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Deglutition Disorders. --- Deglutition disorders. --- Deglutition --- Physiology.
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Swallowing disorders are affecting more and more people through the advancement of medicine and the expansion of older populations. In addition, for a number suffering from more severe dysphagia nasogastric feeding is necessary in order to meet their nutritional needs. The administration of drugs to these patients is not a trivial act and requires proper management to avoid any risk associated with it. In order to ensure optimal treatment for patients, a review of the medication should be undertaken by the physician, pharmacist and other health professionals. The only essential drugs are preserved and adapted according to the pathology of the patient. A change in dosage form or replacement with a similar molecule more easily administered is very often possible. When no alternative has been chosen, the use of grinding or opening of the capsules should be checked. If this is allowed, the rules of hygiene and handling must be scrupulously respected. The type of grinder is chosen according to the patient, whether he is at home or in an institution. The drugs administered by nasogastric tube are selected according to several criteria into account the best efficiency and the minimum of toxicity. In order to lower, the risk of complications, rules concerning the medication administration to these patients are to be respected. The pharmacist, the expert in medicines, has an indispensable role of providing prescribing support to the doctor as well as of providing education and advice on drug administration to nurses and other practice staff. Les troubles de la déglutition concernent de plus en plus de personnes suite à l’avancée de la médecine et par l’expansion des populations âgées. De plus, un certain nombre de patients souffrant de dysphagie plus sévère, se voit installer une sonde entérale pour subvenir à leurs besoins nutritionnels. L’administration des médicaments chez ces patients n’est pas un acte anodin et nécessite une prise en charge correcte afin d’éviter tout risque qui y serait lié. Pour garantir un traitement optimal, une revue de la médication doit être entreprise par le médecin, le pharmacien et les autres professionnels de la santé. Les médicaments uniquement indispensables sont conservés et adaptés en fonction de la pathologie du patient. Un changement de forme galénique ou le remplacement par une molécule similaire plus facilement administrable est très souvent possible. Lorsqu’aucune alternative n’a été retenue, le recours au broyage ou à l’ouverture des gélules doit être vérifié. Si celui-ci est autorisé, les règles d’hygiène et de manipulation doivent être scrupuleusement respectées. Le type de broyeur est choisi en fonction du patient, s’il se trouve à domicile ou en institution. Les médicaments administrés par sonde entérale sont choisis en fonction de plusieurs critères prenant en compte la meilleure efficacité et le minimum de toxicité. Des règles concernant l’administration chez ces patients sont à respecter. Le pharmacien, le spécialiste du médicament, a un rôle indispensable de conseil auprès du médecin et, de formation et d’information aux bonnes pratiques d’administration au personnel infirmier.
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Mastication and Swallowing are functions common to most forms of animal life, yet there exists much uncertainty as to their biological basis, and a diversity of opinion on the treatment of disorders of the mastication and deglutitory appartus. During the last fifteen years ther ehas been a considerable increase in research into clinical aspects related to these two vital functions, and also into their underlying biological, and especially neurophysiological, mechanisms. This volume presents the edited proceedings of a symposium held in 1974 in Vancouver, British Columbia, attended by scientists from several countries who are actively involved in such research. In addition to a broad, up-to-date coverage of its subject, Mastication and Swallowing stresses conceptual aspects and suggests lines of future clinical and basic research.
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