Why Cant a Patient Have Tube Feedings With Dilantin
Welcome to the crushing tablets and drug administration via enteral feeding tubes section for pharmacists. This section includes links to clinical practice resources on crushing tablets for patients with dysphagia / swallowing difficulties, medication administration via enteral feeding tubes and drug-enteral feeding interactions.
Swallowing Difficulties
Prescriber Information
This section is designed to help you prescribe appropriately for patients with dysphagia and those with enteral feed tubes. In both instances basic guidance on what should be considered is provided.
Additionally for those patients where you have decided that crushing is the only option available for you to recommend we have provided information on different types of tablet, different coatings and modified formulations so that you can determine whether crushing may be appropriate or not.
Information on the effect of crushing in both clinical and legal terms is provided as well as information on other formulations which you may choose to prescribe instead.
- Source: swallowingdifficulties.com
- Clinical Resource: Various
- Register to Access Content: No
Safe administration of medications for adults with Swallowing Difficulties (Dysphagia)
Dysphagia can make taking medication more difficult leading to medications remaining in the mouth, being spat out or getting stuck in the pharynx or oesophagus. If a dysphagia assessment recommends thickened liquids, all fluids consumed should be thickened, including those taken with or as part of medication.
- Source: westessexccg.nhs.uk
- Clinical Resource: Clinical Guideline
- Register to Access Content: No
"Do Not Crush" List
The List of Oral Dosage Forms That Should Not Be Crushed, commonly referred to as the "Do Not Crush" list, contains medications that should not be crushed because of their special pharmaceutical formulations or characteristics, such as oral dosage forms that are sustained-release in nature.
- Source: ismp.org
- Clinical Resource: List
- Register to Access Content: Yes – registration is FREE
Guidance on Crushing Tablets or Opening Capsules in a Care Home Setting
This document has been prepared in response to queries generated by care homes and GP practices regarding rules and regulations surrounding crushing tablets or opening capsules for residents in a care home setting
- Source: hertsvalleysccg.nhs.uk
- Clinical Resource: Guidance
- Register to Access Content: No
When Patients Cannot Take Pills: Antiretroviral Drug Formulations for Managing Adult HIV Infection
A thorough search of several drug databases, a literature search of MEDLINE through Ovid, and a review of full prescribing information for each currently available antiretroviral drug, was performed to obtain insight into the bioavailability of antiretrovirals. Implications for the findings are discussed as they relate to adherence, resistance, alternative methods of administration, and the sometimes conflicting information on bioavailability that exists for various antiretroviral agents.
- Source: iasusa.org
- Clinical Resource: Journal Article
- Register to Access Content: No
Medication Administration Through Enteral Feeding Tubes
Drug therapy can be complicated in hospitalized patients requiring an enteral feeding tube (EFT). Some medications may be given via an EFT while others are unsuitable for this form of administration. Inappropriate drug selection for EFT administration can cause potential toxicity, reduced efficacy, and tube obstruction. Therefore, it is important to know which drugs may be altered for EFT administration as well as appropriate therapeutic alternatives that can temporarily be substituted for those that may not be given via that route.
- Source: clevelandclinicmeded.com
- Clinical Resource: Newsletter
- Register to Access Content: No
Medication Administration Through Enteral Feeding Tubes
An overview of enteral feeding tubes, drug administration techniques, considerations for dosage form selection, common drug interactions with enteral formulas, and methods to minimize tube occlusion is given.
- Source: medscape.com
- Clinical Resource: Newsletter
- Register to Access Content: Yes – registration is FREE
To Hold (Enteral Feeding) or Not to Hold: That IS the Question; A Commentary and Tutorial
The purpose of this paper is to serve as a tutorial to guide clinical decision making rather than a comprehensive review of the existing literature. Clinicians are strongly encouraged to review the literature concerning drug-specific management approaches that have been published and exercise good clinical judgment to individualize the patient care plan.
- Source: virginia.edu
- Clinical Resource: Journal Article
- Register to Access Content: No
Drug-Nutrient Considerations in Patients Receiving Parenteral and Enteral Nutrition
This article will focus on basic knowledge needed for identification and appropriate management of drug-nutrient interactions in patients requiring enteral nutrition (EN) and parenteral nutrition (PN). Drug-nutrient interactions will be divided into four categories based upon their mechanisms: 1) ex vivo biopharmaceutical inactivations; 2) interactions affecting absorption; 3) interactions affecting systemic/physiologic dispositions; and 4) interactions affecting elimination/clearance. Each category will be discussed separately and examples will be given to illustrate the use of alternative methods to assure safe drug administration.
- Source: virginia.edu
- Clinical Resource: Journal Article
- Register to Access Content: No
Management of Phenytoin with Enteral Tube Feeding
Though the interaction between enteral tube feeding and phenytoin was first described 30 years ago, the mechanism of the interaction is still poorly understood.
In the discussions below, we will highlight some drug – enteral tube feeding interactions which have been found to be clinically important.
- Source: cpnp.org
- Clinical Resource: Article
- Register to Access Content: No
Enteral administration of protein supplement and valproate: A potential pharmacokinetic interaction
Valproic acid (VPA) and its derivatives are highly protein bound. Certain highly protein bound medications (eg, phenytoin) have specific administration instructions for patients on enteral nutrition supplements to optimize absorption of the medication. Pharmacokinetic interactions between VPA and enteral nutrition or protein supplements demonstrating impaired absorption have not been published to date.
- Source: cpnp.org
- Clinical Resource: Article
- Register to Access Content: No
How Does Warfarin Interact With Enteral Nutrition?
How does warfarin interact with enteral nutrition, and can this interaction be minimized?
- Source: medscape.com
- Clinical Resource: Question and Response
- Register to Access Content: Yes – registration is FREE
Resources last checked: 08/09/2021
Source: https://www.knowledgedose.com/crushing-tablets-drug-administration-via-enteral-feeding-tubes/
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