Do you or someone you know have problems swallowing?  Dysphagia (difficulty or discomfort in swallowing) is a problem for many people, especially stroke victims, the elderly and people with advanced dementia. Difficulty with swallowing oral medications increases the risk of aspiration (breathing in a foreign object or sucking food or the medication into the airway) which can lead to pneumonia. Also, hospice and palliative care patients often develop complications such as impaired gastrointestinal absorption, nausea, vomiting, delirium, or cognitive impairment, all of which would complicate the ability to take required oral medications. These are some of the reasons why alternative routes of administration, including transdermal or rectal, can be very helpful.  
 
Transdermal preparations are applied topically and absorbed through the skin. If a patient has fluctuating or declining liver function, transdermal administration may be advantageous because transdermal meds do not need to pass through the liver before being absorbed, like oral medications do. Transdermal medications can be compounded to treat pain and inflammation, spasms, and nausea/vomiting.
 
 Consultant Pharmacist. 2016 June; 31(6):313-9.
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