Case scenario

Gary is 70 years old and is diagnosed with stage 3 Parkinson’s disease. He is currently living alone since the death of his wife in 2015. He complains of difficulty swallowing medications whole and is looking for recommendations to help with this. He consistently feels the sensation of food getting stuck in his throat/chest and has occasionally choked on his medicines. He has no issue with swallowing foods with smooth texture; he asks whether he could crush his medication and mix them with food. He has hypertension, hyperlipidaemia, and depression. His current medications include levodopa with carbidopa 200 mg/50 mg controlled-release, atorvastatin 40 mg, ezetimibe 10 mg, irbesartan 300 mg and mirtazapine 45 mg.

Learning objectives

After reading this article, pharmacists should be able to:

    • Recognise the difference between medication swallowing difficulties and clinical dysphagia
    • Discuss strategies to manage medication swallowing difficulties
    • Identify the role of pharmacists and interprofessional approaches in managing people who experience difficulties swallowing tablets or capsules.

Competency Standards (2016) addressed: 1.1, 1.3, 1.4, 1.5, 1.6, 2.1, 2.2, 2.3, 2.4, 3.1, 3.2, 3.3, 3.

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