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Many patients lose the ability to swallow at the end of life, effectively compromising the oral route of medication delivery. When the oral route is no longer a viable method of medication administration, alternative routes of delivery must be considered. This lecture reviews the physiology, benefits and burdens of the different routes of medication delivery including sublingual, parenteral (intravenous and subcutaneous), transdermal, rectal (suppository and Macy Catheter). The session will include a discussion on proactive symptom management and recognizing when a patient is at high risk for poor symptom control.

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