Adults Who Can't Swallow Pills

Specialties Emergency

Published

Where I work now we seem to have cornered the market on adults who can't swallow pills. I'm not referring to children or eldery people with dysphagia. I'm talking about gagging and crying like they were four or something. They whine and beg you. "Please don"t make me take that pill. I can't swallow it, I never have been able to."

I swear I see at least one a week. I've tried everything, even crushing pills in applesauce. They just can't swallow the med. Of course they don't want an injection or a suppository either.

Anybody else run into this in the ED?

Specializes in PACU.
Originally posted by LPN2Be2004

Well said.

i second that, i had a hard time swallowing pills before also

i am on the same wagon w/ the daughter who cannot take liquid meds...nothing will make me puke faster....

but i must honestly admit - on a busy nite in the ed when you are trying to move patients and the 19 y/o w/ oral herpes tells you she just cannot swallow that pill - i have been very hard pressed to tell her that she has had much larger things in her mouth - did she gag then too??? :devil:

Originally posted by athomas91

i am on the same wagon w/ the daughter who cannot take liquid meds...nothing will make me puke faster....

but i must honestly admit - on a busy nite in the ed when you are trying to move patients and the 19 y/o w/ oral herpes tells you she just cannot swallow that pill - i have been very hard pressed to tell her that she has had much larger things in her mouth - did she gag then too??? :devil:

Wait a minute...yes, I can understand on a busy night, etc. ...you're not trying to infer that THAT is HOW she got the oral herpes, are you? I have had "cold sores" since I was a young child, passed to me from my mother who had them. I kind of resent the correlation.

Those pills FOR herpes are frickin' HUGE if that's what you're talking about!

Glad to know, though, that I am not the only one with a kid who can't tolerate oral meds. Sorry that you have to deal with that also.

Specializes in FNP, Peds, Epilepsy, Mgt., Occ. Ed.
Originally posted by LisaRN2B

Wait a minute...yes, I can understand on a busy night, etc. ...you're not trying to infer that THAT is HOW she got the oral herpes, are you? I have had "cold sores" since I was a young child, passed to me from my mother who had them. I kind of resent the correlation.

Those pills FOR herpes are frickin' HUGE if that's what you're talking about!

I've never had oral herpes, but I'd think that having cold sores on the lips or *any* kind of herpetic lesions in the mouth would be extremely painful. I've had kids with foot and mouth, oral lesions from chickenpox, etc and everything hurts. It's difficult to get liquids down, much less pills (and large ones at that).

As for what one can or cannot get into one's mouth without gagging, well, is that any more illogical than being able to drink tea, coffee, a soda, or a milkshake but not being able to take liquid meds? I'm not being critical of people who can't take liquid meds, after all I've had problems with pills, but neither one is based on logic and thinking, but a reaction to the sensation, the taste, the feel, or something that happened in the past.

Give your patients meds they can take in some form; isn't that the point??

When I did high tech home health with HIV patients, they had to swallow so many pills it became a reflex rejection. I used to have them swallow a mouth full of water, hold it in the back of their throat drop the pills in and swallow all of it, it always worked, first try.

Specializes in ER.

The original poster talked about people who can't swallow pills, won't take them crushed and won't take a shot either. After all that I think they've refused treatment, and that is up to them. But...most I've encountered like that are able to swallow that pill if they know there it's either a pill or a shot or nothing.

With pill swallowing I've had good results putting the whole pill (small ones) in yogurt or pudding. It just goes down with the food.

And yes...before anyone has a fit...the patients agree to this method.

ummmm..... when she told me about the member w/ the bumps on it that she had in her mouth - asking if those could have been herpes....i am not implying - i am stating that is likely where SHE got HERs from.........of course i am educated enough to know that there are many who do not get oral ulcerations in that manner....let's not be so touchy - i was speaking of a particular pt in a particular situation.....

Specializes in Oncology/Haemetology/HIV.
Originally posted by athomas91

but i must honestly admit - on a busy nite in the ed when you are trying to move patients and the 19 y/o w/ oral herpes tells you she just cannot swallow that pill - i have been very hard pressed to tell her that she has had much larger things in her mouth - did she gag then too???

I know plenty of people that have cold sore, oral yeast, and herpetic problems problems that have had them recurrently since childhood. You really do not need to infer what she has had in her mouth. For all you know, she may have gagged on those "much larger things "(largeness to be debatable at times) - of course she was not swallowing them permanently (I hope).

And please do not use the "patient refused" bit. I have alot of Onco patients that have mucositis or Herpes that come out of remission after decades due to the Chemo. Can they swallow worth a darn - probably not. Should we not work with them and their limitations or should we find a way to treat them? If we do not treat them, they will just come in sicker and we will have to treat them then, only it will take weeks or monthes instead hours.

And canoehead, I would personally rather take a shot than a large pill. I would be more than cooperative to let them NG me for scan/colyte prep (a yearly event) rather than being pukicidal over drinking the stuff. But somehow, I cannot convince my MD of that wisdom.

i can honestly say that the origional poster nor myself would ever have a problem w/ those who have health issues related to swallowing or health issues that have effected their swallowing....

and you may think it is horribly cruel or non-nurse-like, i really don't care - but if you are coming to the ED for a problem and have no health issues and are demanding a med but want it only in a certain way - then my sympathy just ran out the door.

Originally posted by athomas91

i can honestly say that the origional poster nor myself would ever have a problem w/ those who have health issues related to swallowing or health issues that have effected their swallowing....

and you may think it is horribly cruel or non-nurse-like, i really don't care - but if you are coming to the ED for a problem and have no health issues and are demanding a med but want it only in a certain way - then my sympathy just ran out the door.

PREACH IT FRIEND!!! I totally agree!

Originally posted by athomas91

ummmm..... when she told me about the member w/ the bumps on it that she had in her mouth - asking if those could have been herpes....i am not implying - i am stating that is likely where SHE got HERs from.........of course i am educated enough to know that there are many who do not get oral ulcerations in that manner....let's not be so touchy - i was speaking of a particular pt in a particular situation.....

Thank you for the clarification. You left that out of your original post. I was not calling into question your education or your knowledge.

It is a touchy subject to me. I can only imagine that people think I've "had something" in my mouth to have oral herpes. They are painful and ugly and very obvious. Your comment, without the additional info you have now provided, sounded flippant to me regarding the patients condition. So, reread your post, and then try not to be so "touchy." :stone

i am sorry you have had to live w/ implications such as those...my father and my sisters have always had horrible mouth ulcers (usually when sick) and i know they are both painful and unsightly....

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