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Aspiration pneumonia with unsafe swallow and medicines issue — SCE Geriatric Medicine MCQ

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HardStroke careAspiration pneumonia with unsafe swallow and medicines issueSCE Geriatric Medicine

An 86-year-old with acute stroke and aspiration pneumonia has a wet voice and cough after water. Essential medicines include modified-release and enteric-coated preparations. What is the safest immediate medication plan pending specialist swallow assessment?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Keep nil by mouth; individually convert medicines by route and formulation

Explanation lettering: D = shown as B · B = shown as D

A may alter peak exposure and dosing frequency and still uses an unsafe oral route. B assumes liquids are swallow-safe and formulation-compatible; some liquids may be unsuitable with thickeners. C retains aspiration risk for the supposedly ordinary tablets. D requires tube-position confirmation and individual checks because modified-release or enteric-coated products cannot simply be given unchanged. E is correct: manage aspiration risk immediately, then use swallow and pharmacy review to convert essential medicines individually to suitable formulations or non-oral routes.

Reference: BGS: dysphagia management for older people: https://www.bgs.org.uk/dysphagia-management-for-older-people