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General recommendations for drug administration via enteral tubes: Use enteral syringes at all times, not injection syringes. For tubes terminating in the stomach, tap water is acceptable. Diamox injection 500mg can be given via a feeding tube. ACICLOVIR 1. C 2. A* * Dispersible tablets available ALENDRONIC ACID Caution: Alendronic acid tablets should only be crushed and dispersed in water if administered via a feeding tube, NOT orally (very irritant). Once-weekly formulation should be used. ALFACALCIDOL 1. C* 2. D Instructions for administration via nasogastric (NG) or percutaneous endoscopic gastrostomy (PEG) tubes. Gabapentin Rosemont Oral Solution is suitable for use with the following type of NG and PEG tubes: Most medications that you normally take by mouth can be taken through your feeding tube. Medications must be in liquid form or crushed into a powder to prevent your feeding tube from getting clogged. Many medications come in a liquid form. Ask your healthcare provider about liquid forms if you take pills, tablets, or capsules. Any adverse effects, including problems with feeding tubes, should be reported to the prescriber and pharmacist immediately. 4 GENERAL PRINCIPLES When administering medication via enteral tube consideration needs to be taken regarding drug formulation, interactions with feed, type of tube, site of placement, and site of drug absorption. Hard gelatin capsules - enteral tubes Prepare the capsule as follows: 1. Gently ease open the capsule to release the powder. 2. Tip the powder into a beaker - be sure to obtain all the powder. 3. Mix the powder with 15-30mL of water. 214,225 4. Draw up the solution in an enteral syringe. 5. Administer the solution through the enteral feeding Capsules and Tablets: Many short-acting tablets may be pulverized into a fine powder and diluted with water to form a slurry appropriate for EFT administration. The contents of certain capsules may also be mixed with water to be given in a similar man-ner. Both nutrition and medication administration can be improved or maintained through the appropriate use of enteral alternatives such as gastrostomy tubes (GT), nasogastric tubes (NG), gastrostomy buttons (G-Buttons; GB), jejunostomy tubes (JT), and nasojejunal tubes (NJ). Crushing tablets, opening capsules and administration via feeding tubes usually falls outside a drug’s product license and presents an increased risk for patients compared to other routes of administration. Some oral solutions are licensed for administration via NG/PEG feeding tubes, check product information for specific advice. Notes NICE guidelines advise that patients prescribed Gabapentin for epilepsy should receive the same formulation consistently. To administer an oral medication through a feeding tube, the formulation must be in a liquid form. If a suitable liquid product is not available, a liquid can be extemporaneously compounded by opening the capsule or crushing the tablet before mixing in a suitable volume of water 1. Embeda morphine sulfate Capsule Extended‐release (a); do not give via N/G tube E‐Mycin erythromycin Tablet Enteric‐coated Enablex darifenacin Tablet Slow‐release Entocort EC budesonide Capsule Extended‐release; Enteric‐coated (a) Equetro carBAMazepine Capsule Extended‐release (a) Only liquid medications can be given through the G-tube. If the medication comes in a capsule, open the capsule and mix the content in 5mL of warm water. If the medication comes as a pill, please ask your pharmacist if it can be crushed and mixed with water. Neurontin capsules are not only fairly large, but many individuals are prescribed to take multiple capsules at one time, several times a day. Opening The Capsules The good news is if you are having trouble swallowing ( gabapentin ) capsules, they can safely be opened, and the contents of the capsule can be sprinkled onto food or into a drink Am J Health Syst Pharm. 2008;65(24):2347-2357. Administer medications via the oral route when possible. Determine the enteral feeding tube size (e.g., small bore or large bore), insertion site (e BUSPIRONE B CALCIFEROL B Do not give with enteral feed. Stop feed prior to administration, flush tube before and after. CALCIUM RESONIUM Dissolve required Stop feed prior to administration, flush tube amount of powder before and after. in water. Caution: blocks tubes easily CAPTOPRIL 1. B 2. E CARBAMAZEPINE 1. C* * May bind to PVC feeding tubes. 2. A number of specific drug interactions can occur when drugs are administered via feeding tubes (Box A10.D). The most important clinically are with drugs with a narrow therapeutic range, e.g. 2. Types of enteral feeding tube 4 3. Flushing enteral feeding tubes 9 4. Restoring and maintaining patency of enteral feeding tubes 15 5. Drug therapy review 23 6. Choice of medication formulation Alimemazine (Trimeprazine) tartrate25 7. The legal and professional consequences of administering drugs via enteral feeding tubes 38 8. medication administration can be improved or maintained through the appropriate use of enteral alternatives such as gastrostomy tubes (GT), nasogastric tubes (NG), gastrostomy buttons (G-Buttons; GB), jejunostomy tubes (JT), and nasojejunal tubes (NJ).
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