Pharmaceutical Considerations for Patients With Dysphagia
Tram Rex PharmD, Department Editor

$3.95
Gastroenterology Nursing
April 2005 
Volume 28  Number 2
Pages 143 - 144
 
  PDF Version Available!

ABSTRACT
Outline

  • Crushing Oral Medication May Not Always Be Ideal

  • Drug Interaction With Tube Feedings

  • References



    Graphics

  • Table 1

    Taking medication by mouth as a tablet or capsule is the most common and desirable method of administration. However, this route may not be ideal or possible in certain patients, such as those with dysphagia or those who can receive medication only via feeding tubes. Liquid pharmaceutical formulations are desirable in these patients if such medication formulations are available (commercially or compounded by the pharmacy). For medications that are not available in a liquid form, it is a common practice to crush tablets and incorporate the medication into a liquid vehicle. The practice of crushing tablets is not warranted for all tablet or capsule medications and may result in untoward effects and even serious complications. In addition, certain medications, administered via tube feedings, may have significant interactions with the tubing or the enteral feeding contents. Special precautions may need to be taken to avoid the interactions and assure appropriate delivery of the intended medication dose.

    Crushing Oral Medication May Not Always Be Ideal

    Crushing solid medications can change their pharmacokinetic properties and may alter the delivery of the medication. Medication formulations, including sublingual or buccal, enteric-coated, and extended- or sustained-release tablets or capsules, should not be crushed for various reasons.

    Extended-release formulations are designed to release the drug over an extended period of time, thus decreasing the frequency of administration. They can be formulated with multiple layers of medication to be dissolved one at a time, or special pellets or matrixes that dissolve at different time intervals. Most, but not all, extended-release products contain abbreviations affixed to their brand names. ...

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