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tablets, opening capsules) and/or administering a medicine via an unlicensed route (e.g. oral liquid via percutaneous endoscopic gastrostomy (PEG)) may be at least unnecessary and at worst dangerous to the patient. In addition, interactions may occur between medication and feeds that may render the medication ineffective, or may block the tube. 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 The following liquid medicines manufactured by Rosemont Pharmaceuticals have recently received UK licenses for administration via nasogastric (NG) or percutaneous endoscopic gastronomy (PEG) tube: Furosemide Oral Solution 20mg/5mL, 40mg/5mL and 50mg/5mL Ramipril Oral Solution 2.5mg/5mL Metoclopramide Hydrochloride Oral Solution 5mg/5mL Clonazepam Oral Solution 0.5mg/mL, 2mg/mL Gabapentin Oral 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. 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. Health and safety and clinical Many medications may be put into your PEG. Here are some important things you need to know: If any medications cannot be put in your PEG, your pharmacist may help you by reaching out to the healthcare provider that prescribed a medication to suggest another option. 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. 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) Percutaneous endoscopic gastro-jejunostomy (PEGJ), inserted into the jejunum via the abdominal wall and through the stomach. Drug charts should state the route of administration, e.g. NJ, and specify the lumen to be used. Ensure the siting of the tube has been medically confirmed. Stop the infusion of the feed when administering drugs. If necessary, Gabapentin Colonis 50 mg/ml Oral Solution can be administered via intragastric feeding tubes (nasogastric (NG) or percutaneous endoscopic gastrostomy (PEG) tubes). Tubes should be rinsed twice with 10 ml of water immediately after administration. 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). 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 Gabapentin Rosemont Oral Solution 50mg/mL 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: Ensure that the enteral feeding tube is free from obstruction before administration. 1. Some enteral tubes can be inserted through the nose and are 100 intended for short-term use, typically less than 4 weeks. Enteral tubes for chronic use (greater When the oral route is not available, patients may need to be fed and administered medicines through an enteral tube. Tubes may terminate in the stomach or the jejunum, and they may enter via the nose or through the abdominal wall. 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. Gastrostomy tubes may be inserted endoscopically (percutaneous endoscopic gastrostomy or PEG), radiologically (radiologically inserted gastrostomy tube, or RIG) or surgically inserted. The tube was placed as it would have been done for a bedridden patient (Fig. 1). The formula was passed through tubes of different sizes (8 Fr., 10 Fr., 12 Fr., 14 Fr., 16 Fr., and 18 Fr.) that are often used in clinical settings in Japan. Tube passage tests were performed in a fixed order, starting with the 8 Fr. tube.
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