Certified Medical Assistant (CMA AAMA)PharmacologyHard

A medical assistant is preparing to administer an oral medication to an elderly patient who has difficulty swallowing pills. Which of the following actions is most appropriate?

  1. AInstruct the patient to hold the pill under their tongue until it dissolves.
  2. BCrush the pill and mix it with applesauce without consulting the physician.
  3. COffer the patient a glass of water and encourage them to try swallowing the pill whole.
  4. DCheck if the medication is available in a liquid form or can be crushed, and then consult the physician.
Show answer & explanation

Correct answer: D. Check if the medication is available in a liquid form or can be crushed, and then consult the physician.

Before altering any medication (crushing, dissolving, or giving in a different form), it is crucial to verify if it is safe and appropriate to do so. Many medications are extended-release or enteric-coated and crushing them can be dangerous. Consulting the physician is essential after checking available formulations.

Why the other options are wrong

  • A. This describes sublingual administration, which is only appropriate for specific medications designed for that route, and would be unsafe for a standard oral pill.
  • B. Crushing pills without knowing if it's safe can alter drug release, leading to overdose or ineffectiveness. This is unsafe.
  • C. While offering water is good, simply encouraging them to try again doesn't address the underlying difficulty and may not be sufficient.

Medication Administration for Dysphagia

When a patient has difficulty swallowing (dysphagia), alternative medication forms or administration methods must be considered, but always with caution and physician approval to ensure safety and efficacy.

  • Never crush or alter medications without verification.
  • Consult pharmacist or drug reference for crushability.
  • Liquid forms, chewables, or dissolvable tablets are alternatives.
  • Physician's order is always required for changes.

Memory trick: Difficulty Down? Doctor's Decision!

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