastroianni, Patrícia de Carvalho Forgerini, Marcela Dement Neuropsychol Case Report 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. Associação de Neurologia Cognitiva e do Comportamento 2018 /pmc/articles/PMC5901257/ /pubmed/29682241 http://dx.doi.org/10.1590/1980-57642018dn12-010015 Text en https://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Mastroianni, Patrícia de Carvalho
Forgerini, Marcela
Drug administration adjustments for elderly patients with dysphagia: A case report
title 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_short Drug administration adjustments for elderly patients with dysphagia: A case report
title_sort drug administration adjustments for elderly patients with dysphagia: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5901257/
https://www.ncbi.nlm.nih.gov/pubmed/29682241
http://dx.doi.org/10.1590/1980-57642018dn12-010015
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