Swallowing disorders

Gl The safety and efficacy of colesevelam in patients with dysphagia, swallowing disorders, severe Gl motility disorders, or major Gl tract surgery have not been established. Use with caution. 

Langmore, S. E. 2001. Endoscopic Evaluation and Treatment of Swallowing Disorders, Thieme Medical Publishers, Inc., New York, USA. 

New application examples are coming up all the time, such as imaging of gastric function, pulmonary ventilation, perfusion, brain hemorrhage, hyperthermia, swallowing disorders, and breast cancer. A fundamental difficulty is the considerable anisotropy found in the electrical properties of, for example, muscle tissue. 

Xanthan is compatible with many other ingredients in food and gives good flavor release, improves quality, increases stability, simple flavor unharness, and delicate style refreshing. Xanthan gum also helps suspend solid particles, such as spices. It is also a preferred method of thickening liquids for those with swallowing disorders, since it does not change the color or flavor of foods. Xanthan presence permits for food to be frozen... 

Devita MA, Spierer-Rundback MS. Swallowing disorders in patients with prolonged inmbation or tracheostomy tubes. Crit Care Med 1990 18 1328-1332. 

Indications Anorexia, swallowing disorders, gastric statis, intestinal malfunction Inflammatory bowel disease, mucositis following chemotherapy, pancreatitis, multi-organ failure... 

People with any condition that can compromise respiratory function or the handling of respiratory secretions (i.e., a condition that makes it hard to breathe or swallow, such as brain injury or disease, spinal cord injuries, seizure disorders, or other nerve or muscle disorders)... 

PO/d adjust by 5-10 mg/kg q3-6mo based on monthly ferritin 30 mg/kg/d max on empty stomach 30 min before food hold dose if ferritin <500 mcg/L, dissolve in water, orange, apple juice (<1 g/3.5 oz >1 g in 7 oz) drink immediately resuspend residue and swallow do not chew, swallow whole tabs or take w/ Al-contain-ing antacids Caution [B, /-] Disp Tabs SE N/V/D, abd pain, skin rash, HA, fever, cough, Infxn, hearing loss, dizziness, cataracts, retinal disorders, T lOP, lens opacities, dizziness Notes ARF, peripheral cytopenia possible EMS Pt has an T serum iron level, S/Sxs of high iron include V and bloody D, massive fluid and blood loss into the GI system which can lead to shock /or renal failure OD May cause N/D symptomatic and supportive... 

Harmful if inhaled, swallowed, or absorbed through skin. May cause irritation. Prolonged exposure can cause narcotic effect. Chronic effects include damage to liver, kidneys, and blood.2 May cause reproductive disorders.4 TLV-TWA 5 ppm, 18 mg/m3.5... 

Contraindications Dry mouth and mucous membranes, blurred vision, difficulty swallowing, hot dry skin, headache, restless fatigue. Must not be used by persons with cardiovascular disorders or glaucoma. Excessive use may cause brain decomposition. Not recommended. 

Antecollis is a rare form of tardive dystonia, in which there is forward bending of the neck (331). Patients with this disorder are usually quite disabled and distressed, have severe difficulties with vision, speech, swallowing, and inspiratory obstruction, and are unable to lie supine. In three reported cases (331), the patients developed the symptoms after receiving a number of neuroleptic drugs for 4 months to 14 years. Neither withdrawal of neuroleptic drugs nor the administration of anticholinergic agents affected their symptoms. 

A 34-year-old man with AIDS took risperidone 4 mg/ day for a Tourette-like tic disorder. Ritonavir and indinavir were added, and 1 week later he developed significantly impaired swallowing, speaking, and breathing, and worsening of his existing tremors. 

A 44-year-old white man, who had had major depression and anxiety disorder for 25 years, became drowsy after swallowing 20 tablets (10 mg) of zolpidem (44). He was not taking any other medications at the time. A few hours later he became unresponsive and comatose and developed respiratory depression with hypoxia and mild hypercapnia. He subsequently made a full recovery after appropriate medical support. 

---